TIER competency-based training course for the first receivers of CBRN casualties: a European perspective.

PubMed

Djalali, Ahmadreza; Della Corte, Francesco; Segond, Frederique; Metzger, Marie-Helene; Gabilly, Laurent; Grieger, Fiene; Larrucea, Xabier; Violi, Christian; Lopez, Cédric; Arnod-Prin, Philippe; Ingrassia, Pier L

2017-10-01

Education and training are key elements of health system preparedness vis-à-vis chemical, biological, radiological and nuclear (CBRN) emergencies. Medical respondents need sufficient knowledge and skills to manage the human impact of CBRN events. The current study was designed to determine which competencies are needed by hospital staff when responding to CBRN emergencies, define educational needs to develop these competencies, and implement a suitable delivery method. This study was carried out from September 2014 to February 2015, using a three-step modified Delphi method. On the basis of international experiences, publications, and experts' consensus, core competencies for hospital staff - as CBRN casualty receivers - were determined, and training curricula and delivery methods were defined. The course consists of 10 domains. These are as follows: threat identification; health effects of CBRN agents; planning; hospital incident command system; information management; safety, personal protective equipment and decontamination; medical management; essential resources; psychological support; and ethical considerations. Expected competencies for each domain were defined. A blended approach was chosen. By identifying a set of core competencies, this study aimed to provide the specific knowledge and skills required by medical staff to respond to CRBN emergencies. A blended approach may be a suitable delivery method, allowing medical staff to attend the same training sessions despite different time zones and locations. The study output provides a CBRN training scheme that may be adapted and used at the European Union level.

Training Methods to Build Human Terrain Mapping Skills

DTIC Science & Technology

2010-10-01

confidence in making friends, and talking to strangers. • Language – a few key phrases. • Language training with Arabic teacher (not computer -based...session to evaluate the lesson content and delivery method. Based on your feedback we will make changes and corrections to the content and the computer ...requirement, exemplar training materials were developed. The training materials took the form of a modular computer /web-based and web-deliverable course of

Simulation-based education for building clinical teams

PubMed Central

Marshall, Stuart D; Flanagan, Brendan

2010-01-01

Failure to work as an effective team is commonly cited as a cause of adverse events and errors in emergency medicine. Until recently, individual knowledge and skills in managing emergencies were taught, without reference to the additional skills required to work as part of a team. Team training courses are now becoming commonplace, however their strategies and modes of delivery are varied. Just as different delivery methods of traditional education can result in different levels of retention and transfer to the real world, the same is true in team training of the material in different ways in traditional forms of education may lead to different levels of retention and transfer to the real world, the same is true in team training. As team training becomes more widespread, the effectiveness of different modes of delivery including the role of simulation-based education needs to be clearly understood. This review examines the basis of team working in emergency medicine, and the components of an effective emergency medical team. Lessons from other domains with more experience in team training are discussed, as well as the variations from these settings that can be observed in medical contexts. Methods and strategies for team training are listed, and experiences in other health care settings as well as emergency medicine are assessed. Finally, best practice guidelines for the development of team training programs in emergency medicine are presented. PMID:21063559

Education and Training in Psychiatry in the U.K.

ERIC Educational Resources Information Center

Carney, Stuart; Bhugra, Dinesh K.

2013-01-01

Background/Objective: Recent training and education changes have raised important issues in delivery of psychiatric education at all levels. In this article, the authors describe the current status of mental health education in the training of all doctors and postgraduate training and education in psychiatry in the U.K. Method: The authors explore…

Do Pediatric Hematology/Oncology (PHO) Fellows Receive Communication Training?

PubMed Central

File, Wilson; Bylund, Carma L.; Kesselheim, Jennifer; Leonard, David; Leavey, Patrick

2017-01-01

Purpose The Accreditation Council for Graduate Medical Education (ACGME) has established communication as a core competency for physicians in training. However, data suggest that most pediatric residents perceive inadequate training in the delivery of bad news and the majority of former trainees in pediatric oncology received no formal training in the delivery of bad news during fellowship. The study examines communication training in ACGME accredited US pediatric hematology-oncology (PHO) fellowship programs. Methods An online survey was distributed to 315 PHO fellows in training via the American Society of Pediatric Hematology/Oncology (ASPHO) fellow email registry. Each fellow received an initial request to participate and 2 reminders, while participation was encouraged through a random incentive drawing. Results One hundred and ten fellows (35%) responded. Eighty percent of respondents perceived communication training to be important to fellow education, however only 32% reported receiving communication training (other than direct observation). The most common reported teaching method of fellowship communication training was formal lecture (42%). Twenty-three percent of respondents reported neither communication training nor frequent feedback on their communication skills from faculty observation. This same group was the least satisfied with their programs’ approach to teaching communication (P < 0.001). Conclusions There is limited communication training in PHO fellowships despite ACGME requirements and fellows’ interest in this training. Didactic learning remains the most frequently described training method, yet educational theory identifies the limitation of didactic lectures alone. Communication training employing novel teaching methods and emphasizing communication challenges identified by fellows should be developed and evaluated. PMID:24039096

Cultural competence in mental health care: a review of model evaluations

PubMed Central

Bhui, Kamaldeep; Warfa, Nasir; Edonya, Patricia; McKenzie, Kwame; Bhugra, Dinesh

2007-01-01

Background Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. Methods A systematic review that included evaluated models of professional education or service delivery. Results Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. Conclusion There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes. PMID:17266765

The 1998 ASTD State of the Industry Report.

ERIC Educational Resources Information Center

Bassi, Laurie J.; Van Buren, Mark E.

1998-01-01

Displays responses from 540 organizations plus other recent surveys that show how much training is provided at what cost, types of courses provided, training staff, outsourcing, technological delivery methods, and human performance practices. Also looks at whether measures show that training is linked to performance. (JOW)

Training Issues Associated with COTS-based Information Intensive Systems.

ERIC Educational Resources Information Center

Farr, John V.; Verma, Dinesh

2002-01-01

A literature review and survey responses from 194 information technology and aerospace contractors identified methods and outcomes of training delivery. Results were used to develop a framework for evaluating and selecting commercial off-the-shelf systems (COTS) for operations and maintenance training. (Contains 11 references.) (SK)

eLearning: Is There a Place in Athletic Training Education?

PubMed Central

Wright, Kenneth E.; Stewart, Jeffrey; Wright, Vivian H.; Barker, Scott

2002-01-01

Objective: To provide an overview of current issue and research literature that discusses the use of eLearning in an academic curriculum. We address several components to be examined before eLearning is incorporated into athletic training education. Data Sources: We searched MEDLINE and Educational Resources Information Center (ERIC) from 2000 through 2002 using the key words distance education, online learning, and the individual research studies referenced in this article. Data Synthesis: Educational research studies have confirmed that multiple methods in instruction delivery exist. Within the changing culture of higher education, the use of effective communication tools has been shown to increase student knowledge and skills. Through eLearning, methods of instruction design are designed to be student centered and allow the educator to become a facilitator. Conclusions/Recommendations: Even though the use of eLearning faces many challenges in athletic training education, the research literature does support this method of instructional delivery in selected courses in athletic training education. PMID:12937546

eLearning: Is There a Place in Athletic Training Education?

PubMed

Wright, Kenneth E; Stewart, Jeffrey; Wright, Vivian H; Barker, Scott

2002-12-01

OBJECTIVE: To provide an overview of current issue and research literature that discusses the use of eLearning in an academic curriculum. We address several components to be examined before eLearning is incorporated into athletic training education. DATA SOURCES: We searched MEDLINE and Educational Resources Information Center (ERIC) from 2000 through 2002 using the key words distance education, online learning, and the individual research studies referenced in this article. DATA SYNTHESIS: Educational research studies have confirmed that multiple methods in instruction delivery exist. Within the changing culture of higher education, the use of effective communication tools has been shown to increase student knowledge and skills. Through eLearning, methods of instruction design are designed to be student centered and allow the educator to become a facilitator. CONCLUSIONS/RECOMMENDATIONS: Even though the use of eLearning faces many challenges in athletic training education, the research literature does support this method of instructional delivery in selected courses in athletic training education.

The Effects of E-Training versus Traditional Training Delivery Methods on Professional Students in Contemporary Organizations

ERIC Educational Resources Information Center

Seda, Albert

2016-01-01

This research investigated the limitations of Albert Bandura's theory of observational training (also known as observational learning) when applied to e-learning. The study focused on professional employees in different industries around the United States. These professionals engaged in continuous training either in the classroom or on in an…

Evaluation of a Soft Skills Training Program

ERIC Educational Resources Information Center

Charoensap-Kelly, Piyawan; Broussard, Lauren; Lindsly, Mallory; Troy, Megan

2016-01-01

This study was conducted to determine the effectiveness of a soft skills employee training program. We examined willingness to learn and delivery methods (face-to-face vs. online) and their associations with the training outcomes in terms of learning and behavioral change. Results showed that neither participants' willingness to learn nor delivery…

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study

PubMed Central

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-01-01

Introduction and Aims Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Design and Methods Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Results Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Discussion and Conclusions Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. [Fitzgerald N, Molloy H, MacDonald F, McCambridge J. Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study. Drug Alcohol Rev 2015;34:185–93] PMID:25196713

The Top Ten Trends.

ERIC Educational Resources Information Center

Bassi, Laurie J.; And Others

1996-01-01

Trends shaping the workplace are increased skill requirements; more educated, diverse work force; continued corporate restructuring; change in size and composition of training departments; instructional technology advances; new training delivery methods; focus on performance improvement; integrated high-performance work systems; companies becoming…

Measuring Assurance of Learning Goals: Effectiveness of Computer Training and Assessment Tools

ERIC Educational Resources Information Center

Murphy, Marianne C.; Sharma, Aditya; Rosso, Mark

2012-01-01

Teaching office applications such as word processing, spreadsheet and presentation skills has been widely debated regarding its necessity, extent and delivery method. Training and Assessment applications such as MyITLab, SAM, etc. are popular tools for training students and are particularly useful in measuring Assurance of Learning (AOL)…

40 CFR 745.225 - Accreditation of training programs: target housing and child-occupied facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... equipment to be used for lecture and hands-on training. (B) A copy of the course test blueprint for each..., the delivery of the lecture, course test, hands-on training, and assessment activities. This includes... containment and cleanup methods, and post-renovation cleaning verification. (vii) The dust sampling technician...

40 CFR 745.225 - Accreditation of training programs: target housing and child-occupied facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... equipment to be used for lecture and hands-on training. (B) A copy of the course test blueprint for each..., the delivery of the lecture, course test, hands-on training, and assessment activities. This includes... containment and cleanup methods, and post-renovation cleaning verification. (vii) The dust sampling technician...

Development and Delivery of a Physical Activity Intervention for People With Huntington Disease: Facilitating Translation to Clinical Practice

PubMed Central

Quinn, Lori; Trubey, Rob; Gobat, Nina; Dawes, Helen; Edwards, Rhiannon Tudor; Jones, Carys; Townson, Julia; Drew, Cheney; Kelson, Mark; Poile, Vincent; Rosser, Anne; Hood, Kerenza

2016-01-01

Background and Purpose: We studied the development and delivery of a 14-week complex physical activity intervention for people with Huntington disease, where detailed information about the intervention was fully embedded in the trial design process. Methods: Intervention Development: The intervention was developed through a series of focus groups. The findings from the focus groups informed the development of a logic model for the physical activity intervention that was broadly consistent with the framework of self-determination theory. Intervention Delivery: Key components underpinning the delivery of the intervention were implemented including a defined coach training program and intervention fidelity assessment methods. Training of coaches (physical therapists, occupational therapists, research nurses, and exercise trainers) was delivered via group and 1:1 training sessions using a detailed coach's manual, and with ongoing support via video calls, and e-mail communication as needed. Detailed documentation was provided to determine costs of intervention development and coach training. Results: Intervention delivery coaches at 8 sites across the United Kingdom participated in the face-to-face training. Self-report checklists completed by each of the coaches indicated that all components of the intervention were delivered in accordance with the protocol. Mean (standard deviation) intervention fidelity scores (n = 15), as measured using a purpose-developed rating scale, was 11 (2.4) (out of 16 possible points). Coaches' perceptions of intervention fidelity were similarly high. The total cost of developing the intervention and providing training was £30,773 ($47,042 USD). Discussion and Conclusions: An important consideration in promoting translation of clinical research into practice is the ability to convey the detailed components of how the intervention was delivered to facilitate replication if the results are favorable. This report presents an illustrative example of a physical activity intervention, including the development and the training required to deliver it. This approach has the potential to facilitate reproducibility, evidence synthesis, and implementation in clinical practice. Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A122). PMID:26863152

Effective Delivery Methodologies for Education and Training to Rural Australia. Report to the Tasmanian Rural Industry Training Board.

ERIC Educational Resources Information Center

Kilpatrick, Sue

A project examined effective methods of delivering education and training to the residents of rural Australia through a literature review and five interview case studies of formal and nonformal training. Findings with regard to access were as follows: potential participants must be aware that the program exists and is for them; the program must be…

Developing Web-Based Training for Public Health Practitioners: What Can We Learn from a Review of Five Disciplines?

ERIC Educational Resources Information Center

Ballew, Paula; Castro, Sarah; Claus, Julie; Kittur, Nupur; Brennan, Laura; Brownson, Ross C.

2013-01-01

During a time when governmental funding, resources and staff are decreasing and travel restrictions are increasing, attention to efficient methods of public health workforce training is essential. A literature review was conducted to inform the development and delivery of web-based trainings for public health practitioners. Literature was gathered…

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.

Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes

PubMed Central

Ponnusamy, Vellapandian; Grove, J. Robert

2014-01-01

Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key points Consultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services. Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values. Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach. Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year. PMID:25177193

Sport Psychology Service Provision: Preferences for Consultant Characteristics and Mode of Delivery among Elite Malaysian Athletes.

PubMed

Ponnusamy, Vellapandian; Grove, J Robert

2014-09-01

Factors relevant to the working alliance between athletes and sport psychology consultants were investigated in a sample of elite Malaysian athletes (n = 217). The athletes represented a variety of team and individual sports, and they provided information about the perceived importance of seven consultant characteristics/behaviors as well as seven program delivery options. At a full-sample level, general preferences were expressed for consultants to lead a physically active lifestyle, regularly attend training sessions and competitions, and have prior experience as an athlete or coach. General preferences were also expressed for program content to be determined by the coach or consultant, and for regular, small doses of mental skills training to be delivered in a face-to-face context throughout the year. At a sub-group level, team sport athletes had stronger preferences than individual sport athletes for program delivery on a group/team basis, while individual sport athletes had stronger preferences than team sport athletes for having a role in determining program content. Findings are discussed in relation to dominant value themes within Malaysian society and the reinforcement of these themes within specific sport subcultures. Key pointsConsultant characteristics and program delivery methods have an impact on the effectiveness of sport psychology services.Preferred consultant characteristics and preferred methods of delivery may be affected by cultural and subcultural values.Elite Malaysian athletes prefer consultants to lead a physically active lifestyle; to regularly attend training/competition; and to have prior experience as an athlete or coach.Elite Malaysian athletes also prefer that the coach or consultant determine program content, and that mental skills training take place in a face-to-face context throughout the year.

Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia

PubMed Central

2010-01-01

Background Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. Methods A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. Results The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. Conclusions A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java areas. Health education strategies are required to increase community awareness about the importance of health services along with the existing financing mechanisms for the poor communities. Public health strategies involving traditional birth attendants will be beneficial particularly in remote areas where their services are highly utilized. PMID:20701762

Improving Quality and Reducing Waste in Allied Health Workplace Education Programs: A Pragmatic Operational Education Framework Approach.

PubMed

Golder, Janet; Farlie, Melanie K; Sevenhuysen, Samantha

2016-01-01

Efficient utilisation of education resources is required for the delivery of effective learning opportunities for allied health professionals. This study aimed to develop an education framework to support delivery of high-quality education within existing education resources. This study was conducted in a large metropolitan health service. Homogenous and purposive sampling methods were utilised in Phase 1 (n=43) and 2 (n=14) consultation stages. Participants included 25 allied health professionals, 22 managers, 1 educator, and 3 executives. Field notes taken during 43 semi-structured interviews and 4 focus groups were member-checked, and semantic thematic analysis methods were utilised. Framework design was informed by existing published framework development guides. The framework model contains governance, planning, delivery, and evaluation and research elements and identifies performance indicators, practice examples, and support tools for a range of stakeholders. Themes integrated into framework content include improving quality of education and training provided and delivery efficiency, greater understanding of education role requirements, and workforce support for education-specific knowledge and skill development. This framework supports efficient delivery of allied health workforce education and training to the highest standard, whilst pragmatically considering current allied health education workforce demands.

Simulation training and resident performance of singleton vaginal breech delivery.

PubMed

Deering, Shad; Brown, Jill; Hodor, Jonathon; Satin, Andrew J

2006-01-01

To determine whether simulation training improves resident competency in the management of a simulated vaginal breech delivery. Without advance notice or training, residents from 2 obstetrics and gynecology residency programs participated in a standardized simulation scenario of management of an imminent term vaginal breech delivery. The scenario used an obstetric birth simulator and human actors, with the encounters digitally recorded. Residents then received a training session with the simulator on the proper techniques for vaginal breech delivery. Two weeks later they were retested using a similar simulation scenario. A physician, blinded to training status, graded the residents' performance using a standardized evaluation sheet. Statistical analysis included the Wilcoxon signed rank test, McNemar chi2, regression analysis, and paired t test as appropriate with a P value of less than .05 considered significant. Twenty residents from 2 institutions completed all parts of the study protocol. Trained residents had significantly higher scores in 8 of 12 critical delivery components (P < .05). Overall performance of the delivery and safety in performing the delivery also improved significantly (P = .001 for both). Simulation training improved resident performance in the management of a simulated vaginal breech delivery. Performance of a term breech vaginal delivery is well suited for simulation training, because it is uncommon and inevitable, and improper technique may result in significant injury. II-2.

Online course delivery modes and design methods in the radiologic sciences.

PubMed

Kowalczyk, Nina; Copley, Stacey

2013-01-01

To determine the current status of online education in the radiologic sciences and to explore learning management systems, course design methods, and online educational tools used in the radiologic sciences. A random sample of 373 educators from Joint Review Committee-accredited radiography, radiation therapy, and nuclear medicine technology educational programs was invited to participate in this study with an online survey. The majority of the programs responding to the survey do not offer online core courses. However, the institutions that do provide online core radiologic courses reported limited use of online tools for course delivery. BlackBoard was reported as the most commonly used learning management system. No significant relationships were identified in reference to self-reported instructor information technology self-efficacy and the instructors' age, years of teaching in higher education, years of teaching online, or use of asynchronous and synchronous technologies. Survey results did demonstrate a significant relationship between the type of institution and the use of synchronous technologies, suggesting that university-based programs were more likely to use this technology. Although the results suggest that online distance education is still not prevalent in radiologic science education, the past 3 years have seen a substantial increase in online course activity. This increase emphasizes the importance of adequate educator instruction and continuing education in the use of interactive technologies for online content delivery. Most educators report receiving 1 to 4 hours of training prior to online course implementation, but additional postimplementation training is necessary to improve the success of online delivery and further integrate interactive learning activities into an online format. The traditional classroom setting is still the primary course offering for radiologic science programs. PowerPoint remains the primary content delivery tool, suggesting a need for educators to incorporate tools that promote student interactions and interactive learning. Although the results did not reveal a significant relationship between assessed factors, the small correlations identified suggest that the younger instructors have a higher information technology self-efficacy. In addition, survey results suggest that instructors responding to this survey received limited training in reference to online course methods and design both before and after implementing an online course. Although educators may not have a choice regarding the system adopted by their university or college, they should seek additional training regarding the best tools available for online course delivery methods.

Changes in Instructional System Design (ISD): Improving Training Product Delivery to United States Army Soldiers

DTIC Science & Technology

2005-03-18

simulation. This model is a basis of what is called discovery learning. Discovery learning is constructionist method of instruction, which is a concept in...2005 PAGES: 48 CLASSIFICATION: Unclassified The purpose of this study is to identify methods that could speed up the instructional system design...became obvious as the enemy attacked using asymmetric means and methods . For instance: during the war, a mine identification-training product was

Using conversation analytic methods to assess fidelity to a talk-based healthcare intervention for frequently attending patients.

PubMed

Barnes, Rebecca K; Jepson, Marcus; Thomas, Clare; Jackson, Sue; Metcalfe, Chris; Kessler, David; Cramer, Helen

2018-06-01

The study aim was to assess implementation fidelity (i.e., adherence) to a talk-based primary care intervention using Conversation Analytic (CA) methods. The context was a UK feasibility trial where General Practitioners (GPs) were trained to use "BATHE" (Background,Affect,Trouble,Handling,Empathy) - a technique to screen for psychosocial issues during consultations - with frequently attending patients. 35 GPs received BATHE training between July-October 2015. 15 GPs across six practices self-selected to record a sample of their consultations with study patients at three and six months. 31 consultations were recorded. 21/26 patients in four intervention practices gave permission for analysis. The recordings were transcribed and initially coded for the presence or absence of the five BATHE components. CA methods were applied to assess delivery, focusing on position and composition of each component, and patients' responses. Initial coding showed most of the BATHE components to be present in most contacts. However the CA analysis revealed unplanned deviations in position and adaptations in composition. Frequently the intervention was initiated too early in the consultation, and the BATHE questions misunderstood by patients as pertaining to their presenting problems rather than the psychosocial context for their problems. Often these deviations resulted in reducing theoretical fidelity of the intervention as a whole. A CA approach enabled a dynamic assessment of the delivery and receipt of BATHE in situ revealing common pitfalls in delivery and provided valuable examples of more and less efficacious implementations. During the trial this evidence was used in top-up trainings to address problems in delivery and to improve GP engagement. Using CA methods enabled a more accurate assessment of implementation fidelity, a fuller description of the intervention itself, and enhanced resources for future training. When positioned appropriately, BATHE can be a useful tool for eliciting information about the wider context of the medical visit. Copyright © 2018 Elsevier Ltd. All rights reserved.

78 FR 59725 - Construction Fall Protection Systems Criteria and Practices, and Training Requirements; Extension...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-27

...- 1648. Mail, hand delivery, express mail, messenger, or courier service: When using this method, you... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0008] Construction Fall Protection Systems Criteria and Practices, and Training Requirements; Extension of the Office...

Face-to-Face or Distance Training? Two Different Approaches To Motivate SMEs To Learn--An Update.

ERIC Educational Resources Information Center

Allan, John; O'Dwyer, Michele; Ryan, Eamon; Lawless, Naomi

2001-01-01

Two projects attempted to assess and meet small and medium-sized enterprises' training needs. Britain's Learning support for Small Businesses delivery methods included paper, CD-ROM, and the Internet. The University of Limerick, Ireland, offered face-to-face learning for microenterprises. (SK)

Use of alternative and complementary therapies in labor and delivery care: a cross-sectional study of midwives’ training in Catalan hospitals accredited as centers for normal birth

PubMed Central

2013-01-01

Background The use of complementary and alternative medicine (CAM) and complementary and alternative therapies (CAT) during pregnancy is increasing. Scientific evidence for CAM and CAT in the field of obstetrics mainly covers pain relief in labor. Midwives are responsible for labor and delivery care: hence, their knowledge of CAM and CAT is important. The aims of this study are to describe the professional profile of midwives who provide care for natural childbirth in Catalan hospitals accredited as centers for normal birth, to assess midwives’ level of training in CAT and their use of these therapies, and to identify specific resources for CAT in labor wards. Methods A descriptive, cross-sectional, quantitative method was used to assess the level of training and use of CAT by midwives working at 28 hospitals in Catalonia, Spain, accredited as public normal birth centers. Results Just under a third of midwives (30.4%) trained in CAT after completion of basic training. They trained in an average of 5.97 therapies (SD 3.56). The number of CAT in which the midwives were trained correlated negatively with age (r = - 0.284; p < 0.001) and with their time working at the hospital in years (r = - 0.136; p = 0.036). Midwives trained in CAT considered that the following therapies were useful or very useful for pain relief during labor and delivery: relaxation techniques (64.3%), hydrotherapy (84.8%) and the application of compresses to the perineum (75.9%). The availability of resources for providing CAT during normal birth care varied widely from center to center. Conclusions Age may influence attitudes towards training. It is important to increase the number of midwives trained in CAM for pain relief during childbirth, in order to promote the use of CAT and ensure efficiency and safety. CAT resources at accredited hospitals providing normal childbirth care should also be standardized. PMID:24238197

Utilizing grassroots workers in family planning programs in India: prospects and problems.

PubMed

Mani, S B

1991-01-01

In order to rapidly expand the network of delivery systems and speed up the process of acceptance of family planning messages and methods, a shift took place in the Indian family planning program from the bureaucratic "clinical" approach to the people oriented "extension" approach. As a result, there is an increasing emphasis on moving the family planning efforts closer to the grassroots level. A key methodological issue centers on the proper selection, cultural acceptability, and the effectiveness of the grassroots workers who are to be trained and through whom family planning motivational messages and methods are to be introduced. The Indian government, from time to time, has trained and utilized different groups of grassroots workers in its family planning promotional efforts. Anthropological field studies were conducted in two different regions in India to examine the potential and actual roles of two groups of grassroots workers--opinion leaders and traditional birth attendants--in the delivery of family planning services in the rural areas. These studies revealed that while the traditional birth attendants can be trained and utilized to a limited extent in promoting family planning efforts, especially to the eligible female clients, the role of the opinion leaders in such efforts is at best questionable. Based on these field studies, cultural and technical (including bureaucratic) problems in training and utilizing opinion leaders and traditional birth attendants are explored in detail. Modifications in the training program strategies are suggested to improve and expand the family planning delivery system in rural India.

Improving Intercultural Interactions. Modules for Cross-Cultural Training Programs. Multicultural Aspects of Counseling Series 3.

ERIC Educational Resources Information Center

Brislin, Richard W., Ed.; Yoshida, Tomoko, Ed.

This book contains modules for use in cross-cultural training programs. A module differs from a chapter in that it is a collection of materials that guide the reader both on the content of a defined unit of training and the method of delivery of that content. The modules are grouped into four sections, three corresponding to organizations in which…

[Operative vaginal deliveries training].

PubMed

Dupuis, O

2008-12-01

The appropriate use of forceps, vacuums or spatulas facilitates the rapid delivery of foetuses faced with life-threatening situations. It also makes possible the relief of certain cases of prolonged second-stage labor. In France, operative vaginal delivery (OVD) accounts for approximately 10% of all births. OVD training aims to optimize maternal, as well as neonatal safety. It should enable trainees to indicate or contraindicate an OVD safely, as well as to choose the appropriate instrument, use it correctly, and master quality control principles. Traditional OVD training is confronted with both spatial and time-related limitations. Spatial constraints involve both the teacher and trainee who only have limited visual access to the pelvic canal, and the head of the foetus; the time constraint occurs whenever the OVD occurs in an emergency setting. These limitations have been further aggravated by new constraints: decreasing time dedicated to training (European safety rules prohibit work the day after night duty), increasing litigation, and constraints imposed by society. Training by means of simulation removes such limitations making it possible to both avoid exposing pregnant women to the hazards of traditional training, and adapt the training to the skills of each trainee. OVD training should include forceps, vacuums and the use of spatulas. The OVD skills of obstetricians should be audited regularly on both a personal and a confidential level. Such audits could be based on a method using a simulator. Prospective studies comparing traditional and simulation-based training should be encouraged.

Ongoing training of community health workers in low-income and middle-income countries: a systematic scoping review of the literature

PubMed Central

O’Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich

2018-01-01

Objectives Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Design Systematic scoping review. Data sources MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Study selection Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. Results The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). Conclusions This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. PMID:29705769

Advanced Networks in Dental Rich Online MEDiA (ANDROMEDA)

NASA Astrophysics Data System (ADS)

Elson, Bruce; Reynolds, Patricia; Amini, Ardavan; Burke, Ezra; Chapman, Craig

There is growing demand for dental education and training not only in terms of knowledge but also skills. This demand is driven by continuing professional development requirements in the more developed economies, personnel shortages and skills differences across the European Union (EU) accession states and more generally in the developing world. There is an excellent opportunity for the EU to meet this demand by developing an innovative online flexible learning platform (FLP). Current clinical online systems are restricted to the delivery of general, knowledge-based training with no easy method of personalization or delivery of skill-based training. The PHANTOM project, headed by Kings College London is developing haptic-based virtual reality training systems for clinical dental training. ANDROMEDA seeks to build on this and establish a Flexible Learning Platform that can integrate the haptic and sensor based training with rich media knowledge transfer, whilst using sophisticated technologies such as including service-orientated architecture (SOA), Semantic Web technologies, knowledge-based engineering, business intelligence (BI) and virtual worlds for personalization.

75 FR 52035 - Grantee Quarterly Progress Report; Extension of the Office of Management and Budget's (OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

..., hand delivery, express mail, messenger, or courier service: When using this method, you must submit... training, inform them of the importance and proper use of safety and health equipment, and train employers... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0021...

Delivery and Evaluation of Training for School Nutrition Administrators and Managers on Meeting Special Food and Nutrition Needs of Students in the School Setting

ERIC Educational Resources Information Center

Oakley, Charlotte B.; Knight, Kathy; Hobbs, Margie; Dodd, Lacy M.; Cole, Janie

2011-01-01

Purpose/Objectives: The purpose of this investigation was to complete a formal evaluation of a project that provided specialized training for school nutrition (SN) administrators and managers on meeting children's special dietary needs in the school setting. Methods: The training was provided as part of the "Eating Good and Moving Like We…

Storytelling as an Instructional Method: Descriptions and Research Questions

DTIC Science & Technology

2009-01-01

heavily used today in educa- tion and training of all types. We see evidence of this in dentistry (Whipp, Ferguson, Wells & Iacopino, 2000), the... Ergonomics Society, 2596-2598. Barnes, L. B., Christensen, C. R., & Hansen, A. J. (1994). Teaching and the case method: Text, cases, and readings. Boston...delivery, and evaluation of training systems. In G. Salvendy (Ed.), Handbook of human factors and ergonomics (pp. 472-512). (3rd ed.). New York: John

Training of Trainers: Trainer Manual.

ERIC Educational Resources Information Center

University Research Corp., Bethesda, MD.

This manual is designed to train individuals to deliver courses developed within the National Training System of the National Institute on Drug Abuse (NIDA). The training guide, describes the content and activities that constitute training delivery, identifies behaviors and skills associated with training delivery, elaborates on program design and…

Translating knowledge into practice: An exploratory study of dementia-specific training for community-based service providers.

PubMed

O'Sullivan, Grace; Hocking, Clare; McPherson, Kathryn

2017-08-01

Objective To develop, deliver, and evaluate dementia-specific training designed to inform service delivery by enhancing the knowledge of community-based service providers. Methods This exploratory qualitative study used an interdisciplinary, interuniversity team approach to develop and deliver dementia-specific training. Participants included management, care staff, and clients from three organizations funded to provide services in the community. Data on the acceptability, applicability, and perceived outcomes of the training were gathered through focus group discussions and individual interviews. Transcripts were analyzed to generate open codes which were clustered into themes and sub-themes addressing the content, delivery, and value of the training. Findings Staff valued up-to-date knowledge and "real stories" grounded in practice. Clients welcomed the strengths-based approach. Contractual obligations impact on the application of knowledge in practice. Implications The capacity to implement new knowledge may be limited by the legislative policies which frame service provision, to the detriment of service users.

Research and Development Project Summaries, October 1991

DTIC Science & Technology

1991-10-01

delivery methods, training cost reduction, demonstration of technology’ effectiveness, and the reduction of acquisition risk . The majority of the work...demonstrations, risk reduction developments, and cost-effectiveness investigations in simulator and training technologzv. This advanced development program is a...systems. The program is organized around specific demonstration tasks that target critical technical risks that confront future weapons system

A Meta-Analytic Review of Components Associated with Parent Training Program Effectiveness

ERIC Educational Resources Information Center

Kaminski, Jennifer Wyatt; Valle, Linda Anne; Filene, Jill H.; Boyle, Cynthia L.

2008-01-01

This component analysis used meta-analytic techniques to synthesize the results of 77 published evaluations of parent training programs (i.e., programs that included the active acquisition of parenting skills) to enhance behavior and adjustment in children aged 0-7. Characteristics of program content and delivery method were used to predict effect…

Videoconferencing a Stroke Assessment Training Workshop: Effectiveness, Acceptability, and Cost

ERIC Educational Resources Information Center

Miller, Patricia A.; Huijbregts, Maria; French, Esme; Taylor, Denise; Reinikka, Kirsti; Berezny, Laura; Fry, Sherri; Grunin, Anna; Harvey, Melissa

2008-01-01

Introduction: Videoconferencing (VC) is becoming a common method for the delivery of continuing education (CE) to clinicians in remote locations. The purpose of this study was to compare the effectiveness, acceptability, and costs of a full-day training workshop (TW) delivered through two different formats: face-to-face (FTF) and VC. The TW was…

A Delphi Study on Staff Bereavement Training in the Intellectual and Developmental Disabilities Field

ERIC Educational Resources Information Center

Gray, Jennifer A.; Truesdale, Jesslyn

2015-01-01

The Delphi technique was used to obtain expert panel consensus to prioritize content areas and delivery methods for developing staff grief and bereavement curriculum training in the intellectual and developmental disabilities (IDD) field. The Delphi technique was conducted with a panel of 18 experts from formal and informal disability caregiving,…

Commercialisation and Flexible Delivery: Access in Vocational Education and Training.

ERIC Educational Resources Information Center

Jakupec, Viktor; McTaggart, Robin

This book examines flexible delivery of vocational education and training in Australia's technical and further education (TAFE) sector. Discussed in chapter 1 are issues in the invention and implementation of flexible delivery with general reference to Victoria's TAFE sector, vocational education and training, and selected precursors of flexible…

Experiences and Attitudes Among Psychiatric Mental Health Advanced Practice Nurses in the Use of Telemental Health: Results of an Online Survey.

PubMed

Baird, Martha B; Whitney, Lucinda; Caedo, Cassie E

Telemental health (TMH) growth is driven by recent trends in health delivery systems and disparities in access to mental health services. There are currently no standard educational guidelines to prepare psychiatric mental health advanced practice nurses (PMH-APRNs) in TMH delivery. To survey practicing PMH-APRNs across the United States about their experiences and attitudes about use of TMH. Eighty-three participants from the American Psychiatric Nurses Association online discussion board completed a nine-item survey. Length of time practicing as a PMH-APRN, TMH use in practice, populations served, and TMH background. A majority had been practicing as a PMH-APRN for less than a decade and had used TMH, although most reported no prior education or training in this delivery method. Participants did indicate a desire for TMH education. This survey affirms the prevalence of TMH use among PMH-APRN providers, lack of formal training, and necessity for standardized educational guidelines in TMH delivery.

Psychological training of NASA astronauts for extended missions

NASA Technical Reports Server (NTRS)

Holland, A. W.

1992-01-01

The success of operational teams working in remote and hostile environments rests in large part on adequate preparation of those teams prior to emplacement in field settings. Psychological training, directed at the maintenance of crew health and performance becomes increasingly important as space missions grow in duration and complexity. Methods: Topics to be discussed include: the conceptual framework of psychological training; needs analysis; content and delivery options; methods of assessing training efficacy; use of testbeds and analogies and the relationship of training to crew selection and real-time support activities. Results and Conclusions: This paper will discuss the psychological training approach being developed at the NASA/JSC Behavior and Performance Laboratory. This approach will be compared and contrasted with those underway in the U.S. Department of Defense and in other space agencies.

Modeling the Delivery Physiology of Distributed Learning Systems.

ERIC Educational Resources Information Center

Paquette, Gilbert; Rosca, Ioan

2003-01-01

Discusses instructional delivery models and their physiology in distributed learning systems. Highlights include building delivery models; types of delivery models, including distributed classroom, self-training on the Web, online training, communities of practice, and performance support systems; and actors (users) involved, including experts,…

Assessing Paraprofessionals' Perceived Educational Needs and Skill Level with Function-Based Behavioral Intervention

ERIC Educational Resources Information Center

Walker, Virginia L.

2017-01-01

The purpose of this survey study was to assess the perceived skill level and educational needs of special education paraprofessionals in the area of function-based intervention and to identify paraprofessionals' preferred training delivery method(s) and any variables that affect paraprofessionals' preference for these methods. Special education…

Ongoing training of community health workers in low-income andmiddle-income countries: a systematic scoping review of the literature.

PubMed

O'Donovan, James; O'Donovan, Charles; Kuhn, Isla; Sachs, Sonia Ehrlich; Winters, Niall

2018-04-28

Understanding the current landscape of ongoing training for community health workers (CHWs) in low-income and middle-income countries (LMICs) is important both for organisations responsible for their training, as well as researchers and policy makers. This scoping review explores this under-researched area by mapping the current delivery implementation and evaluation of ongoing training provision for CHWs in LMICs. Systematic scoping review. MEDLINE, Embase, AMED, Global Health, Web of Science, Scopus, ASSIA, LILACS, BEI and ERIC. Original studies focusing on the provision of ongoing training for CHWs working in a country defined as low income and middle income according to World Bank Group 2012 classification of economies. The scoping review found 35 original studies that met the inclusion criteria. Ongoing training activities for CHWs were described as supervision (n=19), inservice or refresher training (n=13) or a mixture of both (n=3). Although the majority of studies emphasised the importance of providing ongoing training, several studies reported no impact of ongoing training on performance indicators. The majority of ongoing training was delivered inperson; however, four studies reported the use of mobile technologies to support training delivery. The outcomes from ongoing training activities were measured and reported in different ways, including changes in behaviour, attitudes and practice measured in a quantitative manner (n=16), knowledge and skills (n=6), qualitative assessments (n=5) or a mixed methods approach combining one of the aforementioned modalities (n=8). This scoping review highlights the diverse range of ongoing training for CHWs in LMICs. Given the expansion of CHW programmes globally, more attention should be given to the design, delivery, monitoring and sustainability of ongoing training from a health systems strengthening perspective. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluating and Measuring the Return on Investment of an Emergency Center Health Care Professional Picture Archiving and Communication Systems Training Program

ERIC Educational Resources Information Center

Roelandt, James P.

2012-01-01

Picture archiving and communication system (PACS) workflow directly affects the quality of emergency patient care through radiology exam turn-around times and the speed of delivery of diagnostic radiology results. This study was a mixed methods training and performance improvement study that evaluated the effectiveness and value of a hospital…

Shoulder dystocia documentation: an evaluation of a documentation training intervention.

PubMed

LeRiche, Tammy; Oppenheimer, Lawrence; Caughey, Sharon; Fell, Deshayne; Walker, Mark

2015-03-01

To evaluate the quality and content of nurse and physician shoulder dystocia delivery documentation before and after MORE training in shoulder dystocia management skills and documentation. Approximately 384 charts at the Ottawa Hospital General Campus involving a diagnosis of shoulder dystocia between the years of 2000 and 2006 excluding the training year of 2003 were identified. The charts were evaluated for 14 key components derived from a validated instrument. The delivery notes were then scored based on these components by 2 separate investigators who were blinded to delivery note author, date, and patient identification to further quantify delivery record quality. Approximately 346 charts were reviewed for physician and nurse delivery documentation. The average score for physician notes was 6 (maximum possible score of 14) both before and after the training intervention. The nurses' average score was 5 before and after the training intervention. Negligible improvement was observed in the content and quality of shoulder dystocia documentation before and after nurse and physician training.

Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes: A Cost-Effectiveness Analysis.

PubMed

Simmons, Sandra F; Hollingsworth, Emily K; Long, Emily A; Liu, Xulei; Shotwell, Matthew S; Keeler, Emmett; An, Ruopeng; Silver, Heidi J

2017-02-01

To determine the effect and cost-effectiveness of training nonnursing staff to provide feeding assistance for nutritionally at-risk nursing home (NH) residents. Randomized, controlled trial. Five community NHs. Long-stay NH residents with an order for caloric supplementation (N = 122). Research staff provided an 8-hour training curriculum to nonnursing staff. Trained staff were assigned to between-meal supplement or snack delivery for the intervention group; the control group received usual care. Research staff used standardized observations and weighed-intake methods to measure frequency of between-meal delivery, staff assistance time, and resident caloric intake. Fifty staff (mean 10 per site) completed training. The intervention had a significant effect on between-meal caloric intake (F = 56.29, P < .001), with the intervention group consuming, on average, 163.33 (95% CI = 120.19-206.47) calories per person per day more than the usual care control group. The intervention costs were $1.27 per person per day higher than usual care (P < .001). The incremental cost-effectiveness ratio for the intervention was 134 kcal per dollar. The increase in cost was due to the higher frequency and number of snack items given per person per day and the associated staff time to provide assistance. It is cost effective to train nonnursing staff to provide caloric supplementation, and this practice has a positive effect on residents' between-meal intake. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

The effect of presence of trained husbands beside their wives during childbirth on women's anxiety

PubMed Central

Salehi, Atefeh; Fahami, Fariba; Beigi, Marjan

2016-01-01

Background: Childbirth is accompanied with enormous physical and emotional changes in mothers. Anxiety is the most common problem among these patients. This study was aimed to determine the effect of the presence of trained husbands beside their wives during childbirth on their anxiety. Materials and Methods: In a randomized control trial, 84 primiparous women were enrolled in childbirth educational classes. Anxiety score was compared among three groups; without accompaniment (control), with accompaniment (doula), and with trained husband's support before hospitalization at the time of admission and during the 4th stage of delivery. Data was analyzed using one-way analysis of variance and least significant difference tests. Results: The level of anxiety before hospitalization was not significantly different among the three groups (38.6, 39.2, and 38.4, respectively, in without accompaniment, with accompaniment (doula), and with trained husband's support groups). This level was significantly different among groups during hospitalization (36, 42.1, and 59.1, respectively, as per previous groups’ order). The level of anxiety in the intervention group at 4th stage of delivery was significantly lower than other groups (31.4 versus 43.3 and 69.2, respectively with P < 0.001). Conclusions: According to the results of this study presence of trained husbands beside their wives during delivery decreased mother's anxiety. It is recommended to use this intervention during childbirth. PMID:28194202

Troubling objectivity: the promises and pitfalls of training Haitian clinicians in qualitative research methods.H.

PubMed

Minn, Pierre

2015-01-01

Building research capacity is a central component of many contemporary global health programs and partnerships. While medical anthropologists have been conducting qualitative research in resource-poor settings for decades, they are increasingly called on to train "local" clinicians, researchers, and students in qualitative research methods. In this article, I describe the process of teaching introductory courses in qualitative research methods to Haitian clinicians, hospital staff, and medical students, who rarely encounter qualitative research in their training or practice. These trainings allow participants to identify and begin to address challenges related to health services delivery, quality of care, and provider-patient relations. However, they also run the risk of perpetuating colonial legacies of objectification and reinforcing hierarchies of knowledge and knowledge production. As these trainings increase in number and scope, they offer the opportunity to reflect critically on new forms of transnational interventions that aim to reduce health disparities.

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

Latty, Drew, E-mail: drew.latty@health.nsw.gov.au; Stuart, Kirsty E; Westmead Breast Cancer Institute, Sydney, New South Wales

Radiation treatment to the left breast is associated with increased cardiac morbidity and mortality. The deep inspiration breath-hold technique (DIBH) can decrease radiation dose delivered to the heart and this may facilitate the treatment of the internal mammary chain nodes. The aim of this review is to critically analyse the literature available in relation to breath-hold methods, implementation, utilisation, patient compliance, planning methods and treatment verification of the DIBH technique. Despite variation in the literature regarding the DIBH delivery method, patient coaching, visual feedback mechanisms and treatment verification, all methods of DIBH delivery reduce radiation dose to the heart. Furthermore » research is required to determine optimum protocols for patient training and treatment verification to ensure the technique is delivered successfully.« less

Technologic advances in aural rehabilitation: applications and innovative methods of service delivery.

PubMed

Sweetow, Robert W; Sabes, Jennifer Henderson

2007-06-01

The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described.

Technologic Advances in Aural Rehabilitation: Applications and Innovative Methods of Service Delivery

PubMed Central

Sweetow, Robert W.; Sabes, Jennifer Henderson

2007-01-01

The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described. PMID:17494876

Citizenship Rights Training Manual.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Human Services, Oklahoma City. Developmental Disabilities Services Div.

The goal of this training manual is to encourage citizenship training for individuals with developmental disabilities when such training is indicated. It is intended to be used by interdisciplinary teams and trainers throughout the service delivery system. The manual begins by outlining a philosophy of service delivery, listing some of the basic…

Continuing professional development training needs of medical laboratory personnel in Botswana

PubMed Central

2014-01-01

Background Laboratory professionals are expected to maintain their knowledge on the most recent advances in laboratory testing and continuing professional development (CPD) programs can address this expectation. In developing countries, accessing CPD programs is a major challenge for laboratory personnel, partly due to their limited availability. An assessment was conducted among clinical laboratory workforce in Botswana to identify and prioritize CPD training needs as well as preferred modes of CPD delivery. Methods A self-administered questionnaire was disseminated to medical laboratory scientists and technicians registered with the Botswana Health Professions Council. Questions were organized into domains of competency related to (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, and (iv) pathophysiology, data interpretation, and research. Participants were asked to rank their self-perceived training needs using a 3-point scale in order of importance (most, moderate, and least). Furthermore, participants were asked to select any three preferences for delivery formats for the CPD. Results Out of 350 questionnaires that were distributed, 275 were completed and returned giving an overall response rate of 79%. The most frequently selected topics for training in rank order according to key themes were (mean, range) (i) quality management systems, most important (79%, 74–84%); (ii) pathophysiology, data interpretation, and research (68%, 52–78%); (iii) technical competence (65%, 44–73%); and (iv) laboratory management, leadership, and coaching (60%, 37–77%). The top three topics selected by the participants were (i) quality systems essentials for medical laboratory, (ii) implementing a quality management system, and (iii) techniques to identify and control sources of error in laboratory procedures. The top three preferred CPD delivery modes, in rank order, were training workshops, hands-on workshops, and internet-based learning. Journal clubs at the workplace was the least preferred method of delivery of CPD credits. Conclusions CPD programs to be developed should focus on topics that address quality management systems, case studies, competence assessment, and customer care. The findings from this survey can also inform medical laboratory pre-service education curriculum. PMID:25134431

Building Customer Relationships: A Model for Vocational Education and Training Delivery.

ERIC Educational Resources Information Center

Jarratt, Denise G.; Murphy, Tom; Lowry, Diannah

1997-01-01

Review of the theory of relational marketing and interviews with training providers identified a training delivery model that includes elements of trust and commitment, investment by relationship partners, and knowledge exchange, supporting relationship longevity. (SK)

Research Findings on a Virtual Training Center--Measuring Web Based Training as an Effective Project Management Facilitation Intervention.

ERIC Educational Resources Information Center

Hoyt, Brian; Stockman, Mark

This paper focuses on the design of an assessment plan that can accurately measure the impact of using World Wide Web-based deliveries to increase performance. Key trends in technology and training are reviewed, and effective assessment of online training deliveries is examined. The Virtual Business Training Center (VBTC) is an integrated business…

Cross-Country Skiing Injuries and Training Methods.

PubMed

Nagle, Kyle B

2015-01-01

Cross-country skiing is a low injury-risk sport that has many health benefits and few long-term health risks. Some concern exists that cross-country skiing may be associated with a higher incidence of atrial fibrillation; however, mortality rates among skiers are lower than those among the general population. While continuing to emphasize aerobic and anaerobic training, training methods also should promote ski-specific strength training to increase maximum force and its rate of delivery and to build muscular endurance to maintain that power through a race. Multiple tests are available to monitor training progress. Which tests are most appropriate depends on the specific events targeted. In addition to laboratory-based tests, there also are many simpler, more cost-effective tests, such as short time trials, that can be used to monitor training progress and predict performance particularly at the junior skier level where access and cost may be more prohibitive.

The design and delivery of crew resource management training: exploiting available resources.

PubMed

Salas, E; Rhodenizer, L; Bowers, C A

2000-01-01

Despite widespread acceptance throughout commercial and military settings, crew resource management (CRM) training programs have not escaped doubts about their effectiveness. The current state of CRM training is an example of how an entire body of pertinent research and development has not had the impact on practice that it could. In this paper we outline additional resources (i.e., principles, information, findings, and guidelines) from the team training and training effectiveness research literatures that can be used to improve the design and delivery of CRM training. Some of the resources discussed include knowledge about training effectiveness, training teamwork-related skills, scenario design, and performance measurement. We conclude with a discussion of emerging resources as well as those that need to be developed. The purpose of this paper is to provide the CRM training developer with better access to resources that can be applied to the design and delivery of CRM training programs.

Choosing Training Delivery Media.

ERIC Educational Resources Information Center

Hybert, Peter R.

2000-01-01

Focuses on decisionmaking about delivery media, and introduces CADDI's Performance-based, Accelerated, Customer-Stakeholder-driven Training & Development(SM) (PACT) Processes for training and development (T&D). Describes the media decisions that correspond with the design three levels of PACT: Curriculum Architecture Design, Modular Curriculum…

The face of equipoise - delivering a structured education programme within a randomized controlled trial: qualitative study

PubMed Central

2014-01-01

Background In trials of behavioural interventions, the individuals who deliver the intervention are in a position of key influence on the success of the trial. Their fidelity to the intervention is crucial. Yet little is understood about the experiences of this group of trial personnel. This study aimed to investigate the views and experiences of educators who delivered a structured education intervention to people with type 2 diabetes, which incorporated training in self-monitoring of either blood glucose (SMBG) or urine glucose (SMUG) as part of a randomized controlled trial (RCT). Methods Educators’ views were explored through focus groups before and after training (N = 18) and approximately 1 year into the trial (N = 14), and semi-structured telephone interviews at approximately 2 years (N = 7). Analysis was based on the constant comparative method. Results Educators held preferences regarding the intervention variants; thus, they were not in individual equipoise. Training raised awareness of preferences and their potential to impact on delivery. Educators were confident in their unbiased delivery, but acknowledged the challenges involved. Concealing their preferences was helped by a sense of professionalism, the patient-centred nature of the intervention, and concessions in the trial protocol (enabling participants to swap monitoring methods if needed). Commitment to unbiased delivery was explained through a desire for evidence-based knowledge in the contentious area of SMBG. Conclusions The findings provide insight into a previously unexplored group of trial personnel - intervention deliverers in trials of behavioural interventions - which will be useful to those designing and running similar trials. Rather than individual equipoise, it is intervention deliverers’ awareness of personal preferences and their potential impact on the trial outcome that facilitates unbiased delivery. Further, awareness of community equipoise, the need for evidence, and relevance to the individual enhance commitment to the RCT. Trial registration ISRCTN95696668 PMID:24405854

Training: more user friendly.

PubMed

Horibe, N

1994-03-01

China launched its family planning program in 1971 by initially focusing on public information campaigns and providing services to married couples nationwide. It eventually instituted programs to improve maternal and child health/family planning (MCH/FP) through better quality service. Such programs introduced interpersonal communication and counseling to improve quality service. In 1990, with help from UNICEF and the United Nations Population Fund [UNFPA], the Ministry of Public Health (MOPH) implemented a project to improve MCH/FP in 300 of China's poorest counties. Its training activities are chiefly for physicians and emphasize safe motherhood, breast feeding, diarrhea, case management of acute respiratory infection, and FP. Interpersonal communication and counseling has been included in each of these areas. Also with UNFPA assistance, the State Family Planning Commission (SFPC) began a project in 1991, targeting township and village family planning workers, which concentrates on interpersonal communication and counseling in its service delivery system. MOPH and SFPC are China's 2 vertical service delivery systems and they do not cooperate at the central level. At the lower level, however, they work together in interpersonal communication and counseling training. The training uses the participatory training method, which encourages two-way communication. The curriculum addresses motivation; education and counseling; perception, values, and misconceptions; verbal and nonverbal communications; interviewing and listening skills; and how to help the client's decision making. Feedback is very important. The participatory method training class should not exceed 50 participants, but financial constraints make this difficult in China. Short-term benefits of the training are: inspiration to trainers, increased sensitivity to the clients' needs and feelings, and exposure to an international professional work ethic and practice.

Use of alternative and complementary therapies in labor and delivery care: a cross-sectional study of midwives' training in Catalan hospitals accredited as centers for normal birth.

PubMed

Muñoz-Sellés, Ester; Vallès-Segalés, Antoni; Goberna-Tricas, Josefina

2013-11-15

The use of complementary and alternative medicine (CAM) and complementary and alternative therapies (CAT) during pregnancy is increasing. Scientific evidence for CAM and CAT in the field of obstetrics mainly covers pain relief in labor. Midwives are responsible for labor and delivery care: hence, their knowledge of CAM and CAT is important. The aims of this study are to describe the professional profile of midwives who provide care for natural childbirth in Catalan hospitals accredited as centers for normal birth, to assess midwives' level of training in CAT and their use of these therapies, and to identify specific resources for CAT in labor wards. A descriptive, cross-sectional, quantitative method was used to assess the level of training and use of CAT by midwives working at 28 hospitals in Catalonia, Spain, accredited as public normal birth centers. Just under a third of midwives (30.4%) trained in CAT after completion of basic training. They trained in an average of 5.97 therapies (SD 3.56). The number of CAT in which the midwives were trained correlated negatively with age (r = - 0.284; p < 0.001) and with their time working at the hospital in years (r = - 0.136; p = 0.036). Midwives trained in CAT considered that the following therapies were useful or very useful for pain relief during labor and delivery: relaxation techniques (64.3%), hydrotherapy (84.8%) and the application of compresses to the perineum (75.9%). The availability of resources for providing CAT during normal birth care varied widely from center to center. Age may influence attitudes towards training. It is important to increase the number of midwives trained in CAM for pain relief during childbirth, in order to promote the use of CAT and ensure efficiency and safety. CAT resources at accredited hospitals providing normal childbirth care should also be standardized.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved

PubMed Central

Inrig, Stephen J.; Tiro, Jasmin A.; Melhado, Trisha V.; Argenbright, Keith E.; Craddock Lee, Simon J.

2017-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. Objectives To better understand how to implement a decentralized regional delivery “hub & spoke” model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow’s RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Methods and Design The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow’s RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. Discussion This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting. PMID:28713882

The Delivery and Content of Training for Adult Education Teachers and Volunteer Instructors. Study of ABE/ESL Instructor Training Approaches.

ERIC Educational Resources Information Center

Tibbetts, John; And Others

The delivery and content of training for teachers and volunteer instructors in adult basic education (ABE) and English as a Second Language (ESL) were documented in a study. Two sources of information were the research literature and extant data from states on training activities. Findings indicated that training for adult education teachers and…

Interdisciplinary Delivery of Oral Health Care Student-Training Components.

ERIC Educational Resources Information Center

Roe, Sandy; Branson, Bonnie G.; Lackey, Nancy R.

2001-01-01

Responses from 23 of 37 area health education center project directors revealed that dental and dental hygiene students participated in interdisciplinary allied health studies. Oral health care education was delivered across disciplines; methods included problem-based learning and reflection. (SK)

Clinical effectiveness of combined virtual reality and robot assisted fine hand motion rehabilitation in subacute stroke patients.

PubMed

Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping

2017-07-01

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive rehabilitation training in restoring motor skills after a stroke. This study focuses on the rehabilitation of fine hand motion skills due to their vital role in performing delicate activities of daily living (ADL) tasks. The proposed rehabilitation system combines an adaptive assist-as-needed (AAN) control algorithm and a Virtual Reality (VR) based rehabilitation gaming system (RGS). The developed system is described and its effectiveness is validated through clinical trials on a group of eight subacute stroke patients for a period of six weeks. The impact of the training is verified through standard clinical evaluation methods and measuring key kinematic parameters. A comparison of the pre- and post-training results indicates that the method proposed in this study can improve fine hand motion rehabilitation training effectiveness.

The Whole PIC Catalog: Organization, Planning and Service Delivery Options under JTPA.

ERIC Educational Resources Information Center

National Alliance of Business, Inc., Washington, DC.

This handbook illustrates and discusses organizational options for the delivery of employment and training services within service delivery areas (SDAs) mandated by the Job Training Partnership Act (JTPA) of 1982. Addressed primarily to members of private industry councils (PICs), representatives of local governments, and employment and training…

The effect of primary delivery of the anterior compared with the posterior shoulder on perineal trauma: a study protocol for a randomized controlled trial

PubMed Central

2014-01-01

Background Approximately 85% of vaginal deliveries are accompanied by perineal trauma. The objective of this trial is to compare the incidence and degree of perineal trauma after primary delivery of the anterior compared with the posterior shoulder during vaginal birth. The hypothesis is that primary delivery of the posterior shoulder reduces the rate and degree of perineal trauma. Methods/design This is a single-centre, randomized controlled trial, with computer-generated randomization in a 1:1 allocation ratio. Women planning their first vaginal delivery (n = 650) are randomized to primary delivery of either the anterior or posterior shoulder. The primary outcome is any perineal trauma. Additional outcomes are the perineal injury subtypes, postpartum bleeding, umbilical artery pH, Apgar score at 5 minutes and any neonatal birth trauma. Perineal trauma is assessed by a midwife or doctor blinded to the method of shoulder delivery. All midwives are trained in the two methods of shoulder delivery and in the grading of perineal tears. The trial is being undertaken at a Danish community hospital with 1,600 yearly deliveries. Data will be analyzed according to the intention-to-treat principle. Recruitment started in January 2013 and the trial is planned to proceed for 24 months. Discussion Most delivery assistance techniques are based on tradition and heritage and lack objective evidence. This trial provides an example of how vaginal delivery techniques can be evaluated in a randomized controlled trial. The results of this trial will clarify the role that delivery of the shoulders has on perineal trauma and thereby provide knowledge to recommendations on birthing technique. Trial registration ClinicalTrials.gov: NCT01937546. PMID:25047001

Faculty Development for Medical School Community-Based Faculty: A Council of Academic Family Medicine Educational Research Alliance Study Exploring Institutional Requirements and Challenges.

PubMed

Drowos, Joanna; Baker, Suzanne; Harrison, Suzanne Leonard; Minor, Suzanne; Chessman, Alexander W; Baker, Dennis

2017-08-01

Community-based faculty play a large role in training medical students nationwide and require faculty development. The authors hypothesized that positive relationships exist between clerkships paying preceptors and requiring faculty development, and between protected clerkship directors' time and delivering face-to-face preceptor training, as well as with the number or length of community-based preceptor visits. Through under standing the quantity, delivery methods, barriers, and institutional support for faculty development provided to community-based preceptors teaching in family medicine clerkships, best practices can be developed. Data from the 2015 Council of Academic Family Medicine's Educational Research Alliance survey of Family Medicine Clerkship Directors were analyzed. The cross-sectional survey of clerkship directors is distributed annually to institutional representatives of U.S. and Canadian accredited medical schools. Survey questions focused on the requirements, delivery methods, barriers, and institutional support available for providing faculty development to community-based preceptors. Paying community-based preceptors was positively correlated with requiring faculty development in family medicine clerkships. The greatest barrier to providing faculty development was community-based preceptor time availability; however, face-to-face methods remain the most common delivery strategy. Many family medicine clerkship directors perform informal or no needs assessment in developing faculty development topics for community-based faculty. Providing payment to community preceptors may allow schools to enhance faculty development program activities and effectiveness. Medical schools could benefit from constructing a formal curriculum for faculty development, including formal preceptor needs assessment and program evaluation. Clerkship directors may consider recruiting and retaining community-based faculty by employing innovative faculty development delivery methods.

Training for shoulder dystocia: a trial of simulation using low-fidelity and high-fidelity mannequins.

PubMed

Crofts, Joanna F; Bartlett, Christine; Ellis, Denise; Hunt, Linda P; Fox, Robert; Draycott, Timothy J

2006-12-01

To evaluate the effectiveness of simulation training for shoulder dystocia management and compare training using a high-fidelity mannequin with that using traditional devices. Training was undertaken in six hospitals and a medical simulation center in the United Kingdom. Midwives and obstetricians working for participating hospitals were eligible for inclusion. One hundred forty participants (45 doctors, 95 midwives) were randomized to training with a high-fidelity training mannequin (incorporating force perception training) or traditional low-fidelity mannequins. Performance was assessed pre- and posttraining, using a videoed, standardized shoulder dystocia simulation. Outcome measures were delivery, head-to-body delivery time, use of appropriate and inappropriate actions, force applied, and communication. One hundred thirty-two participants completed the posttraining assessment. All training was associated with improved performance: use of basic maneuvers 114 of 140 (81.4%) to 125 of 132 (94.7%) (P=.002), successful deliveries 60 of 140 (42.9%) to 110 of 132 (83.3%) (P<.001), good communication with the patient 79 of 139 (56.8%) to 109 of 132 (82.6%) (P<.001), pre- and posttraining, respectively. Training with the high-fidelity mannequin was associated with a higher successful delivery rate than training with traditional devices: 94% compared with 72% (odds ratio 6.53, 95% confidence interval 2.05-20.81; P=.002). Total applied force was significantly lower for those who had undergone force training (2,030 Newton seconds versus 2,916 Newton seconds; P=.006) but there was no significant difference in the peak applied force 102 Newtons versus 112 Newtons (P=.242). This study verifies the need for shoulder dystocia training; before training only 43% participants could achieve delivery. All training with mannequins improved the management of simulated shoulder dystocia. Training on a high-fidelity mannequin, including force perception teaching, offered additional training benefits. I.

An Inquiry-Based Approach to Teaching Research Methods in Information Studies

ERIC Educational Resources Information Center

Albright, Kendra; Petrulis, Robert; Vasconcelos, Ana; Wood, Jamie

2012-01-01

This paper presents the results of a project that aimed at restructuring the delivery of research methods training at the Information School at the University of Sheffield, UK, based on an Inquiry-Based Learning (IBL) approach. The purpose of this research was to implement inquiry-based learning that would allow customization of research methods…

Towards reframing health service delivery in Uganda: the Uganda Initiative for Integrated Management of Non-Communicable Diseases

PubMed Central

Schwartz, Jeremy I.; Dunkle, Ashley; Akiteng, Ann R.; Birabwa-Male, Doreen; Kagimu, Richard; Mondo, Charles K.; Mutungi, Gerald; Rabin, Tracy L.; Skonieczny, Michael; Sykes, Jamila; Mayanja-Kizza, Harriet

2015-01-01

Background The burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development. Methods Integrated approaches to health service delivery and healthcare worker (HCW) training will be necessary in order to successfully combat the great challenge posed by NCDs. Results In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD), a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs. Discussion Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda. PMID:25563451

An Evaluation of the AFIT Teleteach Expanded Delivery System (TEDS) Method of Instruction (Phase 1).

DTIC Science & Technology

1980-06-01

S-ce-s, and AMFT’s cwco classrocmns. By so odn.- the= exten ses, any cost.s dL:rectly atcUrL’utacle to A?:btshared by u~sers f"r A’LC and AFSC waere ...34 Audiovisual instruction, May 1971, pp. 85-86. O’Sullivan, Kevin . "Audio For Training and Development: Some Notes about the Medium," Training and

Occupational lead poisoning: who should conduct surveillance and training?

PubMed

Keogh, J P; Gordon, J

1994-11-01

This commentary challenges the current employer-controlled model for delivering occupational health services. Problems emanating from traditional employer-based medical surveillance and worker education programs for occupational lead poisoning are identified. A new public health model for delivering these services is proposed. This model utilizes a case-based and hazard-based method for bringing workplaces and employers into the program and features direct delivery of surveillance and training services by public health agencies.

Development of the TARGET Training Effectiveness Tool and Underlying Algorithms Specifying Training Method - Performance Outcome Relationships

DTIC Science & Technology

2014-05-01

hand and right hand on the piano, or strumming and chording on the guitar . Perceptual This skill category involves detecting and interpreting sensory...measured as the percent correct, # correct, accumulated points, task/test scoring correct action/timing/performance. This also includes quality rating by...competition and scoring , as well as constraints, privileges and penalties. Simulation-Based The primary delivery environment is an interactive synthetic

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.

Use of electronic group method in assessing food safety training needs and delivery methods among international college students in the U.S.

PubMed

Garden-Robinson, Julie; Eighmy, Myron A; Lyonga, Agnes Ngale

2010-12-01

The purpose of this study was to determine the types of unfamiliar foods international students in the U.S. encounter and to assess food safety information that international students would like to receive for mitigating risks associated with handling and preparing unfamiliar foods. The study identified preferred instructional delivery methods and media for receiving food safety training or information. An electronic group method was used for this study. The electronic group method was chosen to maximize group efficiency by allowing participants to share ideas simultaneously and anonymously with minimal use of time and resources.Types of different (unfamiliar) foods were grouped into major categories. Fast and ready-to-eat foods, and processed and frozen foods constituted a major change for some international students, who were accustomed to homemade and fresh foods in their countries. Participants were interested in receiving information about how to safely handle and prepare unfamiliar foods in their new environment. Preferred methods for receiving food safety information included written materials, online publications, presentations, and materials provided during student orientation. Food packages, websites, and television programs were other preferred methods of receiving food safety information. Copyright © 2010 Elsevier Ltd. All rights reserved.

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…

Creating Opportunities: Good Practice in Small Business Training for Australian Rural Women.

ERIC Educational Resources Information Center

Simpson, Lyn; Daws, Leonie; Wood, Leanne

2002-01-01

To overcome barriers to participation in small business training faced by rural Australian women, training needs and delivery issues were identified and a good practice matrix was developed with the following components: marketing, content, delivery, support, impact, and innovation. Underlying principles included unique needs, diversity, use of…

Building capacity for antiretroviral delivery in South Africa: A qualitative evaluation of the PALSA PLUS nurse training programme

PubMed Central

Stein, J; Lewin, S; Fairall, L; Mayers, P; English, R; Bheekie, A; Bateman, E; Zwarenstein, M

2008-01-01

Background South Africa recently launched a national antiretroviral treatment programme. This has created an urgent need for nurse-training in antiretroviral treatment (ART) delivery. The PALSA PLUS programme provides guidelines and training for primary health care (PHC) nurses in the management of adult lung diseases and HIV/AIDS, including ART. A process evaluation was undertaken to document the training, explore perceptions regarding the value of the training, and compare the PALSA PLUS training approach (used at intervention sites) with the provincial training model. The evaluation was conducted alongside a randomized controlled trial measuring the effects of the PALSA PLUS nurse-training (Trial reference number ISRCTN24820584). Methods Qualitative methods were utilized, including participant observation of training sessions, focus group discussions and interviews. Data were analyzed thematically. Results Nurse uptake of PALSA PLUS training, with regard not only to ART specific components but also lung health, was high. The ongoing on-site training of all PHC nurses, as opposed to the once-off centralized training provided for ART nurses only at non-intervention clinics, enhanced nurses' experience of support for their work by allowing, not only for ongoing experiential learning, supervision and emotional support, but also for the ongoing managerial review of all those infrastructural and system-level changes required to facilitate health provider behaviour change and guideline implementation. The training of all PHC nurses in PALSA PLUS guideline use, as opposed to ART nurses only, was also perceived to better facilitate the integration of AIDS care within the clinic context. Conclusion PALSA PLUS training successfully engaged all PHC nurses in a comprehensive approach to a range of illnesses affecting both HIV positive and negative patients. PHC nurse-training for integrated systems-based interventions should be prioritized on the ART funding agenda. Training for individual provider behaviour change is nonetheless only one aspect of the ongoing system-wide interventions required to effect lasting improvements in patient care in the context of an over-burdened and under-resourced PHC system. PMID:19017394

Training of Leadership Skills in Medical Education

PubMed Central

Kiesewetter, Jan; Schmidt-Huber, Marion; Netzel, Janine; Krohn, Alexandra C.; Angstwurm, Matthias; Fischer, Martin R.

2013-01-01

Background: Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians’ everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. Objective: The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. Method: The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for training of leadership skills in medicine in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Results: Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. Conclusions: More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education. PMID:24282452

Training the 21st-Century Health Care Team: Maximizing Interprofessional Education Through Medical-Legal Partnership.

PubMed

Tobin-Tyler, Elizabeth; Teitelbaum, Joel

2016-06-01

For too long, many stakeholders in the health care delivery system have ignored the extent to which social determinants of health (SDH) are inextricably woven into and affect individual and population health. The health care system is undergoing a relatively rapid transformation, which has included in part an increasing recognition of SDH's effects. This recognition, in turn, has led to renewed calls for changing the way that physicians are trained and has accelerated medical education curricular reforms. This Perspective focuses on one such innovative method of team-based care and the opportunities for its integration into medical education: medical-legal partnership, a health care delivery model that embeds civil legal services into the spectrum of health care services provided to low-income or otherwise vulnerable patients and communities.

[Anesthesia in obstetrics: Tried and trusted methods, current standards and new challenges].

PubMed

Kranke, P; Annecke, T; Bremerich, D H; Hanß, R; Kaufner, L; Klapp, C; Ohnesorge, H; Schwemmer, U; Standl, T; Weber, S; Volk, T

2016-01-01

Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology. The topics are in particular, special features and pitfalls of informed consent in the delivery room, challenges in education and training in obstetric anesthesia, expedient inclusion of simulation-assisted training and further education on risk minimization, knowledge and recommendations on fasting for the delivery room and cesarean sections, monitoring in obstetric anesthesia by neuraxial and alternative procedures, the possibilities and limitations of using ultrasound for lumbal epidural catheter positioning in the delivery room, recommended approaches in preparing peridural catheters for cesarean section, basic principles of cardiotocography, postoperative analgesia after cesarean section, the practice of early bonding in the delivery room during cesarean section births and the management of postpartum hemorrhage.

20 CFR 617.23 - Selection of training methods and programs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... establish linkages with other public and private agencies, Workforce Investment Boards (WIBs), employers, and Workforce Investment Act (WIA) service delivery area (SDA) grant recipients, as appropriate, which return adversely affected workers to employment as soon as possible. (b) Firm-specific retraining program...

Retaining Critical Therapeutic Elements of Behavioral Interventions Translated For Delivery via the Internet: Recommendations and an Example Using Pain Coping Skills Training

PubMed Central

Porter, Laura S; Somers, Tamara J; McKee, Daphne C; Keefe, Francis J

2014-01-01

Evidence supporting the efficacy of behavioral interventions based on principles of cognitive behavioral therapies has spurred interest in translating these interventions for delivery via the Internet. However, the benefits of this dissemination method cannot be realized unless the translated interventions are as effective as possible. We describe a challenge that must be overcome to ensure this occurs—Internet interventions must retain therapeutic components and processes underlying the success of face-to-face interventions on which they are based. These components and processes vary in the ease with which they can be translated to the online environment. Moreover, some are subtle and may be overlooked, despite being recognized as essential to the success of face-to-face interventions. We provide preliminary guidance for retaining critical therapeutic components and processes in the translation process, using Pain Coping Skills Training for osteoarthritis pain to illustrate methods. Directions for future research are also discussed. PMID:25532216

Displaying fairness while delivering bad news: Testing the effectiveness of organizational bad news training in the layoff context.

PubMed

Richter, Manuela; König, Cornelius J; Koppermann, Christopher; Schilling, Michael

2016-06-01

Although giving bad news at work is a stressful experience, managers are often underprepared for this challenging task. As a solution, we introduce organizational bad news training that integrates (a) principles of delivering bad news from the context of health care (i.e., bad news delivery component), and (b) principles of organizational justice theory (i.e., fairness component). We argue that both the formal and fair delivery of bad news at work can be enhanced with the help of training to mitigate distress both for the messenger and the recipient. We tested the effectiveness of training for the delivery of a layoff as a typical bad news event at work. In 2 studies, we compared the performance of a training group (receiving both components of training) with that of a control group (Study 1, Study 2) and a basics group (receiving the bad news delivery component only; Study 2) during a simulated dismissal notification meeting. In general, the results supported our hypotheses: Training improved the formal delivery of bad news and predicted indicators of procedural fairness during the conversation in both studies. In Study 2, we also considered layoff victims' negativity after the layoff and found that training significantly reduced negative responses. This relationship was fully mediated by layoff victims' fairness perceptions. Despite preparation, however, giving bad news remained a challenging task in both studies. In summary, we recommend that organizations provide managers with organizational bad news training in order to promote professional and fair bad news conversations at work. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Palliative care education in Latin America: A systematic review of training programs for healthcare professionals.

PubMed

Vindrola-Padros, Cecilia; Mertnoff, Rosa; Lasmarias, Cristina; Gómez-Batiste, Xavier

2018-02-01

The integration of palliative care (PC) education into medical and nursing curricula has been identified as an international priority. PC education has undergone significant development in Latin America, but gaps in the integration of PC courses into undergraduate and postgraduate curricula remain. The aim of our review was to systematically examine the delivery of PC education in Latin America in order to explore the content and method of delivery of current PC programs, identify gaps in the availability of education opportunities, and document common barriers encountered in the course of their implementation. We carried out a systematic review of peer-reviewed academic articles and grey literature. Peer-reviewed articles were obtained from the following databases: CINAHL Plus, Embase, the Web of Science, and Medline. Grey literature was obtained from the following directories: the International Association for Hospice and Palliative Care's Global Directory of Education in Palliative Care, the Worldwide Hospice Palliative Care Alliance's lists of palliative care resources, the Latin American Association for Palliative Care's training resources, and the Latin American Atlas of Palliative Care. The inclusion criteria were that the work: (1) focused on describing PC courses; (2) was aimed at healthcare professionals; and (3) was implemented in Latin America. The PRISMA checklist was employed to guide the reporting of methods and findings. We found 36 programs that were delivered in 8 countries. Most of the programs were composed of interdisciplinary teams, taught at a postgraduate level, focused on pain and symptom management, and utilized classroom-based methods. The tools for evaluating the courses were rarely reported. The main barriers during implementation included: a lack of recognition of the importance of PC education, a lack of funding, and the unavailability of trained teaching staff. Considerable work needs to be done to improve the delivery of PC education programs in Latin American countries. Practice-based methods and exposure to clinical settings should be integrated into ongoing courses to facilitate learning. A regional platform needs to be created to share experiences of successful training programs and foster the development of PC education throughout Latin America.

All That Glitters Is Not Gold: Online Delivery of Education and Training. Review of Research.

ERIC Educational Resources Information Center

Brennan, Ros; McFadden, Mark; Law, Elizabeth

This consolidation study concentrates on major questions about effectiveness of online delivery of education and training in Australia through the literature that describes effects of these new forms of delivery on the learner/user and provider/practitioner. Chapter 1 focuses on sources of data used in the literature review, defines online…

Application of an access technology delivery protocol to two children with cerebral palsy.

PubMed

Mumford, Leslie; Chau, Tom

2015-07-14

This study further delineates the merits and limitations of the Access Technology Delivery Protocol (ATDP) through its application to two children with severe disabilities. We conducted mixed methods case studies to demonstrate the ATDP with two children with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with custom access technologies. After 16 weeks, one child's switch offered improved response efficiency, high teacher satisfaction and increased participation. The other child's switch resulted in improved satisfaction and switch effectiveness but lower overall efficiency. The latter child was no longer using his switch by the end of the study. These contrasting findings indicate that changes to any contextual factors that may impact the user's switch performance should mandate a reassessment of the access pathway. Secondly, it is important to ensure that individuals who will be responsible for switch training be identified at the outset and engaged throughout the ATDP. Finally, the ATDP should continue to be tested with individuals with severe disabilities to build an evidence base for the delivery of response efficient access solutions. Implications for Rehabilitation A data-driven, comprehensive access technology delivery protocol for children with complex communication needs could help to mitigate technology abandonment. Successful adoption of an access technology requires personalized design, training of the technology user, the teaching staff, the caregivers and other communication partners, and integration with functional activities.

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 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…

A Mixed-Methods Comparison of Classroom Context During Food, Health & Choices, a Childhood Obesity Prevention Intervention.

PubMed

Burgermaster, Marissa; Koroly, Jenna; Contento, Isobel; Koch, Pamela; Gray, Heewon L

2017-11-01

Schools are frequent settings for childhood obesity prevention; however, intervention results are mixed. Classroom context may hold important clues to improving these interventions. We used mixed methods to examine classroom context during a curriculum intervention taught by trained instructors in fifth grade classrooms. We identified classrooms with high and low buy-in using cluster analysis and compared intervention delivery and reception, student energy balance-related behavior, and student perceptions about supports and barriers to energy balance. Delivery and reception did not differ between the groups. Between-group differences in unhealthy behaviors were smaller at posttest, due to improvement in low buy-in classes. Although student perceptions of supports and barriers to energy balance were similar across groups, students in high buy-in classes indicated food preferences as a support while students in low buy-in classes indicated food preferences as a barrier. Neighborhood environment emerged as a universal barrier. Trained instructors may improve intervention delivery and reception regardless of classroom context. Social norms could explain high levels of unhealthy behavior in low buy-in classes at baseline; improvement at posttest suggests that the curriculum may have motivated change. All children need more strategies and supportive policies to overcome a challenging food environment. © 2017, American School Health Association.

Patient Involvement in Safe Delivery: A Qualitative Study.

PubMed

Olfati, Forozun; Asefzadeh, Saeid; Changizi, Nasrin; Keramat, Afsaneh; Yunesian, Masud

2015-09-28

Patient involvement in safe delivery planning is considered important yet not widely practiced. The present study aimed at identifythe factors that affect patient involvementin safe delivery, as recommended by parturient women. This study was part of a qualitative research conducted by content analysis method and purposive sampling in 2013.The data were collected through 63 semi-structured interviews in4 hospitalsand analyzed using thematic content analysis. The participants in this research were women before discharge and after delivery. Findings were analyzed using Colaizzi's method. Four categories of factors that could affect patient involvement in safe delivery emerged from our analysis: patient-related (true and false beliefs, literacy, privacy, respect for patient), illness-related (pain, type of delivery, patient safety incidents), health care professional-relatedand task-related factors (behavior, monitoring &training), health care setting-related (financial aspects, facilities). More research is needed to explore the factors affecting the participation of mothers. It is therefore, recommended to: 1) take notice of mother education, their husbands, midwives and specialists; 2) provide pregnant women with insurance coverage from the outset of pregnancy, especially during prenatal period; 3) form a labor pain committee consisting of midwives, obstetricians, and anesthesiologists in order to identify the preferred painless labor methods based on the existing facilities and conditions, 4) carry out research on observing patients' privacy and dignity; 5) pay more attention on the factors affecting cesarean.

AED training and its impact on skill acquisition, retention and performance--a systematic review of alternative training methods.

PubMed

Yeung, Joyce; Okamoto, Deems; Soar, Jasmeet; Perkins, Gavin D

2011-06-01

The most popular method of training in basic life support and AED use remains instructor-led training courses. This systematic review examines the evidence for different training methods of basic life support providers (laypersons and healthcare providers) using standard instructor-led courses as comparators, to assess whether alternative method of training can lead to effective skill acquisition, skill retention and actual performance whilst using the AED. OVID Medline (including Medline 1950-November 2010; EMBASE 1988-November 2010) was searched using "training" OR "teaching" OR "education" as text words. Search was then combined by using AND "AED" OR "automatic external defibrillator" as MESH words. Additionally, the American Heart Association Endnote library was searched with the terms "AED" and "automatic external defibrillator". Resuscitation journal was hand searched for relevant articles. 285 articles were identified. After duplicates were removed, 172 references were reviewed for relevance. From this 22 papers were scrutinized and 18 were included. All were manikin studies. Four LOE 1 studies, seven LOE 2 studies and three LOE 4 studies were supportive of alternative AED training methods. One LOE 2 study was neutral. Three LOE 1 studies provided opposing evidence. There is good evidence to support alternative methods of AED training including lay instructors, self directed learning and brief training. There is also evidence to support that no training is needed but even brief training can improve speed of shock delivery and electrode pad placement. Features of AED can have an impact on its use and further research should be directed to making devices user-friendly and robust to untrained layperson. Copyright © 2011 Elsevier Ireland Ltd. 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.

A qualitative study of the perspectives of key stakeholders on the delivery of clinical academic training in the East Midlands.

PubMed

Green, Ruth H; Evans, Val; MacLeod, Sheona; Barratt, Jonathan

2018-02-01

Major changes in the design and delivery of clinical academic training in the United Kingdom have occurred yet there has been little exploration of the perceptions of integrated clinic academic trainees or educators. We obtained the views of a range of key stakeholders involved in clinical academic training in the East Midlands. A qualitative study with inductive iterative thematic content analysis of findings from trainee surveys and facilitated focus groups. The East Midlands School of Clinical Academic Training. Integrated Clinical Academic Trainees, clinical and academic educators involved in clinical academic training. The experience, opinions and beliefs of key stakeholders about barriers and enablers in the delivery of clinical academic training. We identified key themes many shared by both trainees and educators. These highlighted issues in the systems and process of the integrated academic pathways, career pathways, supervision and support, the assessment process and the balance between clinical and academic training. Our findings help inform the future development of integrated academic training programmes.

Video Modeling Training Effects on Types of Attention Delivered by Educational Care-Providers.

PubMed

Taber, Traci A; Lambright, Nathan; Luiselli, James K

2017-06-01

We evaluated the effects of abbreviated (i.e., one-session) video modeling on delivery of student-preferred attention by educational care-providers. The video depicted a novel care-provider interacting with and delivering attention to the student. Within a concurrent multiple baseline design, video modeling increased delivery of the targeted attention for all participants as well as their delivery of another type of attention that was not trained although these effects were variable within and between care-providers. We discuss the clinical and training implications from these findings.

Retention of Vaginal Breech Delivery Skills Taught in Simulation.

PubMed

Stone, Heather; Crane, Joan; Johnston, Kathy; Craig, Catherine

2018-02-01

The optimal frequency of conducting simulation training for high-acuity, low-frequency events in obstetrics and gynaecology residency programs is unknown. This study evaluated retention over time of vaginal breech delivery skills taught in simulation, by comparing junior and senior residents. In addition, the residents' subjective comfort level to perform this skill clinically was assessed. This prospective cohort study included 22 obstetrics and gynaecology residents in a Canadian residency training program. Digital recordings were completed for pre-training, immediate post-training, and delayed (10-26 weeks later) post-training intervals of a vaginal breech delivery simulation, with skill assessment by a blinded observer using a binary checklist. Residents also completed questionnaires to assess their subjective comfort level at each interval. Junior and senior residents had significant improvements in vaginal breech delivery skills from the pre-training assessment to both the immediate post-training assessment (junior, P <0.001; senior, P <0.001) and the delayed post-training assessment (P <0.001 and P = 0.001, respectively). There was a significant decline in skills between the immediate and delayed post-training sessions for junior and senior residents (P = 0.003 and P <0.001, respectively). Both junior and senior residents gained more comfort immediately after the training (P <0.001 and P <0.001, respectively), without a significant change between immediate post-training and delayed post-training comfort levels (P = 0.19 and P = 0.11, respectively). Residents retained vaginal breech delivery skills taught in simulation 10-26 weeks later, although a decline in skills occurred over this time period. Comfort level was positively affected and retained. These results will aid in determining the frequency of simulation teaching for high-acuity, low-frequency events in a residency simulation curriculum. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Satisfaction with web-based training in an integrated healthcare delivery network: do age, education, computer skills and attitudes matter?

PubMed Central

Atreja, Ashish; Mehta, Neil B; Jain, Anil K; Harris, CM; Ishwaran, Hemant; Avital, Michel; Fishleder, Andrew J

2008-01-01

Background Healthcare institutions spend enormous time and effort to train their workforce. Web-based training can potentially streamline this process. However the deployment of web-based training in a large-scale setting with a diverse healthcare workforce has not been evaluated. The aim of this study was to evaluate the satisfaction of healthcare professionals with web-based training and to determine the predictors of such satisfaction including age, education status and computer proficiency. Methods Observational, cross-sectional survey of healthcare professionals from six hospital systems in an integrated delivery network. We measured overall satisfaction to web-based training and response to survey items measuring Website Usability, Course Usefulness, Instructional Design Effectiveness, Computer Proficiency and Self-learning Attitude. Results A total of 17,891 healthcare professionals completed the web-based training on HIPAA Privacy Rule; and of these, 13,537 completed the survey (response rate 75.6%). Overall course satisfaction was good (median, 4; scale, 1 to 5) with more than 75% of the respondents satisfied with the training (rating 4 or 5) and 65% preferring web-based training over traditional instructor-led training (rating 4 or 5). Multivariable ordinal regression revealed 3 key predictors of satisfaction with web-based training: Instructional Design Effectiveness, Website Usability and Course Usefulness. Demographic predictors such as gender, age and education did not have an effect on satisfaction. Conclusion The study shows that web-based training when tailored to learners' background, is perceived as a satisfactory mode of learning by an interdisciplinary group of healthcare professionals, irrespective of age, education level or prior computer experience. Future studies should aim to measure the long-term outcomes of web-based training. PMID:18922178

Applying a Midwifery Lens to Indigenous Health Care Delivery: The Contribution of Campus Learning and Rural Placements to Effecting Systemic Change.

PubMed

Thackrah, Rosalie D; Thompson, Sandra C

2018-01-01

Study background Increasing cultural safety in health settings is essential to address stark health disparities between Indigenous and non-Indigenous Australians. Respect for cultural knowledge, better communication, and recognition of racism as a determinant of health are required for improved service delivery. How this knowledge is acquired in health professional training and translated to clinical settings is poorly understood. Purpose Impacts of an innovative Indigenous health unit and remote clinical placements on knowledge acquisition and attitude change were explored among midwifery students to inform cultural competency initiatives in health professional training. Methods A multiphased, mixed methods research design used surveys, observations, and interviews. Qualitative analysis was strengthened through triangulation with quantitative data. Results A unit conceived with substantial Indigenous Australian input and which privileged these voices enhanced knowledge and shifted attitudes in a positive direction; however, immediate gains diminished over time. Remote placements had a profound effect on student learning. Exposure to Indigenous Australians in classrooms and communities, and the self-reflection generated, helped dispel stereotypes and challenge assumptions based on limited cultural knowledge and contact. Conclusion Optimization of receptivity to Indigenous Australian content and opportunities for remote placements contributed to students' developing cultural capabilities with implications for all health professional training. Whether this heightened awareness is enough to address institutional racism identified in health service delivery remains unanswered. The focus must include those established health practitioners and administrators who influence organizational culture if real systemic change is to occur. Given appropriate on-going support, graduates can play a vital role in expediting this process.

Improving Student Employee Training: A Study of Web 2.0 Social Media Tools as a Delivery Model

ERIC Educational Resources Information Center

Smith, Sharon D.

2012-01-01

Training student employees in Educational Outreach and Student Services (EOSS) at Arizona State University's West campus is important to maintaining a knowledgeable and productive workforce. This dissertation describes the results of an action research study in which social media tools were utilized as a delivery mechanism for training student…

Towards a new paradigm for innovative training methods for capacity building in remote sensing

NASA Astrophysics Data System (ADS)

Gupta, R. K.; Manikavelu, P. M. Bala; Vijayan, D.; Prasad, T. S.

2006-01-01

Everybody uses a bulb to illustrate an idea but nobody shows where the current comes from. Majority of remote sensing user community comes from natural and social sciences domain while remote sensing technology evolves from physical and engineering sciences. To ensure inculcation and internalization of remote sensing technology by application/resource scientists, trainer needs to transfer physical and engineering concepts in geometric manner. Here, the steering for the transfer of knowledge (facts, procedures, concepts and principles) and skills (thinking, acting, reacting and interacting) needs to take the trainees from Known to Unknown, Concrete to Abstract, Observation to Theory and Simple to Complex. In the initial stage of training/education, experiential learning by instructor led exploring of thematic details in false colour composite (FCC) as well as in individual black and white spectral band(s) imagery by trainees not only creates interest, confidence build-up and orientation towards purposeful learning but also helps them to overcome their inhibitions towards the physical and engineering basal. The methodology to be adopted has to inculcate productive learning, emphasizing more on thinking and trial and error aspects as opposed to reproductive learning based dominantly on being told and imitation. The delivery by trainer needs to ensure dynamic, stimulating and effective discussions through deluging questions pertaining to analysis, synthesis and evaluation nature. This would ensure proactive participation from trainees. Hands-on module leads to creative concretization of concepts. To keep the trainees inspired to learn in an auto mode during post-training period, they need to consciously swim in the current and emerging knowledge pool during training programme. This is achieved through assignment of seminar delivery task to the trainees. During the delivery of seminar, peers and co-trainees drive the trainee to communicate the seminar content not only in what but also in how and why mode. The interest culminated in this manner keeps the entropy of the trainee minimized even during post-training professional life. So, such germinated trainee would always generate positive induction among colleagues; thus, helping in realizing multiplier effect. Based upon above thought process(es), the paper discusses the concept of "thinking curricula" and associated cares needed in training deliveries.

Training of leadership skills in medical education.

PubMed

Kiesewetter, Jan; Schmidt-Huber, Marion; Netzel, Janine; Krohn, Alexandra C; Angstwurm, Matthias; Fischer, Martin R

2013-01-01

Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians' everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for training of leadership skills in medicine in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education.

Learner Assessment Methods Using a Computer Based Interactive Videodisc System.

ERIC Educational Resources Information Center

Ehrlich, Lisa R.

This paper focuses on item design considerations faced by instructional designers and evaluators when using computer videodisc delivery systems as a means of assessing learner comprehension and competencies. Media characteristics of various interactive computer/videodisc training systems are briefly discussed as well as reasons for using such…

Student Perceptions of Web-Based Supplemental Instruction

ERIC Educational Resources Information Center

Freeman, Steven A.; Field, Dennis W.

2004-01-01

The Internet is changing the way in which education is delivered, and in fact, some predict that the Internet will become the dominant distribution system for distance education and training. Many faculty members are expanding their traditional delivery methods (lecture, laboratory, face-to-face discussion) to include educational options ranging…

A Mixed-Method Evaluation of the Feasibility and Acceptability of a Telehealth-Based Parent-Mediated Intervention for Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Pickard, Katherine E.; Wainer, Allison L.; Bailey, Kathryn M.; Ingersoll, Brooke R.

2016-01-01

Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online.…

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

PubMed

Kamesh, Lavanya; Clapham, Mike; Foggensteiner, Lukas

2012-08-01

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

Developing web-based training for public health practitioners: what can we learn from a review of five disciplines?

PubMed Central

Ballew, Paula; Castro, Sarah; Claus, Julie; Kittur, Nupur; Brennan, Laura; Brownson, Ross C.

2013-01-01

During a time when governmental funding, resources and staff are decreasing and travel restrictions are increasing, attention to efficient methods of public health workforce training is essential. A literature review was conducted to inform the development and delivery of web-based trainings for public health practitioners. Literature was gathered and summarized from five disciplines: Information Technology, Health, Education, Business and Communications, following five research themes: benefits, barriers, retention, promotion and evaluation. As a result, a total of 138 articles relevant to web-based training design and implementation were identified. Key recommendations emerged, including the need to conduct formative research and evaluation, provide clear design and layout, concise content, interactivity, technical support, marketing and promotion and incentives. We conclude that there is limited application of web-based training in public health. This review offers an opportunity to learn from other disciplines. Web-based training methods may prove to be a key training strategy for reaching our public health workforce in the environment of limited resources. PMID:22987862

AcademyHealth's Delivery System Science Fellowship: Training Embedded Researchers to Design, Implement, and Evaluate New Models of Care.

PubMed

Kanani, Nisha; Hahn, Erin; Gould, Michael; Brunisholz, Kimberly; Savitz, Lucy; Holve, Erin

2017-07-01

AcademyHealth's Delivery System Science Fellowship (DSSF) provides a paid postdoctoral pragmatic learning experience to build capacity within learning healthcare systems to conduct research in applied settings. The fellowship provides hands-on training and professional leadership opportunities for researchers. Since its inception in 2012, the program has grown rapidly, with 16 health systems participating in the DSSF to date. In addition to specific projects conducted within health systems (and numerous publications associated with those initiatives), the DSSF has made several broader contributions to the field, including defining delivery system science, identifying a set of training objectives for researchers working in delivery systems, and developing a national collaborative network of care delivery organizations, operational leaders, and trainees. The DSSF is one promising approach to support higher-value care by promoting continuous learning and improvement in health systems. © 2017 Society of Hospital Medicine.

Public Investments in Training: Perspectives on Macro-Level Structural Issues and Micro-Level Delivery Systems. EQW Working Papers WP24.

ERIC Educational Resources Information Center

Cascio, Wayne F.

Training issues can be examined from at least two perspectives: the structural level (macro-level) and the micro-level. Structural issues in the delivery of training include the following: absent or uneven corporate commitment, inadequate expenditures by businesses, degrees awarded by schools that do not guarantee skill mastery, poaching of…

Efficacy of a Process Improvement Intervention on Delivery of HIV Services to Offenders: A Multisite Trial

PubMed Central

Shafer, Michael S.; Dembo, Richard; del Mar Vega-Debién, Graciela; Pankow, Jennifer; Duvall, Jamieson L.; Belenko, Steven; Frisman, Linda K.; Visher, Christy A.; Pich, Michele; Patterson, Yvonne

2014-01-01

Objectives. We tested a modified Network for the Improvement of Addiction Treatment (NIATx) process improvement model to implement improved HIV services (prevention, testing, and linkage to treatment) for offenders under correctional supervision. Methods. As part of the Criminal Justice Drug Abuse Treatment Studies, Phase 2, the HIV Services and Treatment Implementation in Corrections study conducted 14 cluster-randomized trials in 2011 to 2013 at 9 US sites, where one correctional facility received training in HIV services and coaching in a modified NIATx model and the other received only HIV training. The outcome measure was the odds of successful delivery of an HIV service. Results. The results were significant at the .05 level, and the point estimate for the odds ratio was 2.14. Although overall the results were heterogeneous, the experiments that focused on implementing HIV prevention interventions had a 95% confidence interval that exceeded the no-difference point. Conclusions. Our results demonstrate that a modified NIATx process improvement model can effectively implement improved rates of delivery of some types of HIV services in correctional environments. PMID:25322311

Does advanced operative obstetrics still have a place in contemporary practice?

PubMed

Tempest, Nicola; Navaratnam, Kate; Hapangama, Dharani Kosala

2015-04-01

This article reviews recent significant contributions to the literature concerning advanced operative obstetric procedures used for rotational vaginal deliveries and their alternative, primary caesarean section. Rising caesarean section rates are a global concern. Caesarean section in the second stage of labour is associated with high rates of maternal and fetal morbidity. Rotational vaginal deliveries may reduce the caesarean section rate without additional adverse effects on maternal and fetal outcomes. A recent national trainees' survey highlighted that training in the management of operative birth in the second stage of labour, especially when there is malposition of the fetal head, is a priority. There is a need for evidence-based guidelines, including standardized documentation of these advanced procedures. Training strategies for junior practitioners to acquire these skills and for experienced practitioners to maintain and disseminate their skills should be prioritized. The safety of rotational delivery methods versus primary caesarean section is likely to prove difficult to assess directly, in the context of a randomized controlled trial, but may be approximated via a national prospective audit.

Multidisciplinary training in perineal care during labor and delivery for the reduction of anal sphincter injuries.

PubMed

Frost, Jonathan; Gundry, Rowan; Young, Helen; Naguib, Adel

2016-08-01

To determine whether the introduction of a multidisciplinary intrapartum perineal-care training program reduced the rate of obstetric anal sphincter injuries in patients undergoing vaginal deliveries. A prospective observational cohort study enrolled women undergoing vaginal deliveries at a district general hospital maternity unit in the United Kingdom between April 1, 2012 and March 31, 2014. All women experiencing obstetric anal sphincter injuries during the study period were identified and the rate of obstetric anal sphincter injuries before (2012-2013) a multidisciplinary training program was implemented was compared with the rate after (2013-2014) implementation using logistic regression analysis. The study enrolled 4920 patients. Following the implementation of the training program, the rate of obstetric anal sphincter injuries decreased from 4.8% to 3.1% of vaginal deliveries (odds ratio 0.66; 95% confidence interval 0.493-0.899; P = 0.008). The integration of intrapartum perineal-care training into mandatory annual staff training was associated with a statistically and clinically significant reduction in the rate of obstetric anal sphincter injuries. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved.

PubMed

Inrig, Stephen J; Tiro, Jasmin A; Melhado, Trisha V; Argenbright, Keith E; Craddock Lee, Simon J

2014-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. To better understand how to implement a decentralized regional delivery "hub & spoke" model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow's RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow's RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting.

The development and implementation of a theory-informed, integrated mother-child intervention in rural Uganda.

PubMed

Singla, Daisy R; Kumbakumba, Elias

2015-12-01

A randomised cluster effectiveness trial of a parenting intervention in rural Uganda found benefits to child development among children 12-36 months, relevant parenting practices related to stimulation, hygiene and diet, and prevented the worsening of mothers' depressive symptoms. An examination of underlying implementation processes allows researchers and program developers to determine whether the program was implemented as intended and highlight barriers and facilitators that may influence replication and scale-up. The objectives of this study were to describe and critically examine (a) perceived barriers and facilitators related to implementation processes of intervention content, training and supervision and delivery from the perspectives of delivery agents and supervisors; (b) perceived barriers and facilitators related to enactment of practices from the perspective of intervention mothers participating in the parenting program; and c) whether the program was implemented as intended. Semi-structured interviews were conducted at midline with peer delivery agents (n = 12) and intervention mothers (n = 31) and at endline with supervisors (n = 4). Content analysis was used to analyze qualitative data in terms of barriers and facilitators of intervention content, training and supervision, delivery and enactment. Additionally, mothers' recall and enactment of practices were coded and analyzed statistically. Monitoring of group sessions and home visits were examined to reveal whether the program was implemented as intended. Among the program's five key messages, 'love and respect' targeting maternal psychological well-being was the most practiced by mothers, easiest to implement by delivery agents, and mothers reported the most internal facilitators for this message. A detailed manual and structured monitoring forms were perceived to facilitate training, intervention delivery, and supervision. Interactive and active strategies based on social-cognitive learning theory were reported as facilitators to intervention delivery. Only program attendance, but not barriers, facilitators or message recall, was significantly positively related to message enactment. Monitoring of group sessions and home visits showed that the program was largely implemented as intended. This implementation assessment revealed a number of important barriers and facilitators from the perspectives of delivery agents, supervisors and program participants. The methods and results are useful to examining and informing the content, delivery, and scaling up of the current program as well as future mother-child interventions in LMIC settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Combined Effects of Adaptive Control and Virtual Reality on Robot-Assisted Fine Hand Motion Rehabilitation in Chronic Stroke Patients: A Case Study.

PubMed

Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping; Todd, Catherine

2018-01-01

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive training that is needed to trigger neuroplasticity following a stroke. However, the lack of fully adaptive assist-as-needed control of the robotic devices and an inadequate immersive virtual environment that can promote active participation during training are obstacles hindering the achievement of better training results with fewer training sessions required. This study thus focuses on these research gaps by combining these 2 key components into a rehabilitation system, with special attention on the rehabilitation of fine hand motion skills. The effectiveness of the proposed system is tested by conducting clinical trials on a chronic stroke patient and verified through clinical evaluation methods by measuring the key kinematic features such as active range of motion (ROM), finger strength, and velocity. By comparing the pretraining and post-training results, the study demonstrates that the proposed method can further enhance the effectiveness of fine hand motion rehabilitation training by improving finger ROM, strength, and coordination. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Enhancing Icing Training for Pilots Through Web-Based Multimedia

NASA Technical Reports Server (NTRS)

Fletcher, William; Nolan, Gary; Adanich, Emery; Bond, Thomas H.

2006-01-01

The Aircraft Icing Project of the NASA Aviation Safety Program has developed a number of in-flight icing education and training aids designed to increase pilot awareness about the hazards associated with various icing conditions. The challenges and advantages of transitioning these icing training materials to a Web-based delivery are discussed. Innovative Web-based delivery devices increased course availability to pilots and dispatchers while increasing course flexibility and utility. These courses are customizable for both self-directed and instructor-led learning. Part of our goal was to create training materials with enough flexibility to enable Web-based delivery and downloadable portability while maintaining a rich visual multimedia-based learning experience. Studies suggest that using visually based multimedia techniques increases the effectiveness of icing training materials. This paper describes these concepts, gives examples, and discusses the transitional challenges.

What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes

PubMed Central

Finch, Caroline F; Doyle, Tim LA; Dempsey, Alasdair R; Elliott, Bruce C; Twomey, Dara M; White, Peta E; Diamantopoulou, Kathy; Young, Warren; Lloyd, David G

2014-01-01

Background Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future. PMID:24047571

“If Only Someone Had Told Me…”: Lessons From Rural Providers

PubMed Central

Chipp, Cody; Dewane, Sarah; Brems, Christiane; Johnson, Mark E.; Warner, Teddy D.; Roberts, Laura W.

2010-01-01

Purpose Health care providers face challenges in rural service delivery due to the unique circumstances of rural living. The intersection of rural living and health care challenges can create barriers to care that providers may not be trained to navigate, resulting in burnout and high turnover. Through the exploration of experienced rural providers’ knowledge and lessons learned, this study sought to inform future practitioners, educators, and policy makers in avenues through which to enhance training, recruiting, and maintaining a rural workforce across multiple health care domains. Methods Using a qualitative study design, 18 focus groups were conducted, with a total of 127 health care providers from Alaska and New Mexico. Transcribed responses from the question, “What are the 3 things you wish someone would have told you about delivering health care in rural areas?” were thematically coded. Findings Emergent themes coalesced into 3 overarching themes addressing practice-related factors surrounding the challenges, adaptations, and rewards of being a rural practitioner. Conclusion Based on the themes, a series of recommendations are offered to future rural practitioners related to community engagement, service delivery, and burnout prevention. The recommendations offered may help practitioners enter communities more respectfully and competently. They can also be used by training programs and communities to develop supportive programs for new practitioners, enabling them to retain their services and help practitioners integrate into the community. Moving toward an integrative paradigm of health care delivery wherein practitioners and communities collaborate in service delivery will be the key to enhancing rural health care and reducing disparities. PMID:21204979

Accelerating change: Fostering innovation in healthcare delivery at academic medical centers.

PubMed

Ostrovsky, Andrey; Barnett, Michael

2014-03-01

Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research. This paper proposes two initiatives to jumpstart disruptive innovation at AMCs: an institutional "innovation incubator" program and a clinician-innovator career track coupled with innovation training programs. Copyright © 2013 Elsevier Inc. All rights reserved.

Autoshaping with common and distinctive stimulus elements, compact and dispersed arrays.

PubMed

Sperling, S E; Perkins, M E

1979-05-01

Four groups of pigeons were trained with a standard autoshaping procedure in which a brief fixed-duration interval always followed by a grain delivery alternated with a longer variable-duration interval never associated with grain delivery. One of two stimuli was always presented during each interval. One of them contained three black dots and a black star on a green background; the other contained four black dots on a green background. The four elements of each stimulus were arranged in a more compact array for two groups and in a more dispersed array for the other two groups. Which of the two stimuli preceded grain delivery was counterbalanced within each pair of groups. The speed of occurrence of the first autoshaped peck was not affected by whether the stimulus containing the distinctive star element preceded grain delivery, but autoshaping was faster when the stimulus arrays were compact than when they were dispersed. During 560 response-independent training trials that followed the first autoshaped peck, this pattern reversed; both discriminative control over responding and the relative frequency of pecking the stimulus that preceded grain delivery were greater for the two groups where this stimulus contained the discriminative element than for the two groups where it contained only common elements. During subsequent testing with stimuli containing only a single element each, the distinctive feature was responded to proportionately more often by the two groups for which it had been an element of the stimulus preceding grain delivery than by the two groups for which it had been an element of the stimulus complex that never was associated with grain delivery. These data add further support to the hypothesis that the initial occurrence of autoshaped responding and its subsequent maintenance are not affected by the same variables. They also suggest that automaintenance is as sensitive as response-dependent training to the presence or absence of a distinctive stimulus element among several common elements and that this sensitivity appears to be independent of the specific method used for presenting the stimuli during automaintenance.

Autoshaping with common and distinctive stimulus elements, compact and dispersed arrays1

PubMed Central

Sperling, Sally E.; Perkins, Mark E.

1979-01-01

Four groups of pigeons were trained with a standard autoshaping procedure in which a brief fixed-duration interval always followed by a grain delivery alternated with a longer variable-duration interval never associated with grain delivery. One of two stimuli was always presented during each interval. One of them contained three black dots and a black star on a green background; the other contained four black dots on a green background. The four elements of each stimulus were arranged in a more compact array for two groups and in a more dispersed array for the other two groups. Which of the two stimuli preceded grain delivery was counterbalanced within each pair of groups. The speed of occurrence of the first autoshaped peck was not affected by whether the stimulus containing the distinctive star element preceded grain delivery, but autoshaping was faster when the stimulus arrays were compact than when they were dispersed. During 560 response-independent training trials that followed the first autoshaped peck, this pattern reversed; both discriminative control over responding and the relative frequency of pecking the stimulus that preceded grain delivery were greater for the two groups where this stimulus contained the discriminative element than for the two groups where it contained only common elements. During subsequent testing with stimuli containing only a single element each, the distinctive feature was responded to proportionately more often by the two groups for which it had been an element of the stimulus preceding grain delivery than by the two groups for which it had been an element of the stimulus complex that never was associated with grain delivery. These data add further support to the hypothesis that the initial occurrence of autoshaped responding and its subsequent maintenance are not affected by the same variables. They also suggest that automaintenance is as sensitive as response-dependent training to the presence or absence of a distinctive stimulus element among several common elements and that this sensitivity appears to be independent of the specific method used for presenting the stimuli during automaintenance. PMID:16812139

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: a qualitative interview study.

PubMed

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-03-01

Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

Activating Lay Health Influencers to Promote Tobacco Cessation

PubMed Central

Muramoto, Myra L.; Hall, John R.; Nichter, Mark; Nichter, Mimi; Aickin, Mikel; Connolly, Tim; Matthews, Eva; Campbell, Jean Z.; Lando, Harry A.

2014-01-01

Objective Evaluate the effect of tobacco cessation brief-intervention (BI) training for lay “health influencers,” on knowledge, self-efficacy and the proportion of participants reporting BI delivery post-training. Methods Randomized, community-based study comparing In-person or Web-based training, with mailed materials. Results In-person and Web-training groups had significant post-training cessation knowledge and self-efficacy gains. All groups increased the proportion of individuals reporting BIs at follow-up, with no significant between-group differences. Irrespective of participants’ prior intervention experience, 80–86% reported BIs within the past 90 days; 71–79% reported ≥1 in the past 30. Conclusions Web and In-person training significantly increase health influencer cessation knowledge and self-efficacy. With minimal prompting and materials, even persons without BI experience can be activated to encourage tobacco cessation. PMID:24636035

What works in delivering dementia education or training to hospital staff? A critical synthesis of the evidence.

PubMed

Surr, Claire A; Gates, Cara

2017-10-01

The quality of care delivered to people with dementia in hospital settings is of international concern. People with dementia occupy up to one quarter of acute hospital beds, however, staff working in hospitals report lack of knowledge and skills in caring for this group. There is limited evidence about the most effective approaches to training hospital staff on dementia. The purpose of this literature review was to examine published evidence on the most effective approaches to dementia training and education for hospital staff. The review was conducted using critical synthesis and included qualitative, quantitative and mixed/multi- methods studies. Kirkpatrick's four level model for the evaluation of training interventions was adopted to structure the review. The following databases were searched: MEDLINE, PsycINFO, CINAHL, AMED, British Education Index, Education Abstracts, ERIC (EbscoHost), The Cochrane Library-Cochrane reviews, Economic evaluations, CENTRAL (Wiley), HMIC (Ovid), ASSIA, IBSS (Proquest), Conference Proceedings Citation Indexes (Web of Science), using a combination of keyword for the following themes: Dementia/Alzheimer's, training/education, staff knowledge and patient outcomes. A total of 20 papers were included in the review, the majority of which were low or medium quality, impacting on generalisability. The 16 different training programmes evaluated in the studies varied in terms of duration and mode of delivery, although most employed face-to-face didactic techniques. Studies predominantly reported on reactions to training and knowledge, only one study evaluated outcomes across all of the levels of the Kirkpatrick model. Key features of training that appeared to be more acceptable and effective were identified related to training content, delivery methods, practicalities, duration and support for implementation. The review methodology enabled inclusion of a broad range of studies and permitted common features of successful programmes to be identified. Such features may be used in the design of future dementia training programmes, to increase their potential for effectiveness. Further research on the features of effective dementia training for hospital staff is required. Copyright © 2017 Elsevier Ltd. All rights reserved.

A qualitative study of the perspectives of key stakeholders on the delivery of clinical academic training in the East Midlands

PubMed Central

Evans, Val; MacLeod, Sheona

2018-01-01

Objective Major changes in the design and delivery of clinical academic training in the United Kingdom have occurred yet there has been little exploration of the perceptions of integrated clinic academic trainees or educators. We obtained the views of a range of key stakeholders involved in clinical academic training in the East Midlands. Design A qualitative study with inductive iterative thematic content analysis of findings from trainee surveys and facilitated focus groups. Setting The East Midlands School of Clinical Academic Training. Participants Integrated Clinical Academic Trainees, clinical and academic educators involved in clinical academic training. Main outcome measures The experience, opinions and beliefs of key stakeholders about barriers and enablers in the delivery of clinical academic training. Results We identified key themes many shared by both trainees and educators. These highlighted issues in the systems and process of the integrated academic pathways, career pathways, supervision and support, the assessment process and the balance between clinical and academic training. Conclusions Our findings help inform the future development of integrated academic training programmes. PMID:29487745

Challenges of training and delivery of pediatric surgical services in Africa.

PubMed

Chirdan, Lohfa B; Ameh, Emmanuel A; Abantanga, Francis A; Sidler, Daniel; Elhalaby, Essam A

2010-03-01

The practice of pediatric surgery in Africa presents multiple challenges. This report presents an overview of problems encountered in the training of pediatric surgeons as well as the delivery of pediatric surgical services in Africa. A returned structured self-administered questionnaire sent to pediatric surgeons practicing in Africa was reviewed and analyzed using SPSS version 11.5 (SPSS, Chicago, IL). Forty-nine (57%) of 86 questionnaires were returned from 8 countries. Great variability in the requirements and training of pediatric surgeons, even within the same country, was found. Many surgical colleges are responsible for standardization and board certification of pediatric surgeons across Africa. There were 6 (12%) centers that train middle level manpower. Twenty-six (53%) participants have 1 to 2 trainees, whereas 22 (45%) have irregular or no trainee. A pediatric surgical trainee needs 2 to 4 (median, 2) years of training in general surgery to be accepted for training in pediatric surgery, and it takes a trainee between 2 to 4 (median, 3) years to complete training as a pediatric surgeon in the countries surveyed. The number of pediatric surgeons per million populations is lowest in Malawi (0.06) and highest in Egypt (1.5). Problems facing adequate delivery of pediatric surgical services enumerated by participants included poor facilities, lack of support laboratory facilities, shortage of manpower, late presentation, and poverty. The training of pediatric surgical manpower in some African countries revealed great variability in training with multiple challenges. Delivery of pediatric surgical services in Africa presents problems like severe manpower shortage, high pediatric surgeon workload, and poor facilities. Standardization of pediatric surgery training across the continent is advocated, and the problems of delivery of pediatric surgical services need to be addressed urgently, not only by health care planners in Africa but by the international community and donor agencies, if the African child is to have access to essential pediatric surgical services like his or her counterpart in other developed parts of the world.

Development and evaluation of an educational training package to promote health and wellbeing.

PubMed

Gartshore, Emily; Briggs, Lydia; Blake, Holly

2017-11-23

supporting the health and wellbeing of healthcare employees is a national priority in the UK. to design, deliver and evaluate an educational package to promote health and wellbeing for nurses and midwives. an online training package was developed and administered in two ways: online (HAWN-online) or in a face-to-face workshop (HAWN-contact). A mixed methods evaluation was used to assess usability and acceptability of HAWN training. 316 nurses, midwives and students completed the online training package and 16 participants attended the workshop. HAWN-online significantly increased knowledge in core areas of workplace health and wellbeing. Nurses and midwives valued online and face-to-face delivery but found there were barriers to attendance at workshops. Participants advocated that training in workplace health should be mandatory for all frontline staff. employers should take steps to promote staff wellbeing through HAWN training, and address barriers to accessing workplace health training or supportive services.

Delivery of Brief Interventions for Heavy Drinking in Primary Care: Outcomes of the ODHIN 5-Country Cluster Randomized Trial

PubMed Central

Anderson, Peter; Coulton, Simon; Kaner, Eileen; Bendtsen, Preben; Kłoda, Karolina; Reynolds, Jillian; Segura, Lidia; Wojnar, Marcin; Mierzecki, Artur; Deluca, Paolo; Newbury-Birch, Dorothy; Parkinson, Kathryn; Okulicz-Kozaryn, Katarzyna; Drummond, Colin; Gual, Antoni

2017-01-01

PURPOSE We aimed to test whether 3 strategies—training and support, financial reimbursement, and an option to direct screen-positive patients to an Internet-based method of giving brief advice—have a longer-term effect on primary care clinicians’ delivery of screening and advice to heavy drinkers operationalized with the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) tool. METHODS We undertook a cluster randomized factorial trial with a 12-week implementation period in 120 primary health care units throughout Catalonia, England, Netherlands, Poland, and Sweden. Units were randomized to 8 groups: care as usual (control); training and support alone; financial reimbursement alone; electronic brief advice alone; paired combinations of these conditions; and all 3 combined. The primary outcome was the proportion of consulting adult patients (aged 18 years and older) receiving intervention—screening and, if screen-positive, advice—at 9 months. RESULTS Based on the factorial design, the ratio of the log of the proportion of patients given intervention at the 9-month follow-up was 1.39 (95% CI, 1.03–1.88) in units that received training and support as compared with units that did not. Neither financial reimbursement nor directing screen-positive patients to electronic brief advice led to a higher proportion of patients receiving intervention. CONCLUSIONS Training and support of primary health care units has a lasting, albeit small, impact on the proportion of adult patients given an alcohol intervention at 9 months. PMID:28694269

The impact of training and delivering alcohol brief intervention on the knowledge and attitudes of community pharmacists: a before and after study.

PubMed

Dhital, Ranjita; Whittlesea, Cate M; Milligan, Peter; Khan, Natasha S; Norman, Ian J

2013-03-01

Alcohol misuse is the third leading cause of ill health in the UK. Alcohol brief intervention can identify risky drinkers and motivate individuals to take action. Community pharmacists have been identified as having a role in providing brief interventions. This study aimed to evaluate: pharmacists' attitudes towards hazardous/harmful drinkers and knowledge before training and after delivering brief intervention; and their experience of training. Pharmacists' attitudes to alcohol problems were assessed using Short Alcohol and Alcohol Problems Perception Questions before training and after brief intervention delivery. Alcohol misuse knowledge was assessed by questionnaire prior to and immediately after training, and after the delivery period. Following brief intervention delivery, pharmacists' experience of training was obtained using a questionnaire and focus groups. Qualitative thematic analysis identified experiences of brief intervention training. Quantitative data were analysed using spss. One hundred and thirty-nine alcohol interventions were delivered by 19 pharmacists over five months (recruiters). Ten pharmacists completed no interventions (non-recruiters). Both groups improved their alcohol knowledge between baseline and immediately following training; and their knowledge decreased between the end of training and following service delivery. Pharmacists who were initially more motivated recruited more participants and increased their work satisfaction. This confirmed findings of previous studies that pharmacists unfamiliar with brief intervention could be trained to deliver this service. Pharmacists with positive attitude towards drinkers delivered a greater number of alcohol interventions and experienced increased work satisfaction than those pharmacists with less positive attitudes. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Managers’ Perceptions of the Value and Impact of HAZWOPER Worker Health and Safety Training

PubMed Central

Riley, Kevin; Slatin, Craig; Rice, Carol; Rosen, Mitchel; Weidner, B. Louise; Fleishman, Jane; Alerding, Linda; Delp, Linda

2018-01-01

Background Worker training is a core component of the OSHA Hazardous Waste Operations and Emergency Response (HAZWOPER) standard, but few studies have considered what motivates managers to provide HAZWOPER training to employees or what they value in that training. Methods In 2012, four university-based programs conducted an exploratory survey of managers who sent employees to HAZWOPER courses. Results from 109 respondents were analyzed. Results Forty-two percent of respondents cited regulations as the most important reason to provide HAZWOPER training; many indicated they would provide less training if there were no standard in place. Three-quarters (74%) reported training had improved workplace conditions. Fewer than half said they were likely to involve trained employees in aspects of the organization’s H&S program. Discussion Compliance with regulatory requirements is an important factor shaping managers’ training delivery decisions. Managers recognize positive impacts of training. These impacts could be enhanced by further leveraging employee H&S knowledge and skills. PMID:26010141

Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia.

PubMed

Titaley, Christiana R; Hunter, Cynthia L; Dibley, Michael J; Heywood, Peter

2010-08-11

Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java areas. Health education strategies are required to increase community awareness about the importance of health services along with the existing financing mechanisms for the poor communities. Public health strategies involving traditional birth attendants will be beneficial particularly in remote areas where their services are highly utilized.

Outsourcing Physical Education in Primary Schools: Evaluating the Impact of Externally Provided Programmes on Generalist Teachers

ERIC Educational Resources Information Center

Whipp, Peter R.; Hutton, Heidi; Grove, J. Robert; Jackson, Ben

2011-01-01

In place of generalist delivery, externally provided physical activity programmes (EPPAPs) are potentially an effective method for offering primary school students specialist physical education (PE) instruction, as well as providing training for generalist classroom teachers. In the present study, a group of generalist teachers were interviewed…

20 CFR 639.8 - How is the notice served?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false How is the notice served? 639.8 Section 639.8 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR WORKER ADJUSTMENT AND RETRAINING NOTIFICATION § 639.8 How is the notice served? Any reasonable method of delivery to the parties...

Got Tools? The Blended Learning Analysis and Design Expediter

ERIC Educational Resources Information Center

Elsenheimer, Jim

2006-01-01

Blended learning is an approach to instructional design that seeks to maximize learning potential by applying the most effective form of instruction for a given program element. The term "blended learning" should not refer to just the mixing of training delivery methods (as it is often defined) but to the orchestrated application and integration…

Work-Based Learning: Valuing Practice as an Educational Event

ERIC Educational Resources Information Center

Raelin, Joseph A.

2010-01-01

The dominant method of providing formal knowledge to students in education in North America is through classroom training. The focus of this effort is on the delivery of a broad range of conceptual knowledge and skills in various liberal and professional fields of endeavor. Besides classroom instruction, the other predominant mode is through…

Online Training Impact on Adjunct Faculty Compliance and Satisfaction with Professional Development

ERIC Educational Resources Information Center

Pete, Elizabeth

2016-01-01

The problem addressed by this project study was low levels of adjunct faculty compliance and satisfaction with the professional development program at a local college. The purpose of the study was to determine if an alternative delivery method would yield higher levels of compliance and satisfaction than would a traditional professional…

On-Line Pesticide Training with Narrated Powerpoint Presentations

ERIC Educational Resources Information Center

Johnson, Steven B.

2015-01-01

UMaine Cooperative Extension is the primary educational delivery organization for pesticide recertification credits in Maine. Shrinking budgets and staff numbers are making traditional face-to-face delivery increasingly difficult to maintain. To address this issue, on-line pesticide applicator recertification training credits were developed. The…

Surgical education and adult learning: Integrating theory into practice.

PubMed

Rashid, Prem

2017-01-01

Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: 'surgical education theory' and 'adult learning theory medical'. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable.

Surgical education and adult learning: Integrating theory into practice

PubMed Central

Rashid, Prem

2017-01-01

Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: ‘surgical education theory’ and ‘adult learning theory medical’. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable. PMID:28357046

Activity confrontation methods: A reflexive and metacognitive approach for interprofessional collaboration training.

PubMed

Aiguier, Gregory; Oboeuf, Alexandre; Cobbaut, Jean-Philippe; Vanpee, Dominique

2015-01-01

Integration of interprofessional collaboration into healthcare education and training programmes has become a fundamental issue. Its objective is to learn how to collectively build collaborative care practice that addresses the uniqueness of each context and the specific situation of the patient. It is also about understanding the process of collectively building collaborative care practice in order to be able to apply it in different contexts. This article describes a study that aimed to examine the value of relying on activity confrontation methods to develop training. These methods consist of filming practitioners during an activity and encouraging them to analyse it. It was found that these methods encourage reflexive analysis of the motives for pursuing interprofessional action (identifying constitutive factors) but also a metacognitive approach on the conditions of learning (p < 0.01). In addition to the educational dimensions (methods and leadership positions) and organisational dimensions (frameworks), it was found that the patient's role is essential in developing interprofessional care practice and training (p < 0.01). Given the nature of these findings, this article goes on to suggest that the patient must be considered a "partner" in development and delivery of interprofessional learning and care.

A Survey of Hospice Volunteer Coordinators: Training Methods and Objectives of Current Hospice Volunteer Training Programs.

PubMed

Brock, Cara M; Herndon, Christopher M

2017-06-01

Currently more than 5800 hospice organizations operate in the United States. 1 Hospice organizations are required by the Centers for Medicare and Medicaid Services (CMS) to use volunteers for services provided to patients. 2 Although CMS regulates the amount of hours hospice volunteers should provide, there are currently no national requirements for objectives of training. 3 The purpose of this study was to gather information from a sample of hospices regarding volunteer coordinator background, current training for volunteers, importance of training objectives, and any comments regarding additional objectives. Representative state hospice organizations were contacted by e-mail requesting their participation and distribution of the survey throughout their member hospices. The survey asked demographical questions, along with ratings of training components based on perceived level of importance and time spent on each objective. A total of 90 surveys were received, and the response rate was undeterminable. Results showed the majority of hospices were nonprofit, had less than 100 currently trained volunteers, and maintained an average daily patient census of less than 50. Questions regarding training programs indicated that most use live lecture methods of approximately 19 hours or less in duration. Overall, responding hospice organizations agreed that all objectives surveyed were important in training volunteers. The small number of respondents to this survey makes generalization nationwide difficult, however it is a strong starting point for the development of further surveys on hospice volunteer training and achieving a standardized set of training objectives and delivery methods.

The Current Status and Factors Associated With Implanon Service Provision by the Health Extension Workers at the Health Post Level, Wolaita Zone, Southern Ethiopia: A Cross-Sectional Study

PubMed Central

Desalegn, Ketsela; Loha, Eskindir; Meskele, Mengistu

2017-01-01

Objective: Family Planning is often taken as one of the “Magic Bullet” interventions owing to its high impact and wide reaching nature in achieving multiple goals. This study aimed to assess the current status and the factors associated with health post level Implanon service provision through trained health extension workers in Wolaita zone, southern Ethiopia. Materials and methods: A cross sectional study was conducted among trained health extension workers in Wolaita zone in February 2013. A simple random sampling technique was used to identify a total of 285 trained HEWs. First bivariate, then multivariate logistic regression model along with 95% confidence interval was used to see the independent effect of factors associated with current Implanon service provision by the health extension workers. Results: Currently, the number of Implaon providing trained health extension workers in Wolaita was 264(45.8%). Distance of health post from district health offices and health center, turnover of trained health extension workers in the health post, interest of trained health extension workers in providing Implanon and their job satisfaction to serve as a health extension workers and availability of service delivery guidelines and teaching aids were associated with the current provision of Implanon by health extension workers. Conclusion: Implanon provision among trained health extension workers was affected by different factors. Hence, improving the working conditions of trained health extension workers, regular and periodic facilitative supervision, availing service delivery guidelines and improvement of health management information system are recommended. PMID:29114263

Computer and Internet Interventions to Optimize Listening and Learning for People With Hearing Loss: Accessibility, Use, and Adherence.

PubMed

Ferguson, Melanie; Henshaw, Helen

2015-09-01

The aim of this research forum article was to examine accessibility, use, and adherence to computerized and online interventions for people with hearing loss. Four intervention studies of people with hearing loss were examined: 2 auditory training studies, 1 working memory training study, and 1 study of multimedia educational support. A small proportion (approximately 15%) of participants had never used a computer, which may be a barrier to the accessibility of computer and Internet-based interventions. Computer competence was not a factor in intervention use or adherence. Computer skills and Internet access influenced participant preference for the delivery method of the multimedia educational support program. It is important to be aware of current barriers to computer and Internet-delivered interventions for people with hearing loss. However, there is a clear need to develop and future-proof hearing-related applications for online delivery.

Evaluation of a training programme to induct medical students in delivering public health talks

PubMed Central

Tan, Ngiap Chuan; Mitesh, Shah; Koh, Yi Ling Eileen; Ang, Seng Bin; Chan, Hian Hui Vincent; How, Choon How; Tay, Ee Guan; Hwang, Siew Wai

2017-01-01

INTRODUCTION It is uncommon for medical students to deliver public health talks as part of their medical education curriculum. This study evaluated the effectiveness of a novel training programme that required medical students to deliver public health talks during their family medicine (FM) clerkship in a Singapore primary care institution. METHODS The FM faculty staff guided teams of third-year medical students to select appropriate topics for health talks that were to be conducted at designated polyclinics. The talks were video-recorded and appraised for clarity, content and delivery. The appraisal was done by the student’s peers and assigned faculty staff. The audience was surveyed to determine their satisfaction level and understanding of the talks. The students also self-rated the effectiveness of this new teaching activity. RESULTS A total of 120 medical students completed a questionnaire to rate the effectiveness of the new teaching activity. 85.8% of the students felt confident about the delivery of their talks, 95.8% reported having learnt how to deliver talks and 92.5% perceived this new training modality as useful in their medical education. Based on the results of the audience survey, the speakers were perceived as knowledgeable (53.1%), confident (51.3%) and professional (39.0%). Assessment of 15 video-recorded talks showed satisfactory delivery of the talks by the students. CONCLUSION The majority of the students reported a favourable overall learning experience under this new training programme. This finding is supported by the positive feedback garnered from the audience, peers of the medical students and the faculty staff. PMID:26891745

Healthcare for Persons with Intellectual and Developmental Disability in the Community

PubMed Central

Ervin, David A.; Hennen, Brian; Merrick, Joav; Morad, Mohammed

2014-01-01

Introduction: While there has been impressive progress in creating and improving community healthcare delivery systems that support people with intellectual and developmental disabilities (IDD), there is much more that can and should be done. Methods: This paper offers a review of healthcare delivery concepts on which new models are being developed, while also establishing an historical context. We review the need for creating fully integrated models of healthcare, and at the same time offer practical considerations that range from specific healthcare delivery system components to the need to expand our approach to training healthcare providers. The models and delivery systems, and the areas of needed focus in their development are reviewed to set a starting point for more and greater work going forward. Conclusion: Today, we celebrate longer life spans of people with IDD, increased attention to the benefits of healthcare that is responsive to their needs, and the development of important healthcare delivery systems that are customized to their needs. We also know that the growing body of research on health status offers incentive to continue developing healthcare structures for people with IDD by training healthcare providers about the needs of people with IDD, by establishing systems of care that integrate acute healthcare with long-term services and support, by developing IDD medicine as a specialty, and by building health promotion and wellness resources to provide people with IDD a set of preventative health supports. PMID:25077139

Integration of E-Learning and Knowledge Management.

ERIC Educational Resources Information Center

Woelk, Darrell; Agarwal, Shailesh

E-Learning technology today is used primarily to handcraft training courses about carefully selected topics for delivery to employees registered for those courses. This paper investigates the integration of e-learning and knowledge management technology to improve the capture, organization and delivery of both traditional training courses and…

Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity.

PubMed

Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne

2008-01-18

Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as selecting programs with features that minimize complexity while maximizing flexibility. Time constraints in the classroom should be considered when choosing a program. Student behavior also influences program delivery, so schools should train teachers in the use of classroom management skills. This project involved comprehensive program monitoring and technical assistance that likely facilitated the identification and resolution of problems and contributed to the overall high quality of implementation. Schools should recognize the importance of training and technical assistance to ensure quality program delivery.

Provider training to screen and initiate evidence-based pediatric obesity treatment in routine practice settings: A randomized pilot trial

PubMed Central

Kolko, Rachel P.; Kass, Andrea E.; Hayes, Jacqueline F.; Levine, Michele D.; Garbutt, Jane M.; Proctor, Enola K.; Wilfley, Denise E.

2016-01-01

Introduction This randomized pilot trial evaluated two training modalities for first-line, evidence-based pediatric obesity services (screening and goal-setting) among nursing students. Method Participants (N=63) were randomized to Live Interactive Training (Live) or Web-facilitated Self-study Training (Web). Pre-training, post-training, and one-month follow-up assessments evaluated training feasibility, acceptability, and impact (knowledge, and skill via simulation). Moderator (previous experience) and predictor (content engagement) analyses were conducted. Results Nearly-all (98%) participants completed assessments. Both trainings were acceptable, with higher ratings for Live and participants with previous experience (p’s<.05). Knowledge and skill improved from pre-training to post-training and follow-up in both conditions (p’s<.001). Live demonstrated greater content engagement (p’s<.01). Conclusions The training package was feasible, acceptable, and efficacious among nursing students. Given that Live had higher acceptability and engagement, and online training offers greater scalability, integrating interactive Live components within Web-based training may optimize outcomes, which may enhance practitioners’ delivery of pediatric obesity services. PMID:26873293

Regional Cooperation To Meet Global Competition.

ERIC Educational Resources Information Center

Price, Thomas

In response to the recognition that significant changes were required in service delivery approaches to meet the changing needs for workforce training, Illinois' Joliet Junior College (JJC) implemented a series of innovative training programs. The guiding philosophy behind the programs was that service delivery must correspond to shifts in focus…

Training Parents to Teach; Four Models. First Chance for Children, Vol. 3.

ERIC Educational Resources Information Center

Grim, Janet, Ed.

Described in a monograph published by the Technical Assistance Delivery System (TADS) are the rationale, intake and screening procedures, service delivery, liaison and follow through, and evaluation of parent training models from four preschool demonstration centers for handicapped children. An overview discusses the purposes and dimensions of…

The effect of a multidisciplinary obstetric emergency team training program, the In Time course, on diagnosis to delivery interval following umbilical cord prolapse - A retrospective cohort study.

PubMed

Copson, Sean; Calvert, Katrina; Raman, Puvaneswary; Nathan, Elizabeth; Epee, Mathias

2017-06-01

Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval. We also aimed to investigate if an improvement in perinatal outcomes could be demonstrated. A retrospective cohort study was performed. All cases of cord prolapse in the designated time period were identified and reviewed and a comparison of outcome measures pre- and post-training was undertaken. Thirty-one cases were identified in the pre-training period, and compared to 64 cases post-training. Documentation improved significantly post-training. There were non-significant improvements in use of spinal anaesthetic, and in the length of stay in the special care neonatal unit. There was a significant increase in the number of babies with Apgar scores less than seven at 5 min. There were no differences in the diagnosis to delivery interval, or in perinatal mortality rates. Obstetric emergency training was associated with improved teamwork, as evidenced by the improved documentation post-training in this study, but not with improved diagnosis to delivery interval. Long-term follow-up studies are required to ascertain whether training has an impact on longer-term paediatric outcomes, such as cerebral palsy rates. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

A roadmap for acute care training of frontline Healthcare workers in LMICs.

PubMed

Shah, Nirupa; Bhagwanjee, Satish; Diaz, Janet; Gopalan, P D; Appiah, John Adabie

2017-10-01

This 10-step roadmap outlines explicit procedures for developing, implementing and evaluating short focused training programs for acute care in low and middle income countries (LMICs). A roadmap is necessary to develop resilient training programs that achieve equivalent outcomes despite regional variability in human capacity and infrastructure. Programs based on the roadmap should address shortfalls in human capacity and access to care in the short term and establish the ground work for health systems strengthening in the long term. The primary targets for acute care training are frontline healthcare workers at the clinic level. The programs will differ from others currently available with respect to the timelines, triage method, therapeutic interventions and potential for secondary prevention. The roadmap encompasses multiple iterative cycles of the Plan-Do-Study-Act framework. Core features are integration of frontline trainees with the referral system while promoting research, quality improvement and evaluation from the bottom-up. Training programs must be evidence based, developed along action timelines and use adaptive training methods. A systems approach is essential because training programs that take cognizance of all factors that influence health care delivery have the potential to produce health systems strengthening (HSS). Copyright © 2017 Elsevier Inc. All rights reserved.

[Effects of an Individual Breast-feeding Promotion Program for Married Immigrant Women].

PubMed

Park, Mi Kyoung; Moon, So Hyun

2016-02-01

This study was designed to evaluate the effects of an individual breast-feeding promotion program to address breast-feeding knowledge, attitude, method and rate of practice for married immigrant women. A non-equivalent control group quasi-experimental design was used (experimental group=16, control group=17). The intervention consisted of 3 phases: (1) Within 2 hours of delivery - individual breast-feeding training through video/verbal/practical training education and demonstration (2) After 1~2 days - group training using video, model doll, and breast models (3) After 7 days - family visit, counseling, retraining and reinforcement training. The data were analyzed using non-parametric tests with the SPSS program. Married immigrant women who participated in the individual breast-feeding program scored high in knowledge, attitude, method and rate of practice compared to the control group. The results indicate that the individual breast-feeding program is very effective in increasing breast-feeding knowledge, attitude, method and rate of practicing breast feeding for married immigrant women. So, nurses are encouraged to aggressively utilize individual breast-feeding programs to help married immigrant women, who are exposed to vulnerability due to various situations.

Home birth attendants in low income countries: who are they and what do they do?

PubMed Central

2012-01-01

Background Nearly half the world’s babies are born at home. We sought to evaluate the training, knowledge, skills, and access to medical equipment and testing for home birth attendants across 7 international sites. Methods Face-to-face interviews were done by trained interviewers to assess level of training, knowledge and practices regarding care during the antenatal, intrapartum and postpartum periods. The survey was administered to a sample of birth attendants conducting home or out-of-facility deliveries in 7 sites in 6 countries (India, Pakistan, Guatemala, Democratic Republic of the Congo, Kenya and Zambia). Results A total of 1226 home birth attendants were surveyed. Less than half the birth attendants were literate. Eighty percent had one month or less of formal training. Most home birth attendants did not have basic equipment (e.g., blood pressure apparatus, stethoscope, infant bag and mask manual resuscitator). Reporting of births and maternal and neonatal deaths to government agencies was low. Indian auxilliary nurse midwives, who perform some home but mainly clinic births, were far better trained and differed in many characteristics from the birth attendants who only performed deliveries at home. Conclusions Home birth attendants in low-income countries were often illiterate, could not read numbers and had little formal training. Most had few of the skills or access to tests, medications and equipment that are necessary to reduce maternal, fetal or neonatal mortality. PMID:22583622

Delivery practices of traditional birth attendants in Dhaka slums, Bangladesh.

PubMed

Fronczak, N; Arifeen, S E; Moran, A C; Caulfield, L E; Baqui, A H

2007-12-01

This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993-May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related complications, and postpartum morbidity were collected through interviews with 1,506 women, 489 home-based birth attendants, and audits in 20 facilities where the women from this study gave birth. Associations among maternal characteristics, birth practices, delivery-location, and early postpartum morbidity were specifically explored. Self-reported postpartum morbidity was associated with maternal characteristics, delivery-related complications, and some birthing practices. Dais with more experience were more likely to use potentially-harmful birthing practices which increased the risk of postpartum morbidity among women with births at home. Postpartum morbidity did not differ by birth-location. Safe motherhood programmes must develop effective strategies to discourage potentially-harmful home-based delivery practices demonstrated to contribute to morbidity.

Cost-effectiveness of peer role play and standardized patients in undergraduate communication training.

PubMed

Bosse, Hans Martin; Nickel, Martin; Huwendiek, Sören; Schultz, Jobst Hendrik; Nikendei, Christoph

2015-10-24

The few studies directly comparing the methodological approach of peer role play (RP) and standardized patients (SP) for the delivery of communication skills all suggest that both methods are effective. In this study we calculated the costs of both methods (given comparable outcomes) and are the first to generate a differential cost-effectiveness analysis of both methods. Medical students in their prefinal year were randomly assigned to one of two groups receiving communication training in Pediatrics either with RP (N = 34) or 19 individually trained SP (N = 35). In an OSCE with standardized patients using the Calgary-Cambridge Referenced Observation Guide both groups achieved comparable high scores (results published). In this study, corresponding costs were assessed as man-hours resulting from hours of work of SP and tutors. A cost-effectiveness analysis was performed. Cost-effectiveness analysis revealed a major advantage for RP as compared to SP (112 vs. 172 man hours; cost effectiveness ratio .74 vs. .45) at comparable performance levels after training with both methods. While both peer role play and training with standardized patients have their value in medical curricula, RP has a major advantage in terms of cost-effectiveness. This could be taken into account in future decisions.

Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh

PubMed Central

Saha, Kuntal Kumar; Chowdhury, Ashfaqul Haq; Garnett, Sarah P.; Arifeen, Shams El; Menon, Purnima

2017-01-01

Background In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS) by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC) and management of sick children younger than five years. Methods Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children. Results Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19%) healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average. Conclusions Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should be considered to identify alternative and appropriate service delivery platforms before nationwide scale up. PMID:28542530

Advanced methods for teaching electronic-nose technologies to diagnosticians and clinical laboratory technicians

Treesearch

Alphus D. Wilson

2012-01-01

Electronic-detection technologies and instruments increasingly are being utilized in the biomedical field to perform a wide variety of clinical operations and laboratory analyses to facilitate the delivery of health care to patients. The introduction of improved electronic instruments for diagnosing diseases and for administering treatments has required new training of...

A Mexico City-Based Immersion Education Program: Training Mental Health Clinicians for Practice with Latino Communities

ERIC Educational Resources Information Center

Platt, Jason James

2012-01-01

This article describes the philosophical foundations and educational methods of a Spanish language and cultural immersion program based in Mexico City, Mexico. The program is designed to assist U.S. graduate students in marriage and family therapy and clinical psychology programs to improve clinical service delivery with Latino clients. Utilizing…

Peer Programs: An In-Depth Look at Peer Helping: Planning, Implementation, and Administration.

ERIC Educational Resources Information Center

Tindall, Judith A.

The goal of this book is to provide a program designed to teach peer helping professionals a method and rationale for training peer helpers. Peer helping programs are a major delivery system of affective education or deliberate psychological education. Peer helping programs can provide prevention, intervention, and support systems for people.…

Getting the Most from Your Interactive Whiteboard Investment: Three Guiding Principles for Designing Effective Professional Development

ERIC Educational Resources Information Center

DeSantis, Josh

2012-01-01

The adoption of interactive whiteboards (IWB) in many schools outpaced the delivery of adequate professional development on their use. Many teachers receive IWBs without adequate training on methods to use the technology to improve their instruction. Consequently, IWBs remain an underutilized resource in many classrooms. Teachers who are given…

Linking Assessment and Instruction Using Ontologies. CSE Technical Report 693

ERIC Educational Resources Information Center

Chung, Gregory K. W. K.; Delacruz, Girlie C.; Dionne, Gary B.; Bewley, William L.

2006-01-01

In this study we report on a test of a method that uses ontologies to individualize instruction by directly linking assessment results to the delivery of relevant content. Our sample was 2nd Lieutenants undergoing entry-level training on rifle marksmanship. Ontologies are explicit expressions of the concepts in a domain, the links among the…

The effect of water immersion delivery on the strength of pelvic floor muscle and pelvic floor disorders during postpartum period

PubMed Central

Zhao, Yun; Xiao, Mei; Tang, Fei; Tang, Wan; Yin, Heng; Sun, Guo-Qiang; Lin, Yin; Zhou, Yong; Luo, Yan; Li, Lu-Man; Tan, Zhi-Hua

2017-01-01

Abstract Background: Water immersion delivery is a non-pharmacological approach to ease labor pain. This paper aims to investigate the effect of water immersion delivery on increasing strength of pelvic floor muscle (PFM) and relieving pelvic floor disorders (PFDs) during postpartum period. Methods: A total of 2749 vaginal-delivery primiparas in postpartum 6-8 weeks were selected as research objects. Based on the modes of delivery, 600 patients were assigned into water immersion delivery group, 2149 were assigned into conventional delivery group. The scales of PFM strength and pelvic organ prolapsed (POP) were determined by specially trained personnel using digital palpation, and the symptoms of stress urinary incontinence (SUI) were investigated by questionnaire survey. The weak PFM strength was improved by doing Kegel exercise at home for 6-8 weeks. Results: We found that ①The rate of episiotomy in water immersion delivery group was 77.50% (465/600), which was lower than that in conventional delivery group (84.69%, 1820/2149) (P < .01); The primiparas without having an episiotomy have higher PFM strength than those having an episiotomy for both groups (P < .01). ②There was a negative correlation between the scale of PFM strength and SUI or POP, wherein the r-values were −0.135 and −0.435, respectively (P < .01). ③The rate of SUI was 6.50% (39/600) in water immersion delivery group and 6.89% (148/2149) in the conventional delivery group, wherein the intergroup difference was not significant (P > .05); ④The rates of vaginal wall prolapsed and uterus prolapsed were 29.83% (179/600) and 2.83% (17/600) in water immersion delivery group and 30.95% (665/2149) and 4.37% (94/2149) in the conventional delivery group, wherein the intergroup difference was not significant (P > .05). ⑤After Kegel exercise, the strength of PFM was promoted (P < .01). Conclusion: Water immersion delivery has been proved to a beneficial alternative method for conventional delivery method. This delivery mode is associated with fewer episiotomy rate, and avoiding episiotomy is beneficial for maintaining PFM strength of women in postpartum 6-8 weeks. The strength of PFM during postpartum period can be improved by doing Kegel exercise at home. PMID:29019880

Helping mothers survive bleeding after birth: an evaluation of simulation-based training in a low-resource setting.

PubMed

Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris; Mduma, Estomih; Broerse, Jacqueline; Evjen-Olsen, Bjørg; van Roosmalen, Jos; Stekelenburg, Jelle

2014-03-01

To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. Educational intervention study. Rural referral hospital in Northern Tanzania. Clinicians, nurse-midwives, medical attendants, and ambulance drivers involved in maternity care. In March 2012, health care workers were trained in HMS BAB, a half-day simulation-based training, using a train-the-trainer model. The training focused on basic delivery care, active management of third stage of labor, and treatment of postpartum hemorrhage, including bimanual uterine compression. Evaluation questionnaires provided information on course perception. Knowledge, skills, and confidence of facilitators and learners were tested before and after training. Four master trainers trained eight local facilitators, who subsequently trained 89 learners. After training, all facilitators passed the knowledge test, but pass rates for the skills test were low (29% pass rate for basic delivery and 0% pass rate for management of postpartum hemorrhage). Evaluation revealed that HMS BAB training was considered acceptable and feasible, although more time should be allocated for training, and teaching materials should be translated into the local language. Knowledge, skills, and confidence of learners increased significantly immediately after training. However, overall pass rates for skills tests of learners after training were low (3% pass rate for basic delivery and management of postpartum hemorrhage). The HMS BAB simulation-based training has potential to contribute to education of health care providers. We recommend a full day of training and validation of the facilitators to improve the training. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Rural school nurse perception of book studies as an effective method for professional development.

PubMed

Gray, Lorali

2014-05-01

School nurses who serve public school districts in rural Northwest Washington face barriers in accessing Continuing Education (CE) for professional development as they often practice in remote, isolated school communities. Acknowledging these barriers, the author discusses the inclusion of book studies within an existing training structure as an innovative method of providing professional development. By utilizing training that is already attended by rural school nurses, CE can be enhanced without incurring additional travel, cost, or training time. The school nurse's perception of the effectiveness of book studies as a CE method was examined per a descriptive, qualitative program evaluation. Over a period of 5 years, evaluation and feedback data from 12 rural school nurses were compiled from nine individual school nurse book study evaluations and one general satisfaction survey. Findings indicated overall school nurse satisfaction and belief that school nurse book studies are an effective and beneficial method for the delivery of professional development--a method that promotes collaborative learning and collegiality, informs practice, and provides insight into the broader health and social issues impacting today's students.

Why the Critics of Poor Health Service Delivery Are the Causes of Poor Service Delivery: A Need to Train the Policy-makers

PubMed Central

Harding, Nancy

2015-01-01

This comment on Professor Fotaki’s Editorial agrees with her arguments that training health professionals in more compassionate, caring and ethically sound care will have little value unless the system in which they work changes. It argues that for system change to occur, senior management, government members and civil servants themselves need training so that they learn to understand the effects that their policies have on health professionals. It argues that these people are complicit in the delivery of unethical care, because they impose requirements that contradict health professionals’ desire to deliver compassionate and ethical forms of care. PMID:26340498

In-Flight Icing Training for Pilots Using Multimedia Technology

NASA Technical Reports Server (NTRS)

Burke, Kevin M.; VanZante, Judith Foss; Bond, Thomas H.

2004-01-01

Over the last five years, the Aircraft Icing Project of the NASA Aviation Safety Program has developed a number of in-flight icing education and training aids to support increased awareness for pilots of the hazards associated with atmospheric icing conditions. Through the development of this work, a number of new instructional design approaches and media delivery methods have been introduced to enhance the learning experience, expand user interactivity and participation, and, hopefully, increase the learner retention rates. The goal of using these multimedia techniques is to increase the effectiveness of the training materials. This paper will describe the mutlimedia technology that has been introduced and give examples of how it was used.

Use of Social Support during Communication about Sickle Cell Carrier Status

PubMed Central

Bradford, Lisa; Roedl, Sara J.; Christopher, Stephanie A.; Farrell, Michael H.

2012-01-01

Objective To examine the use of social support behaviors by primary care providers during delivery of positive newborn screening results for Sickle Cell Anemia carrier status. Methods Transcripts from 125 primary care providers who conveyed Sickle Cell Anemia carrier status to standardized parents were content analyzed using categories derived from Cutrona and Suhr’s social support taxonomy. Frequencies and cross-tabulation matrices were calculated to study providers’ social support utilization. Results Results showed most primary care providers (80%) incorporate social support behaviors into delivery of Sickle Cell Anemia carrier results and most frequently employed social network (61.6%) and informational support (38.4%) behaviors. Providers used tangible aid (8%), esteem (1.6%), and emotional support (9.6%) behaviors less frequently. Conclusion Cutrona and Suhr’s taxonomy may be a useful tool for assessing supportive communication during the delivery of Sickle Cell Anemia carrier status and could be incorporated into population scale assessments of communication quality assurance. Practice Implications Primary care providers may need training in how to adapt supportive behaviors to parents’ needs during communication of Sickle Cell Anemia carrier status. They also may benefit from specific training about how to use esteem and emotional support. PMID:22658247

The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

PubMed Central

Kozhimannil, Katy B.; Casey, Michelle M.; Hung, Peiyin; Han, Xinxin; Prasad, Shailendra; Moscovice, Ira S.

2015-01-01

Purpose The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. Methods We conducted a telephone survey of 306 rural hospitals in 9 states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin, from November 2013-March 2014 to assess their obstetric workforce. Bivariate associations between hospitals’ annual birth volume and obstetric workforce characteristics were examined, as well as qualitative analysis of workforce changes and staffing challenges. Findings Hospitals with lower birth volume (< 240 births per year) are more likely to have family physicians and general surgeons attending deliveries, while those with a higher birth volume more frequently have obstetricians and midwives attending deliveries. Reported staffing challenges include scheduling, training, census fluctuation, recruitment and retention, and intra-hospital relationships. Conclusions Individual hospitals working in isolation may struggle to address staffing challenges. Federal and state policy makers, regional collaboratives, and health care delivery systems can facilitate solutions through programs such as telehealth, simulation training, and interprofessional education. PMID:25808202

Increase in Cesarean Operative Time Following Institution of the 80-Hour Workweek

PubMed Central

Smrtka, Michael P.; Gunatilake, Ravindu P.; Harris, Benjamin; Yu, Miao; Lan, Lan; Brancazio, Leo R.; Valea, Fidel A.; Grotegut, Chad A.; Brown, Haywood L.

2015-01-01

Background  In 2003, the Accreditation Council for Graduate Medical Education limited resident duty hours to 80 hours per week. More than a decade later, the effect of the limits on resident clinical competence is not fully understood. Objective  We sought to assess the effect of duty hour restrictions on resident performance of an uncomplicated cesarean delivery. Methods  We reviewed unlabored primary cesarean deliveries at Duke University Hospital after 34 weeks gestation, between 2003 and 2011. Descriptive statistics and linear regression were used to compare total operative time with incision to delivery time as a function of years since institution of the 80-hour workweek. Resident training level, subject body mass index, estimated blood loss, and skin closure method were controlled for in the regression model. Results  We identified 444 deliveries that met study criteria. The mean (SD) total operative time in 2003–2004 was 43.3 (14.3) minutes and 59.6 (10.7) minutes in 2010–2011 (P < .001). Multivariable regression demonstrated an increase in total operative time of 1.9 min/y (P < .001) but no change in incision to delivery time (P = .05). The magnitude of increased operative time was seen among junior residents (2.0 min/y, P < .001) compared to that of senior residents (1.2 min/y, P = .06). Conclusions  Since introduction of the 2003 duty hour limits, there has been an increase of nearly 20 minutes in the time required for a routine cesarean delivery. It is unclear if the findings are due to a change in residency duty hours or to another aspect of residency training. PMID:26457141

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

PubMed Central

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Objectives Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. Methods This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. Results The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Conclusions Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services. PMID:26405800

Delivery of Education and Training in Oregon's Adult Corrections Institutions. An Analysis of Present and Future Directions.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR. Education and Work Program.

This report on education and training in Oregon corrections institutions begins with a brief discussion of trends in correctional education and funding patterns. It then examines three general models of corrections education service delivery: educational programming under institutional superintendents, statewide programming facilitated by a state…

Evidence Report: Risk of Performance Errors Due to Training Deficiencies

NASA Technical Reports Server (NTRS)

Barshi, Immanuel

2012-01-01

The Risk of Performance Errors Due to Training Deficiencies is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. Given that training content, timing, intervals, and delivery methods must support crew task performance, and given that training paradigms will be different for long-duration missions with increased crew autonomy, there is a risk that operators will lack the skills or knowledge necessary to complete critical tasks, resulting in flight and ground crew errors and inefficiencies, failed mission and program objectives, and an increase in crew injuries.

Training for cervical cancer prevention programs in low-resource settings: focus on visual inspection with acetic acid and cryotherapy.

PubMed

Blumenthal, P D; Lauterbach, M; Sellors, J W; Sankaranarayanan, R

2005-05-01

The modern approach to cervical cancer prevention, characterized by use of cytology and multiple visits for diagnosis and treatment, has frequently proven challenging and unworkable in low-resource settings. Because of this, the Alliance for Cervical Cancer Prevention (ACCP) has made it a priority to investigate and assess alternative approaches, particularly the use of visual screening methods, such as visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI), for precancer and cancer detection and the use of cryotherapy as a precancer treatment method. As a result of ACCP experience in providing training to nurses and doctors in these techniques, it is now widely agreed that training should be competency based, combining both didactic and hands-on approaches, and should be done in a clinical setting that resembles the service-delivery conditions at the program site. This article reviews ACCP experiences and perceptions about the essentials of training in visual inspection and cryotherapy and presents some lessons learned with regard to training in these techniques in low-resource settings.

A Survey of the Manpower Training Needs of Connecticut Business and Industry with Special Emphasis on the Development of a Computer-Based Model for Vocational-Career Information Delivery Systems. Final Report.

ERIC Educational Resources Information Center

Connecticut Business and Industry Association, Hartford.

Conducting a survey of manpower training needs of business and industry in Connecticut and identifying elements of a vocational-career information delivery system were the two major focuses of the study described in this report. Content is presented in three chapters. Chapter 1 reviews and analyzes the manpower training needs survey and results.…

[Electronic fetal monitoring and management of adverse outcomes: how to perform and improve a training program for clinicians?].

PubMed

Secourgeon, J-F

2012-10-01

Electronic fetal monitoring during labor is the most commonly used method to evaluate the fetal status, but it remains exposed to some criticism. By comparison with intermittent auscultation and in the light of the results of the great studies in the last 30 years, it may be accused its failure to improve the neonatal outcome and its responsibility in the increase on operative deliveries. Actually, the electronic fetal monitoring is a tool whose effectiveness is linked to the accuracy of the analysis developed by the clinician. Studies on assessment of the tracing interpretation indicate that there is always a lack of quality, which may be improved through training programs. It also reveals the benefit of the fetal blood sampling to reduce operative deliveries and the generalization of this method, in addition to electronic fetal monitoring, is recommended by referral agencies. More generally, the continuous monitoring is only a part of the patient safety strategy in the labour ward and we are currently observing, in some European countries and in the United States, the development of training programs concerning the management of the adverse outcomes in obstetrics. The good performances related to the quality of care are demonstrated by the findings of the studies performed in the centers that have implemented an active training policy. In France, the professionals directly involved in the field of the perinatology should benefit from such educational programs that could be organized within the care networks under the authority of referral agencies. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Effects of shoulder dystocia training on the incidence of brachial plexus injury.

PubMed

Inglis, Steven R; Feier, Nikolaus; Chetiyaar, Jyothi B; Naylor, Margaret H; Sumersille, Melanie; Cervellione, Kelly L; Predanic, Mladen

2011-04-01

We sought to determine whether implementation of shoulder dystocia training reduces the incidence of obstetric brachial plexus injury (OBPI). After implementing training for maternity staff, the incidence of OBPI was compared between pretraining and posttraining periods using both univariate and multivariate analyses in deliveries complicated by shoulder dystocia. The overall incidence of OBPI in vaginal deliveries decreased from 0.40% pretraining to 0.14% posttraining (P < .01). OBPI after shoulder dystocia dropped from 30% to 10.67% posttraining (P < .01). Maternal body mass index (P < .01) and neonatal weight (P = .02) decreased and head-to-body delivery interval increased in the posttraining period (P = .03). Only shoulder dystocia training remained associated with reduced OBPI (P = .02) after logistic regression analysis. OBPI remained less in the posttraining period (P = .01), even after excluding all neonates with birthweights >2 SD above the mean. Shoulder dystocia training was associated with a lower incidence of OBPI and the incidence of OBPI in births complicated by shoulder dystocia. Copyright © 2011 Mosby, Inc. All rights reserved.

A survey of U.S. Fish and Wildlife Service employees regarding topics for distance education-Summary report to respondents

USGS Publications Warehouse

Ratz, Joan M.; Shuster, Rudy M.; Marcy, Ann M.

2011-01-01

Our preliminary conclusion, based only on frequencies of responses and averages, is that our survey respondents appear to prefer traditional instructor-led training. However, they would still enroll in distance education courses. The distance education technologies of audio conferencing, computer-mediated training, and written resource provision are the technologies respondents reported being most familiar and accessible to them. For four of the five topic areas-creating and maintaining partnerships, technology, program planning and development, and outreach methods-the response frequencies and averages indicate that the topics were viewed as both relevant and important. Respondents were more neutral regarding the relevance and importance of the topic of evaluation methods. Respondents reported preferences for different types of information on different topics and also reported preferences in delivery mode of training for each topic area. Detailed results and conclusions will be included in the completion reports for the two studies.

Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review*

PubMed Central

Agarwal, Smisha; Perry, Henry B; Long, Lesley-Anne; Labrique, Alain B

2015-01-01

Objectives Given the large-scale adoption and deployment of mobile phones by health services and frontline health workers (FHW), we aimed to review and synthesise the evidence on the feasibility and effectiveness of mobile-based services for healthcare delivery. Methods Five databases – MEDLINE, EMBASE, Global Health, Google Scholar and Scopus – were systematically searched for relevant peer-reviewed articles published between 2000 and 2013. Data were extracted and synthesised across three themes as follows: feasibility of use of mobile tools by FHWs, training required for adoption of mobile tools and effectiveness of such interventions. Results Forty-two studies were included in this review. With adequate training, FHWs were able to use mobile phones to enhance various aspects of their work activities. Training of FHWs to use mobile phones for healthcare delivery ranged from a few hours to about 1 week. Five key thematic areas for the use of mobile phones by FHWs were identified as follows: data collection and reporting, training and decision support, emergency referrals, work planning through alerts and reminders, and improved supervision of and communication between healthcare workers. Findings suggest that mobile based data collection improves promptness of data collection, reduces error rates and improves data completeness. Two methodologically robust studies suggest that regular access to health information via SMS or mobile-based decision-support systems may improve the adherence of the FHWs to treatment algorithms. The evidence on the effectiveness of the other approaches was largely descriptive and inconclusive. Conclusions Use of mHealth strategies by FHWs might offer some promising approaches to improving healthcare delivery; however, the evidence on the effectiveness of such strategies on healthcare outcomes is insufficient. PMID:25881735

Wealth inequality and utilization of reproductive health services in the Republic of Vanuatu: insights from the multiple indicator cluster survey, 2007

PubMed Central

2011-01-01

Background Although the Republic of Vanuatu has improved maternal indicators, more needs to be done to improve equity among the poorest in the use of reproductive health services to expedite the progress towards the Millennium Development Goal 5(MDG 5) target. While large developing country studies provide evidence of a rich-poor gap in reproductive health services utilization, not much is written in terms of Pacific Islands. Thus, this study aims to examine the degree of inequality in utilization of reproductive health services in a nationally representative sample of Vanuatu households. Methods This paper used data from the 2007 Vanuatu Multiple Indicator Cluster Survey (MICS). The analyses were based on responses from 615 ever married women, living with at least one child below two years of age. Outcomes included antenatal care (ANC) and use of birth attendants at delivery, place of delivery, and counseling and testing for HIV/AIDS. Descriptive statistics and multivariate logistic regression methods were employed in the analysis. Results Findings revealed that the economic well-being status of the household to which women belong, played a crucial role in explaining the variation in service utilization. Inequality in utilization was found to be more pronounced between the poorest and richest groups within the wealth quintiles. In adjusted models, mothers in the richest bands of wealth were 5.50 (95% confidence interval [CI]: 1.34-22.47), 2.12 (95% CI: 1.02-3.42), 4.0 (95% CI 1.58-10.10), and 2.0 (95% CI 1.02-5.88) times more likely to have assisted delivery from medically trained personnel, have institutional deliveries, and have counseling and testing for HIV/AIDS. Conclusions Association between household wealth inequality and utilization of ANC and delivery assistance from medically trained personnel, institutional delivery, and counseling and testing for HIV/AIDS suggest that higher utilization of reproductive health care services in Vanuatu poor-rich inequalities need to be addressed. Reducing poverty and making services more available and accessible to the poor may be essential for improving overall reproductive health care utilization rate in Vanuatu. PMID:22132828

Experiences and lessons learned for delivery of micronutrient powders interventions

PubMed Central

Reerink, Ietje; Poonawala, Alia; Nyhus Dhillon, Christina; Aburto, Nancy; Chaudhery, Deepika; Kroeun, Hou; Griffiths, Marcia; Haque, Mohammad Raisul; Bonvecchio, Anabelle; Jefferds, Maria Elena; Rawat, Rahul

2017-01-01

Abstract An effective delivery strategy coupled with relevant social and behaviour change communication (SBCC) have been identified as central to the implementation of micronutrient powders (MNP) interventions, but there has been limited documentation of what works. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” three working groups were formed to summarize experiences and lessons across countries regarding MNP interventions for young children. This paper focuses on programmatic experiences related to MNP delivery (models, platforms, and channels), SBCC, and training. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that most countries distributed MNP free of charge via the health sector, although distribution through other platforms and using subsidized fee for product or mixed payment models have also been used. Community‐based distribution channels have generally shown higher coverage and when part of an infant and young child feeding approach, may provide additional benefit given their complementarity. SBCC for MNP has worked best when focused on meeting the MNP behavioural objectives (appropriate use, intake adherence, and related infant and young child feeding behaviours). Programmers have learned that reincorporating SBCC and training throughout the intervention life cycle has allowed for much needed adaptations. Diverse experiences delivering MNP exist, and although no one‐size‐fits‐all approach emerged, well‐established delivery platforms, community involvement, and SBCC‐centred designs tended to have more success. Much still needs to be learned on MNP delivery, and we propose a set of implementation research questions that require further investigation. PMID:28960878

Is it possible to improve communication around radiotherapy delivery: A randomized study to assess the efficacy of team training?

PubMed

Liénard, Aurore; Delevallez, France; Razavi, Darius; Gibon, Anne-Sophie; Libert, Yves; Delvaux, Nicole; Marchal, Serge; Etienne, Anne-Marie; Bragard, Isabelle; Reynaert, Christine; Slachmuylder, Jean-Louis; Durieux, Jean-François; Farvacques, Christine; Scalliet, Pierre; Van Houtte, Paul; Coucke, Philippe; Merckaert, Isabelle

2016-05-01

The aim of this study was to assess the efficacy of a 38-h communication skills training program designed for multidisciplinary radiotherapy teams. Four radiotherapy teams were randomly assigned to a training program or to a waiting list. Assessments were scheduled at baseline (T1) and then after the training was completed or four months later (T2), respectively. Communication around radiotherapy delivery was assessed based on audio recordings of the first and last radiotherapy sessions in order to assess team members' communication skills and the expression of concerns by breast cancer patients (analyzed with content analysis software LaComm). 198 radiotherapy sessions were recorded. During the first radiotherapy sessions, members of the trained teams exhibited more assessment skills (p=0.048), provided more setting information (p<0.001), and used more social words (p=0.019) compared to the members of the untrained teams. During the last radiotherapy session, members of the trained teams used more assessment skills (p=0.004) and patients interacting with members of the trained teams expressed more sadness words (p=0.023). Training of multidisciplinary teams has the potential to transfer skills that affect the short exchanges that take place around radiotherapy delivery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Geropsychology Post-Doctoral Training in Public Sector Service Delivery: The USF/Tampa VA Fellowship Model

ERIC Educational Resources Information Center

Molinari, Victor; Chiriboga, David A.; Schonfeld, Lawrence; Haley, William E.; Schinka, John A.; Hyer, Kathy; Dupree, Larry W.

2005-01-01

There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care…

Internet-Based Intervention Training for Parents of Young Children with Disabilities: A Promising Service-Delivery Model

ERIC Educational Resources Information Center

Meadan, Hedda; Daczewitz, Marcus E.

2015-01-01

Efficient early intervention (EI) services are required to serve the needs of young children with disabilities and the needs of their families. Effective EI includes family-centred practices, evidence-based interventions, parent involvement/training, and delivery in children's natural environments. Due to the challenges of providing…

Therapist Perspectives on Training in a Package of Evidence-Based Practice Strategies for Children with Autism Spectrum Disorders Served in Community Mental Health Clinics

PubMed Central

Drahota, Amy; Stadnick, Nicole; Brookman-Frazee, Lauren

2012-01-01

Therapist perspectives regarding delivery of evidence-based practice (EBP) strategies are needed to understand the feasibility of implementation in routine service settings. This qualitative study examined the perspectives of 13 therapists receiving training and delivering a package of EBPs to children with autism spectrum disorders (ASD) in community mental health clinics. Therapists perceived the training and intervention delivery as effective at improving their clinical skills, the psychotherapy process, and child and family outcomes. Results expand parent pilot study findings, and add to the literature on training community providers and limited research on training providers to deliver EBPs to children with ASD. PMID:23086499

Experiential Growth Group in Counselor Education: A Review of Its Pedagogy, Research, and Ethical Dilemmas

ERIC Educational Resources Information Center

Zhu, Peitao

2018-01-01

The experiential growth group (EGG) is a common pedagogical activity employed in counselor education and is required by CACREP and ASGW standards. However, various parameters of such a training modality were not specified. The author first reviewed the multitude of current EGG delivery methods and student experiences in EGG. Then, 3 aspects of the…

Requirements for sustainable schistosomiasis control.

PubMed

Traoré, M

1996-01-01

In Mali the increased transmission of schistosomiasis following the construction of numerous reservoirs and irrigation schemes, together with experience gained in tackling the disease, have led to a major effort to train personnel in control methods, to achieve decentralized delivery and management, and to foster self-reliance in this field. The author outlines the essential components of a sound national control programme requiring long-term commitment.

Influence of Mobile Learning Training on Pre-Service Social Studies Teachers' Technology and Mobile Phone Self-Efficacies

ERIC Educational Resources Information Center

Gloria, Adedoja; Oluwadara, Abimbade

2016-01-01

Current instructional deliveries favour the use of mobile technology because of its inherent potentials and benefits such as portability, ease of use cost and others. Despite these benefits, many teachers especially in Sub-Saharan Africa still prefer the conventional method and use mobile phones for social engagements such as texting, chatting,…

Analysis of Parent, Teacher, and Consultant Speech Exchanges and Educational Outcomes of Students with Autism during COMPASS Consultation

ERIC Educational Resources Information Center

Ruble, Lisa; Birdwhistell, Jessie; Toland, Michael D.; McGrew, John H.

2011-01-01

The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate…

Decision-making strategies: ignored to the detriment of healthcare training and delivery?

PubMed Central

Desmond, Chris; Brubaker, Kathryn A.; Ellner, Andrew L.

2013-01-01

Context: People do not always make health-related decisions which reflect their best interest – best interest being defined as the decision they would make if they carefully considered the options and fully understood the information available. A substantial literature has developed in behavioral economics and social psychology that seeks to elucidate the patterns in individual decision-making. While this is particularly relevant to healthcare, the insights from these fields have only been applied in a limited way. To address the health challenges of the twenty-first century, healthcare providers and healthcare systems designers need to more fully understand how individuals are making decisions. Methods: We provide an overview of the theories of behavioral economics and social psychology that relate to how individuals make health-related decisions. The concentration on health-related decisions leads to a focus on three topics: (1) mental shortcuts and motivated reasoning; (2) implications of time; and (3) implications of affect. The first topic is relevant because health-related decisions are often made in a hurry without a full appreciation of the implications and the deliberation they warrant. The second topic is included because the link between a decision and its health-related outcomes can involve a significant time lag. The final topic is included because health and affect are so often linked. Findings: The literature reviewed has implications for healthcare training and delivery. Selection for medical training must consider the skills necessary to understand and adapt to how patients make decisions. Training on the insights garnered from behavioral economics and social psychology would better prepare healthcare providers to effectively support their clients to lead healthy lives. Healthcare delivery should be structured to respond to the way in which decisions are made. Conclusions: These patterns in decision-making call into question basic assumptions our healthcare system makes about the best way to treat patients and deliver care. This literature has implications for the way we train physicians and deliver care. PMID:25264501

Decision-making strategies: ignored to the detriment of healthcare training and delivery?

PubMed

Desmond, Chris; Brubaker, Kathryn A; Ellner, Andrew L

2013-01-01

Context : People do not always make health-related decisions which reflect their best interest - best interest being defined as the decision they would make if they carefully considered the options and fully understood the information available. A substantial literature has developed in behavioral economics and social psychology that seeks to elucidate the patterns in individual decision-making. While this is particularly relevant to healthcare, the insights from these fields have only been applied in a limited way. To address the health challenges of the twenty-first century, healthcare providers and healthcare systems designers need to more fully understand how individuals are making decisions. Methods : We provide an overview of the theories of behavioral economics and social psychology that relate to how individuals make health-related decisions. The concentration on health-related decisions leads to a focus on three topics: (1) mental shortcuts and motivated reasoning; (2) implications of time; and (3) implications of affect. The first topic is relevant because health-related decisions are often made in a hurry without a full appreciation of the implications and the deliberation they warrant. The second topic is included because the link between a decision and its health-related outcomes can involve a significant time lag. The final topic is included because health and affect are so often linked. Findings : The literature reviewed has implications for healthcare training and delivery. Selection for medical training must consider the skills necessary to understand and adapt to how patients make decisions. Training on the insights garnered from behavioral economics and social psychology would better prepare healthcare providers to effectively support their clients to lead healthy lives. Healthcare delivery should be structured to respond to the way in which decisions are made. Conclusions : These patterns in decision-making call into question basic assumptions our healthcare system makes about the best way to treat patients and deliver care. This literature has implications for the way we train physicians and deliver care.

The current situation in education and training of health-care professionals across Africa to optimise the delivery of palliative care for cancer patients

PubMed Central

Rawlinson, FM; Gwyther, L; Kiyange, F; Luyirika, E; Meiring, M; Downing, J

2014-01-01

The need for palliative care education remains vital to contribute to the quality of life of patients, both adults and children, with cancer in Africa. The number of patients with cancer continues to rise, and with them the burden of palliative care needs. Palliative care has been present in Africa for nearly four decades, and a number of services are developing in response to the HIV/AIDS epidemic. However, the needs of cancer patients remain a challenge. Education and training initiatives have developed throughout this time, using a combination of educational methods, including, more recently, e-learning initiatives. The role of international and national organisations in supporting education has been pivotal in developing models of education and training that are robust, sustainable, and affordable. Developing a material for education and professional development needs to continue in close collaboration with that already in production in order to optimise available resources. Seeking ways to evaluate programmes in terms of their impact on patient care remains an important part of programme delivery. This article reviews the current situation. PMID:25624873

Review of Instructional Approaches in Ethics Education.

PubMed

Mulhearn, Tyler J; Steele, Logan M; Watts, Logan L; Medeiros, Kelsey E; Mumford, Michael D; Connelly, Shane

2017-06-01

Increased investment in ethics education has prompted a variety of instructional objectives and frameworks. Yet, no systematic procedure to classify these varying instructional approaches has been attempted. In the present study, a quantitative clustering procedure was conducted to derive a typology of instruction in ethics education. In total, 330 ethics training programs were included in the cluster analysis. The training programs were appraised with respect to four instructional categories including instructional content, processes, delivery methods, and activities. Eight instructional approaches were identified through this clustering procedure, and these instructional approaches showed different levels of effectiveness. Instructional effectiveness was assessed based on one of nine commonly used ethics criteria. With respect to specific training types, Professional Decision Processes Training (d = 0.50) and Field-Specific Compliance Training (d = 0.46) appear to be viable approaches to ethics training based on Cohen's d effect size estimates. By contrast, two commonly used approaches, General Discussion Training (d = 0.31) and Norm Adherence Training (d = 0.37), were found to be considerably less effective. The implications for instruction in ethics training are discussed.

Creation and Assessment of a Bad News Delivery Simulation Curriculum for Pediatric Emergency Medicine Fellows.

PubMed

Chumpitazi, Corrie E; Rees, Chris A; Chumpitazi, Bruno P; Hsu, Deborah C; Doughty, Cara B; Lorin, Martin I

2016-05-01

Background  Bad news in the context of health care has been broadly defined as significant information that negatively alters people's perceptions of the present or future. Effectively delivering bad news (DBN) in the setting of the emergency department requires excellent communication skills. Evidence shows that bad news is frequently given inadequately. Studies show that trainees need to devote more time to developing this skill through formalized training. This program's objectives were to utilize trained standardized patients in a simulation setting to assist pediatric emergency medicine (PEM) fellows in the development of effective, sensitive, and compassionate communication with patients and family members when conveying bad news, and to recognize and respond to the patient/parent's reaction to such news. Methods PEM fellows participated in a novel curriculum utilizing simulated patients (SPs) acting as the patient's parent and immersive techniques in a realistic and supportive environment. A baseline survey was conducted to ascertain participant demographics and previous experience with simulation and DBN. Experienced, multi-disciplinary faculty participated in a training workshop with the SPs one week prior to course delivery. Three scenarios were developed for bad news delivery. Instructors watched via remote video feed while the fellows individually interacted with the SPs and then participated in a confidential debriefing. Fellows later joined for group debriefing. Fellow characteristics, experience, and self-perceived comfort pre/post-course were collected.   Results Baseline data demonstrated that 78% of fellows reported DBN two or more times per month. Ninety-three percent of fellows in this study were present during the delivery of news about the death of a child to a parent or family member in the six-month period preceding this course. Fellows' self-reported comfort level in DBN to a patient/family and dealing with patient and parent emotions improved significantly (p=0.034 and p=0.046, respectively). Conclusions Pediatric emergency medicine fellows frequently deliver bad news. A course using SPs was well received by trainees and resulted in improvement in self-assessed skills and comfort. This curriculum provides the opportunity for fellows to receive patient/parent feedback of their communication skills and observations from skilled instructors. This methodology should be considered when creating training curricula for bad news delivery skills.

The PULSAR primary care protocol: a stepped-wedge cluster randomized controlled trial to test a training intervention for general practitioners in recovery-oriented practice to optimize personal recovery in adult patients.

PubMed

Enticott, Joanne C; Shawyer, Frances; Brophy, Lisa; Russell, Grant; Fossey, Ellie; Inder, Brett; Mazza, Danielle; Vasi, Shiva; Weller, Penelope June; Wilson-Evered, Elisabeth; Edan, Vrinda; Meadows, Graham

2016-12-20

General practitioners (GPs) in Australia play a central role in the delivery of mental health care. This article describes the PULSAR (Principles Unite Local Services Assisting Recovery) Primary Care protocol, a novel mixed methods evaluation of a training intervention for GPs in recovery-oriented practice. The aim of the intervention is to optimize personal recovery in patients consulting study GPs for mental health issues. The intervention mixed methods design involves a stepped-wedge cluster randomized controlled trial testing the outcomes of training in recovery-oriented practice, together with an embedded qualitative study to identify the contextual enablers and challenges to implementing recovery-oriented practice. The project is conducted in Victoria, Australia between 2013 and 2017. Eighteen general practices and community health centers are randomly allocated to one of two steps (nine months apart) to start an intervention comprising GP training in the delivery of recovery-oriented practice. Data collection consists of cross-sectional surveys collected from patients of participating GPs at baseline, and again at the end of Steps 1 and 2. The primary outcome is improvement in personal recovery using responses to the Questionnaire about the Process of Recovery. Secondary outcomes are improvements in patient-rated measures of personal recovery and wellbeing, and of the recovery-oriented practice they have received, using the INSPIRE questionnaire, the Warwick-Edinburgh Mental Well-being Scale, and the Kessler Psychological Distress Scale. Participant data will be analyzed in the group that the cluster was assigned to at each study time point. Another per-protocol dataset will contain all data time-stamped according to the date of intervention received at each cluster site. Qualitative interviews with GPs and patients at three and nine months post-training will investigate experiences and challenges related to implementing recovery-oriented practice in primary care. Recovery-oriented practice is gaining increasing prominence in mental health service delivery and the outcomes of such an approach within the primary care sector for the first time will be evaluated in this project. If findings are positive, the intervention has the potential to extend recovery-oriented practice to GPs throughout the community. Australian and New Zealand Clinical Trial Registry ( ACTRN12614001312639 ). Registered: 8 August 2014.

Satellite-Delivered Learning.

ERIC Educational Resources Information Center

Arnall, Gail C.

1987-01-01

Discusses the application of satellite information delivery to training. Describes a new trend, horizontal programming. Also discusses vertical programming and in-house production of training materials. Lists vendors of satellite-based training. (CH)

When promotoras and technology meet: A qualitative analysis of promotoras’ use of small media to increase cancer screening among South Texas Latinos

PubMed Central

Fernandez, Maria E.; LaRue, Denise M.; Bartholomew, L. Kay

2012-01-01

Computer-based multimedia technologies can be used to tailor health messages, but promotoras (Spanish-speaking community health workers) rarely use these tools. Promotoras delivered health messages about colorectal cancer screening to medically underserved Latinos in South Texas using two small media formats: a “low-tech” format (flipchart and video); and a “high-tech” format consisting of a tailored, interactive computer program delivered on a tablet computer. Using qualitative methods, we observed promotora training and intervention delivery, and conducted interviews with five promotoras to compare and contrast program implementation of both formats. We discuss the ways each format aided or challenged promotoras’ intervention delivery. Findings reveal that some aspects of both formats enhanced intervention delivery by tapping into Latino health communication preferences and facilitating interpersonal communication, while other aspects hindered intervention delivery. This study contributes to our understanding of how community health workers use low- and high-tech small media formats when delivering health messages to Latinos. PMID:21986243

A multi-method review of home-based chemotherapy.

PubMed

Evans, J M; Qiu, M; MacKinnon, M; Green, E; Peterson, K; Kaizer, L

2016-09-01

This study summarises research- and practice-based evidence on home-based chemotherapy, and explores existing delivery models. A three-pronged investigation was conducted consisting of a literature review and synthesis of 54 papers, a review of seven home-based chemotherapy programmes spanning four countries, and two case studies within the Canadian province of Ontario. The results support the provision of home-based chemotherapy as a safe and patient-centred alternative to hospital- and outpatient-based service. This paper consolidates information on home-based chemotherapy programmes including services and drugs offered, patient eligibility criteria, patient views and experiences, delivery structures and processes, and common challenges. Fourteen recommendations are also provided for improving the delivery of chemotherapy in patients' homes by prioritising patient-centredness, provider training and teamwork, safety and quality of care, and programme management. The results of this study can be used to inform the development of an evidence-informed model for the delivery of chemotherapy and related care, such as symptom management, in patients' homes. © 2015 John Wiley & Sons Ltd.

Systematizing the Delivery of Local Employment and Training Services. The Job Center Technical Assistance Guide.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Industry, Labor and Human Relations, Madison.

This technical assistance guide was developed to consolidate a statewide understanding of the effort to systematize the delivery of employment and training programs through the local formation of job centers in Wisconsin, and to provide a compilation, drawn from 20 local models, that explains how the programs are delivered. The guide is organized…

Cognitive Defusion versus Thought Distraction: A Clinical Rationale, Training, and Experiential Exercise in Altering Psychological Impacts of Negative Self-Referential Thoughts

ERIC Educational Resources Information Center

Masuda, Akihiko; Feinstein, Amanda B.; Wendell, Johanna W.; Sheehan, Shawn T.

2010-01-01

Using two modes of intervention delivery, the present study compared the effects of a cognitive defusion strategy with a thought distraction strategy on the emotional discomfort and believability of negative self-referential thoughts. One mode of intervention delivery consisted of a clinical rationale and training (i.e., Partial condition). The…

Internet Treatment Delivery of Parent-Adolescent Conflict Training for Families with an ADHD Teen: A Feasibility Study

ERIC Educational Resources Information Center

Carpenter, Erika M.; Frankel, Fred; Marina, Michael; Duan, Naihua; Smalley, Susan L.

2004-01-01

The present study examines the feasibility of Internet delivery of a Parent-Adolescent Conflict Training (PACT) program to families with an ADHD teen. The goals of the project are to ascertain the willingness of families to participate in this web-based study, identify relevant issues related to confidentiality of Internet data collection, and…

A pilot study to evaluate incorporating eye care for children into reproductive and child health services in Dar-es-Salaam, Tanzania: a historical comparison study

PubMed Central

2014-01-01

Background Many blinding eye conditions of childhood are preventable or treatable, particularly in developing countries. However, primary eye care (PEC) for children is poorly developed, leading to unnecessary visual loss. Activities for control by health workers entail interventions for systemic conditions (measles, vitamin A deficiency), identification and referral of children with sight threatening conditions and health education for caregivers. This pilot study evaluated integrating a package of activities to promote child eye health into Reproductive and Child Health (RCH) services in Dar-es-Salaam, Tanzania. Methods Design: historical comparison study. Fifteen Clinical Officers and 15 nurses in 15 randomly selected RCH clinics were trained in PEC for children in July 2010. They were given educational materials (poster and manual) and their supervisors were orientated. Knowledge and practices were assessed before and 3 weeks after training. One year later their knowledge and practices were compared with a different group of 15 Clinical Officers and 15 nurses who had not been trained. Results Before training staff had insufficient knowledge to identify, treat and refer children with eye diseases, even conjunctivitis. Some recommended harmful practices or did not know that cataract requires urgent referral. Eye examination, vitamin A supplementation of mothers after delivery and cleaning the eyes at birth with instillation of antibiotics (Crede’s prophylaxis) were not routine, and there were no eye-specific educational materials. Three weeks after training several clinics delivering babies started Crede’s prophylaxis, vitamin A supplementation of women after delivery increased from 83.7% to 100%, and all staff included eye conditions in health education sessions. At one year, trained staff were more likely to correctly describe, diagnose and treat conjunctivitis (z=2.34, p=0.04)(30%-vs-60.7%). Mystery mothers observed health education sessions in 7/10 RCH clinics with trained staff, five (71.4%) of which included eye conditions. Conclusions Primary eye care for children in Dar-es-Salaam is inadequate but training RCH staff can improve knowledge in the short term and change practices. Attendance by mothers and their children is high in RCH clinics, making them ideal for delivery of PEC. Ongoing supportive supervision is required to maintain knowledge and practices, as well as systems to track referrals. PMID:24932133

Establishing and delivering pulmonary rehabilitation in rural and remote settings: The opinions, attitudes and concerns of health care professionals.

PubMed

Johnston, Catherine L; Maxwell, Lyndal J; Alison, Jennifer A

2016-04-01

Pulmonary rehabilitation is recommended for people with chronic lung disease however access remains limited in rural and remote settings. The aim of this project was to explore the perspectives of rural and remote health care professionals regarding the establishment and delivery of pulmonary rehabilitation. Rural (NSW) and remote (NT) Australian healthcare settings. Health care professionals (n = 25) who attended a training program focussing on the delivery of pulmonary rehabilitation. Surveys with open written questions were completed by participants following the training program. Key informants also participated in face-to-face interviews. Thematic analysis was undertaken of data collected on participant opinions, attitudes and concerns regarding the establishment and delivery of pulmonary rehabilitation in their individual situation. Participating health care professionals (predominantly nurses and physiotherapists) identified a number of issues relating to establishing and delivering pulmonary rehabilitation; including staffing, time and case load constraints, patient and community attitudes, lack of professional knowledge and confidence and inability to ensure sustainability. The practicalities of delivering pulmonary rehabilitation, particularly exercise prescription and training, were also important concerns raised. Lack of health care professional staffing, knowledge and confidence were reported to be factors impacting the establishment and delivery of pulmonary rehabilitation. This study has facilitated a greater understanding of the issues surrounding the establishment and delivery of pulmonary rehabilitation in rural and remote settings. Further research is required to investigate the contribution of health professional training and associated factors to improving the availability and delivery of pulmonary rehabilitation in rural and remote settings. © 2015 National Rural Health Alliance Inc.

The development of a novel cricket bowling system: recreating spin and swing bowling deliveries at the elite level

NASA Astrophysics Data System (ADS)

West, A. A.; Justham, L.

2008-03-01

During the game of cricket, bowlers create different deliveries by altering the manner in which they release the ball from their hand. The orientation of the seam, the speed at which the ball is released and the magnitude and direction of the spin combine to determine the motion of the ball through the air and its movement after impact with the wicket. These factors have to be considered if automatic training machines are to be capable of replicating elite bowling deliveries. The need for automotive systems for batting and fielding training at the elite level has arisen due to: (i) the capabilities of human bowlers are limited by the onset of fatigue and the risk of injury and (ii) a large number of accurate and repeatable deliveries to be ''programmable'' by coaches to ensure batsmen and fielders are tested to the limits of their abilities and a training benefit is achieved.

Improving health outcomes of children through effective parenting: model and methods.

PubMed

Okafor, Martha; Sarpong, Daniel F; Ferguson, Aneeqah; Satcher, David

2013-12-23

This article reports on the design, development, testing and presentation of preliminary evidence of a translational, culturally relevant parenting education model, titled Smart and Secured Children (SSC). SSC, a quality parenting curriculum, prepares disparate African American parents as leaders for transforming their parenting behaviors and leading their peers and community in changing existing parenting culture. The article recommends expanded utility of identified promising processes, approaches and practices to engage African American parents to lead in addressing health inequity conditions in their families and communities. It adds to the growing scientific literature on the association between parent-child relationship quality and a wide variety of children physical, emotional and social outcomes. SSC applied principles of developmental theories; community based participatory research (CBPR), and iterative Delphi method between the community stakeholders, parents and researchers. The delivery approach of SSC was revamped from professional-led to parent-led content presentation and delivery methods using a conversational learning approach, referred to as 'conversepedia'. Parents' leadership development training and delivery of this curriculum in social supportive groups improved their mental wellbeing, parenting capacity and leadership skills. Parents do matter and can choose positive influence in their lives and are capable of reversing negative peer influence.

Improving Health Outcomes of Children through Effective Parenting: Model and Methods

PubMed Central

Okafor, Martha; Sarpong, Daniel F.; Ferguson, Aneeqah; Satcher, David

2013-01-01

This article reports on the design, development, testing and presentation of preliminary evidence of a translational, culturally relevant parenting education model, titled Smart and Secured Children (SSC). SSC, a quality parenting curriculum, prepares disparate African American parents as leaders for transforming their parenting behaviors and leading their peers and community in changing existing parenting culture. The article recommends expanded utility of identified promising processes, approaches and practices to engage African American parents to lead in addressing health inequity conditions in their families and communities. It adds to the growing scientific literature on the association between parent–child relationship quality and a wide variety of children physical, emotional and social outcomes. SSC applied principles of developmental theories; community based participatory research (CBPR), and iterative Delphi method between the community stakeholders, parents and researchers. The delivery approach of SSC was revamped from professional-led to parent-led content presentation and delivery methods using a conversational learning approach, referred to as ‘conversepedia’. Parents’ leadership development training and delivery of this curriculum in social supportive groups improved their mental wellbeing, parenting capacity and leadership skills. Parents do matter and can choose positive influence in their lives and are capable of reversing negative peer influence. PMID:24366048

Portable Video Media Versus Standard Verbal Communication in Surgical Information Delivery to Nurses: A Prospective Multicenter, Randomized Controlled Crossover Trial.

PubMed

Kam, Jonathan; Ainsworth, Hannah; Handmer, Marcus; Louie-Johnsun, Mark; Winter, Matthew

2016-10-01

Continuing education of health professionals is important for delivery of quality health care. Surgical nurses are often required to understand surgical procedures. Nurses need to be aware of the expected outcomes and recognize potential complications of such procedures during their daily work. Traditional educational methods, such as conferences and tutorials or informal education at the bedside, have many drawbacks for delivery of this information in a universal, standardized, and timely manner. The rapid uptake of portable media devices makes portable video media (PVM) a potential alternative to current educational methods. To compare PVM to standard verbal communication (SVC) for surgical information delivery and educational training for nurses and evaluate its impact on knowledge acquisition and participant satisfaction. Prospective, multicenter, randomized controlled crossover trial. Two hospitals: Gosford District Hospital and Wyong Hospital. Seventy-two nursing staff (36 at each site). Information delivery via PVM--7-minute video compared to information delivered via SVC. Knowledge acquisition was measured by a 32-point questionnaire, and satisfaction with the method of education delivery was measured using the validated Client Satisfaction Questionnaire (CSQ-8). Knowledge acquisition was higher via PVM compared to SVC 25.9 (95% confidence interval [CI] 25.2-26.6) versus 24.3 (95% CI 23.5-25.1), p = .004. Participant satisfaction was higher with PVM 29.5 (95% CI 28.3-30.7) versus 26.5 (95% CI 25.1-27.9), p = .003. Following information delivery via SVC, participants had a 6% increase in knowledge scores, 24.3 (95% CI 23.5-25.1) versus 25.7 (95% CI 24.9-26.5) p = .001, and a 13% increase in satisfaction scores, 26.5 (95% CI 25.1-27.9) versus 29.9 (95% CI 28.8-31.0) p < .001, when they crossed-over to information delivery via PVM. PVM provides a novel method for providing education to nurses that improves knowledge retention and satisfaction with the educational process. © 2016 Sigma Theta Tau International.

Contribution of traditional birth attendants to the formal health system in Ethiopia: the case of Afar region.

PubMed

Temesgen, Tedla Mulatu; Umer, Jemal Yousuf; Buda, Dawit Seyoum; Haregu, Tilahun Nigatu

2012-01-01

Traditional birth attendants (TBAs) have been a subject of discussion in the provision of maternal and newborn health care. The objective of this study was to assess the role of trained traditional birth attendants in maternal and newborn health care in Afar Regional State of Ethiopia. A qualitative study was used where 21 in-depth interviews and 6 focus group discussions were conducted with health service providers, trained traditional birth attendants, mothers, men, kebele leaders and district health personnel. The findings of this study indicate that trained traditional birth attendants are the backbone of the maternal and child health development in pastoralist communities. However, the current numbers are inadequate and cannot meet the needs of the pastoralist communities including antenatal care, delivery, postnatal care and family planning. In addition to service delivery, all respondents agreed on multiple contributions of trained TBAs, which include counselling, child care, immunisation, postnatal care, detection of complication and other social services. Without deployment of adequate numbers of trained health workers for delivery services, trained traditional birth attendants remain vital for the rural community in need of maternal and child health care services. With close supportive supervision and evaluation of the trainings, the TBAs can greatly contribute to decreasing maternal and newborn mortality rates.

The development and implementation of the structured training programme for caregivers of inpatients after stroke (TRACS) intervention: the London Stroke Carers Training Course.

PubMed

Forster, Anne; Dickerson, Josie; Melbourn, Anne; Steadman, Jayne; Wittink, Margreet; Young, John; Kalra, Lalit; Farrin, Amanda

2015-03-01

To describe the content and delivery of the adapted London Stroke Carers Training Course intervention evaluated in the Training Caregivers after Stroke (TRACS) trial. The London Stroke Carers Training Course is a structured training programme for caregivers of inpatients who are likely to return home after their stroke. The course was delivered by members of the multidisciplinary team while the patient was in the stroke unit with one recommended 'follow through' session after discharge home. The intervention consists of 14 training components (six mandatory) that were identified as important knowledge/skills that caregivers would need to be able to care for the stroke patient after discharge home. Following national training days, the London Stroke Carers Training Course was disseminated to intervention sites by the cascade method of implementation. The intervention was adapted for implementation across a range of stroke units. Training days were well attended (median 2.5 and 2.0 attendees per centre for the first and second days, respectively) and the feedback positive, demonstrating 'face validity' for the intervention. However cascading of this training to other members of the multidisciplinary team was not consistent, with 7/18 centres recording no cascade training. The adapted London Stroke Carers Training Course provided a training programme that could be delivered in a standardised, structured way in a variety of stroke unit settings throughout the UK. The intervention was well received by stroke unit staff, however, the cascade method of implementation was not as effective as we would have wished. © The Author(s) 2014.

Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial

PubMed Central

Bergström, M; Kieler, H; Waldenström, U

2009-01-01

Objective To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers. Design Randomised controlled multicentre trial. Setting Fifteen antenatal clinics in Sweden between January 2006 and May 2007. Sample A total of 1087 nulliparous women and 1064 of their partners. Methods Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery. Main outcome measures Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire. Results The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings. Conclusion Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education. PMID:19538406

It Takes Two to Talk--The Hanen Program and families of children with motor disorders: a UK perspective.

PubMed

Pennington, L; Thomson, K

2007-11-01

Speech and language therapy for young children who have motor disorders targets both the children themselves and their parents. Therapy for parents often involves training about communication and how to foster children's development. It Takes Two to Talk--The Hanen Program for Parents has become popular in the UK, but has not been specifically evaluated for this client group. This study, which was part of a larger investigation of the acceptability and potential effects of the programme on the communication patterns of mothers and their young children with motor disorders, investigated therapists' experiences of providing the training in the National Health Service (NHS) and their views on its effectiveness. Four focus groups, which involved 16 speech and language therapists who provide It Takes Two to Talk in NHS Trusts in England, were analysed using qualitative methods. The themes indicated that therapists perceived the training programme to be effective in helping parents to develop a facilitative communication style. Therapists reported secondary outcomes of positive changes in parents' confidence and in relationships between parents and their children and between parents and therapists. Barriers to the provision and success of the programme were thought to relate to resources, parents' apprehensions about the programme's content and delivery and support from key stakeholders. Barriers were seen to be minimized in services where other members of the healthcare teams actively supported the training programme and where the intervention was integrated as part of a care pathway. The information from this study may assist service providers in the marketing, planning and delivery of new intervention methods, to ensure that they are seen as valuable and acceptable by parents.

Focus on Process Improvement: An Evaluation of the Use of the RFP Process in the Distribution of Federal Workforce Education Funds in Minnesota. Perkins-JTPA Evaluation.

ERIC Educational Resources Information Center

Feickert, Joan Davis; And Others

A study evaluated the use of the request for proposal (RFP) process as a method of distributing federal vocational education and job training funds in Minnesota. Thirty-seven employees of Minnesota technical colleges, community-based organizations, service delivery areas, and state agencies who had actually prepared proposals requesting Job…

The Development, Diffusion and Evaluation of a Fall Hazard Safety Training Program for Residential Construction Workers Utilizing Instructor Led and New Media Delivery

ERIC Educational Resources Information Center

Fullen, Mark D.

2009-01-01

The numbers of workers in the residential construction industry are on the rise. Falls have continually been the largest contributor to residential construction worker deaths and injuries. These workers are largely self-employed or working for small companies. These individuals are difficult to reach through traditional methods. This research…

Faculty Perceptions of the Need to Include Training in Pedagogy in Non-Teaching Degree Programs in Florida

ERIC Educational Resources Information Center

Robinson, Terrell Emon

2012-01-01

Just as PK-12 teachers are taught how to teach, college and university professors should also receive instruction in how to teach. They should acquire pedagogical skills and understand methods for planning and content delivery prior to entering the classroom. The knowledge base of the discipline and a focus on research are emphasized in the…

Helping Mothers Survive Bleeding After Birth: retention of knowledge, skills, and confidence nine months after obstetric simulation-based training.

PubMed

Nelissen, Ellen; Ersdal, Hege; Mduma, Estomih; Evjen-Olsen, Bjørg; Broerse, Jacqueline; van Roosmalen, Jos; Stekelenburg, Jelle

2015-08-25

It is important to know the decay of knowledge, skills, and confidence over time to provide evidence-based guidance on timing of follow-up training. Studies addressing retention of simulation-based education reveal mixed results. The aim of this study was to measure the level of knowledge, skills, and confidence before, immediately after, and nine months after simulation-based training in obstetric care in order to understand the impact of training on these components. An educational intervention study was carried out in 2012 in a rural referral hospital in Northern Tanzania. Eighty-nine healthcare workers of different cadres were trained in "Helping Mothers Survive Bleeding After Birth", which addresses basic delivery skills including active management of third stage of labour and management of postpartum haemorrhage (PPH). Knowledge, skills, and confidence were tested before, immediately after, and nine months after training amongst 38 healthcare workers. Knowledge was tested by completing a written 26-item multiple-choice questionnaire. Skills were tested in two simulated scenarios "basic delivery" and "management of PPH". Confidence in active management of third stage of labour, management of PPH, determination of completeness of the placenta, bimanual uterine compression, and accessing advanced care was self-assessed using a written 5-item questionnaire. Mean knowledge scores increased immediately after training from 70 % to 77 %, but decreased close to pre-training levels (72 %) at nine-month follow-up (p = 0.386) (all p-levels are compared to pre-training). The mean score in basic delivery skills increased after training from 43 % to 51 %, and was 49 % after nine months (p = 0.165). Mean scores of management of PPH increased from 39 % to 51 % and were sustained at 50 % at nine months (p = 0.003). Bimanual uterine compression skills increased from 19 % before, to 43 % immediately after, to 48 % nine months after training (p = 0.000). Confidence increased immediately after training, and was largely retained at nine-month follow-up. Training resulted in an immediate increase in knowledge, skills, and confidence. While knowledge and simulated basic delivery skills decayed after nine months, confidence and simulated obstetric emergency skills were largely retained. These findings indicate a need for continuation of training. Future research should focus on the frequency and dosage of follow-up training.

Improving Culturally Appropriate Care Using a Community-Based Participatory Research Approach: Evaluation of a Multicomponent Cultural Competency Training Program, Arkansas, 2015–2016

PubMed Central

Long, Christopher R.; Rowland, Brett; Moore, Sarah; Wilmoth, Ralph; Ayers, Britni

2017-01-01

Introduction The United States continues to become more racially and ethnically diverse, and racial/ethnic minority communities encounter sociocultural barriers to quality health care, including implicit racial/ethnic bias among health care providers. In response, health care organizations are developing and implementing cultural competency curricula. Using a community-based participatory research (CBPR) approach, we developed and evaluated a cultural competency training program to improve the delivery of culturally appropriate care in Marshallese and Hispanic communities. Methods We used a mixed-methods evaluation approach based on the Kirkpatrick model of training evaluation. We collected quantitative evaluation data immediately after each training session (March 19, 2015–November 30, 2016) and qualitative data about implementation at 2 points: immediately after each session and 6 months after training. Individuals and organizational units provided qualitative data. Results We delivered 1,250 units of in-person training at 25 organizations. Participants reported high levels of changes in knowledge (91.2%), competence (86.6%), and performance (87.2%) as a result of the cultural competency training. Organizations reported making policy and environmental changes. Conclusion Initial outcomes demonstrate the value of developing and implementing cultural competency training programs using a CBPR approach. Additional research is needed to determine the effect on long-term patient outcomes. PMID:28771402

Experiences and lessons learned for delivery of micronutrient powders interventions.

PubMed

Reerink, Ietje; Namaste, Sorrel Ml; Poonawala, Alia; Nyhus Dhillon, Christina; Aburto, Nancy; Chaudhery, Deepika; Kroeun, Hou; Griffiths, Marcia; Haque, Mohammad Raisul; Bonvecchio, Anabelle; Jefferds, Maria Elena; Rawat, Rahul

2017-09-01

An effective delivery strategy coupled with relevant social and behaviour change communication (SBCC) have been identified as central to the implementation of micronutrient powders (MNP) interventions, but there has been limited documentation of what works. Under the auspices of "The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance," three working groups were formed to summarize experiences and lessons across countries regarding MNP interventions for young children. This paper focuses on programmatic experiences related to MNP delivery (models, platforms, and channels), SBCC, and training. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that most countries distributed MNP free of charge via the health sector, although distribution through other platforms and using subsidized fee for product or mixed payment models have also been used. Community-based distribution channels have generally shown higher coverage and when part of an infant and young child feeding approach, may provide additional benefit given their complementarity. SBCC for MNP has worked best when focused on meeting the MNP behavioural objectives (appropriate use, intake adherence, and related infant and young child feeding behaviours). Programmers have learned that reincorporating SBCC and training throughout the intervention life cycle has allowed for much needed adaptations. Diverse experiences delivering MNP exist, and although no one-size-fits-all approach emerged, well-established delivery platforms, community involvement, and SBCC-centred designs tended to have more success. Much still needs to be learned on MNP delivery, and we propose a set of implementation research questions that require further investigation. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Operator Training: Who Is Responsible?

ERIC Educational Resources Information Center

Wubbena, Robert L.

1979-01-01

Summarized are the findings of a study to identify and correct water pollution control operator training deficiencies. Several models are presented to aid in developing a coordinated delivery system for operator training and certification. (CS)

Impact of training of traditional birth attendants on the newborn care.

PubMed

Satishchandra, D M; Naik, V A; Wantamutte, A S; Mallapur, M D

2009-01-01

To study the impact of training of Traditional Birth Attendants (TBAs) on the Newborn care in resource poor setting in rural area. A community based study in the Primary Health Center (PHC) area was conducted over one year period between March 2006 to February 2007. The study participants were 50 Traditional Birth Attendants (TBAs)who conduct home deliveries in the PHC area. Training was conducted for two days which included topics on techniques of conducting safe delivery and newborn care practices. Pre-test evaluation regarding knowledge and practices about newborn care was done. Post-test evaluation was done at first month (early) and at fifth month (late) after the training. Analysis was done by using Mc. Nemer's test, Chi- square test with Yates's correction and Fischer's exact test. Pre-test evaluation showed that, knowledge and practices about newborn care services provided by the previously trained TBAs and untrained TBAs were poor. Early and late post-test evaluation showed that, there was a progressive improvement in the newborn care provided by both the groups. Preintervention period (one year prior to the training) and postintervention period (one year after the training) showed that, there was a statistically significant (p<0.05) reduction in the perinatal deaths (11 to 3) and neonatal deaths (10 to 2) among the deliveries conducted by TBAs after the training. Training programme for TBAs with regular reinforcements in the resource poor setting will not only improve the quality of newborn care but also reduces perinatal deaths.

Perspectives of rural health and human service practitioners following suicide prevention training programme in Australia: A thematic analysis.

PubMed

Jones, Martin; Ferguson, Monika; Walsh, Sandra; Martinez, Lee; Marsh, Michael; Cronin, Kathryn; Procter, Nicolas

2018-05-01

There are well-established training programmes available to support health and human services professionals working with people vulnerable to suicide. However, little is known about involving people with lived experience in the delivery of suicide prevention training with communities with increased rates of suicide. The aim of this paper was to report on a formative dialogical evaluation that explored the views of health and human services workers with regard to a suicide prevention training programme in regional (including rural and remote areas) South Australia which included meaningful involvement of a person with lived experience in the development and delivery of the training. In 2015, eight suicide prevention training workshops were conducted with health and human services workers. All 248 participants lived and worked in South Australian regional communities. We interviewed a subsample of 24 participants across eight sites. A thematic analysis of the interviews identified five themes: Coproduction is key, It is okay to ask the question, Caring for my community, I can make a difference and Learning for future training. The overall meta-theme was "Involvement of a person with lived experience in suicide prevention training supports regional communities to look out for people at risk of suicide." This paper highlights the need for suicide prevention training and other workforce development programmes to include lived experience participation as a core component in development and delivery. © 2018 John Wiley & Sons Ltd.

20 CFR 628.420 - Job training plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Job training plan. 628.420 Section 628.420... THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.420 Job training plan. (a) The Governor shall issue instructions and schedules to assure that job training plans and plan modifications...

20 CFR 628.420 - Job training plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Job training plan. 628.420 Section 628.420... THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.420 Job training plan. (a) The Governor shall issue instructions and schedules to assure that job training plans and plan modifications...

20 CFR 628.420 - Job training plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Job training plan. 628.420 Section 628.420... THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.420 Job training plan. (a) The Governor shall issue instructions and schedules to assure that job training plans and plan modifications...

Obstetric attending physician characteristics and their impact on vacuum and forceps delivery rates: University of California at San Francisco experience from 1977 to 1999.

PubMed

Chang, Anne Lynn S; Noah, Melinda Scully; Laros, Russell K

2002-06-01

The objective of our study was to determine the impact of obstetric attending physician characteristics (eg, region of previous residency training, sex, year of graduation from residency) on the rates of vacuum and forceps delivery at our institution. The analysis was based on 19,897 vaginal deliveries that were performed by 171 attending physicians and 160 resident physicians between 1977 and 1999 at the University of California at San Francisco Medical Center. Z -tests and multivariate logistic regression were performed on a perinatal database that contained standard obstetric variables. Male attending physicians had a higher percentage of forceps deliveries compared with female attending physicians (11.1% vs 6.6%; P <.001); female attending physicians had a higher percentage of vacuum deliveries compared with male attending physicians (9.8% vs 5.1%; P <.001). However, multivariate regression analysis revealed that only the year in which the procedure was performed affected both the forceps and vacuum delivery rates (P <.041). The region of previous residency training of the attending physician affected the vacuum delivery rate (P <.0001) but not the forceps delivery rate (P >.06) in multivariate logistic regression analysis. Factors such as the sex of the obstetric attending physician, the sex of the resident, and the year of graduation from residency for the obstetric attending physician did not have a significant impact on the forceps or vacuum delivery rates (all P >.05). Our study is the first to report that the apparent gender differences in forceps and vacuum delivery rates among obstetric attending physicians was due to the year in which the procedure was performed and not due to sex per se. We also found that the region of previous residency training for the obstetric attending physician significantly influenced the vacuum delivery rate.

A mixed-method evaluation of the feasibility and acceptability of a telehealth-based parent-mediated intervention for children with autism spectrum disorder.

PubMed

Pickard, Katherine E; Wainer, Allison L; Bailey, Kathryn M; Ingersoll, Brooke R

2016-10-01

Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online. This study used mixed-methods analysis to create a more thorough understanding of parent experiences likely to influence the adoption and implementation of the program in community settings. Specific research questions included (1) What are parents' perceptions of the online program? (2) How does ImPACT Online compare to other services that parents are accessing for their children? And (3) Do parents' experience in, and perceptions of, the program differ based on whether they received a therapist-assisted version of the program? Results from 28 parents of a child with autism spectrum disorder indicate that parents saw improvements in their child's social communication skills and their own competence during the course of the program, regardless of whether they received therapist assistance. However, qualitative interviews indicate that parents who received therapist assistance were more likely endorse the acceptability and observability of the program. These findings support the potential for Internet-based service delivery to more efficiently disseminate evidence-based parent training interventions for autism spectrum disorder. © The Author(s) 2016.

Factors associated with adverse clinical outcomes among obstetric trainees

PubMed Central

Aiken PhD, Catherine E.; Aiken, Abigail; Park, Hannah; Brockelsby, Jeremy C.; Prentice, Andrew

2016-01-01

Objective To determine whether UK obstetric trainees transitioning from directly to indirectly-supervised practice have a higher likelihood of adverse patient outcomes from operative deliveries compared to other indirectly supervised trainees and to examine whether performing more procedures under direct supervision is associated with fewer adverse outcomes in initial indirect practice. Methods We examined all deliveries (13,861) conducted by obstetricians at a single centre over 5 years (2008-2013). Mixed-effects logistic regression models were used to compare estimated blood loss, maternal trauma, umbilical arterial pH, delayed neonatal respiration, failed instrumental delivery, and critical incidents for trainees in their first indirectly-supervised year with trainees in all other years of indirect practice. Outcomes for trainees in their first indirectly-supervised 3 months were compared to their outcomes for the remainder of the year. Linear regression was used to examine the relationship between number of procedures performed under direct supervision and initial outcomes under indirect supervision. Results Trainees in their first indirectly-supervised year had a higher likelihood of >2 litres estimated blood loss at any delivery (OR 1.32;CI(1.01-1.64) p<0.05) and of failed instrumental delivery (OR 2.33;CI(1.37-3.29) p<0.05) compared with other indirectly-supervised trainees. Other measured outcomes showed no significant differences. Within the first three months of indirect supervision, the likelihood of operative vaginal deliveries with >1litre estimated blood loss (OR 2.54;CI(1.88-3.20) p<0.05) was higher compared to the remainder of the first year. Performing more deliveries under direct supervision prior to beginning indirectly-supervised training was associated with decreased risk of >1litre estimated blood loss (p<0.05). Conclusions Obstetric trainees in their first year of indirectly-supervised practice have a higher likelihood of immediate adverse delivery outcomes, which are primarily maternal rather than neonatal. Undertaking more directly supervised procedures prior to transitioning to indirectly-supervised practice may reduce adverse outcomes, suggesting that experience is a key consideration in obstetric training programme design. PMID:26077215

Simulation to Improve Trainee Knowledge and Comfort About Twin Vaginal Birth.

PubMed

Easter, Sarah Rae; Gardner, Roxane; Barrett, Jon; Robinson, Julian N; Carusi, Daniela

2016-10-01

To describe a simulation-based curriculum on twin vaginal delivery and evaluate its effects on trainee knowledge and comfort about twin vaginal birth. Trainees participated in a three-part simulation consisting of a patient counseling session, a twin delivery scenario, and a breech extraction skills station. Consenting trainees completed a 21-item presimulation survey and a 22-item postsimulation survey assessing knowledge, experience, attitudes, and comfort surrounding twin vaginal birth. Presimulation and postsimulation results were compared using univariate analysis. Our primary outcomes were change in knowledge and comfort before and after the simulation. Twenty-four obstetrics and gynecology residents consented to participation with 18 postsimulation surveys available for comparison (75%). Trainees estimated their participation in 445 twin deliveries (median 19, range 0-52) with only 20.4% of these as vaginal births. Participants reported a need for more didactic or simulated training on this topic (64% and 88%, respectively). Knowledge about twin delivery improved after the simulation (33.3% compared with 58.3% questions correct, P<.01). Before training, 33.3% of participants reported they would strongly counsel a patient to attempt vaginal birth instead of elective cesarean delivery for twins compared with 50% after training (P=.52). Personal comfort with performing a breech extraction of a nonvertex second twin improved from 5.5% to 66.7% after the simulation (P<.01). Resident exposure to twin vaginal birth is infrequent and variable with a demonstrable need for more training. Our contemporary obstetric climate is prioritizing vaginal birth despite less frequent operative obstetric interventions. We describe a reproducible twin delivery simulation associated with a favorable effect on resident knowledge and comfort levels.

SU-F-E-09: Respiratory Signal Prediction Based On Multi-Layer Perceptron Neural Network Using Adjustable Training Samples

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

Sun, W; Jiang, M; Yin, F

Purpose: Dynamic tracking of moving organs, such as lung and liver tumors, under radiation therapy requires prediction of organ motions prior to delivery. The shift of moving organ may change a lot due to huge transform of respiration at different periods. This study aims to reduce the influence of that changes using adjustable training signals and multi-layer perceptron neural network (ASMLP). Methods: Respiratory signals obtained using a Real-time Position Management(RPM) device were used for this study. The ASMLP uses two multi-layer perceptron neural networks(MLPs) to infer respiration position alternately and the training sample will be updated with time. Firstly, amore » Savitzky-Golay finite impulse response smoothing filter was established to smooth the respiratory signal. Secondly, two same MLPs were developed to estimate respiratory position from its previous positions separately. Weights and thresholds were updated to minimize network errors according to Leverberg-Marquart optimization algorithm through backward propagation method. Finally, MLP 1 was used to predict 120∼150s respiration position using 0∼120s training signals. At the same time, MLP 2 was trained using 30∼150s training signals. Then MLP is used to predict 150∼180s training signals according to 30∼150s training signals. The respiration position is predicted as this way until it was finished. Results: In this experiment, the two methods were used to predict 2.5 minute respiratory signals. For predicting 1s ahead of response time, correlation coefficient was improved from 0.8250(MLP method) to 0.8856(ASMLP method). Besides, a 30% improvement of mean absolute error between MLP(0.1798 on average) and ASMLP(0.1267 on average) was achieved. For predicting 2s ahead of response time, correlation coefficient was improved from 0.61415 to 0.7098.Mean absolute error of MLP method(0.3111 on average) was reduced by 35% using ASMLP method(0.2020 on average). Conclusion: The preliminary results demonstrate that the ASMLP respiratory prediction method is more accurate than MLP method and can improve the respiration forecast accuracy.« less

Computation of Low Speed Cavity Noise

NASA Technical Reports Server (NTRS)

Blech, Richard A. (Technical Monitor); Loh, Ching Y.

2004-01-01

Over the last five years, the Aircraft Icing Project of the NASA Aviation Safety Program has developed a number of in-flight icing education and training aids to support increased awareness for pilots of the hazards associated with atmospheric icing conditions. Through the development of this work, a number of new instructional design approaches and media delivery methods have been introduced to enhance the learning experience, expand user interactivity and participation, and, hopefully, increase the learner retention rates. The goal of using these multimedia techniques is to increase the effectiveness of the training materials. This paper will describe the multimedia technology that has been introduced and give examples of how it was used.

Erythropoiesis-stimulating agents and other methods to enhance oxygen transport

PubMed Central

Elliott, S

2008-01-01

Oxygen is essential for life, and the body has developed an exquisite method to collect oxygen in the lungs and transport it to the tissues. Hb contained within red blood cells (RBCs), is the key oxygen-carrying component in blood, and levels of RBCs are tightly controlled according to demand for oxygen. The availability of oxygen plays a critical role in athletic performance, and agents that enhance oxygen delivery to tissues increase aerobic power. Early methods to increase oxygen delivery included training at altitude, and later, transfusion of packed RBCs. A breakthrough in understanding how RBC formation is controlled included the discovery of erythropoietin (Epo) and cloning of the EPO gene. Cloning of the EPO gene was followed by commercial development of recombinant human Epo (rHuEpo). Legitimate use of this and other agents that affect oxygen delivery is important in the treatment of anaemia (low Hb levels) in patients with chronic kidney disease or in cancer patients with chemotherapy-induced anaemia. However, competitive sports was affected by illicit use of rHuEpo to enhance performance. Testing methods for these agents resulted in a cat-and-mouse game, with testing labs attempting to detect the use of a drug or blood product to improve athletic performance (doping) and certain athletes developing methods to use the agents without being detected. This article examines the current methods to enhance aerobic performance and the methods to detect illicit use. PMID:18362898

20 CFR 617.20 - Responsibilities for the delivery of reemployment services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... services; (6) Providing or procuring self-directed job search training, when necessary; (7) Providing training, job search and relocation assistance; (8) Developing a training plan with the individual; (9... reemployment services. 617.20 Section 617.20 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION...

Resource Consumption of a Diffusion Model for Prevention Programs: The PROSPER Delivery System

PubMed Central

Crowley, Daniel M.; Jones, Damon E.; Greenberg, Mark T.; Feinberg, Mark E.; Spoth, Richard L.

2012-01-01

Purpose To prepare public systems to implement evidence-based prevention programs for adolescents, it is necessary to have accurate estimates of programs’ resource consumption. When evidence-based programs are implemented through a specialized prevention delivery system, additional costs may be incurred during cultivation of the delivery infrastructure. Currently, there is limited research on the resource consumption of such delivery systems and programs. In this article, we describe the resource consumption of implementing the PROSPER (PROmoting School–Community–University Partnerships to Enhance Resilience) delivery system for a period of 5 years in one state, and how the financial and economic costs of its implementation affect local communities as well as the Cooperative Extension and University systems. Methods We used a six-step framework for conducting cost analysis, using a Cost–Procedure–Process–Outcome Analysis model (Yates, Analyzing costs, procedures, processes, and outcomes in human services: An introduction, 1996; Yates, 2009). This method entails defining the delivery System; bounding cost parameters; identifying, quantifying, and valuing systemic resource Consumption, and conducting sensitivity analysis of the cost estimates. Results Our analyses estimated both the financial and economic costs of the PROSPER delivery system. Evaluation of PROSPER illustrated how costs vary over time depending on the primacy of certain activities (e.g., team development, facilitator training, program implementation). Additionally, this work describes how the PROSPER model cultivates a complex resource infrastructure and provides preliminary evidence of systemic efficiencies. Conclusions This work highlights the need to study the costs of diffusion across time and broadens definitions of what is essential for successful implementation. In particular, cost analyses offer innovative methodologies for analyzing the resource needs of prevention systems. PMID:22325131

The effect of water immersion delivery on the strength of pelvic floor muscle and pelvic floor disorders during postpartum period: An experimental study.

PubMed

Zhao, Yun; Xiao, Mei; Tang, Fei; Tang, Wan; Yin, Heng; Sun, Guo-Qiang; Lin, Yin; Zhou, Yong; Luo, Yan; Li, Lu-Man; Tan, Zhi-Hua

2017-10-01

Water immersion delivery is a non-pharmacological approach to ease labor pain. This paper aims to investigate the effect of water immersion delivery on increasing strength of pelvic floor muscle (PFM) and relieving pelvic floor disorders (PFDs) during postpartum period. A total of 2749 vaginal-delivery primiparas in postpartum 6-8 weeks were selected as research objects. Based on the modes of delivery, 600 patients were assigned into water immersion delivery group, 2149 were assigned into conventional delivery group. The scales of PFM strength and pelvic organ prolapsed (POP) were determined by specially trained personnel using digital palpation, and the symptoms of stress urinary incontinence (SUI) were investigated by questionnaire survey. The weak PFM strength was improved by doing Kegel exercise at home for 6-8 weeks. We found that ①The rate of episiotomy in water immersion delivery group was 77.50% (465/600), which was lower than that in conventional delivery group (84.69%, 1820/2149) (P < .01); The primiparas without having an episiotomy have higher PFM strength than those having an episiotomy for both groups (P < .01). ②There was a negative correlation between the scale of PFM strength and SUI or POP, wherein the r-values were -0.135 and -0.435, respectively (P < .01). ③The rate of SUI was 6.50% (39/600) in water immersion delivery group and 6.89% (148/2149) in the conventional delivery group, wherein the intergroup difference was not significant (P > .05); ④The rates of vaginal wall prolapsed and uterus prolapsed were 29.83% (179/600) and 2.83% (17/600) in water immersion delivery group and 30.95% (665/2149) and 4.37% (94/2149) in the conventional delivery group, wherein the intergroup difference was not significant (P > .05). ⑤After Kegel exercise, the strength of PFM was promoted (P < .01). Water immersion delivery has been proved to a beneficial alternative method for conventional delivery method. This delivery mode is associated with fewer episiotomy rate, and avoiding episiotomy is beneficial for maintaining PFM strength of women in postpartum 6-8 weeks. The strength of PFM during postpartum period can be improved by doing Kegel exercise at home.

Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults.

PubMed

Washburn, Lisa T; Cornell, Carol E; Phillips, Martha; Felix, Holly; Traywick, LaVona

2014-09-01

The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability. All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability. Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders. Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.

Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania

PubMed Central

2013-01-01

Background Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women’s health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Methods Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. Results The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Conclusions Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health. PMID:23448583

Singing for Lung Health: a qualitative assessment of a British Lung Foundation programme for group leaders

PubMed Central

Lewis, Adam; Cave, Phoene; Hopkinson, Nicholas S

2017-01-01

Introduction Singing for Lung Health (SLH) groups are an increasingly popular intervention for people with respiratory disease. There are limited data as to how these groups should be developed and run. We aimed to evaluate the experience of singing leaders both to assess the training provided by the British Lung Foundation (BLF) and to provide information to guide future development of programmes. Methods A convenience sample of 15 leaders who had received BLF SLH training participated in the BLF service evaluation. Fifteen singing groups were observed, and singing leader interviews and questionnaires were collected. Inductive themes from the qualitative data were the primary outcome. The content of observed singing groups was also rated against the training leaders had received. Results Singing leaders valued the BLF training but felt that a significant level of expertise is required before joining. Singing leaders often found setting up groups challenging and some found clinician support beneficial. There were important technical aspects of running a lung health group including issues around content, for example, choice of repertoire to suit breathing pattern, and delivery, for example, pace, rhythm and management of group dynamics. Leaders said that group participants reported physical health improvements such as reduced breathlessness on activity. The content and delivery of singing classes observed displayed a good level of fidelity, suggesting that SLH training is effective. Conclusion The experience of the leaders highlights the requirements, support and technical skills needed to run SLH groups, which have features distinct from generic community singing groups. PMID:29071079

Developing Expatriates for the Asia-Pacific Region: A Comparative Analysis of Multinational Enterprise Managers from Five Countries across Three Continents. [and] Invited Reaction: Developing Expatriates for the Asia-Pacific Region.

ERIC Educational Resources Information Center

Osman-Gani, AAhad M.; van Reine, Peter Prud'homme; Trompenaars, Fons

2000-01-01

Osman-Gani's study surveyed 501 U.S., Germany, Japanese, Korean, and Singaporean managers working abroad, finding significant differences in views of types of training (pre- and postarrival, repatriation, language, cross-cultural) and appropriate delivery methods. Van Reine and Trompenaars' reaction article highlights how cultural background,…

Training the Trainers of Tomorrow Today - driving excellence in medical education.

PubMed

Fellow-Smith, Elizabeth; Beveridge, Ed; Hogben, Katy; Wilson, Graeme; Lowe, John; Abraham, Rachel; Ingle, Digby; Bennett, Danielle; Hernandez, Carol

2013-01-01

Training the Trainers of Tomorrow Today (T4) is a new way to deliver "Training for Trainers". Responding to local dissatisfaction with existing arrangements, T4 builds on 3 essential requirements for a future shape of training: 1. Clinical Leadership and a Collaborative Approach 2. Cross-Specialty Design and Participation 3. Local Delivery and Governance Networks Design principles also included: 3 levels of training to reflect differing needs of clinical supervisors, educational supervisors and medical education leader, mapping to GMC requirements and the London Deanery's Professional Development Framework; alignment of service, educational theory and research; recognition of challenges in delivering and ensuring attendance in busy acute and mental health settings, and the development of a faculty network. The delivery plan took into account census of professional development uptake and GMC Trainee Surveys. Strong engagement and uptake from the 11 Trusts in NW London has been achieved, with powerful penetration into all specialties. Attendance has exceeded expectations. Against an initial 12 month target of 350 attendances, 693 were achieved in the first 8 months. Evaluation of content demonstrates modules are pitched appropriately to attendees needs, with positive feedback from trainers new to the role. Delivery style has attracted high ratings of satisfaction: 87% attendees rating delivery as "good\\excellent". External evaluation of impact demonstrated improved training experiences through changes in supervision, the learning environment and understanding of learning styles. We have addressed sustainability of the programme by advertising and recruiting Local Faculty Development Trainers. Volunteer consultants and higher trainees are trained to deliver the programme on a cascade model, supported by the Specialty Tutors, individual coaching and educational bursaries. The Trainers are local champions for excellence in training, provide a communication between the programme and local providers, are a repository of expertise in their service, and trouble shoot local barriers to engagement.

Training traditional birth attendants on the use of misoprostol and a blood measurement tool to prevent postpartum haemorrhage: lessons learnt from Bangladesh.

PubMed

Bell, Suzanne; Passano, Paige; Bohl, Daniel D; Islam, Arshadul; Prata, Ndola

2014-03-01

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs' knowledge, attitudes, and practices. Acknowledgeing TBAs' important role in the community and in home deliveries and integrating them into the formal healthcare system has the potential to result in changes similar to those seen in this study.

Getting to Grips with Online Delivery.

ERIC Educational Resources Information Center

Booker, Di

This booklet, which is intended for general readers wishing to understand important trends in vocational education and training (VET) in Australia, provides an overview of the basic issues in online delivery of VET. The following topics are discussed in the booklet's first six sections: (1) basic principles of online delivery; (2) benefits and…

77 FR 65581 - Verizon Business Networks Services, Inc., Senior Analyst, Service Program Delivery (SA-SPD...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,827] Verizon Business Networks... Verizon Business Network Services, Inc., Senior Analyst-Service Program Delivery, Hilliard, Ohio (subject.... Specifically, the worker group supplies service program delivery services. At the request of the State of Ohio...

Improvements in the delivery of resuscitation and newborn care after Helping Babies Breathe training.

PubMed

Kamath-Rayne, B D; Josyula, S; Rule, A R L; Vasquez, J C

2017-10-01

To evaluate changes in neonatal resuscitation and postnatal care following Helping Babies Breathe (HBB) training at a community hospital in rural Honduras. We hypothesized that HBB training would improve resuscitation and essential newborn care interventions. Direct observation and video recording of delivery room care spanned before and after an initial HBB workshop held in August 2013. Rates of essential newborn care interventions were compared in resuscitations performed by individuals who had and had not received HBB training, and run charts recording performance of newborn care practices over time were developed. Ten percent of deliveries (N=250) were observed over the study period, with 156 newborn resuscitations performed by individuals without HBB training, compared to 94 resuscitations performed by HBB trainees. After HBB training, significant improvements were seen in skin-to-skin care, breastfeeding within 60 min of age, and delayed cord clamping after 1 min (all P<0.01). More babies cared for by HBB trainees received basic neonatal resuscitation such as drying and stimulation. Run charts tracking these practices over time showed significant improvements after HBB training that were sustained during the study period, but remained below ideal goals. With improvement in drying/stimulation practices, fewer babies required bag/mask ventilation. In a rural Honduran community hospital, improvements in basic neonatal resuscitation and postnatal essential newborn care practices can be seen after HBB training. Further improvements in newborn care practices may require focused quality improvement initiatives for hospitals to sustain high quality care.

Maximising harm reduction in early specialty training for general practice: validation of a safety checklist

PubMed Central

2012-01-01

Background Making health care safer is a key policy priority worldwide. In specialty training, medical educators may unintentionally impact on patient safety e.g. through failures of supervision; providing limited feedback on performance; and letting poorly developed behaviours continue unchecked. Doctors-in-training are also known to be susceptible to medical error. Ensuring that all essential educational issues are addressed during training is problematic given the scale of the tasks to be undertaken. Human error and the reliability of local systems may increase the risk of safety-critical topics being inadequately covered. However adherence to a checklist reminder may improve the reliability of task delivery and maximise harm reduction. We aimed to prioritise the most safety-critical issues to be addressed in the first 12-weeks of specialty training in the general practice environment and validate a related checklist reminder. Methods We used mixed methods with different groups of GP educators (n = 127) and specialty trainees (n = 9) in two Scottish regions to prioritise, develop and validate checklist content. Generation and refinement of checklist themes and items were undertaken on an iterative basis using a range of methods including small group work in dedicated workshops; a modified-Delphi process; and telephone interviews. The relevance of potential checklist items was rated using a 4-point scale content validity index to inform final inclusion. Results 14 themes (e.g. prescribing safely; dealing with medical emergency; implications of poor record keeping; and effective & safe communication) and 47 related items (e.g. how to safety-net face-to-face or over the telephone; knowledge of practice systems for results handling; recognition of harm in children) were judged to be essential safety-critical educational issues to be covered. The mean content validity index ratio was 0.98. Conclusion A checklist was developed and validated for educational supervisors to assist in the reliable delivery of safety-critical educational issues in the opening 12-week period of training, and aligned with national curriculum competencies. The tool can also be adapted for use as a self-assessment instrument by trainees to guide patient safety-related learning needs. Dissemination and implementation of the checklist and self-rating scale are proceeding on a national, voluntary basis with plans to evaluate its feasibility and educational impact. PMID:22721273

Delivering Training for Highly Demanding Information Systems

ERIC Educational Resources Information Center

Norton, Andrew Lawrence; Coulson-Thomas, Yvette May; Coulson-Thomas, Colin Joseph; Ashurst, Colin

2012-01-01

Purpose: There is a lack of research covering the training requirements of organisations implementing highly demanding information systems (HDISs). The aim of this paper is to help in the understanding of appropriate training requirements for such systems. Design/methodology/approach: This research investigates the training delivery within a…

Comparison of the effect of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume on midwifery students: A randomized clinical trial

PubMed Central

Kordi, Masoumeh; Fakari, Farzaneh Rashidi; Mazloum, Seyed Reza; Khadivzadeh, Talaat; Akhlaghi, Farideh; Tara, Mahmoud

2016-01-01

Introduction: Delay in diagnosis of bleeding can be due to underestimation of the actual amount of blood loss during delivery. Therefore, this research aimed to compare the efficacy of web-based, simulation-based, and conventional training on the accuracy of visual estimation of postpartum hemorrhage volume. Materials and Methods: This three-group randomized clinical trial study was performed on 105 midwifery students in Mashhad School of Nursing and Midwifery in 2013. The samples were selected by the convenience method and were randomly divided into three groups of web-based, simulation-based, and conventional training. The three groups participated before and 1 week after the training course in eight station practical tests, then, the students of the web-based group were trained on-line for 1 week, the students of the simulation-based group were trained in the Clinical Skills Centre for 4 h, and the students of the conventional group were trained for 4 h presentation by researchers. The data gathering tool was a demographic questionnaire designed by the researchers and objective structured clinical examination. Data were analyzed by software version 11.5. Results: The accuracy of visual estimation of postpartum hemorrhage volume after training increased significantly in the three groups at all stations (1, 2, 4, 5, 6 and 7 (P = 0.001), 8 (P = 0.027)) except station 3 (blood loss of 20 cc, P = 0.095), but the mean score of blood loss estimation after training did not significantly different between the three groups (P = 0.95). Conclusion: Training increased the accuracy of estimation of postpartum hemorrhage, but no significant difference was found among the three training groups. We can use web-based training as a substitute or supplement of training along with two other more common simulation and conventional methods. PMID:27500175

An access technology delivery protocol for children with severe and multiple disabilities: a case demonstration.

PubMed

Mumford, Leslie; Lam, Rachel; Wright, Virginia; Chau, Tom

2014-08-01

This study applied response efficiency theory to create the Access Technology Delivery Protocol (ATDP), a child and family-centred collaborative approach to the implementation of access technologies. We conducted a descriptive, mixed methods case study to demonstrate the ATDP method with a 12-year-old boy with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with a custom smile-based access technology. At the 16 week mark, the new access technology offered better response quality; teacher satisfaction was high; average technology usage was 3-4 times per week for up to 1 h each time; switch sensitivity and specificity reached 78% and 64%, respectively, and participation scores increased by 38%. This case supports further development and testing of the ATDP with additional children with multiple or severe disabilities.

A Research Mentor Training Curriculum for Clinical and Translational Researchers

PubMed Central

House, Stephanie; Spencer, Kimberly; Asquith, Pamela; Carney, Paula; Masters, Kristyn S.; McGee, Richard; Shanedling, Janet; Vecchiarelli, Stephanie; Fleming, Michael

2012-01-01

Abstract Purpose To design and evaluate a research mentor training curriculum for clinical and translational researchers. The resulting 8‐hour curriculum was implemented as part of a national mentor training trial. Method The mentor training curriculum was implemented with 144 mentors at 16 academic institutions. Facilitators of the curriculum participated in a train‐the‐trainer workshop to ensure uniform delivery. The data used for this report were collected from participants during the training sessions through reflective writing, and following the last training session via confidential survey with a 94% response rate. Results A total of 88% of respondents reported high levels of satisfaction with the training experience, and 90% noted they would recommend the training to a colleague. Participants also reported significant learning gains across six mentoring competencies as well as specific impacts of the training on their mentoring practice. Conclusions The data suggest the described research mentor training curriculum is an effective means of engaging research mentors to reflect upon and improve their research mentoring practices. The training resulted in high satisfaction, self‐reported skill gains as well as behavioral changes of clinical and translational research mentors. Given success across 16 diverse sites, this training may serve as a national model. Clin Trans Sci 2013; Volume 6: 26–33 PMID:23399086

Adapting operational research training to the Rwandan context: the Intermediate Operational Research Training programme

PubMed Central

Odhiambo, Jackline; Amoroso, Cheryl L.; Barebwanuwe, Peter; Warugaba, Christine; Hedt-Gauthier, Bethany L.

2017-01-01

ABSTRACT Background: Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery. Objective: This paper describes the implementation of IORT to share experiences with other organizations interested in developing similar training programmes. Methods: The Intermediate Operational Research Training utilized a deliverable-driven training model, using learning-by-doing pedagogy with intensive hands-on mentorship to build research skills from protocol development to scientific publication. The course had short (two-day) but frequent training sessions (seven sessions over eight months). Trainees were clinical and programme staff working at the district level who were paired to jointly lead a research project. Results: Of 10 trainees admitted to the course from a pool of 24 applicants, nine trainees completed the course with five research projects published in peer-reviewed journals. Strengths of the course included supportive national and institutional research capacity guidelines, building from a successful training model, and trainee commitment. Challenges included delays in ethical review, high mentorship workload of up to 250 hours of practicum mentorship, lack of access to literature in subscription journals and high costs of open access publication. Conclusions: The IORT course was an effective way to support the district-based government and NGO staff in gaining research skills, as well as answering research questions relevant to health service delivery at district hospitals. Other NGOs should build on successful programmes while adapting course elements to address context-specific challenges. Mentorship for LMIC trainees is critical for effectiveness of research capacity building initiatives. PMID:29119872

Training competent and effective Primary Health Care Workers to fill a void in the outer islands health service delivery of the Marshall Islands of Micronesia

PubMed Central

Keni, Bhalachandra H

2006-01-01

Background Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities. In an effort to remedy the effectiveness of health care delivery to these islands, a program to train mid-level health care workers (Hospital Assistants) was developed and implemented by the Ministry of Health in conjunction with the hospital in Majuro, the capital city of the Marshall Islands. Methods A physician instructor with experience and expertise in primary health care in these regions conducted the program. The curriculum included training in basic health science, essentials of endemic disorders and their clinical management appropriate to the outer islands. Emphasis was given to prevention and health promotion as well as to the curative aspects. For clinical observation, the candidates were assigned to clinical departments of the Majuro hospital for 1 year during their training, as assistants to the nursing staff. This paper discusses the details of the training, the modalities used to groom the candidates, and an assessment of the ultimate effectiveness of the program. Results Out of 16 boys who began training, 14 candidates were successful in completing the program. In 1998 a similar program was conducted exclusively for women under the auspices of Asian Development Bank funding, hence women were not part of this program. Conclusion For developing countries of the Pacific, appropriately trained human resources are an essential component of economic progress, and the health workforce is an important part of human resources for sustainable progress and development. PMID:17173693

A phase III randomized three-arm trial of physical therapist delivered pain coping skills training for patients with total knee arthroplasty: the KASTPain protocol

PubMed Central

2012-01-01

Background Approximately 20% of patients report persistent and disabling pain following total knee arthroplasty (TKA) despite an apparently normally functioning prosthesis. One potential risk factor for unexplained persistent pain is high levels of pain catastrophizing. We designed a three-arm trial to determine if a pain coping skills training program, delivered prior to TKA, effectively reduces function-limiting pain following the procedure in patients with high levels of pain catastrophizing. Methods/design The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Discussion The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Trial Registration NCT01620983 PMID:22906061

The Effectiveness of Homeland Security Training for Rural Communities: A Comparative Analysis of Web-Based and Instructor-Led Training Delivery

ERIC Educational Resources Information Center

Baggett, Ryan K.

2012-01-01

The development of advanced training technologies such as Web Based Training (WBT), coupled with the proliferation of computer and Internet availability, has increased training opportunities for rural communities. This advancement is critical to meeting the training needs of emergency response personnel in rural communities who routinely face the…

Training of Evaluators in the Third World: Implementation of the Action Training Model (ATM) in Kenya and Botswana.

ERIC Educational Resources Information Center

Bhola, H. S.

The Action Training Model (ATM) was developed for the delivery of evaluation training to development workers in Kenya and Botswana and implemented under the aegis of the German Foundation for International Development. Training of evaluators is a challenge in any context, but in the Third World environment, evaluation training offers special…

Interventionist training and intervention fidelity monitoring and maintenance for CONNECT, a nurse-led primary palliative care in oncology trial.

PubMed

Robbins-Welty, Gregg A; Mueser, Lisa; Mitchell, Chandler; Pope, Nicole; Arnold, Robert; Park, SeoYoung; White, Doug; Smith, Kenneth J; Reynolds, Charles; Rosenzweig, Margaret; Bakitas, Marie; Schenker, Yael

2018-06-01

Intervention fidelity is a critical component of behavioral research that has received inadequate attention in palliative care studies. With increasing focus on the need for palliative care models that can be widely disseminated and delivered by non-specialists, rigorous yet pragmatic strategies for training interventionists and maintaining intervention fidelity are needed. (1) Describe components of a plan for interventionist training and monitoring and maintaining intervention fidelity as part of a primary palliative care trial (CONNECT) and (2) present data about perceived training effectiveness and delivery of key intervention content. Post-training evaluations, visit checklists, and visit audio-recordings. Data were collected from June, 2016 through April, 2017. We include procedures for (1) identification, training and certification of oncology nurses as CONNECT interventionists; (2) monitoring intervention delivery; and (3) maintaining intervention quality. All nurses (N = 14) felt prepared to deliver key competencies after a 3-day in-person training. As assessed via visit checklists, interventionists delivered an average of 94% (SD 13%) of key content for first intervention visits and 85% (SD 14%) for subsequent visits. As assessed via audio-recordings, interventionists delivered an average of 85% (SD 8%) of key content for initial visits and 85% (SD 12%) for subsequent visits. We present a 3-part strategy for training interventionists and monitoring and maintaining intervention delivery in a primary palliative care trial. Training was effective in having nurses feel prepared to deliver primary palliative care skills. As assessed via nursing checklists and visit audio-recordings, intervention fidelity was high.

Can formal education and training improve the outcome of instrumental delivery?

PubMed

Cheong, Y C; Abdullahi, H; Lashen, H; Fairlie, F M

2004-04-15

The primary objective was to examine the effect of formal education and training on instrumental delivery with respect to its success rate and associated neonatal and maternal morbidity. The secondary objective was to determine factors that could influence the success rate of instrumental delivery. Prospective case-control study with historical controls set in a teaching hospital in Sheffield. The prospective group included all women who had instrumental deliveries between 1 November 1999 and 29 February 2000. The control group included all women who delivered between 1 February 1997 and 1 February 1998. An educational package involving formal postgraduate training and self-directed learning were introduced in the time period between the prospective and the control groups. Medical notes were reviewed in the historical controls. For both the control and prospective groups, the following patient characteristics were recorded: maternal age, parity, whether or not onset of labour was induced, use of oxytocin in the second stage of labour, delay in the second stage, operator grade, vaginal findings at delivery and the use of epidural analgesia. The overall failure rate was not different in the prospective group (16%) compared with the control group (18.5%). However, the introduction of an educational package was associated with significant decrease in maternal morbidity associated with cervical, severe labial and high vaginal tears (Odds Ratio (OR) 0.29, CI 0.09-0.97) and neonatal morbidity associated with admission to SCBU (OR 0.72, CI 0.02-0.60), severe neonatal scalp injury (OR 0.14, CI 0.02-0.98) and facial injuries (OR 0.02, CI 0.01-0.04). The factors identified to affect the success of instrumental deliveries were: OP and OT positions of the baby at delivery (OR 0.28, CI 0.17-0.44) and inexperienced operators (OR 0.11, CI 0.02-0.58). In this study, formal education and training of medical staff did not influence the success rate of instrumental delivery but was associated with improved safety for both mother and baby.

Customized Job Training and Credit Programs.

ERIC Educational Resources Information Center

Clarke, Robert G.

1984-01-01

Outlines the similarities and differences between traditional degree programs and industrial training programs and offers suggestions for colleges initiating industrial training efforts, covering areas such as administrative responses, the target group, internal communication, faculty, instructional implications, program delivery, finances,…

Pro-ELT; A Teacher Training Blended Approach

ERIC Educational Resources Information Center

Eshtehardi, Reza

2014-01-01

Pro-ELT is a blended teacher training course. The aim of Pro-ELT is to strengthen English teaching and learning through a blended training approach that includes; quality face to face delivery, supported distance learning and integrated proficiency and methodology training. It delivers quality language teaching and teacher development courses to…

Delivering Training Strategies: The Balanced Scorecard at Work

ERIC Educational Resources Information Center

Baraldi, Stefano; Cifalinò, Antonella

2015-01-01

Aligning the value of training to organizational goals is an emerging need in human resource management. This study, aiming at expanding the research on training evaluation from a strategic management perspective, examines whether the use of the Balanced Scorecard approach can enable an effective delivery of training strategies, thus strengthening…

Planning and Preparing for Training in Reserve Component Units

DTIC Science & Technology

2002-04-01

Maneuver should be emphasized over gunnery because maneuver is more difficult. • BCBST (brigade command and battle staff training) can be the funding ... model for delivery of management training to Guard company and battalion members. • Training tasks should be spread out over a longer cycle. The year is

Reading, Pa.: Training Local People.

ERIC Educational Resources Information Center

Connell, Eileen

1978-01-01

Describes the training process for the local takeover of the New York University--Reading (Pennsylvania) Consortium interactive cable television project for the delivery of social services to senior citizens. The process included hiring and training of staff, training of users, and creation and staffing of the organization needed to operate the…

Online Parent Training to Support Children with Complex Communication Needs

ERIC Educational Resources Information Center

Douglas, Sarah N.; Nordquist, Erica; Kammes, Rebecca; Gerde, Hope

2017-01-01

Parent training can help support the development of communication skills for young children with complex communication needs (CCN). Online delivery of such training may alleviate some of the burden on families, thereby increasing participation and outcomes. To determine the effectiveness of online parent training in communication partner…

Training Package Implementation: Innovative and Flexible Approaches.

ERIC Educational Resources Information Center

Meyers, Dave; Blom, Kaaren

The implementation of training packages (TPs) in Australian workplaces was examined through case studies of the use of TPs in nontraditional trade areas by six innovative registered training organizations (RTOs) across Australia. The study focused on the extent to which new and flexible approaches to learning, training delivery, and assessment…

Redesigning Care Delivery with Patient Support Personnel: Learning from Accountable Care Organizations

PubMed Central

Gorbenko, Ksenia O.; Fraze, Taressa; Lewis, Valerie A.

2017-01-01

INTRODUCTION Accountable care organizations (ACOs) are a value-based payment model in the United States rooted in holding groups of healthcare providers financially accountable for the quality and total cost of care of their attributed population. To succeed in reaching their quality and efficiency goals, ACOs implement a variety of care delivery changes, including workforce redesign. Patient support personnel (PSP)—non-physician staff such as care coordinators, community health workers, and others—are critical to restructuring care delivery. Little is known about how ACOs are redesigning their patient support personnel in terms of responsibilities, location, and evaluation. METHODS We conducted semi-structured one-hour interviews with 25 executives at 16 distinct ACOs. The interviews were recorded, transcribed, and coded for themes, using a qualitative coding and analysis process. RESULTS ACOs deployed PSP to perform four clusters of responsibilities: care provision, care coordination, logistical help with transportation, and social and emotional support. ACOs deployed these personnel strategically across settings (primary care, inpatient services, emergency department, home care and community) depending on their population needs. Most ACOs used personnel with the same level of training across settings. Few ACOs planned to conduct a comprehensive evaluation of their PSP to optimize their value. DISCUSSION ACO strategies in workforce redesign indicate a shift from a physician-centered to a team-based approach. Employing personnel with varying levels of clinical training to perform different tasks can help further optimize care delivery. More robust evaluation of the deployment of PSP and their performance is needed to demonstrate cost-saving benefits of workforce redesign. PMID:28217305

Improving Maternal and Newborn Health: Effectiveness of a Community Health Worker Program in Rural Kenya

PubMed Central

Adam, Mary B.; Dillmann, Maria; Chen, Mei-kuang; Mbugua, Simon; Ndung’u, Joram; Mumbi, Priscilla; Waweru, Eunice; Meissner, Peter

2014-01-01

Background Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance. Methods The study utilized a quasi-experimental nonequivalent design that examined relevant demographic items and knowledge about maternal and newborn health combined with a comprehensive retrospective birth history of women’s children using oral interviews of women who were exposed to health messages delivered by CHWs and those who were not exposed. The project trained CHWs in three geographically distinct areas. Results Mean knowledge scores were higher in those women who reported being exposed to the health messages from CHWs, Eburru 32.3 versus 29.2, Kinale 21.8 vs 20.7, Nyakio 26.6 vs 23.8. The number of women delivering under skilled attendance was higher for those mothers who reported exposure to one or more health messages, compared to those who did not. The percentage of facility deliveries for women exposed to health messages by CHWs versus non-exposed was: Eburru 46% versus 19%; Kinale 94% versus 73%: and Nyakio 80% versus 78%. Conclusion The delivery of health messages by CHWs increased knowledge of maternal and newborn care among women in the local community and encouraged deliveries under skilled attendance. PMID:25090111

Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery

PubMed Central

2014-01-01

Background Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians’ notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification. Methods Data sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes. Results Modifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges. Conclusions The tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of health care providers in CRA and CRAFT and the establishment of a local training and certification program. PMID:24708838

Comparative and cost-effectiveness research: Competencies, opportunities, and training for nurse scientists.

PubMed

Stone, Patricia W; Cohen, Catherine; Pincus, Harold Alan

Comparative and cost-effectiveness research develops knowledge on the everyday effectiveness and value of treatments and care delivery models. To describe comparative and cost-effectiveness research; identify needed competencies for this research; identify federal funding; and describe current training opportunities. Published recommended competencies were reviewed. Current federal funding and training opportunities were identified. A federally funded training program and other training opportunities are described. Fourteen core competencies were identified that have both analytic and theoretical foci from nursing and other fields. There are multiple sources of federal funding for research and training. Interdisciplinary training is needed. Comparative and cost-effectiveness research has the opportunity to transform health care delivery and improve the outcomes of patients. Nurses, as clinicians and scientists, are in a unique position to contribute to this important research. We encourage nurses to seek the needed interdisciplinary research training to participate in this important endeavor. We also encourage educators to use the competencies and processes identified in current training programs to help shape their doctoral programs. Copyright © 2017 Elsevier Inc. All rights reserved.

Promotion of tobacco cessation through dental hygiene education: a pilot study.

PubMed

Monson, Angela L; Engeswick, Lynnette M

2005-08-01

The purposes of this pilot study were as follows: 1) to determine the percentage and frequency of dental hygiene graduates who were providing tobacco cessation counseling (TCC) activities, after receiving TCC training during their formative years of education; 2) to identify the graduates' stages of change using the transtheoretical model regarding TCC; and 3) to identify factors influencing the delivery of TCC. A convenience sample of fifty-one Minnesota State University, Mankato (MSU) dental hygiene graduates were surveyed in this study. Wilcoxen signed rank tests were used to analyze the relationship between counseling actions and dental hygienists' stage of change in four TCC activities: asking, advising, assisting, and arranging follow-up. Pros and cons affecting the delivery of TCC were also examined. Findings indicate that dental hygienists who received TCC education during their training do not provide cessation counseling to a high percentage of their patients even though they believe in the value of such activity. However, dental hygienists are more likely to provide TCC to patients with periodontal disease than other dental patients. 1) addressing the potential frustration of the dental hygienist and coping methods when providing TCC during training may alleviate one of the barriers to TCC; 2) ready access to tobacco education materials may alleviate one of the barriers to TCC; and 3) emphasis during TCC training on providing education for all patients as part of health promotion, rather than just periodontal patients, may increase the overall counseling provided.

Healthcare librarians and the delivery of critical appraisal training: barriers to involvement.

PubMed

Maden-Jenkins, Michelle

2011-03-01

  Many healthcare librarians are undertaking training in critical appraisal but a significant number are not cascading the training to their end-users.   To examine the barriers to healthcare librarian involvement in delivering critical appraisal training.   A questionnaire survey of 57 library services across 48 NHS Trust Library Services in north west England followed up with 21 semi-structured interviews.   Two types of barriers were noted: extrinsic barriers (organisational, environmental, training, role expectations) and intrinsic barriers (knowledge, skills, attitude).   These barriers are not mutually exclusive and by overcoming one of them it does not necessarily follow that healthcare librarians will engage in delivering critical appraisal skills training. The challenge lies in developing strategies to deal effectively with these barriers to encourage and support healthcare librarians in the delivery of critical appraisal training at a level at which they feel confident and able. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

A feasibility study of expert patient and community mental health team led bipolar psychoeducation groups: implementing an evidence based practice

PubMed Central

2013-01-01

Background Group psychoeducation is a cost effective intervention which reduces relapse and improves functioning in bipolar disorder but is rarely implemented. The aim of this study was to identify the acceptability and feasibility of a group psychoeducation programme delivered by community mental health teams (CMHTs) and peer specialist (PS) facilitators. Organisational learning was used to identify and address systematically barriers and enablers, at organisational, health professional and patient levels, to its implementation into a routine service. Methods A systematic examination of barriers and enablers to a three day training process informed the delivery of a first treatment group and a similar process informed the delivery of the second treatment group. Triangulation of research methods improved its internal validity: direct observation of training, self-rated surveys of participant experiences, group discussion, and thematically analysed individual participant and facilitator interviews were employed. Results Barriers and enablers were identified at organisational, educational, treatment content, facilitator and patient levels. All barriers under the control of the research team were addressed with subsequent improvements in patient knowledge about the condition and about local service. In addition, self-management, agency and altruism were enhanced. Barriers that could not be addressed required senior clinical and education leadership outside the research team’s control. PS and professional facilitators were successfully trained and worked together to deliver groups which were generally reported as being beneficial. Conclusion Psychoeducation groups involving CMHT and PS facilitators is acceptable and feasible but their sustainment requires senior leadership within and outside the organisation that control finance and education services. PMID:24215655

Interest in Insects: The Role of Entomology in Environmental Education

PubMed Central

Weeks, Faith J.; Oseto, Christian Y.

2018-01-01

University-based outreach programs have a long history of offering environmental education programs to local schools, but often these lessons are not evaluated for their impact on teachers and students. The impact of these outreach efforts can be influenced by many things, but the instructional delivery method can affect how students are exposed to new topics or how confident teachers feel about incorporating new concepts into the classroom. A study was conducted with a series of university entomology outreach programs using insects as a vehicle for teaching environmental education. These programs were used to assess differences between three of the most common university-based outreach delivery methods (Scientist in the Classroom, Teacher Training Workshops, and Online Curriculum) for their effect on student interest and teacher self-efficacy. Surveys administered to 20 fifth grade classrooms found that the delivery method might not be as important as simply getting insects into activities. This study found that the lessons had a significant impact on student interest in environmental and entomological topics, regardless of treatment. All students found the lessons to be more interesting, valuable, and important over the course of the year. Treatment also did not influence teacher self-efficacy, as it remained high for all teachers. PMID:29473884

Pelvic floor muscle training for prevention and treatment of urinary and fecal incontinence in antenatal and postnatal women: a short version Cochrane review.

PubMed

Boyle, Rhianon; Hay-Smith, E Jean C; Cody, June D; Mørkved, Siv

2014-03-01

Pelvic floor muscle training (PFMT) is commonly recommended during pregnancy and after birth both for prevention and the treatment of incontinence. Effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence. Cochrane Incontinence Group Specialized Register; handsearching (searched February 7, 2012); the references of relevant articles. Randomized or quasi-randomized controlled trials in pregnant or postnatal women having pelvic floor muscle training (PFMT) versus no PFMT or standard care. Duplicate trial assessment, selection and data abstraction. Twenty-two trials involving 8,485 women. Continent pregnant women (prevention) who had intensive antenatal PFMT were less likely to report urinary incontinence up to 6 months after delivery (risk ratio (RR) 0.71, 95% CI 0.54-0.95). Incontinent postnatal women (treatment) who received PFMT were less likely to report urinary incontinence 12 months after delivery (RR 0.60, 95% CI 0.35-1.03). In a mixed population (women with and without incontinence symptoms in late pregnancy or after delivery), PFMT did not reduce incontinence rates after delivery. For women who are continent during pregnancy, PFMT may prevent urinary incontinence up to 6 months after delivery. The extent to which mixed prevention and treatment approaches to PFMT in the postnatal period are effective is less clear that is, offering advice on PFMT to all pregnant or postpartum women whether they have incontinence symptoms or not. There was little evidence about long-term effects for either urinary or fecal incontinence. © 2013 Wiley Periodicals, Inc.

Quality Control of High-Dose-Rate Brachytherapy: Treatment Delivery Analysis Using Statistical Process Control

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

Able, Charles M., E-mail: cable@wfubmc.edu; Bright, Megan; Frizzell, Bart

Purpose: Statistical process control (SPC) is a quality control method used to ensure that a process is well controlled and operates with little variation. This study determined whether SPC was a viable technique for evaluating the proper operation of a high-dose-rate (HDR) brachytherapy treatment delivery system. Methods and Materials: A surrogate prostate patient was developed using Vyse ordnance gelatin. A total of 10 metal oxide semiconductor field-effect transistors (MOSFETs) were placed from prostate base to apex. Computed tomography guidance was used to accurately position the first detector in each train at the base. The plan consisted of 12 needles withmore » 129 dwell positions delivering a prescribed peripheral dose of 200 cGy. Sixteen accurate treatment trials were delivered as planned. Subsequently, a number of treatments were delivered with errors introduced, including wrong patient, wrong source calibration, wrong connection sequence, single needle displaced inferiorly 5 mm, and entire implant displaced 2 mm and 4 mm inferiorly. Two process behavior charts (PBC), an individual and a moving range chart, were developed for each dosimeter location. Results: There were 4 false positives resulting from 160 measurements from 16 accurately delivered treatments. For the inaccurately delivered treatments, the PBC indicated that measurements made at the periphery and apex (regions of high-dose gradient) were much more sensitive to treatment delivery errors. All errors introduced were correctly identified by either the individual or the moving range PBC in the apex region. Measurements at the urethra and base were less sensitive to errors. Conclusions: SPC is a viable method for assessing the quality of HDR treatment delivery. Further development is necessary to determine the most effective dose sampling, to ensure reproducible evaluation of treatment delivery accuracy.« less

Barriers and enablers to delivery of the Healthy Kids Check: an analysis informed by the Theoretical Domains Framework and COM-B model

PubMed Central

2014-01-01

Background More than a fifth of Australian children arrive at school developmentally vulnerable. To counteract this, the Healthy Kids Check (HKC), a one-off health assessment aimed at preschool children, was introduced in 2008 into Australian general practice. Delivery of services has, however, remained low. The Theoretical Domains Framework, which provides a method to understand behaviours theoretically, can be condensed into three core components: capability, opportunity and motivation, and the COM-B model. Utilising this system, this study aimed to determine the barriers and enablers to delivery of the HKC, to inform the design of an intervention to promote provision of HKC services in Australian general practice. Methods Data from 6 focus group discussions with 40 practitioners from general practices in socio-culturally diverse areas of Melbourne, Victoria, were analysed using thematic analysis. Results Many practitioners expressed uncertainty regarding their capabilities and the practicalities of delivering HKCs, but in some cases HKCs had acted as a catalyst for professional development. Key connections between immunisation services and delivery of HKCs prompted practices to have systems of recall and reminder in place. Standardisation of methods for developmental assessment and streamlined referral pathways affected practitioners’ confidence and motivation to perform HKCs. Conclusion Application of a systematic framework effectively demonstrated how a number of behaviours could be targeted to increase delivery of HKCs. Interventions need to target practice systems, the support of office staff and referral options, as well as practitioners’ training. Many behavioural changes could be applied through a single intervention programme delivered by the primary healthcare organisations charged with local healthcare needs (Medicare Locals) providing vital links between general practice, community and the health of young children. PMID:24886520

Educating teenagers about hearing health by training them to educate children.

PubMed

Welch, David; Reddy, Ravi; Hand, Jennifer; Devine, Irina May

2016-09-01

We investigated the change in hearing-health behaviour amongst teenagers trained to deliver the Dangerous Decibels programme to younger children. The Dangerous Decibels programme uses a two-stage process to train 8-12 year-old children to protect their hearing from noise: (1) a team of experts train 'Educators' who (2) give classroom training to children in schools. Training teenagers as Educators may add a second level of benefit if teenagers internalize the hearing-health messages that they present and thus protect their own hearing better. They were assessed before training, immediately after, and three months later (after all had presented the classroom training) using a questionnaire. In addition, a focus group was conducted with a subgroup of the Educators to assess their subjective experience. We trained 44 Educators aged 14-17 years. Results were generally positive: there were significant and sustained improvements in knowledge, self-reported behaviour, and perceived supports towards protecting hearing, and trends but not significant changes in attitudes or perceived barriers to hearing protection. Providing training to teenagers had benefits beyond the delivery of training to younger children, but improvements in the delivery model may increase the uptake and impact on the teenagers.

Barriers to Learners' Successful Completion of VET Flexible Delivery Programs.

ERIC Educational Resources Information Center

Grace, Lauri

In the early 1990s, Australian policymakers began explicitly promoting increased use of flexible delivery in vocational education and training (VET). Some researchers argued that many students lack the learning skills required to deal with the unique demands of flexible delivery. Concerns were also raised about the VET sector's capacity to help…

Physiology-driven adaptive virtual reality stimulation for prevention and treatment of stress related disorders.

PubMed

Cosić, Kresimir; Popović, Sinisa; Kukolja, Davor; Horvat, Marko; Dropuljić, Branimir

2010-02-01

The significant proportion of severe psychological problems related to intensive stress in recent large peacekeeping operations underscores the importance of effective methods for strengthening the prevention and treatment of stress-related disorders. Adaptive control of virtual reality (VR) stimulation presented in this work, based on estimation of the person's emotional state from physiological signals, may enhance existing stress inoculation training (SIT). Physiology-driven adaptive VR stimulation can tailor the progress of stressful stimuli delivery to the physiological characteristics of each individual, which is indicated for improvement in stress resistance. Following an overview of physiology-driven adaptive VR stimulation, its major functional subsystems are described in more detail. A specific algorithm of stimuli delivery applicable to SIT is outlined.

Disaster planning for vulnerable populations: leveraging Community Human Service Organizations direct service delivery personnel.

PubMed

Levin, Karen L; Berliner, Maegan; Merdjanoff, Alexis

2014-01-01

Given the variability, complexities, and available resources for local vulnerable populations, it is clear that preparing effectively for catastrophic events cannot be accomplished with a single, simple template. Inclusion of Community Human Service Organizations' (CHSO's) direct service delivery personnel ensures that emergency disaster planning efforts for vulnerable populations are effective and responsive to unique needs and constraints. By leveraging existing local resources, it extends the preparedness system's reach to the whole community. CHSO personnel already perform community-based services and directly engage with vulnerable and special needs populations; typically they are on the front lines during an emergency event. Generally, however, the CHSOs, staff, and clients are neither adequately prepared for disasters nor well integrated into emergency systems. To address preparedness gaps identified during Hurricane Sandy, regional CHSO and local health department partners requested that the Columbia Regional Learning Center provide preparedness trainings for their agencies and staff responsible for vulnerable clients. Evaluation of this initiative was begun with a mixed-methods approach consisting of collaborative learning activities, a function-based assessment tool, and a 5 Steps to Preparedness module. Results from a survey were inclusive because of a low response rate but suggested satisfaction with the training format and content; increases in awareness of a client preparedness role; and steps toward improved personal, agency, and client preparedness. Direct service delivery personnel can leverage routine client interactions for preparedness planning and thus can contribute significantly to vulnerable population and community disaster readiness. Trainings that provide preparedness tools can help support this role. CHSO personnel are knowledgeable and have the expertise to assist clients in personal preparedness planning; yet, there are challenges around their ability and willingness to take on additional responsibilities.

Virtual grand rounds: a new educational approach in social work that benefits long-term care providers and patients in rural Idaho.

PubMed

Cunningham, B J; Vande Merwe, R

2009-01-01

Nationwide, rural USA is experiencing a shortage of social workers. In rural Idaho, three state-wide non-profit organizations worked together to develop Virtual Grand Rounds (VGRs), a new approach to delivering continuing education to social workers and residential care coordinators, in order to promote their retention in the workforce. This study examined participant satisfaction and the potential for the delivery system to be replicated in other states. Between July 2002 and December 2006, 740 person-hours (359 attendees x 2.06 hours) of continuing education were delivered to resident care coordinators and social workers in 9 sessions of VGRs. In total, 287 evaluation forms (79% return rate) were collected on the quality of the presentation, the presenter's expertise and delivery, the relevance and value of the presentation to the attendee, and the quality of the technology. The questionnaire consisted of 10 questions that aimed to measure participant satisfaction level, using a five-point Likert scale with a comments section. Programs and presenters received positive scores. Participants approved of the delivery method and the overall satisfaction rating was 4.1. As to whether the information presented would lead to changes in practice, participants responded positively with a score of 3.25. The Telehealth Idaho program contributed to a thorough training for new healthcare employees and for those in rural Idaho unable to attend the annual conference for essential training. Initial successes led to an expansion of the program to include other facility staff, and other topics which provided a new training system and infrastructure. This represents one unique contribution to addressing the rural social workers shortage.

Peer Education: Productive Engagement for Older African Americans in Recovery From Depression.

PubMed

Conner, Kyaien O; Gum, Amber; Johnson, Angela; Cadet, Tamara; Brown, Charlotte

2017-06-17

Older adults who have personal experience with the mental health service delivery system gain unique and potentially valuable insight from their treatment experiences. Research suggests that incorporating trained individuals in recovery from a mental illness (i.e., peer educators) into mental health service delivery roles results in substantial benefits for current mental health consumers, particularly for older adults and racial and ethnic minorities who may feel disenfranchised from the traditional mental health service delivery system. However, little research has examined the impact of participating in these activities on the peer educators themselves. This mixed methods study examines the experiences of 10 African American older adults in recovery from depression currently working as trained peer educators. Peer educators reported feeling more positive, feeling their lives had significantly improved, and feeling better in general due to their peer educator roles. This qualitative investigation highlights four unique themes that can explain the benefit of serving in this capacity (i.e., Community Engagement, Life Long Learning and Education, Mental Health Recovery and Productive Aging). This study suggests that serving has a peer educator has a number of beneficial outcomes for African American older adults in recovery from depression. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Spectroscopy and imaging of oxygen delivery to tissue under strenuous conditions (NIR in athletes)

NASA Astrophysics Data System (ADS)

Chance, Britton; Nioka, Shoko; Long, Hong; Xie, Chunhua; Ma, XuHui; Ntziachristos, Vasilis; Luo, Qingming

2000-04-01

It was demonstrated that the dynamics of muscle oxygen utilization can readily be measured using dual wavelength hemoglobin oximetry. This method can be used for muscle training exercise and also for evaluation of exercise performance where the anaerobic threshold must be avoided. It was shown that CW imaging technology gives images along the surface of the muscle while the time resolved spectroscopy gives images transverse to the muscle.

Developing Army Leaders: Lessons for Teaching Critical Thinking in Distributed, Resident, and Mixed-Delivery Venues

DTIC Science & Technology

2014-01-01

Based and Affective Theories of Learning Outcomes to New Methods of Training Evaluation,” Journal of Applied Psychology Monograph, Vol. 2, No. 2, 1993...officers. Thus, the Command and Staff General School offers non-resident alternatives for the Common Core: an advanced distributed learning (ADL...course delivered online and a course combining in-person instruction and distributed learning taught in The Army School System (TASS). This report

Diversity training for the community aged care workers: A conceptual framework for evaluation.

PubMed

Appannah, Arti; Meyer, Claudia; Ogrin, Rajna; McMillan, Sally; Barrett, Elizabeth; Browning, Colette

2017-08-01

Older Australians are an increasingly diverse population, with variable characteristics such as culture, sexual orientation, socioeconomic status, and physical capabilities potentially influencing their participation in healthcare. In response, community aged care workers may need to increase skills and uptake of knowledge into practice regarding diversity through appropriate training interventions. Diversity training (DT) programs have traditionally existed in the realm of business, with little research attention devoted to scientifically evaluating the outcomes of training directed at community aged care workers. A DT workshop has been developed for community aged care workers, and this paper focuses on the construction of a formative evaluative framework for the workshop. Key evaluation concepts and measures relating to DT have been identified in the literature and integrated into the framework, focusing on five categories: Training needs analysis; Reactions; Learning outcomes, Behavioural outcomes and Results The use of a mixed methods approach in the framework provides an additional strength, by evaluating long-term behavioural change and improvements in service delivery. As little is known about the effectiveness of DT programs for community aged care workers, the proposed framework will provide an empirical and consistent method of evaluation, to assess their impact on enhancing older people's experience of healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

Surgical skills simulation in trauma and orthopaedic training.

PubMed

Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

2014-12-19

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.

Measuring trainer fidelity in the transfer of suicide prevention training

PubMed Central

Cross, Wendi F.; Pisani, Anthony R.; Schmeelk-Cone, Karen; Xia, Yinglin; Tu, Xin; McMahon, Marcie; Munfakh, Jimmie Lou; Gould, Madelyn S.

2014-01-01

Background Finding effective and efficient models to train large numbers of suicide prevention interventionists, including ‘hotline’ crisis counselors, is a high priority. Train-the-trainer (TTT) models are widely used but understudied. Aims To assess the extent to which trainers following TTT delivered the Applied Suicide Intervention Skills Training (ASIST) program with fidelity, and to examine fidelity across two trainings and seven training segments. Methods We recorded and reliably rated trainer fidelity, defined as adherence to program content and competence of program delivery, for 34 newly trained ASIST trainers delivering the program to crisis center staff on two separate occasions. A total of 324 observations were coded. Trainer demographics were also collected. Results On average, trainers delivered two-thirds of the program. Previous training was associated with lower levels of trainer adherence to the program. 18% of trainers' observations were rated as solidly competent. Trainers did not improve fidelity from their first to second training. Significantly higher fidelity was found for lectures and lower fidelity was found for interactive training activities including asking about suicide and creating a safe plan. Conclusions We found wide variability in trainer fidelity to the ASIST program following TTT and few trainers had high levels of both adherence and competence. More research is needed to examine the cost-effectiveness of TTT models. PMID:24901061

Interprofessional education for personalized medicine through technology-based learning.

PubMed

Haga, Susanne B; Mills, Rachel; Aucoin, Julia; Taekman, Jeff

2015-06-01

The delivery of personalized medicine utilizing genetic and genomic technologies is anticipated to involve many medical specialties. Interprofessional education will be key to the delivery of personalized medicine in order to reduce disjointed or uncoordinated clinical care, and optimize effective communication to promote patient understanding and engagement regarding the use of or need for these services. While several health professional organizations have endorsed and/or developed core competencies for genetics and genomics, the lack of interprofessional guidelines and training may hamper the delivery of coordinated personalized medicine. In this perspective, we consider the potential for interprofessional education and training using technology-based approaches, such as virtual simulation and gaming, compared with traditional educational approaches.

Linkages between Vocational Education and Training Providers and Industry.

ERIC Educational Resources Information Center

Choi, Jihee; Misko, Josie; Kang, Kyeong-Jong; Phan, Oanh

A study described the general and vocational education and training (VET) systems in Korea and Australia, focusing on the role of training providers and industry in the delivery of entry-level vocational education and training in both countries. The study also analyzed the nature of the linkages established between VET institutions in the two…

Assessment of Effectiveness of Web-Based Training on Demand

ERIC Educational Resources Information Center

Liu, Chien-Hung; Chiang, Tzu-Chiang; Huang, Yueh-Min

2007-01-01

e-Learning is bringing training to the attention of upper management in a way that other learning technologies have never done. Web-based training will remain predominant to the design and delivery of workplace learning in the 21st century because of its advantages over traditional classroom-based training. A comprehensive framework that…

Employment and Training for America's Homeless: Best Practices Guide.

ERIC Educational Resources Information Center

Beck, Susan Kessler; Trutko, John W.; Isbell, Kellie; Rothstein, Frances; Barnow, Burt S.

This document is a how-to guide to help employment and training agencies tailor their delivery systems to be more effective in training, placing, and retaining homeless individuals in gainful employment. The guide is written from the perspective of an employment and training agency and based largely on the experiences of 63 organizations from…

Process evaluation of a national school-based iron supplementation program for adolescent girls in Iran.

PubMed

Kheirouri, Sorayya; Alizadeh, Mohammad

2014-09-16

Iron deficiency anemia remains as one of the most common nutritional problems in Iran, especially in women and girls. A process evaluation study of the national iron supplementation program targeting girls attending high schools was conducted to examine degree of exposure and satisfaction of the targets with the intervention components, and to assess the delivery (quantity), fidelity (quality), and environmental mediators of the intervention. Three assessment tools were developed and used for the process evaluation. A total of 8 schools were selected using a simple randomization method. Data were collected from students (n = 658 of 661 participants), teachers (n = 80), and school principals (n = 7 of 8). For the qualitative measures semi-structured interviews were conducted with the three study groups. Mean continuous compliance was 62.3%. Intolerance to pills and no water supply in classrooms accounted for 47.72% and 36.21% of the refusals, respectively. The refusal rate was significantly correlated (p < 0.001) with the absence of a classroom water supply, and with each student's knowledge of iron deficiency issues (p < 0.05). The odds of refusal in the absence of a classroom water supply were 2.02 (95% CI 1 · 044 to 3 · 900) times greater than for those classrooms with a water supply. Student exposure to the program's goal was satisfactory; however, delivery and fidelity of educational materials and training sessions were inadequate. The findings suggest that the methods of delivery and the fidelity of the program components, education materials and training sessions were insufficient and need to be improved. Additionally, specific attention has to be given to contextual factors to ensure the success of the program.

PowerPoint or chalk and talk: Perceptions of medical students versus dental students in a medical college in India.

PubMed

Seth, Vikas; Upadhyaya, Prerna; Ahmad, Mushtaq; Moghe, Vijay

2010-01-01

To assess students' perceptions of the impact of PowerPoint (PPT) presentations in lectures in comparison to the traditional chalk and talk method and lectures using transparencies and overhead projector (TOHP). The study analyzes the preferences for teaching aids of medical students versus dental students. Second year medical and dental undergraduates were asked to fill in a nine-item questionnaire about their perceptions of the three lecture delivery methods. Following analysis of the questionnaire the students were interviewed further. The results were analyzed separately for medical and dental students to see if there was any difference in their perceptions. The majority of the medical students (65.33%) preferred PPT presentations, while 15.16% of students preferred the lectures using chalkboard, and 19.51% preferred TOHP for teaching (P < 0.001). Of the dental students: 41.84% preferred chalkboard, 31.21% preferred TOHP, and 25.85% students preferred PPT presentations in the lectures (P < 0.05). Some important comments of the students were also recorded on interview which could be valuable for the medical teachers. The medical students clearly preferred the use of PPT presentations while the dental students did not. The study does not bring out evidence based superiority of any lecture delivery method. It appears that in the hands of a trained teacher any teaching aid would be appropriate and effective. This highlights the need for formal training in teaching technologies to develop good presentation skills and thus motivate the students.

PowerPoint or chalk and talk: Perceptions of medical students versus dental students in a medical college in India

PubMed Central

Seth, Vikas; Upadhyaya, Prerna; Ahmad, Mushtaq; Moghe, Vijay

2010-01-01

Purpose To assess students’ perceptions of the impact of PowerPoint (PPT) presentations in lectures in comparison to the traditional chalk and talk method and lectures using transparencies and overhead projector (TOHP). The study analyzes the preferences for teaching aids of medical students versus dental students. Methods Second year medical and dental undergraduates were asked to fill in a nine-item questionnaire about their perceptions of the three lecture delivery methods. Following analysis of the questionnaire the students were interviewed further. The results were analyzed separately for medical and dental students to see if there was any difference in their perceptions. Results The majority of the medical students (65.33%) preferred PPT presentations, while 15.16% of students preferred the lectures using chalkboard, and 19.51% preferred TOHP for teaching (P < 0.001). Of the dental students: 41.84% preferred chalkboard, 31.21% preferred TOHP, and 25.85% students preferred PPT presentations in the lectures (P < 0.05). Some important comments of the students were also recorded on interview which could be valuable for the medical teachers. Conclusion: The medical students clearly preferred the use of PPT presentations while the dental students did not. The study does not bring out evidence based superiority of any lecture delivery method. It appears that in the hands of a trained teacher any teaching aid would be appropriate and effective. This highlights the need for formal training in teaching technologies to develop good presentation skills and thus motivate the students. PMID:23745057

Beyond Web-Based Training: Learning Unplugged.

ERIC Educational Resources Information Center

Gayeski, Diane M.

2002-01-01

Discussion of corporate training focuses on the Internet, Web-based training, and the latest trend toward wireless technology. Topics include the emerging workplace, including continuous learning and collaboration and aiding performance; mobile delivery systems for corporate instructional designers; and types of mobile devices, including PDAs…

Partnerships in the New Employment and Training System. Survey Report II. Job Training Partnership Act Research Findings.

ERIC Educational Resources Information Center

Brady, Elaine

A study examined the level and type of integration and coordination that exist among local employment and training practitioners and local and state educational agencies and institutions in the delivery of employment and training services as mandated by the Job Training Partnership Act (JTPA). To gather data for the study, researchers conducted…

An Overview of the Special Operations Interactive Medical Training Program (SOIMTP).

DTIC Science & Technology

1998-01-08

morphine, penicillin v potassium, hydroxyzine, hydrocortisone, meclizine hydrochloride, tolnaftate, acetamenophen, amoxicillin, clotrimazole cream ...dystocia, calf delivery, colt delivery, deworming, immunizations, horse colic , equine infectious anemia, heartworm disease, and other related topics

Training in patient navigation: A review of the research literature

PubMed Central

Ustjanauskas, Amy E.; Bredice, Marissa; Nuhaily, Sumayah; Kath, Lisa; Wells, Kristen J.

2016-01-01

Despite the proliferation of patient navigation programs designed to increase timely receipt of health care, little is known about the content and delivery of patient navigation training, or best practices in this arena. The current study begins to address these gaps in understanding, as it is the first study to comprehensively review descriptions of patient navigation training in the peer-reviewed research literature. Seventy-five patient navigation efficacy studies published since 1995, identified through PubMed and by the authors, were included in this narrative review. Fifty-nine of the included studies (79%) mentioned patient navigation training, and fifty-five of these studies additionally provided a description of training. Most studies did not thoroughly document patient navigation training practices. Additionally, several topics integral to the role of patient navigators, as well as components of training central to successful adult learning, were not commonly described in the research literature. Descriptions of training also varied widely across studies in terms of duration, location, format, learning strategies employed, occupation of trainer, and content. These findings demonstrate the need for established standards of navigator training as well as future research on the optimal delivery and content of patient navigation training. PMID:26656600

Training in Patient Navigation: A Review of the Research Literature.

PubMed

Ustjanauskas, Amy E; Bredice, Marissa; Nuhaily, Sumayah; Kath, Lisa; Wells, Kristen J

2016-05-01

Despite the proliferation of patient navigation programs designed to increase timely receipt of health care, little is known about the content and delivery of patient navigation training, or best practices in this arena. The current study begins to address these gaps in understanding, as it is the first study to comprehensively review descriptions of patient navigation training in the peer-reviewed research literature. Seventy-five patient navigation efficacy studies published since 1995, identified through PubMed and by the authors, were included in this narrative review. Fifty-nine of the included studies (79%) mentioned patient navigation training, and 55 of these studies additionally provided a description of training. Most studies did not thoroughly document patient navigation training practices. Additionally, several topics integral to the role of patient navigators, as well as components of training central to successful adult learning, were not commonly described in the research literature. Descriptions of training also varied widely across studies in terms of duration, location, format, learning strategies employed, occupation of trainer, and content. These findings demonstrate the need for established standards of navigator training as well as for future research on the optimal delivery and content of patient navigation training. © 2015 Society for Public Health Education.

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

PubMed

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

2018-01-01

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

Education and Training at SNL: Past and Present

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

BOMBER, THOMAS M.; DREWIEN, CELESTE A.

2002-11-01

The purpose of this review was to provide insights and information to Sandia National Laboratories' (SNL) Education Council on the state of technical education and training at SNL in order to address the concern that a change in philosophy surrounding education had occurred. To accomplish this, the status of current and past technical training and education programs were compared, and significant changes at SNL were assessed for their impact on education and training. Major changes in education and training are in the advertisement of course offerings, the course delivery methods, and the funding mechanisms for student and instructor time asmore » well as course costs. The significant changes in SNL which influenced technical training and education are the considerable increase in mandatory or compliance training, a fundamental shift in SNL's management structure from an institutional structure to a more business-like, project-budgeted structure, and the change in SNL's mission at the end of the Cold War. These changes contributed to less time for technical training, reduction of training funds, elimination of some training, and a Service Center approach to paying for training. Most importantly, the overall combined effect has resulted in a shift from a strategic to a tactical training approach. The Corporate Training Department (CTD) has maneuvered to accommodate these changes and keep abreast of constantly changing needs.« less

77 FR 18973 - Reinforced Concrete in Construction, and Preventing Backover Injuries and Fatalities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

... mail, express delivery, hand (courier) delivery, or messenger service. Submit a copy of comments and... delivery, or messenger service. The hours of operation for the OSHA Docket Office are 8:15 a.m.-4:45 p.m.... General Reinforcing Safety F. Impalement G. Training H. Injuries I. Economic Issues J. References I...

Development and Evaluation of a Psychosocial Intervention for Children and Teenagers Experiencing Diabetes (DEPICTED): a protocol for a cluster randomised controlled trial of the effectiveness of a communication skills training programme for healthcare professionals working with young people with type 1 diabetes

PubMed Central

2010-01-01

Background Diabetes is the third most common chronic condition in childhood and poor glycaemic control leads to serious short-term and life-limiting long-term complications. In addition to optimal medical management, it is widely recognised that psychosocial and educational factors play a key role in improving outcomes for young people with diabetes. Recent systematic reviews of psycho-educational interventions recognise the need for new methods to be developed in consultation with key stakeholders including patients, their families and the multidisciplinary diabetes healthcare team. Methods/design Following a development phase involving key stakeholders, a psychosocial intervention for use by paediatric diabetes staff and not requiring input from trained psychologists has been developed, incorporating a communication skills training programme for health professionals and a shared agenda-setting tool. The effectiveness of the intervention will be evaluated in a cluster-randomised controlled trial (RCT). The primary outcome, to be measured in children aged 4-15 years diagnosed with type 1 diabetes for at least one year, is the effect on glycaemic control (HbA1c) during the year after training of the healthcare team is completed. Secondary outcomes include quality of life for patients and carers and cost-effectiveness. Patient and carer preferences for service delivery will also be assessed. Twenty-six paediatric diabetes teams are participating in the trial, recruiting a total of 700 patients for evaluation of outcome measures. Half the participating teams will be randomised to receive the intervention at the beginning of the trial and remaining centres offered the training package at the end of the one year trial period. Discussion The primary aim of the trial is to determine whether a communication skills training intervention for specialist paediatric diabetes teams will improve clinical and psychological outcomes for young people with type 1 diabetes. Previous research indicates the effectiveness of specialist psychological interventions in achieving sustained improvements in glycaemic control. This trial will evaluate an intervention which does not require the involvement of trained psychologists, maximising the potential feasibility of delivery in a wider NHS context. Trial registration Current Controlled Trials ISRCTN61568050. PMID:20144218

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa.

PubMed

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-08-11

A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d'Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative's model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d'Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South-South collaboration has been central to the initiative's accomplishments: Guinea's clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. © Pleah et al.

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa

PubMed Central

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-01-01

ABSTRACT A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d’Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative’s model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d’Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South–South collaboration has been central to the initiative’s accomplishments: Guinea’s clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. PMID:27540120

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.

49 CFR 110.40 - Activities eligible for funding.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subdivision who need the proposed training and to select courses consistent with the National Curriculum. (2) Delivery of comprehensive preparedness and response training to public sector employees. Design and... staff to manage the training effort designed to result in increased benefits, proficiency, and rapid...

Providing Relaxation Training to Cancer Chemotherapy Patients: A Comparison of Three Delivery Techniques.

ERIC Educational Resources Information Center

Carey, Michael P.; Burish, Thomas G.

1987-01-01

Evaluated effectiveness of three strategies for delivering relaxation training to cancer chemotherapy patients who were experiencing treatment-related side effects. Professionally, as opposed to paraprofessionally, administered or audiotaped progressive muscle-relaxation training and guided relaxation imagery reduced emotional distress and…

Some Results from Rehabilitation Team Training.

ERIC Educational Resources Information Center

Settles, Robert B.; Crisler, Jack R.

Provision of training for an interdisciplinary rehabilitation team in a center serving mental patients was investigated. An autonomous service delivery rehabilitation team was formed and provided training in cooperative function. Findings indicate that the experimental team became a particularly cohesive functional unit, and that their support of…

Designing Training for Global Environments: Knowing What Questions To Ask.

ERIC Educational Resources Information Center

Gayeski, Diane M.; Sanchirico, Christine; Anderson, Janet

2002-01-01

Presents a framework for identifying important issues for instructional design and delivery in global settings. Highlights include cultural factors in global training; an instructional design model; corporate globalization strategy; communication and training norms; language barriers; implicit value differences; and technical and legal…

Handbook of Adult Curriculum Development.

ERIC Educational Resources Information Center

Training Research and Development Station, Prince Albert (Saskatchewan).

Alternative instructional designs and delivery systems for adult training are described in a collection of presentations from the National Workshop on Canada Manpower Training. Most are based on experience of the Saskatchewan NewStart program and of the Training Research and Development Station, Saskatchewan. Presentations cover in detail…

A fit for purpose training programme for the decontamination of personnel.

PubMed

O'Mara, E; Cole, P; Wynn, A; Collison, R

2015-06-01

Contingency plans are a crucial part of operating any nuclear facility. The success of a contingency plan depends on the efficacy of the plan and the confidence and understanding of those who must enact it. This project focused on both of these aspects, clarifying technique and then designing and delivering a training programme for decontamination. The design of the training was based on the IAEA Systematic Approach to Training (SAT). The delivery focused on ways of increasing retention including use of practical examples and assessment, peer assessment and visual contingency plans. A quantitative survey of the trainees was conducted using a questionnaire before and after the training programme delivery. The results clearly demonstrate an improvement across all elements of skills and knowledge required to undertake decontamination. Effective training is fundamental to the development of a good safety culture and the methodology used in this work has led to a clear improvement in radiation protection culture at the Devonport site.

Developing a method for specifying the components of behavior change interventions in practice: the example of smoking cessation.

PubMed

Lorencatto, Fabiana; West, Robert; Seymour, Natalie; Michie, Susan

2013-06-01

There is a difference between interventions as planned and as delivered in practice. Unless we know what was actually delivered, we cannot understand "what worked" in effective interventions. This study aimed to (a) assess whether an established taxonomy of 53 smoking cessation behavior change techniques (BCTs) may be applied or adapted as a method for reliably specifying the content of smoking cessation behavioral support consultations and (b) develop an effective method for training researchers and practitioners in the reliable application of the taxonomy. Fifteen transcripts of audio-recorded consultations delivered by England's Stop Smoking Services were coded into component BCTs using the taxonomy. Interrater reliability and potential adaptations to the taxonomy to improve coding were discussed following 3 coding waves. A coding training manual was developed through expert consensus and piloted on 10 trainees, assessing coding reliability and self-perceived competence before and after training. An average of 33 BCTs from the taxonomy were identified at least once across sessions and coding waves. Consultations contained on average 12 BCTs (range = 8-31). Average interrater reliability was high (88% agreement). The taxonomy was adapted to simplify coding by merging co-occurring BCTs and refining BCT definitions. Coding reliability and self-perceived competence significantly improved posttraining for all trainees. It is possible to apply a taxonomy to reliably identify and classify BCTs in smoking cessation behavioral support delivered in practice, and train inexperienced coders to do so reliably. This method can be used to investigate variability in provision of behavioral support across services, monitor fidelity of delivery, and identify training needs.

PROPEL: implementation of an evidence based pelvic floor muscle training intervention for women with pelvic organ prolapse: a realist evaluation and outcomes study protocol.

PubMed

Maxwell, Margaret; Semple, Karen; Wane, Sarah; Elders, Andrew; Duncan, Edward; Abhyankar, Purva; Wilkinson, Joyce; Tincello, Douglas; Calveley, Eileen; MacFarlane, Mary; McClurg, Doreen; Guerrero, Karen; Mason, Helen; Hagen, Suzanne

2017-12-22

Pelvic Organ Prolapse (POP) is estimated to affect 41%-50% of women aged over 40. Findings from the multi-centre randomised controlled "Pelvic Organ Prolapse PhysiotherapY" (POPPY) trial showed that individualised pelvic floor muscle training (PFMT) was effective in reducing symptoms of prolapse, improved quality of life and showed clear potential to be cost-effective. However, provision of PFMT for prolapse continues to vary across the UK, with limited numbers of women's health physiotherapists specialising in its delivery. Implementation of this robust evidence from the POPPY trial will require attention to different models of delivery (e.g. staff skill mix) to fit with differing care environments. A Realist Evaluation (RE) of implementation and outcomes of PFMT delivery in contrasting NHS settings will be conducted using multiple case study sites. Involving substantial local stakeholder engagement will permit a detailed exploration of how local sites make decisions on how to deliver PFMT and how these lead to service change. The RE will track how implementation is working; identify what influences outcomes; and, guided by the RE-AIM framework, will collect robust outcomes data. This will require mixed methods data collection and analysis. Qualitative data will be collected at four time-points across each site to understand local contexts and decisions regarding options for intervention delivery and to monitor implementation, uptake, adherence and outcomes. Patient outcome data will be collected at baseline, six months and one year follow-up for 120 women. Primary outcome will be the Pelvic Organ Prolapse Symptom Score (POP-SS). An economic evaluation will assess the costs and benefits associated with different delivery models taking account of further health care resource use by the women. Cost data will be combined with the primary outcome in a cost effectiveness analysis, and the EQ-5D-5L data in a cost utility analysis for each of the different models of delivery. Study of the implementation of varying models of service delivery of PFMT across contrasting sites combined with outcomes data and a cost effectiveness analysis will provide insight into the implementation and value of different models of PFMT service delivery and the cost benefits to the NHS in the longer term.

Handover training: does one size fit all? The merits of mass customisation.

PubMed

Kicken, Wendy; Van der Klink, Marcel; Barach, Paul; Boshuizen, H P A

2012-12-01

Experts have recommended training and standardisation as promising approaches to improve handovers and minimise the negative consequences of discontinuity of care. Yet the content and delivery of handover training have been only superficially examined and described in literature. The aim of this study was to formulate recommendations for effective handover training and to examine whether standardisation is a viable approach to training large numbers of healthcare professionals. A training needs analysis was conducted by means of a questionnaire, which was filled out by 96 healthcare professionals in primary and secondary care in the Netherlands, Spain, Sweden and Poland. Preferences and recommendations regarding training delivery aspects and training topics that should be included in the handover training were measured. The majority of the participants recommended a short conventional training session with practice assignments, to be completed in small, multidisciplinary groups. Formal examination, e-learning and self-study were not favoured. Recommended training topics were: communication skills, standardised procedures, knowing what to hand over, alertness to vulnerable patient groups and awareness of responsibility. The idea of completely standardised handover training is not in line with the identified differences in preferences and recommendations between different handover stakeholders. Mass customisation of training, in which generic training is adapted to local or individual needs, presents a promising solution to address general and specific needs, while containing the financial and time costs of designing and delivering handover training.

A Partnership Training Program: Studying Targeted Drug Delivery Using Nanoparticles in Breast Cancer Diagnosis and Therapy

DTIC Science & Technology

2014-10-01

time-resolved synchrotron SAXS and WAXS study. J Cryst Growth 2012;344:51–8. Hurst SJ, Lytton-Jean AKR , Mirkin CA. Maximizing DNA loading on a range of...TITLE: A Partnership Training Program: Studying Targeted Drug Delivery Using Nanoparticles in Breast Cancer Diagnosis and Therapy PRINCIPAL...notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it

[Breaking bad news in oncology: the Belgian experience].

PubMed

Delevallez, F; Lienard, A; Gibon, A-S; Razavi, D

2014-10-01

Breaking bad news is a complex and frequent clinical task for physicians working in oncology. It can have a negative impact on patients and their relatives who are often present during breaking bad news consultations. Many factors influence how the delivery of bad news will be experienced especially the communication skills used by physicians. A three-phase process (post-delivery phase, delivery phase, pre-delivery phase) has been developed to help physician to handle this task more effectively. Communication skills and specific breaking bad news training programs are both necessary and effective. A recent study conducted in Belgium has shown their impact on the time allocated to each of the three phases of this process, on the communication skills used, on the inclusion of the relative in the consultation and on physicians' physiological arousal. These results underscore the importance of promoting intensive communication skills and breaking bad news training programs for health care professionals.

Kinesin regulation dynamics through cargo delivery, a single molecule investigation

NASA Astrophysics Data System (ADS)

Kovacs, Anthony; Kessler, Jonathan; Lin, Huawen; Dutcher, Susan; Wang, Yan Mei

2015-03-01

Kinesins are microtubule-based motors that deliver cargo to their destinations in a highly regulated manner. Although in recent years numerous regulators of cargo delivery have been identified, the regulation mechanism of kinesin through the cargo delivery and recycling process is not known. By performing single molecule fluorescence imaging measurements in Chlamydomonas flagella, which are 200 nm in diameter, 10 microns in length, and contain 9 sets of microtubule doublets, we tracked the intraflagellar transport (IFT) trains, BBSome cargo, and kinesin-2 motors through the cargo delivery process and determined the aforementioned dynamics. Upon arrival at the microtubule plus end at the flagellar tip, (1) IFT trains and BBSome cargo remain intact, dissociate together from kinesins and microtubules, and diffuse along flagellar membrane for a mean of 2.3 sec before commencing retrograde travel. (2) Kinesin motors remain bound to and diffuse along microtubules for 1.3 sec before dissociating into the flagellar lumen for recycling.

Enhancing Care of Aged and Dying Prisoners: Is e-Learning a Feasible Approach?

PubMed

Loeb, Susan J; Penrod, Janice; Myers, Valerie H; Baney, Brenda L; Strickfaden, Sophia M; Kitt-Lewis, Erin; Wion, Rachel K

Prisons and jails are facing sharply increased demands in caring for aged and dying inmates. Our Toolkit for Enhancing End-of-life Care in Prisons effectively addressed end-of-life (EOL) care; however, geriatric content was limited, and the product was not formatted for broad dissemination. Prior research adapted best practices in EOL care and aging; but, delivery methods lacked emerging technology-focused learning and interactivity. Our purposes were to uncover current training approaches and preferences and to ascertain the technological capacity of correctional settings to deliver computer-based and other e-learning training. An environmental scan was conducted with 11 participants from U.S. prisons and jails to ensure proper fit, in terms of content and technology capacity, between an envisioned computer-based training product and correctional settings. Environmental scan findings focused on content of training, desirable qualities of training, prominence of "homegrown" products, and feasibility of commercial e-learning. This study identified qualities of training programs to adopt and pitfalls to avoid and revealed technology-related issues to be mindful of when designing computer-based training for correctional settings, and participants spontaneously expressed an interest in geriatrics and EOL training using this learning modality as long as training allowed for tailoring of materials.

Effects of knee injury primary prevention programs on anterior cruciate ligament injury rates in female athletes in different sports: a systematic review.

PubMed

Michaelidis, Michael; Koumantakis, George A

2014-08-01

Anterior Cruciate Ligament (ACL) injury is frequently encountered in sports. To analyze the effects of ACL injury prevention programs on injury rates in female athletes between different sports. A comprehensive literature search was performed in September 2012 using Pubmed Central, Science Direct, CINAHL, PEDro, Cochrane Library, SCOPUS, SPORTDiscus. The key words used were: 'anterior cruciate ligament', 'ACL', 'knee joint', 'knee injuries', 'female', 'athletes', 'neuromuscular', 'training', 'prevention'. The inclusion criteria applied were: (1) ACL injury prevention training programs for female athletes; (2) Athlete-exposure data reporting; (3) Effect of training on ACL incidence rates for female athletes. 13 studies met the inclusion criteria. Three training programs in soccer and one in handball led to reduced ACL injury incidence. In basketball no effective training intervention was found. In season training was more effective than preseason in ACL injury prevention. A combination of strength training, plyometrics, balance training, technique monitoring with feedback, produced the most favorable results. Comparing the main components of ACL injury prevention programs for female athletes, some sports-dependent training specificity issues may need addressing in future studies, related primarily to the individual biomechanics of each sport but also their most effective method of delivery. Copyright © 2013 Elsevier Ltd. All rights reserved.

Administration of misoprostol by trained traditional birth attendants to prevent postpartum haemorrhage in homebirths in Pakistan: a randomised placebo-controlled trial.

PubMed

Mobeen, N; Durocher, J; Zuberi, Nf; Jahan, N; Blum, J; Wasim, S; Walraven, G; Hatcher, J

2011-02-01

to determine if misoprostol is safe and efficacious in preventing postpartum haemorrhage (PPH) when administered by trained traditional birth attendants (TBA) at home deliveries. a randomised, double-blind, placebo-controlled trial. Chitral, Khyber Pakhtunkhwa Province, Pakistan. a total of 1119 women giving birth at home. from June 2006 to June 2008, consenting women were randomised to receive 600 microg oral misoprostol (n = 534) or placebo (n = 585) after delivery to determine whether misoprostol reduced the incidence of PPH (≥ 500 ml). the primary outcomes were measured blood loss ≥ 500 ml after delivery and drop in haemoglobin >2 g/dl from before to after delivery. oral misoprostol was associated with a significant reduction in the rate of PPH (≥ 500 ml) (16.5 versus 21.9%; relative risk 0.76, 95% CI 0.59-0.97). There were no measurable differences between study groups for drop in haemoglobin >2 g/dl (relative risk 0.79, 95% CI 0.62-1.02); but significantly fewer women receiving misoprostol had a drop in haemoglobin >3 g/dl, compared with placebo (5.1 versus 9.6%; relative risk 0.53, 95% CI 0.34-0.83). Shivering and chills were significantly more common with misoprostol. There were no maternal deaths among participants. postpartum administration of 600 microg oral misoprostol by trained TBAs at home deliveries reduces the rate of PPH by 24%. Given its ease of use and low cost, misoprostol could reduce the burden of PPH in community settings where universal oxytocin prophylaxis is not feasible. Continual training and skill-building for TBAs, along with monitoring and evaluation of programme effectiveness, should accompany any widespread introduction of this drug.

Extending dental nurses' duties: a national survey investigating skill-mix in Scotland's child oral health improvement programme (Childsmile).

PubMed

Gnich, Wendy; Deas, Leigh; Mackenzie, Sarah; Burns, Jacqueline; Conway, David I

2014-11-25

Childsmile is Scotland's national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses' ability to fully deliver their extended roles is necessary to ensure nurses' potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs' roles by EDDNs, in general dental practice across Scotland. A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses': role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). This study has provided insight into EDDNs' experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs' roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement.

Making In-Class Skills Training More Effective: The Scope for Interactive Videos to Complement the Delivery of Practical Pedestrian Training

ERIC Educational Resources Information Center

Hammond, James; Cherrett, Tom; Waterson, Ben

2015-01-01

Skills and awareness of young pedestrians can be improved with on-street practical pedestrian training, often delivered in schools in the UK by local authorities with the intention of improving road safety. This training is often supplemented by in-class paper-based worksheet activities that are seen to be less effective than practical training in…

Enhancing Technical and Vocational Education and Training (TVET) in Nigeria for Sustainable Development: Competency-Based Training (CBT) Approach

ERIC Educational Resources Information Center

Okoye, K. R. E.; Michael, Ofonmbuk Isaac

2015-01-01

This paper attempts to examine the concept of Competency-Based Training (CBT) as a veritable mode of delivery of Technical and Vocational Education and Training (TVET) and at the same time highlights some of the strengths and weaknesses of implementing competency-base training. The characteristics, principles and benefits of CBT were also x-rayed.…

The Impact of the Developmental Training Model on Staff Development in Air Force Child Development Programs

ERIC Educational Resources Information Center

Bird, Candace Maria Edmonds

2010-01-01

In an effort to standardize training delivery and to individualize staff development based on observation and reflective practice, the Air Force implemented the Developmental Training Model (DTM) in its Child Development Programs. The goal of the Developmental Training Model is to enhance high quality programs through improvements in the training…

Training Traditional Birth Attendants on the Use of Misoprostol and a Blood Measurement Tool to Prevent Postpartum Haemorrhage: Lessons Learnt from Bangladesh

PubMed Central

Passano, Paige; Bohl, Daniel D.; Islam, Arshadul; Prata, Ndola

2014-01-01

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs’ knowledge, attitudes, and practices. Acknowledgeing TBAs’ important role in the community and in home deliveries and integrating them into the formal healthcare system has the potential to result in changes similar to those seen in this study. PMID:24847601

Anesthesia for Cesarean Delivery: A Cross-Sectional Survey of Provincial, District, and Mission Hospitals in Zimbabwe.

PubMed

Lonnée, Herman A; Madzimbamuto, Farai; Erlandsen, Ole R M; Vassenden, Astrid; Chikumba, Edson; Dimba, Rutenda; Myhre, Arne K; Ray, Sunanda

2018-06-01

Cesarean delivery is the most common surgical procedure in low- and middle-income countries, so provision of anesthesia services can be measured in relation to it. This study aimed to assess the type of anesthesia used for cesarean delivery, the level of training of anesthesia providers, and to document the availability of essential anesthetic drugs and equipment in provincial, district, and mission hospitals in Zimbabwe. In this cross-sectional survey of 8 provincial, 21 district, and 13 mission hospitals, anesthetic providers were interviewed on site using a structured questionnaire adapted from standard instruments developed by the World Federation of Societies of Anaesthesiologists and the World Health Organization. The anesthetic workforce for the hospitals in this survey constituted 22% who were medical officers and 77% nurse anesthetists (NAs); 55% of NAs were recognized independent anesthetic providers, while 26% were qualified as assistants to anesthetic providers and 19% had no formal training in anesthesia. The only specialist physician anesthetist was part time in a provincial hospital. Spinal anesthesia was the most commonly used method for cesarean delivery (81%) in the 3 months before interview, with 19% general anesthesia of which 4% was ketamine without airway intubation. The mean institutional cesarean delivery rate was 13.6% of live births, although 5 district hospitals were <5%. The estimated institutional maternal mortality ratio was 573 (provincial), 251 (district), and 211 (mission hospitals) per 100,000 live births. Basic monitoring equipment (oximeters, electrocardiograms, sphygmomanometers) was reported available in theatres. Several unsafe practices continue: general anesthesia without a secure airway, shortage of essential drugs for spinal anesthesia, inconsistent use of recovery area or use of table tilt or wedge, and insufficient blood supplies. Postoperative analgesia management was reported inadequate. This study identified areas where anesthetic provision and care could be improved. Provincial hospitals, where district/mission hospitals refer difficult cases, did not have the higher level anesthesia expertise required to manage these cases. More intensive mentorship and supervision from senior clinicians is essential to address the shortcomings identified in this survey, such as the implementation of evidence-based safe practices, supply chain failures, high maternal morbidity, and mortality. Training of medical officers and NAs should be strengthened in leadership, team work, and management of complications.

Effectiveness and value of massage skills training during pre-registration nurse education.

PubMed

Cook, Neal F; Robinson, Jacqueline

2006-10-01

The integration of Complementary and alternative medicine (CAM) interventions into healthcare practices is becoming more popular and frequently accessed by patients. Various disciplines have integrated CAM techniques education into the preparation of their practitioners in response to this, but this varies widely, as does its success. Students'experiences of such education in pre-registration is largely unknown in the UK, and methods by which to successful achieve effective learning within this arena are largely unreported within the literature. This study highlighted three specifics aims; to examine the perspectives of pre-registration nursing students on being taught massage skills during pre-registration nurse education; to identify the learning and development that occurs during massage skills training; and to identify methods of enhancing the provision of such skills training and its experience. This paper demonstrates the value of integrating complementary therapies into nurse education, developing the holistic approach of student nurses and their concept of caring. In addition it contributes significantly to the knowledge base of the effectiveness of the value of CAM education in nurse preparation, highlighting the high value students place on CAM education and demonstrating notable development in the preparation of holistic practitioners. The method utilised also yielded ways to improve the delivery of such education, and demonstrates how creative teaching methods can motivate and enhance effective learning.

20 CFR 628.400 - Scope and purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... entity. This subpart also contains the requirements for the local job training plan as well as the... Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE II OF THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System § 628.400 Scope and purpose. This...

Consideration of Problem-Based Learning in Athletic Training Education

ERIC Educational Resources Information Center

Gillette, Cordial M.

2017-01-01

Context: Athletic training educators are faced with the tasks of assessing learning styles, preparing and delivering content, and assessing student learning. Within content delivery, some educators may subscribe to certain learning theories and teaching strategies. One teaching strategy that holds potential for athletic training education is…

Development of an Internet-Based Parent Training Intervention for Children with ASD

DTIC Science & Technology

2013-10-01

daily routines and activities. In the second phase of the project (Years 2 and 3), the focus is on pilot testing two delivery methods for the online...evidence-based curriculum that uses a blend of developmental and behavioral intervention strategies during daily routines and activities. In the first...post-treatment during a 10-minute parent-child play session and a snack using the Project ImPACT intervention Fidelity Checklist (n=11). Parents are

Evaluating the need for alternative didactic learning options in pediatric dental residency training.

PubMed

Keck, Douglas B; Rutkauskas, John S; Clothey, Rebecca A

2009-06-01

The need for an alternative means of delivery of a didactic curriculum to pediatric dental residents is described. It is our hope with this project to encourage a much-needed didactic curriculum for programs lacking faculty and to endorse other programs in which academicians exist but cannot cover all the material with which a resident needs to become familiar in the two years of postgraduate residency training. A decrease in faculty number due to retirement, debt burden, or marginal recruitment techniques along with an increase in positions in pediatric dentistry residency programs poses a unique educational dilemma. Using a mixed-method research methodology, we sent a twelve-question survey to 105 pediatric dentistry residency program directors and department chairs, followed by eight telephone interviews. Results from a 55 percent return rate show that the debt burden of most pediatric dental residents is well over $100,000 and that this affects a resident's decision to enter academia, as does the relative lack of positive recruitment techniques and poor faculty remuneration. The survey results affirm the need for improvement in the didactic curriculum of pediatric dentistry residents and show that program directors and department chairs also feel that an alternative delivery method using DVD or online/web-based programs would be welcomed. Despite their extremely heavy workloads, educators are willing to contribute by providing lectures or reading lists in their area of expertise.

Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study.

PubMed

El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight

2017-07-01

Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P < 0.001) compared to the previous case. Major complication rate and pericardial effusion rate were not associated with case number (P = 0.755 and P = 0.620, respectively). There were no differences in the safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

Effect of chronic delivery of the Toll-like receptor 4 antagonist (+)-Naltrexone on incubation of heroin craving

PubMed Central

Theberge, Florence R.; Li, Xuan; Kambhampati, Sarita; Pickens, Charles L.; St. Laurent, Robyn; Bossert, Jennifer M.; Baumann, Michael H.; Hutchinson, Mark R.; Rice, Kenner C.; Watkins, Linda R.; Shaham, Yavin

2013-01-01

Background Recent evidence implicates toll-like receptor 4 (TLR4) in opioid analgesia, tolerance, conditioned place preference, and self-administration. Here we determined the effect of the TLR4 antagonist (+)-naltrexone (a μ-opioid receptor inactive isomer) on the time-dependent increases in cue-induced heroin seeking after withdrawal (incubation of heroin craving). Methods In an initial experiment, we trained rats for 9 h/day to self-administer heroin (0.1 mg/kg/infusion) for 9 days; lever presses were paired with a 5-sec tone-light cue. We then assessed cue-induced heroin seeking in 30-min extinction sessions on withdrawal day 1; immediately after testing, we surgically implanted rats with Alzet minipumps delivering (+)-naltrexone (0, 7.5, 15, 30 mg/kg/day, s.c.) for 14 days. We then tested the rats for incubated cue-induced heroin seeking in 3-h extinction tests on withdrawal day 13. Results We found that chronic delivery of (+)-naltrexone via minipumps during the withdrawal phase decreased incubated cue-induced heroin seeking. In follow-up experiments, we found that acute injections of (+)-naltrexone immediately before withdrawal day 13 extinction test had no effect on incubated cue-induced heroin seeking. Furthermore, chronic delivery of (+)-naltrexone (15 or 30 mg/kg/day) or acute systemic injections (15 or 30 mg/kg) had no effect on ongoing extended access heroin self-administration. Finally, in rats trained to self-administer methamphetamine (0.1 mg/kg/infusion, 9 h/d, 9 days), chronic delivery of (+)-naltrexone (30 mg/kg/day) during the withdrawal phase had no effect on incubated cue-induced methamphetamine seeking. Conclusions The present results suggest a critical role of TLR4 in the development of incubation of heroin, but not methamphetamine, craving. PMID:23384483

Big data driven cycle time parallel prediction for production planning in wafer manufacturing

NASA Astrophysics Data System (ADS)

Wang, Junliang; Yang, Jungang; Zhang, Jie; Wang, Xiaoxi; Zhang, Wenjun Chris

2018-07-01

Cycle time forecasting (CTF) is one of the most crucial issues for production planning to keep high delivery reliability in semiconductor wafer fabrication systems (SWFS). This paper proposes a novel data-intensive cycle time (CT) prediction system with parallel computing to rapidly forecast the CT of wafer lots with large datasets. First, a density peak based radial basis function network (DP-RBFN) is designed to forecast the CT with the diverse and agglomerative CT data. Second, the network learning method based on a clustering technique is proposed to determine the density peak. Third, a parallel computing approach for network training is proposed in order to speed up the training process with large scaled CT data. Finally, an experiment with respect to SWFS is presented, which demonstrates that the proposed CTF system can not only speed up the training process of the model but also outperform the radial basis function network, the back-propagation-network and multivariate regression methodology based CTF methods in terms of the mean absolute deviation and standard deviation.

Transfer of infrared thermography predictive maintenance technologies to Soviet-designed nuclear power plants: experience at Chernobyl

NASA Astrophysics Data System (ADS)

Pugh, Ray; Huff, Roy

1999-03-01

The importance of infrared (IR) technology and analysis in today's world of predictive maintenance and reliability- centered maintenance cannot be understated. The use of infrared is especially important in facilities that are required to maintain a high degree of equipment reliability because of plant or public safety concerns. As with all maintenance tools, particularly those used in predictive maintenance approaches, training plays a key role in their effectiveness and the benefit gained from their use. This paper details an effort to transfer IR technology to Soviet- designed nuclear power plants in Russia, Ukraine, and Lithuania. Delivery of this technology and post-delivery training activities have been completed recently at the Chornobyl nuclear power plant in Ukraine. Many interesting challenges were encountered during this effort. Hardware procurement and delivery of IR technology to a sensitive country were complicated by United States regulations. Freight and shipping infrastructure and host-country customs policies complicated hardware transport. Training activities were complicated by special hardware, software and training material translation needs, limited communication opportunities, and site logistical concerns. These challenges and others encountered while supplying the Chornobyl plant with state-of-the-art IR technology are described in this paper.

Implementing an exercise-training programme to prevent lower-limb injuries: considerations for the development of a randomised controlled trial intervention delivery plan.

PubMed

Finch, Caroline F; White, Peta; Twomey, Dara; Ullah, Shahid

2011-08-01

To identify important considerations for the delivery of an exercise training intervention in a randomised controlled trial to maximise subsequent participation in that randomised controlled trial and intervention uptake. A cross-sectional survey, with a theoretical basis derived from the Health Belief Model (HBM) and the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. 374 male senior Australian Football players, aged 17-38 years. Beliefs about lower-limb injury causation/prevention, and the relative value of exercise training for performance and injury prevention. The data are interpreted within HBM constructs and implications for subsequent intervention implementation considered within the RE-AIM framework. Ordinal logistic regression compared belief scores across player characteristics. 74.4% of players agreed that doing specific exercises during training would reduce their risk of lower-limb injury and would be willing to undertake them. However, 64.1% agreed that training should focus more on improving game performance than injury prevention. Younger players (both in terms of age and playing experience) generally had more positive views. Players were most supportive of kicking (98.9%) and ball-handling (97.0%) skills for performance and warm-up runs and cool-downs (both 91.5%) for injury prevention. Fewer than three-quarters of all players believed that balance (69.2%), landing (71.3%) or cutting/stepping (72.8) training had injury-prevention benefits. Delivery of future exercise training programmes for injury prevention aimed at these players should be implemented as part of routine football activities and integrated with those as standard practice, as a means of associating them with training benefits for this sport.

Postpartum pelvic floor muscle training and urinary incontinence: a randomized controlled trial.

PubMed

Hilde, Gunvor; Stær-Jensen, Jette; Siafarikas, Franziska; Ellström Engh, Marie; Bø, Kari

2013-12-01

To evaluate whether postpartum pelvic floor muscle training decrease prevalence of any urinary incontinence (UI) in primiparous women with and without UI at inclusion (mixed population) and further to perform stratified analyses on women with and without major levator ani muscle defects. A two-armed assessor-blinded randomized controlled trial including primiparous women 6 weeks after vaginal delivery was conducted. Participants were stratified on major levator ani muscle defects, verified by transperineal ultrasonography, and thereafter randomly allocated to training or control. All participants were taught to contract the pelvic floor muscles. The control participants received no further intervention, whereas training participants attended a weekly supervised pelvic floor muscle training class and performed daily home exercise for 16 weeks. Primary outcome was self-reported UI analyzed by relative risk. We included 175 women, 55 with major levator ani muscle defects and 120 without. Prevalence of UI at baseline was 39.1% in the training group (n=87) and 50% among those in the control group (n=88). Fifteen women (8.6%) were lost to follow-up. At 6 months after delivery (postintervention), 34.5% and 38.6% reported UI in the training and control groups, respectively. Relative risk analysis of UI gave a nonsignificant effect size of 0.89 (95% confidence interval [CI] 0.60-1.32). Results were similar for the stratum with and without major levator ani muscle defects, 0.89 (95% CI 0.51-1.56) and 0.90 (95% CI 0.53-1.52), respectively. Postpartum pelvic floor training did not decrease UI prevalence 6 months after delivery in primiparous women. Stratified analysis on women with and without major levator ani muscle defects showed similar nonsignificant results. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01069484. : I.

High Oxygen Delivery to Preserve Exercise Capacity in Patients with Idiopathic Pulmonary Fibrosis Treated with Nintedanib. Methodology of the HOPE-IPF Study.

PubMed

Ryerson, Christopher J; Camp, Pat G; Eves, Neil D; Schaeffer, Michele; Syed, Nafeez; Dhillon, Satvir; Jensen, Dennis; Maltais, Francois; O'Donnell, Denis E; Raghavan, Natya; Roman, Michael; Stickland, Michael K; Assayag, Deborah; Bourbeau, Jean; Dion, Genevieve; Fell, Charlene D; Hambly, Nathan; Johannson, Kerri A; Kalluri, Meena; Khalil, Nasreen; Kolb, Martin; Manganas, Helene; Morán-Mendoza, Onofre; Provencher, Steve; Ramesh, Warren; Rolf, J Douglass; Wilcox, Pearce G; Guenette, Jordan A

2016-09-01

Pulmonary rehabilitation improves dyspnea and exercise capacity in idiopathic pulmonary fibrosis (IPF); however, it is unknown whether breathing high amounts of oxygen during exercise training leads to further benefits. Herein, we describe the design of the High Oxygen Delivery to Preserve Exercise Capacity in IPF Patients Treated with Nintedanib study (the HOPE-IPF study). The primary objective of this study is to determine the physiological and perceptual impact of breathing high levels of oxygen during exercise training in patients with IPF who are receiving antifibrotic therapy. HOPE-IPF is a two-arm double-blind multicenter randomized placebo-controlled trial of 88 patients with IPF treated with nintedanib. Patients will undergo 8 weeks of three times weekly aerobic cycle exercise training, breathing a hyperoxic gas mixture with a constant fraction of 60% inhaled oxygen, or breathing up to 40% oxygen as required to maintain an oxygen saturation level of at least 88%. End points will be assessed at baseline, postintervention (Week 8), and follow-up (Week 26). The primary analysis will compare the between-group baseline with post-training change in endurance time during constant work rate cycle exercise tests. Additional analyses will evaluate the impact of training with high oxygen delivery on 6-minute walk distance, dyspnea, physical activity, and quality of life. The HOPE-IPF study will lead to a comprehensive understanding of IPF exercise physiology, with the potential to change clinical practice by indicating the need for increased delivery of supplemental oxygen during pulmonary rehabilitation in patients with IPF. Clinical trial registered with www.clinicaltrials.gov (NCT02551068).

Value of a regional family practice residency training program site

PubMed Central

Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve

2014-01-01

Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693

Safe Sleep Practices of Kansas Birthing Hospitals

PubMed Central

Ahlers-Schmidt, Carolyn R.; Schunn, Christy; Sage, Cherie; Engel, Matthew; Benton, Mary

2018-01-01

Background Sleep-related death is tied with congenital anomalies as the leading cause of infant mortality in Kansas, and external risk factors are present in 83% of these deaths. Hospitals can impact caregiver intentions to follow risk-reduction strategies. This project assessed the current practices and policies of Kansas hospitals with regard to safe sleep. Methods A cross-sectional survey of existing safe sleep practices and policies in Kansas hospitals was performed. Hospitals were categorized based on reported delivery volume and data were compared across hospital sizes. Results Thirty-one of 73 (42%) contacted hospitals responded. Individual survey respondents represented various hospital departments including newborn/well-baby (68%), neonatal intensive care unit (3%) and other non-nursery departments or administration (29%). Fifty-eight percent of respondents reported staff were trained on infant safe sleep; 44% of these held trainings annually. High volume hospitals tended to have more annual training than low or mid volume birth hospitals. Thirty-nine percent reported a safe sleep policy, though most of these (67%) reported never auditing compliance. The top barrier to safe sleep education, regardless of delivery volume, was conflicting patient and family member beliefs. Conclusions Hospital promotion of infant safe sleep is being conducted in Kansas to varying degrees. High and mid volume birth hospitals may need to work more on formal auditing of safe sleep practices, while low volume hospitals may need more staff training. Low volume hospitals also may benefit from access to additional caregiver education materials. Finally, it is important to note hospitals should not be solely responsible for safe sleep education. PMID:29844848

Training traditional birth attendants to use misoprostol and an absorbent delivery mat in home births.

PubMed

Prata, Ndola; Quaiyum, Md Abdul; Passano, Paige; Bell, Suzanne; Bohl, Daniel D; Hossain, Shahed; Azmi, Ashrafi Jahan; Begum, Mohsina

2012-12-01

A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in operations research among 77,337 home births in rural Bangladesh. The purpose of this study was to evaluate TBAs' knowledge acquisition, knowledge retention, and changes in attitudes and practices related to PPH management in home births after undergoing training on the use of misoprostol and the blood collection delivery mat. We conclude that the training was highly effective and that the two interventions were safely and correctly used by TBAs at home births. Data on TBA practices indicate adherence to protocol, and 18 months after the interventions were implemented, TBA knowledge retention remained high. This program strengthens the case for community-based use of misoprostol and warrants consideration of this intervention as a potential model for scale-up in settings where complete coverage of skilled birth attendants (SBAs) remains a distant goal. Copyright © 2012 Elsevier Ltd. All rights reserved.

Advanced Cardiac Life Support (ACLS) utilizing Man-Tended Capability (MTC) hardware onboard Space Station Freedom

NASA Technical Reports Server (NTRS)

Smith, M.; Barratt, M.; Lloyd, C.

1992-01-01

Because of the time and distance involved in returning a patient from space to a definitive medical care facility, the capability for Advanced Cardiac Life Support (ACLS) exists onboard Space Station Freedom. Methods: In order to evaluate the effectiveness of terrestrial ACLS protocols in microgravity, a medical team conducted simulations during parabolic flights onboard the KC-135 aircraft. The hardware planned for use during the MTC phase of the space station was utilized to increase the fidelity of the scenario and to evaluate the prototype equipment. Based on initial KC-135 testing of CPR and ACLS, changes were made to the ventricular fibrillation algorithm in order to accommodate the space environment. Other constraints to delivery of ACLS onboard the space station include crew size, minimum training, crew deconditioning, and limited supplies and equipment. Results: The delivery of ACLS in microgravity is hindered by the environment, but should be adequate. Factors specific to microgravity were identified for inclusion in the protocol including immediate restraint of the patient and early intubation to insure airway. External cardiac compressions of adequate force and frequency were administered using various methods. The more significant limiting factors appear to be crew training, crew size, and limited supplies. Conclusions: Although ACLS is possible in the microgravity environment, future evaluations are necessary to further refine the protocols. Proper patient and medical officer restraint is crucial prior to advanced procedures. Also emphasis should be placed on early intubation for airway management and drug administration. Preliminary results and further testing will be utilized in the design of medical hardware, determination of crew training, and medical operations for space station and beyond.

Coordinating a national rangeland monitoring training program: Success and lessons learned

USDA-ARS?s Scientific Manuscript database

One of the best ways to ensure quality of information gathered in a rangeland monitoring program is through a strong and uniform set of trainings. Curriculum development and delivery of monitoring trainings poses unique challenges that are not seen in academic settings. Participants come from a rang...

Basic Skills Support in Business and Industry.

ERIC Educational Resources Information Center

Byatt, Janet; Davies, Karen

This guide is designed as a tool for English and Welsh businesses wanting to provide basic skills training for their employees. It provides practical solutions to the problems of identifying employees' basic skills needs and selecting the best model of training delivery to address identified training needs. The introductory section discusses basic…

Preventing Occupational Skin Disease: A Review of Training Programs.

PubMed

Zack, Bethany; Arrandale, Victoria H; Holness, D Linn

Occupational contact dermatitis (OCD) is a common occupational disease that impacts a variety of worker groups. Skin protection and disease prevention training programs have shown promise for improving prevention practices and reducing the incidence of OCD. This review details the features of training programs for primary prevention of OCD and identifies gaps in the literature. Twelve studies were identified for in-depth review: many studies included wet workers employed in health care, hairdressing, cleaning, and food preparation; 1 program featured manufacturing workers. Few programs provided content on allergic contact dermatitis, and only 1 was evaluated for long-term effectiveness. Effective programs were similar in content, delivery method, and timing and were characterized by industry specificity, multimodal learning, participatory elements, skin care resource provision, repeated sessions, and management engagement. Long-term effectiveness, generalizability beyond OCD, workplace health and safety culture impact, and translation of programs in the North American context represent areas for future research.

Building Social Networks for Maternal and Newborn Health in Poor Urban Settlements: A Cross-Sectional Study in Bangladesh

PubMed Central

Adams, Alayne M.; Nababan, Herfina Y.; Hanifi, S. M. Manzoor Ahmed

2015-01-01

Background The beneficial influence of social networks on health and wellbeing is well-established. In poor urban settlements in Bangladesh, BRAC’s Manoshi programme trains community health workers (CHWs) to support women through pregnancy, delivery and postpartum periods. This paper test the hypothesis that the introduction of CHWs as weak ties into the social networks of Manoshi members mediates improvements in maternal and neonatal health (MNH) best practices by providing support, facilitating ideational change, connecting mother to resources, and strengthening or countering the influence of strong ties. Methods 1000 women who had given birth in the last three months were identified and interviewed as part of ongoing monitoring of 5 poor urban settlements in Dhaka, Bangladesh. A social networks questionnaire was administered which elicited women’s perceived networks around pregnancy, delivery and post-partum periods. Mediation analysis was performed to test the hypothesis that penetration of Manoshi CHWs into women’s perceived networks has a beneficial effect on MNH best practises. Results The presence and influence of Manoshi CHWs in women’s networks significantly mediated the effect of Manoshi membership on MNH best practices. Respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to deliver with a trained birth attendant (OR 3.61; 95%CI 2.36–5.51), to use postnatal care (OR 3.09; 95%CI 1.83–5.22), and to give colostrum to their newborn (OR 7.51; 95%CI 3.51–16.05). Conclusion Manoshi has succeeded in penetrating the perceived pregnancy, delivery and post-partum networks of poor urban women through the introduction of trained CHWs. Study findings demonstrate the benefits of moving beyond urban health care delivery models that concentrate on the provision of clinical services by medical providers, to an approach that nurtures the power of social networks as a means to support the poorest and most marginalized in changing behaviour and effectively accessing appropriate maternal services. PMID:25910191

Gamify and Recognize Prior Learning: How to Succeed in Educators' Further Professional Training with Open Badges

ERIC Educational Resources Information Center

Lius, Esko

2016-01-01

Traditional further professional training has been losing its position and importance in teacher upskilling. Traditional modes of training delivery do not work well in situations where much of the competences have been gained informally, or when teachers find it difficult to attend training days that fit poorly to their schedules or location. This…

Design and Delivery of Customized Training Programs for New and Expanding Business and Industry.

ERIC Educational Resources Information Center

Ghanatabadi, Jolyne; Saylor, Collette

1988-01-01

Discusses the six-step process the Des Moines Area Community College (Iowa) uses to design and deliver customized training for new and expanding businesses. Also discusses the New Jobs Training Act that provided tax incentives to those businesses and granted exclusive rights to the state's community colleges to contract for training with them.…

Working with a Competency-Based Training Package: A Contextual Investigation from the Perspective of a Group of TAFE Teachers

ERIC Educational Resources Information Center

Southren, Michael

2015-01-01

Reforms in the Australian vocational education and training (VET) landscape have generated significant interest in the changes to the delivery and nature of formal (off-the-job) training provided by Registered Training Organisations. Existing research has provided valuable insights into the evolving role of teachers, and speculated upon the…

Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08.

PubMed

Lumbiganon, Pisake; Laopaiboon, Malinee; Gülmezoglu, A Metin; Souza, João Paulo; Taneepanichskul, Surasak; Ruyan, Pang; Attygalle, Deepika Eranjanie; Shrestha, Naveen; Mori, Rintaro; Nguyen, Duc Hinh; Hoang, Thi Bang; Rathavy, Tung; Chuyun, Kang; Cheang, Kannitha; Festin, Mario; Udomprasertgul, Venus; Germar, Maria Julieta V; Yanqiu, Gao; Roy, Malabika; Carroli, Guillermo; Ba-Thike, Katherine; Filatova, Ekaterina; Villar, José

2010-02-06

There has been concern about rising rates of caesarean section worldwide. This Article reports the third phase of the WHO global survey, which aimed to estimate the rate of different methods of delivery and to examine the relation between method of delivery and maternal and perinatal outcomes in selected facilities in Africa and Latin America in 2004-05, and in Asia in 2007-08. Nine countries participated in the Asia global survey: Cambodia, China, India, Japan, Nepal, Philippines, Sri Lanka, Thailand, and Vietnam. In each country, the capital city and two other regions or provinces were randomly selected. We studied all women admitted for delivery during 3 months in institutions with 6000 or fewer expected deliveries per year and during 2 months in those with more than 6000 deliveries. We gathered data for institutions to obtain a detailed description of the health facility and its resources for obstetric care. We obtained data from women's medical records to summarise obstetric and perinatal events. We obtained data for 109 101 of 112 152 deliveries reported in 122 recruited facilities (97% coverage), and analysed 107 950 deliveries. The overall rate of caesarean section was 27.3% (n=29 428) and of operative vaginal delivery was 3.2% (n=3465). Risk of maternal mortality and morbidity index (at least one of: maternal mortality, admission to intensive care unit [ICU], blood transfusion, hysterectomy, or internal iliac artery ligation) was increased for operative vaginal delivery (adjusted odds ratio 2.1, 95% CI 1.7-2.6) and all types of caesarean section (antepartum without indication 2.7, 1.4-5.5; antepartum with indication 10.6, 9.3-12.0; intrapartum without indication 14.2, 9.8-20.7; intrapartum with indication 14.5, 13.2-16.0). For breech presentation, caesarean section, either antepartum (0.2, 0.1-0.3) or intrapartum (0.3, 0.2-0.4), was associated with improved perinatal outcomes, but also with increased risk of stay in neonatal ICU (2.0, 1.1-3.6; and 2.1, 1.2-3.7, respectively). To improve maternal and perinatal outcomes, caesarean section should be done only when there is a medical indication. US Agency for International Development (USAID); UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), WHO, Switzerland; Ministry of Health, Labour and Welfare of Japan; Ministry of Public Health, China; and Indian Council of Medical Research. Copyright 2010 Elsevier Ltd. All rights reserved.

Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

PubMed Central

Shidhaye, Rahul; Shrivastava, Sanjay; Murhar, Vaibhav; Samudre, Sandesh; Ahuja, Shalini; Ramaswamy, Rohit; Patel, Vikram

2016-01-01

Background The large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care. Aims To operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district. Method Mixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility. Results The MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment. Conclusions There are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models. PMID:26447172

Training community practitioners in a research intervention: practice examples at the intersection of cancer, Western science, and native Hawaiian healing.

PubMed

Ka'opua, Lana Sue I

2003-01-01

This practice paper describes the preintervention training component of a feasibility study exploring the use of ho'oponopono, an indigenous Hawaiian healing practice, for enhancing psychosocial adaptation to breast cancer among Native Hawaiian women. Practitioners' adherence to research protocols and competence in intervention delivery are both regarded as essential to obtaining valid results in tests of intervention feasibility and efficacy; thus, training in this study dually focused on fortification of adherence and enhancing competence among those recruited to deliver the ho'oponopono intervention. A manual-based training, using adult pedagogical strategies infused with Native Hawaiian cultural practices, was delivered to community practitioners. Effects of the training on practitioners' knowledge and skills were evaluated through multiple methods. Knowledge significantly increased between pre- and post-intervention assessment. However, knowledge application for some practitioners was hindered by skill deficits, stylistic differences, and cultural conflict. Ongoing attention to competence and adherence is indicated. In-service training may bolster competence; however, practitioners may have difficulty in adhering to protocols for different reasons, and individualized clinical supervision and cultural consultation may be helpful in some situations.

Introducing the female condom through the public health sector: experiences from South Africa.

PubMed

Mantell, J E; Scheepers, E; Karim, Q A

2000-10-01

The successful implementation of new public health policy is influenced by provider preparedness and user acceptability of the new intervention. This paper describes the development and implementation of a participatory Training of Trainers (TOT) programme as a precursor to launch the South African government's female-initiated HIV prevention strategies in public health clinics. Three hundred peer-trainees from throughout South Africa were trained through a comprehensive, modular and interactive three-day workshop. The workshop content included: HIV/AIDS knowledge, beliefs and attitudes; values clarification regarding HIV infection and sexuality; sexual desensitization; 'hands-on' training in the use of and introduction of the female condom; and counselling, communication and programme planning skills. The TOT generated a cadre of knowledgeable health care workers for training others and provided a support structure at the service delivery level for ensuring potential users' access to the female condom within each province. Qualitative assessments of the training and trainer debriefing sessions suggest that the training was successful in increasing knowledge and promoting positive attitudes about female condoms. In addition, the expanded repertoire of problem-solving approaches left providers feeling confident about recommending this method to clients.

Stress inoculation training supported by physiology-driven adaptive virtual reality stimulation.

PubMed

Popović, Sinisa; Horvat, Marko; Kukolja, Davor; Dropuljić, Branimir; Cosić, Kresimir

2009-01-01

Significant proportion of psychological problems related to combat stress in recent large peacekeeping operations underscores importance of effective methods for strengthening the stress resistance of military personnel. Adaptive control of virtual reality (VR) stimulation, based on estimation of the subject's emotional state from physiological signals, may enhance existing stress inoculation training (SIT). Physiology-driven adaptive VR stimulation can tailor the progress of stressful stimuli delivery to the physiological characteristics of each individual, which is indicated for improvement in stress resistance. Therefore, following an overview of SIT and its applications in the military setting, generic concept of physiology-driven adaptive VR stimulation is presented in the paper. Toward the end of the paper, closed-loop adaptive control strategy applicable to SIT is outlined.

Telephone-delivered problem-solving training after mild traumatic brain injury: Qualitative analysis of service members' perceptions.

PubMed

Brockway, Jo Ann; St De Lore, Jef; Fann, Jesse R; Hart, Tessa; Hurst, Samantha; Fey-Hinckley, Sara; Savage, Jocelyn; Warren, Michael; Bell, Kathleen R

2016-08-01

The purpose of this study was to identify the specific reasons for service members' satisfaction or dissatisfaction with problem-solving training (PST), telephone delivery, and other aspects of a telephone-delivered PST intervention in order to determine what might enhance this approach for future clinical use. Standard qualitative methods were employed, using a "process" coding strategy to explore the conceptual perceptions of the intervention experience as suggested by the data recorded from final telephone interviews of 80 service members who participated in a randomized controlled trial evaluating the efficacy of telephone-delivered PST after having sustained concussions or mild traumatic brain injuries during recent (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A diagnostic study of Department of Health training courses for family planning providers.

PubMed

Rood, S; Raquepo, M; Ladia, M A

1993-01-01

A study in the Philippines sought to observe and describe the family planning (FP) training program in two regions. This program trains physicians, nurses, and midwives as a team and includes a Basic/Comprehensive (B/C) course in FP with didactic and practicum elements, training in interpersonal communication skills (ICS) for those who have completed with B/C course, and a Preceptors Course for those who will supervise the practicum phase of the B/C course. The study gathered specific information on 1) trainee absenteeism and drop-out rates, 2) course content and effects, 3) the trainee selection process, 4) the practicum requirement for the B/C course, and 5) service delivery values and quality of care. Data were collected through observations, questionnaires, exit interviews with clients during the practicum phase, interviews with supervisors and public officials (mayors), and focus group discussions with regional trainers. This assessment led to the following recommendations: 1) maintain the current team approach; 2) reserve basic orientation-type subjects for office-based training to allow more time for FP topics in the training programs; 3) use caution in making a switch to "competency-based" training because of the possibility that supervision is inadequate for such a training method; 4) improve scheduling; 5) enforce the prerequisites for participation in the ICS and Preceptors Courses; 6) assign only one trainee to a preceptor area during the practicum and reduce the quota of IUD insertions to reduce pressure to obtain IUD acceptors; 7) create a "model" FP clinic each time a preceptor is trained; 8) pay more attention to natural FP methods; and 9) maintain an emphasis on quality of care.

20 CFR 669.220 - What is the role of the NFJP grantee in the One-Stop delivery system?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is the role of the NFJP grantee in the One-Stop delivery system? 669.220 Section 669.220 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR NATIONAL FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The Service Delivery System for the...

Research, Development, Training, and Evaluation (RDTE) Support Delivery Order 1: Computational Cognitive Models

DTIC Science & Technology

1993-09-01

AL/HR-TR- 1993-0072 AD-A271 837 RESEARCH, DEVELOPMENT, TRAINING, AND A EVALUATION (RDTE) SUPPORT R DELIVERY ORDER 1 : COMPUTATIONAL COGNITIVE M MODELS...Stephen E. Deutsch :-"LEC"E R Eva Hudlicka eNOV04 1 0 Marilyn J. Adams0 Carl E. FeehrerN G BOLT BERANEK AND NEWMAN, INCG10 MOULTON STREET CAMBRIDGE...Washington. DC 20503 1 . AGENCY USE ONLY (Leave blank) 2 REPORT DATE 3. REPORT TYPE AND DATES COVERED Sep 1993 Final - March 1992 to April 1993 4

Indian Health Service Training Center, Training Course TC-72-2 (April 17-May 5, 1972): Pueblo de Santa Clara - A Description of the Perceived Health Needs of the People of Santa Clara Pueblo and the Management Processes Involved in the Delivery of Health Services to Them.

ERIC Educational Resources Information Center

Public Health Service (DHEW), Washington, DC. Div. of Indian Health.

Members of the Health Services Management class conducted a descriptive study of the perceived health problems of the people of Santa Clara Pueblo and the management processes involved in the delivery of health services to them. Data were obtained from personal interviews with 38 Tribal members, 9 officals, 6 employees working primarily in the…

78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

...., Commercial/ Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford... financial reporting. The group develops databases for creating reports for corporate, regulatory, and... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,815] Hartford Financial...

Effects of state organizational structure and forensic examiner training on pretrial competence assessments.

PubMed

Edens, J F; Poythress, N G; Nicholson, R A; Otto, R K

1999-05-01

States differ widely in their delivery of pretrial forensic evaluation services, in terms of organizational structure and training requirements of forensic examiners. It was hypothesized that defendants adjudicated incompetent to proceed in states using community-based, private-practitioner systems would show less impairment on a competence assessment measure, the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA), than defendants adjudicated incompetent in states using traditional, inpatient systems. It also was hypothesized that mean MacCAT-CA scores for incompetent defendants from states requiring forensic training/certification would be lower than for defendants from states lacking such requirements. Results indicated significant differences across the four types of service delivery systems examined. However, planned comparisons revealed no differences between a state using a traditional, inpatient model and a state employing a community-based, private-practitioner model. Analyses examining the effects of mandatory forensic training failed to support the hypothesis that training requirements result in the adoption of higher thresholds for determining incompetence.

Maximising harm reduction in early specialty training for general practice: validation of a safety checklist.

PubMed

Bowie, Paul; McKay, John; Kelly, Moya

2012-06-21

Making health care safer is a key policy priority worldwide. In specialty training, medical educators may unintentionally impact on patient safety e.g. through failures of supervision; providing limited feedback on performance; and letting poorly developed behaviours continue unchecked. Doctors-in-training are also known to be susceptible to medical error. Ensuring that all essential educational issues are addressed during training is problematic given the scale of the tasks to be undertaken. Human error and the reliability of local systems may increase the risk of safety-critical topics being inadequately covered. However adherence to a checklist reminder may improve the reliability of task delivery and maximise harm reduction. We aimed to prioritise the most safety-critical issues to be addressed in the first 12-weeks of specialty training in the general practice environment and validate a related checklist reminder. We used mixed methods with different groups of GP educators (n=127) and specialty trainees (n=9) in two Scottish regions to prioritise, develop and validate checklist content. Generation and refinement of checklist themes and items were undertaken on an iterative basis using a range of methods including small group work in dedicated workshops; a modified-Delphi process; and telephone interviews. The relevance of potential checklist items was rated using a 4-point scale content validity index to inform final inclusion. 14 themes (e.g. prescribing safely; dealing with medical emergency; implications of poor record keeping; and effective & safe communication) and 47 related items (e.g. how to safety-net face-to-face or over the telephone; knowledge of practice systems for results handling; recognition of harm in children) were judged to be essential safety-critical educational issues to be covered. The mean content validity index ratio was 0.98. A checklist was developed and validated for educational supervisors to assist in the reliable delivery of safety-critical educational issues in the opening 12-week period of training, and aligned with national curriculum competencies. The tool can also be adapted for use as a self-assessment instrument by trainees to guide patient safety-related learning needs. Dissemination and implementation of the checklist and self-rating scale are proceeding on a national, voluntary basis with plans to evaluate its feasibility and educational impact.

Training: Plugging the information gaps

NASA Technical Reports Server (NTRS)

Scott, Carol J.

1993-01-01

Training is commonly viewed as an add-on function to the development cycle. It is imperative that this view be changed. The training developer needs to be a colleague in the system development process, contributing and learning along with the other development participants. Training developers can make contributions to design concepts that favor end-users. Early involvement will enhance the likelihood of training availability concurrent with software delivery. End-users will benefit and cost-savings will be realized.

20 CFR 628.415 - Selection of SDA grant recipient and administrative entity.

Code of Federal Regulations, 2010 CFR

2010-04-01

... recipient. (1) The SDA grant recipient and the entity to administer the SDA's job training plan for title II... administrative entity. 628.415 Section 628.415 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE II OF THE JOB TRAINING PARTNERSHIP ACT Local Service Delivery System...

Change, Training and Farm Profitability. A National Farmers Federation Discussion Paper.

ERIC Educational Resources Information Center

Kilpatrick, Sue

1996-01-01

A project collected empirical data on the effectiveness of training in agriculture in Australia. Emphasis was on types of training and delivery modes most effective in enabling profitable changes to farm management or agricultural practice and on other catalysts that result in farmers making changes to increase profitability. Data were obtained…

Evaluation of Consumer Health Training and Education Programs.

ERIC Educational Resources Information Center

Kellogg, Muriel; And Others

PL89-749, passed in 1966, included a number of provisions for increasing participation of consumers in the improvement of the health care delivery system, including development of training programs to equip consumers for participation in the health planning process. The evaluation attempts to ascertain the direct effect of training programs on…

Corporate Training Delivery: Dollars and Sense. Unconventional Wisdom.

ERIC Educational Resources Information Center

Workforce Economics, 2001

2001-01-01

With accelerating technology in the workplace, worker training has become a key component of almost every corporation's long-range strategic plan. Almost all companies provide some form of training in computer operations to new and existing employees, and more than 90 percent of companies also provided a range of management, leadership, and…

Training in the Prevention and Treatment of Child Abuse and Neglect. The User Manual Series.

ERIC Educational Resources Information Center

Broadhurst, Diane D.; MacDicken, Robert A.

Intended primarily for persons or agencies responsible for providing training to professionals and interested citizens involved in delivery of services to abusive and neglectful families, the manual addresses the importance of training in the identification, reporting, diagnosis, treatment, and prevention of child abuse and neglect. Chapters focus…

Career Education and Training for Teen Parents Program. Final Report.

ERIC Educational Resources Information Center

Whipple, Vicky

The Career Education and Training for Teen Parents Program was implemented at Kishwaukee College (Malta, Illinois) to provide educational and vocational services to teen parents (ages 14 to 21) and to establish a regional delivery system and community linkages that would integrate training, education, and support services for teen parents in the…

Performance Consulting. Moving beyond Training. Berrett-Koehler Organizational Performance Series.

ERIC Educational Resources Information Center

Robinson, Dana Gaines; Robinson, James C.

This book, which is intended for individuals who are directly or indirectly involved in human resources development, is based on the premise that today's training professionals must become "performance consultants" and shift their focus from training delivery to the performance of the company and its individual contributors. The book is…

Traditional Birth Attendant Training and Local Birthing Practices in India

ERIC Educational Resources Information Center

Saravanan, Sheela; Turrell, Gavin; Johnson, Helen; Fraser, Jenny; Patterson, Carla

2011-01-01

Training birth attendants (TBAs) to provide essential maternal and infant health care services during delivery and ongoing community care in developing countries. Despite inadequate evidence of relevance and effectiveness of TBA training programmes, there has been a policy shift since the 1990s in that many donor agencies funding TBA training…

Customized Job Training for Business and Industry. New Directions for Community Colleges, Number 48.

ERIC Educational Resources Information Center

Kopecek, Robert J., Ed.; Clarke, Robert G., Ed.

1984-01-01

This sourcebook describes and analyzes contracted customized training for business and industry provided by community colleges. First, "Customized Job Training: Should Your Community College Be Involved?" by Robert J. Kopecek identifies issues to be considered in program decision making and suggests an organizational model for program delivery.…

Stimulus- and response-reinforcer contingencies in autoshaping, operant, classical, and omission training procedures in rats.

PubMed

Atnip, G W

1977-07-01

Separate groups of rats received 500 trials of lever-press training under autoshaping (food delivery followed 10-second lever presentations, or occurred immediately following a response); operant conditioning (responding was necessary for food delivery); and classical conditioning (food followed lever presentations regardless of responding). Each group then received 500 trials on an omission procedure in which food was omitted on trials with a response. Another group received 1000 trials on the omission procedure, and a fifth group, random control, received 1000 uncorrelated presentations of lever and food. The autoshaping, operant, and classical groups reached high response levels by the end of initial training. Acquisition was fastest in the autoshaping group. Responding remained consistently low in the control group. The omission group responded at a level between the control group and the other three groups. During omission training, responding in these three groups declined to the omission-group level. During omission training, the rats continued contacting the lever frequently after lever pressing had declined. Response maintenance under omission training seems not to require topographic similarity between the response and reinforcer-elicited consummatory behaviors.

Stimulus- and response-reinforcer contingencies in autoshaping, operant, classical, and omission training procedures in rats

PubMed Central

Atnip, Gilbert W.

1977-01-01

Separate groups of rats received 500 trials of lever-press training under autoshaping (food delivery followed 10-second lever presentations, or occurred immediately following a response); operant conditioning (responding was necessary for food delivery); and classical conditioning (food followed lever presentations regardless of responding). Each group then received 500 trials on an omission procedure in which food was omitted on trials with a response. Another group received 1000 trials on the omission procedure, and a fifth group, random control, received 1000 uncorrelated presentations of lever and food. The autoshaping, operant, and classical groups reached high response levels by the end of initial training. Acquisition was fastest in the autoshaping group. Responding remained consistently low in the control group. The omission group responded at a level between the control group and the other three groups. During omission training, responding in these three groups declined to the omission-group level. During omission training, the rats continued contacting the lever frequently after lever pressing had declined. Response maintenance under omission training seems not to require topographic similarity between the response and reinforcer-elicited consummatory behaviors. PMID:16812014

The facilitators and impediment factors of midwifery student's empowerment in pregnancy and delivery care: A qualitative study

PubMed Central

Janighorban, Mojgan; Yamani, Nikoo; Yousefi, Hojatollah

2016-01-01

Background: The organizational environment and its existing context may deeply affect on empowerment of individuals. In educational institutions as well as other organizations, students are going to be powerful when opportunities for growth and achievement of power are provided for them in learning and educational environments. This study has been carried out to explain the facilitators and impediment factors of midwifery student's empowerment in pregnancy and delivery care. Materials and Methods: The current qualitative study has been conducted with participation of 15 midwifery senior students, 10 midwifery academic teachers, and 2 employed midwives in educational hospitals. The given data were collected through individual and group semi-structured interviews, and there were analyzed using directed content analysis method. Results: Three main categories of opportunity for acquisition of knowledge, opportunity for acquisition of clinical skills and opportunity for acquisition of clinical experiences formed structure of access to opportunity in the course of an explanation of facilitators and impediment factors for midwifery student's empowerment in pregnancy and delivery care. Conclusion: To prepare and train the skilled midwives for giving care services to mothers during pregnancy and on delivery and after this period, the academic teachers and clinical instructors should pay due attention to providing the needed opportunities to acquire the applied knowledge and proficiency in the required skills for clinical work and the necessary clinical experiences in these individuals during college period. PMID:27904613

Capacity building for critical care training delivery: Development and evaluation of the Network for Improving Critical care Skills Training (NICST) programme in Sri Lanka.

PubMed

Stephens, Tim; De Silva, A Pubudu; Beane, Abi; Welch, John; Sigera, Chathurani; De Alwis, Sunil; Athapattu, Priyantha; Dharmagunawardene, Dilantha; Peiris, Lalitha; Siriwardana, Somalatha; Abeynayaka, Ashoka; Jayasinghe, Kosala Saroj Amarasena; Mahipala, Palitha G; Dondorp, Arjen; Haniffa, Rashan

2017-04-01

To deliver and evaluate a short critical care nurse training course whilst simultaneously building local training capacity. A multi-modal short course for critical care nursing skills was delivered in seven training blocks, from 06/2013-11/2014. Each training block included a Train the Trainer programme. The project was evaluated using Kirkpatrick's Hierarchy of Learning. There was a graded hand over of responsibility for course delivery from overseas to local faculty between 2013 and 2014. Sri Lanka. Participant learning assessed through pre/post course Multi-Choice Questionnaires. A total of 584 nurses and 29 faculty were trained. Participant feedback was consistently positive and each course demonstrated a significant increase (p≤0.0001) in MCQ scores. There was no significant difference MCQ scores (p=0.186) between overseas faculty led and local faculty led courses. In a relatively short period, training with good educational outcomes was delivered to nearly 25% of the critical care nursing population in Sri Lanka whilst simultaneously building a local faculty of trainers. Through use of a structured Train the Trainer programme, course outcomes were maintained following the handover of training responsibility to Sri Lankan faculty. The focus on local capacity building increases the possibility of long term course sustainability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Delivery Strategies to Enhance the Sustainability of Training: Lessons from the Food and Agriculture Organization of the United Nations

ERIC Educational Resources Information Center

de Rosa, Cecilia; Nadeau, Andrew; Hernandez, Emilio; Kafeero, Fred; Zahiga, Jacques

2016-01-01

The Food and Agriculture Organization of the United Nations (FAO) utilizes training as a major component of the support it provides to its member countries in Africa. In the past, stand-alone training events targeting individual actors were the norm. However, an external evaluation indicated that this type of training scores low in terms of…

Determinants of referral practices of clients by traditional birth attendants in Ilorin, Nigeria.

PubMed

Abodunrin, O L; Akande, T M; Musa, I O; Aderibigbe, S A

2010-06-01

A sizeable number of deliveries still take place with the assistance of Traditional Birth Attendants in Nigeria. This study aims to determine the factors that determine the referral practices of the TBAs in Ilorin of high risk and complicated pregnancies. This descriptive study was conducted among all the 162 registered TBAs in Ilorin that were traceable using pre-tested semi-structured interviewer-administered questionnaire. About 90%, whose source of skill acquisition was by inheritance did not refer their clients appropriately compared with 48% of those whose source of skill acquisition was through formal training (p<0.05). The more the numbers of trainings, the more appropriate the referral (p<0.05). Having supervisory visit by qualified personnel is associated with appropriate referral practices (p<0.05). Regular training and re-training of TBAs with routine monitoring and supportive supervision will promote prompt referral of high risk and complicated pregnancies and deliveries.

Applying the trigger review method after a brief educational intervention: potential for teaching and improving safety in GP specialty training?

PubMed Central

2013-01-01

Background The Trigger Review Method (TRM) is a structured approach to screening clinical records for undetected patient safety incidents (PSIs) and identifying learning and improvement opportunities. In Scotland, TRM participation can inform GP appraisal and has been included as a core component of the national primary care patient safety programme that was launched in March 2013. However, the clinical workforce needs up-skilled and the potential of TRM in GP training has yet to be tested. Current TRM training utilizes a workplace face-to-face session by a GP expert, which is not feasible. A less costly, more sustainable educational intervention is necessary to build capability at scale. We aimed to determine the feasibility and impact of TRM and a related training intervention in GP training. Methods We recruited 25 west of Scotland GP trainees to attend a 2-hour TRM workshop. Trainees then applied TRM to 25 clinical records and returned findings within 4-weeks. A follow-up feedback workshop was held. Results 21/25 trainees (84%) completed the task. 520 records yielded 80 undetected PSIs (15.4%). 36/80 were judged potentially preventable (45%) with 35/80 classified as causing moderate to severe harm (44%). Trainees described a range of potential learning and improvement plans. Training was positively received and appeared to be successful given these findings. TRM was valued as a safety improvement tool by most participants. Conclusion This small study provides further evidence of TRM utility and how to teach it pragmatically. TRM is of potential value in GP patient safety curriculum delivery and preparing trainees for future safety improvement expectations. PMID:24000946

Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study

PubMed Central

Morita, Plinio P; Tallevi, Kevin; Armour, Kevin; Li, John; Nolan, Robert P; Cafazzo, Joseph A

2016-01-01

Background Elevated blood pressure is one of the main risk factors for death globally. Behavioral neurocardiac training (BNT) is a complementary approach to blood pressure and stress management that is intended to exercise the autonomic reflexes, improve stress recovery, and lower blood pressure. BNT involves cognitive-behavioral therapy with a paced breathing technique and heart rate variability biofeedback. BNT is limited to in-clinic delivery and faces an accessibility barrier because of the need for clinical oversight and the use of complex monitoring tools. Objective The objective of this project was to design, develop, and evaluate a wearable electrocardiographic (ECG) sensor system for the delivery of BNT in a home setting. Methods The wearable sensor system, Beat, consists of an ECG sensor and a mobile app. It was developed iteratively using the principles of test-driven Agile development and user-centered design. A usability study was conducted at Toronto General Hospital to evaluate feasibility and user experience and identify areas of improvement. Results The Beatsensor was designed as a modular patch to be worn on the user’s chest and uses standard ECG electrodes. It streams a single-lead ECG wirelessly to a mobile phone using Bluetooth Low Energy. The use of small, low-power electronics, a low device profile, and a tapered enclosure allowed for a device that can be unobtrusively worn under clothing. The sensor was designed to operate with a mobile app that guides users through the BNT exercises to train them to a slow-paced breathing technique for stress recovery. The BNT app uses the ECG captured by the sensor to provide heart rate variability biofeedback in the form of a real-time heart rate waveform to complement and reinforce the impact of the training. Usability testing (n=6) indicated that the overall response to the design and user experience of the system was perceived positively. All participants indicated that the system had a positive effect on stress management and that they would use it at home. Areas of improvement were identified, which focused primarily on the delivery of training and education on BNT through the app. Conclusions The outcome of this project was a wearable sensor system to deliver BNT at home. The system has the potential to offer a complementary approach to blood pressure and stress management at home and reduce current accessibility barriers. PMID:27106171

Unmet needs in health training among nurses in rural Chinese township health centers: a cross-sectional hospital-based study.

PubMed

Mo, Yan; Hu, Guijie; Yi, Yanhua; Ying, Yanping; Huang, Huiqiao; Huang, Zhongxian; Lin, Jiafeng

2017-01-01

Maintaining a sufficient and competent rural nursing workforce is an important goal of the Chinese health delivery system. However, few studies have investigated the health training status or conducted a needs assessment of rural Chinese nurses during this time of great transformations in health policy. This study was conducted to explore the current health training status of nurses working in rural Chinese township health centers (THCs) and to ascertain their perceived needs. A cross-sectional survey using a self-administered structured questionnaire was conducted among 240 THC nurses in Guangxi Zhuang Autonomous Region, China from March 2014 to August 2014. The survey questionnaire was adapted from the Second Chinese Survey of Demographic Data and Training Demand for Health Professionals in THCs developed by the Ministry of Education. The nurses in THCs were young, with a low educational level. Their perceived needs for health training included further clinical studies at city-level hospitals to improve their skills and theoretical studies at medical universities in emergency medicine and general practice. Overall, 71.9% of the nurses with a secondary technical school background expected to pursue junior college studies, and 68.5% of the nurses with a junior college education expected to pursue a bachelor's degree. A decentralized program with theoretical studies at medical universities and practical studies at county hospitals was regarded as feasible by 66.9% of the respondents. Health-training programs for nurses in Chinese THCs must be improved in terms of coverage, delivery mode, and content. A decentralized degree-linked training program in which medical universities and city hospitals collaborate would be an appropriate mode of delivery.

Learning From Experience: Qualitative Analysis to Develop a Cognitive Task List for Kielland Forceps Deliveries.

PubMed

Simpson, Andrea N; Hodges, Ryan; Snelgrove, John; Gurau, David; Secter, Michael; Mocarski, Eva; Pittini, Richard; Windrim, Rory; Higgins, Mary

2015-05-01

Fetal malposition is a common indication for Caesarean section in the second stage of labour. Rotational (Kielland) forceps are a valuable tool in select situations for successful vaginal delivery; however, learning opportunities are scarce. Our aim was to identify the verbal and non-verbal components of performing a safe Kielland forceps delivery through filmed demonstrations by expert practitioners on models to develop a task list for training purposes. Labour and delivery nurses at three university-affiliated hospitals identified clinicians whom they considered skilled in Kielland forceps deliveries. These physicians gave consent and were filmed performing Kielland forceps deliveries on a model, describing their assessment and technique and sharing clinical pearls based on their experience. Two clinicians reviewed the videos independently and recorded verbal and non-verbal components of the assessment; thematic analysis was performed and a core task list was developed. The algorithm was circulated to participants to ensure consensus. Eleven clinicians were identified; eight participated. Common themes were prevention of persistent malposition where possible, a thorough assessment to determine suitability for forceps delivery, roles of the multidisciplinary team, description of the Kielland forceps and technical aspects related to their use, the importance of communication with the parents and the team (including consent, debriefing, and documentation), and "red flags" that indicate the need to stop when safety criteria cannot be met. Development of a cognitive task list, derived from years of experience with Kielland forceps deliveries by expert clinicians, provides an inclusive algorithm that may facilitate standardized resident training to enhance education in rotational forceps deliveries.

Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study

PubMed Central

Reed, Suzanne; Kassis, Karyn; Nagel, Rollin; Verbeck, Nicole; Mahan, John D.; Shell, Richard

2015-01-01

Background While both patients and physicians identify communication of bad news as an area of great challenge, the factors underlying this often complex task remain largely unknown. Emotional intelligence (EI) has been positively correlated with good general communication skills and successful leadership, but there is no literature relating EI to the delivery of bad news. Purpose Our objectives were to determine: 1) performance of first-year pediatric residents in the delivery of bad news in a standardized patient (SP) setting; and 2) the role of EI in these assessments. Our hypothesis was that pediatric trainees with higher EI would demonstrate more advanced skills in this communication task. Methods Forty first- year residents participated. Skill in bad news delivery was assessed via SP encounters using a previously published assessment tool (GRIEV_ING Death Notification Protocol). Residents completed the Emotional and Social Competency Inventory (ESCI) as a measure of EI. Results Residents scored poorly on bad news delivery skills but scored well on EI. Intraclass correlation coefficients indicated moderate to substantial inter-rater reliability among raters using the delivering bad news assessment tool. However, no correlation was found between bad news delivery performance and EI. Conclusions We concluded that first-year pediatric residents have inadequate skills in the delivery of bad news. In addition, our data suggest that higher EI alone is not sufficient to effectively deliver death news and more robust skill training is necessary for residents to gain competence and acquire mastery in this important communication domain. PMID:26286897

Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study.

PubMed

Reed, Suzanne; Kassis, Karyn; Nagel, Rollin; Verbeck, Nicole; Mahan, John D; Shell, Richard

2015-01-01

Background While both patients and physicians identify communication of bad news as an area of great challenge, the factors underlying this often complex task remain largely unknown. Emotional intelligence (EI) has been positively correlated with good general communication skills and successful leadership, but there is no literature relating EI to the delivery of bad news. Purpose Our objectives were to determine: 1) performance of first-year pediatric residents in the delivery of bad news in a standardized patient (SP) setting; and 2) the role of EI in these assessments. Our hypothesis was that pediatric trainees with higher EI would demonstrate more advanced skills in this communication task. Methods Forty first- year residents participated. Skill in bad news delivery was assessed via SP encounters using a previously published assessment tool (GRIEV_ING Death Notification Protocol). Residents completed the Emotional and Social Competency Inventory (ESCI) as a measure of EI. Results Residents scored poorly on bad news delivery skills but scored well on EI. Intraclass correlation coefficients indicated moderate to substantial inter-rater reliability among raters using the delivering bad news assessment tool. However, no correlation was found between bad news delivery performance and EI. Conclusions We concluded that first-year pediatric residents have inadequate skills in the delivery of bad news. In addition, our data suggest that higher EI alone is not sufficient to effectively deliver death news and more robust skill training is necessary for residents to gain competence and acquire mastery in this important communication domain.

Modeling Heavy/Medium-Duty Fuel Consumption Based on Drive Cycle Properties

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

Wang, Lijuan; Duran, Adam; Gonder, Jeffrey

This paper presents multiple methods for predicting heavy/medium-duty vehicle fuel consumption based on driving cycle information. A polynomial model, a black box artificial neural net model, a polynomial neural network model, and a multivariate adaptive regression splines (MARS) model were developed and verified using data collected from chassis testing performed on a parcel delivery diesel truck operating over the Heavy Heavy-Duty Diesel Truck (HHDDT), City Suburban Heavy Vehicle Cycle (CSHVC), New York Composite Cycle (NYCC), and hydraulic hybrid vehicle (HHV) drive cycles. Each model was trained using one of four drive cycles as a training cycle and the other threemore » as testing cycles. By comparing the training and testing results, a representative training cycle was chosen and used to further tune each method. HHDDT as the training cycle gave the best predictive results, because HHDDT contains a variety of drive characteristics, such as high speed, acceleration, idling, and deceleration. Among the four model approaches, MARS gave the best predictive performance, with an average absolute percent error of -1.84% over the four chassis dynamometer drive cycles. To further evaluate the accuracy of the predictive models, the approaches were first applied to real-world data. MARS outperformed the other three approaches, providing an average absolute percent error of -2.2% of four real-world road segments. The MARS model performance was then compared to HHDDT, CSHVC, NYCC, and HHV drive cycles with the performance from Future Automotive System Technology Simulator (FASTSim). The results indicated that the MARS method achieved a comparative predictive performance with FASTSim.« less

Randomized controlled trial on the effects of training in the use of closed-circuit television on reading performance.

PubMed

Burggraaff, Marloes C; van Nispen, Ruth M A; Hoeben, Frank P; Knol, Dirk L; van Rens, Ger H M B

2012-04-24

To investigate the effectiveness of training in the use of closed-circuit television (CCTV) on reading performance in visually impaired patients. In a multicenter masked randomized controlled trial, 122 patients were randomized either to a treatment group that received usual delivery instructions from the CCTV supplier combined with concise outpatient standardized training, or to a control group that received delivery instructions only. The main outcome measure was reading performance, which was obtained by measuring reading acuity, reading speed, reading errors, column-tracking time, and technical reading, approximately two weeks after patients had received their CCTV and 3 months later. Videotapes of all measurements were rated by two investigators. Training effects were analyzed with linear mixed modeling. There were no statistically significant differences in results between the treatment and control group. However, introducing a CCTV increased reading acuity (mean difference [MD] 0.93 logRAD; P < 0.01) and maximum reading speed (MD 15 wpm; P < 0.01), and decreased the number of errors (MD 0.33; P = 0.04), compared to reading without CCTV. Average reading speed (P = 0.05), number of errors (P = 0.04), and column-tracking time (P = 0.01) improved over time. Prescribing a CCTV and the delivery instructions by the supplier seemed sufficient to improve reading performance. Additional training in the use of this device did not result in further improvement. Based on these results, outpatient low-vision rehabilitation centers may consider reallocating part of the training resources into other evidence-based rehabilitation programs. (trialregister.nl number, NTR1031.).

Training NOAA Staff on Effective Communication Methods with Local Climate Users

NASA Astrophysics Data System (ADS)

Timofeyeva, M. M.; Mayes, B.

2011-12-01

Since 2002 NOAA National Weather Service (NWS) Climate Services Division (CSD) offered training opportunities to NWS staff. As a result of eight-year-long development of the training program, NWS offers three training courses and about 25 online distance learning modules covering various climate topics: climate data and observations, climate variability and change, NWS national and local climate products, their tools, skill, and interpretation. Leveraging climate information and expertise available at all NOAA line offices and partners allows delivery of the most advanced knowledge and is a very critical aspect of the training program. NWS challenges in providing local climate services includes effective communication techniques on provide highly technical scientific information to local users. Addressing this challenge requires well trained, climate-literate workforce at local level capable of communicating the NOAA climate products and services as well as provide climate-sensitive decision support. Trained NWS climate service personnel use proactive and reactive approaches and professional education methods in communicating climate variability and change information to local users. Both scientifically-unimpaired messages and amiable communication techniques such as story telling approach are important in developing an engaged dialog between the climate service providers and users. Several pilot projects NWS CSD conducted in the past year applied the NWS climate services training program to training events for NOAA technical user groups. The technical user groups included natural resources managers, engineers, hydrologists, and planners for transportation infrastructure. Training of professional user groups required tailoring the instructions to the potential applications of each group of users. Training technical user identified the following critical issues: (1) Knowledge of target audience expectations, initial knowledge status, and potential use of climate information; (2) Leveraging partnership with climate services providers; and, (3) Applying 3H training approach, where the first H stands for Head (trusted science), the second H stands for Heart (make it easy), and the third H for Hand (support with applications).

A general-purpose development environment for intelligent computer-aided training systems

NASA Technical Reports Server (NTRS)

Savely, Robert T.

1990-01-01

Space station training will be a major task, requiring the creation of large numbers of simulation-based training systems for crew, flight controllers, and ground-based support personnel. Given the long duration of space station missions and the large number of activities supported by the space station, the extension of space shuttle training methods to space station training may prove to be impractical. The application of artificial intelligence technology to simulation training can provide the ability to deliver individualized training to large numbers of personnel in a distributed workstation environment. The principal objective of this project is the creation of a software development environment which can be used to build intelligent training systems for procedural tasks associated with the operation of the space station. Current NASA Johnson Space Center projects and joint projects with other NASA operational centers will result in specific training systems for existing space shuttle crew, ground support personnel, and flight controller tasks. Concurrently with the creation of these systems, a general-purpose development environment for intelligent computer-aided training systems will be built. Such an environment would permit the rapid production, delivery, and evolution of training systems for space station crew, flight controllers, and other support personnel. The widespread use of such systems will serve to preserve task and training expertise, support the training of many personnel in a distributed manner, and ensure the uniformity and verifiability of training experiences. As a result, significant reductions in training costs can be realized while safety and the probability of mission success can be enhanced.

Knowledge, attitudes and practices of traditional birth attendants in pastoralist communities of Laikipia and Samburu counties, Kenya: a cross-sectional survey

PubMed Central

Reeve, Matthew; Onyo, Pamela; Nyagero, Josephat; Morgan, Alison; Nduba, John; Kermode, Michelle

2016-01-01

Introduction Current efforts to reduce maternal and newborn mortality focus on promoting institutional deliveries with skilled birth attendants (SBAs), and discouraging deliveries at home attended by traditional birth attendants (TBAs). In rural Kenya, semi-nomadic pastoralist communities are underserved by the formal health system, experience high maternal and neonatal mortality, and rely primarily on TBAs for delivery care, despite Government proscription of TBA-assisted births. This study examined the knowledge, attitude and practices of TBAs serving these communities to assess the potential for collaboration between TBAs and SBAs. Methods A cross-sectional, interviewer-administered survey was conducted among 171 TBAs from Maasai and Samburu pastoralist communities in Laikipia and Samburu counties, Kenya, as part of a larger mixed-methods study in partnership with a local service provider. Results BAs were relatively elderly (mean age 59.6 years), and attended an average of 5-6 deliveries per year. A minority (22.2%) had received formal training. They provided antenatal, intra-partum and post-partum care. Most TBA care was non-interventionist, but not necessarily consistent with best practice. Most had encountered birth complications, but knowledge regarding management of complications was sub-optimal. Most had previously referred at least one woman to a health facility (80.1%), were key participants in decision making to refer women (96.5%), and had been present at an institutional delivery (54.4%). Conclusion TBAs continue to be key providers of maternal and neonatal healthcare in regions where the formal health system has poor coverage or acceptability. Strengthening existing TBA/SBA collaborations could improve both community links to the formal health system, and the quality of care provided to pastoralist women, while remaining consistent with current Government policy. PMID:28439337

The Availability and Use of Postpartum LARC in Mexico and Among Hispanics in the United States.

PubMed

Potter, Joseph E; Hubert, Celia; White, Kari

2017-09-01

Objectives In the 1980s, policy makers in Mexico led a national family planning initiative focused, in part, on postpartum IUD use. The transformative impact of this initiative is not well known, and is relevant to current efforts in the United States (US) to increase women's use of long-acting reversible contraception (LARC). Methods Using six nationally representative surveys, we illustrate the dramatic expansion of postpartum LARC in Mexico and compare recent estimates of LARC use immediately following delivery through 18 months postpartum to estimates from the US. We also examine unmet demand for postpartum LARC among 321 Mexican-origin women interviewed in a prospective study on postpartum contraception in Texas in 2012, and describe differences in the Mexican and US service environments using a case study with one of these women. Results Between 1987 and 2014, postpartum LARC use in Mexico doubled, increasing from 9 to 19 % immediately postpartum and from 13 to 26 % by 18 months following delivery. In the US, <0.1 % of women used an IUD or implant immediately following delivery and only 9 % used one of these methods at 18 months. Among postpartum Mexican-origin women in Texas, 52 % of women wanted to use a LARC method at 6 months following delivery, but only 8 % used one. The case study revealed provider and financial barriers to postpartum LARC use. Conclusions Some of the strategies used by Mexico's health authorities in the 1980s, including widespread training of physicians in immediate postpartum insertion of IUDs, could facilitate women's voluntary initiation of postpartum LARC in the US.

Training Health Care Paraprofessionals

ERIC Educational Resources Information Center

Linton, Corinne B.

1977-01-01

This review of the allied health occupations training programs offered by Brevard Community College (Cocoa, Florida) covers organization of the division, objectives, selection and admission process, instructional delivery system, clinical facilities, advisory committees, high school relations, continuing education programs, and program success.…

Designing for International Teletraining.

ERIC Educational Resources Information Center

Chute, Alan G.; Shatzer, Linda S.

The ability to bridge together geographically-distant populations for training is made possible through teletraining, a human performance system which integrates telecommunications into the planning, design, and delivery of training programs. Typically, teletraining uses standard telephone lines or digital communication services to provide…

The effects of a regional natural history course on outcome expectancy, self-efficacy, and instructional methods of science teachers

NASA Astrophysics Data System (ADS)

Dechant, Thomas Fredrick

Recent concerns about the effectiveness of science instruction have prompted a variety of strategies and research to effect positive changes. Research has indicated that among the contributing factors to the success of students learning science are teacher outcome expectancy, self-efficacy, and the selection and use of various teaching methods. Inservice training opportunities for public school teachers have been proposed as a strategy that can yield positive changes in these areas. Environmental education has also been proposed as a viable component of teaching science, but focus on global, and the omission of local themes is common. This study assessed the effects of an inservice training course entitled "Natural History of the Southern Appalachians" on regional teachers' outcome expectancy, self-efficacy, and science teaching methods. Through the administration of the Science Teaching Efficacy Belief Instrument and the Science Teaching Strategies Survey before taking the course and after taking the course, changes in the teachers outcome expectancy (p<.05), self-efficacy (p<.10), and teaching strategy selection were measured. In all three areas, desired positive changes have resulted from teachers completing the course. It appears that regionally specific Natural History training gives teachers inexpensive options to teach science, as well as making them more comfortable with the delivery of science instruction.

Clean delivery practices in rural northern Ghana: a qualitative study of community and provider knowledge, attitudes, and beliefs

PubMed Central

2012-01-01

Background Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1) Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2) Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3) Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of facility-based delivery, the disconnect between healthcare providers and the community, and the critical role grandmothers play in ensuring clean delivery practices. Future interventions to address clean delivery and prevention of neonatal infections include educating healthcare providers about harmful traditional practices so they are specifically addressed, strengthening facilities, and incorporating influential community members such as grandmothers to ensure success. PMID:22703032

Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders

PubMed Central

Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

2016-01-01

ABSTRACT Background: The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public‐sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. Methods: We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. Results: The direct service delivery cost of Medicines360’s LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product’s non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation and provider training should be prioritized. Conclusion: Introducing a new, more affordable LNG IUS product could help expand choice for women in Kenya and increase use of long-acting reversible contraception. Further evaluation is needed to identify the full costs required for introduction—including the cost of demand creation—as well as research among potential and actual LNG IUS users, their partners, and health care providers to help inform scale-up of the method. PMID:27540128

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.

Multimedia Delivery of Coastal Zone Management Training.

ERIC Educational Resources Information Center

Clark, M. J.; And Others

1995-01-01

Describes Coastal Zone Management (CZM) multimedia course modules, educational software written by the GeoData Institute at the University of Southamptom for an environmental management undergraduate course. Examines five elements that converge to create CZM multimedia teaching: course content, source material, a hardware/software delivery system,…

Engaging Faculty in Telecommunications-Based Instructional Delivery Systems.

ERIC Educational Resources Information Center

Swalec, John J.

In the design and development of telecommunications-based instructional delivery systems, attention to faculty involvement and training is often overlooked until the system is operational. The Waubonsee Telecommunications Instructional Consortium (TIC), in Illinois, is one network that benefited from early faculty input. Even before the first…

Building Global Learning Communities through the Internet.

ERIC Educational Resources Information Center

Mende, Richard

From Spring 1995 to Spring 1996, Cambrian College, in Ontario (Canada), undertook a project to develop Canada's first full program using Internet technology. The major challenges accomplished included the selection of the program; adaptation of materials for digital delivery; selection of a delivery technology; faculty training; and program…

Veterinary vaccine nanotechnology: pulmonary and nasal delivery in livestock animals.

PubMed

Calderon-Nieva, Daniella; Goonewardene, Kalhari Bandara; Gomis, Susantha; Foldvari, Marianna

2017-08-01

Veterinary vaccine development has several similarities with human vaccine development to improve the overall health and well-being of species. However, veterinary goals lean more toward feasible large-scale administration methods and low cost to high benefit immunization. Since the respiratory mucosa is easily accessible and most infectious agents begin their infection cycle at the mucosa, immunization through the respiratory route has been a highly attractive vaccine delivery strategy against infectious diseases. Additionally, vaccines administered via the respiratory mucosa could lower costs by removing the need of trained medical personnel, and lowering doses yet achieving similar or increased immune stimulation. The respiratory route often brings challenges in antigen delivery efficiency with enough potency to induce immunity. Nanoparticle (NP) technology has been shown to enhance immune activation by producing higher antibody titers and protection. Although specific mechanisms between NPs and biological membranes are still under investigation, physical parameters such as particle size and shape, as well as biological tissue distribution including mucociliary clearance influence the protection and delivery of antigens to the site of action and uptake by target cells. For respiratory delivery, various biomaterials such as mucoadhesive polymers, lipids, and polysaccharides have shown enhanced antibody production or protection in comparison to antigen alone. This review presents promising NPs administered via the nasal or pulmonary routes for veterinary applications specifically focusing on livestock animals including poultry.

Tibetan women's perspectives and satisfaction with delivery care in a rural birth center.

PubMed

Gipson, Jessica D; Gyaltsen, Kunchok; Gyal, Lhusham; Kyi, Tsering; Hicks, Andrew L; Pebley, Anne R

2015-06-01

To identify sociodemographic characteristics and factors involved in Tibetan women's decisions to deliver at the Tibetan Birth and Training Center (TBTC) in rural western China. In the present mixed-methods study, a random sample of married women who delivered at the TBTC between June 2011 and June 2012 were surveyed. Additionally, four focus group discussions were conducted among married women living in the TBTC catchment area. Descriptive analyses were conducted, and dominant themes were identified. In focus group discussions, women (n=33) reported that improved roads and transportation meant that access to health facilities was easier than in the past. Although some of the 114 survey participants voiced negative perceptions of healthcare facilities and providers, 99 (86.8%) indicated that they chose to deliver at the TBTC because they preferred to have a doctor present. Most women (75 [65.8%]) said their mother/mother-in-law made the final decision about delivery location. Women valued logistic and cultural aspects of the TBTC, and 108 (94.7%) said that they would recommend the TBTC to a friend. Study participants preferred delivery care that combines safety and comfort. The findings highlight avenues for further promotion of facility delivery among populations with lower rates of skilled deliveries. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Development of Training Materials for Community Based Rehabilitation Workers in Guyana.

ERIC Educational Resources Information Center

O'Toole, Brian; McConkey, Roy

1995-01-01

This paper describes video training packages that have been developed in Guyana as part of Hopeful Steps, a program which uses the Community Based Rehabilitation (CBR) model of service delivery for training rehabilitation workers and volunteers and now serves children with disabilities and their families in five rural regions of the country. (DB)

The Most Effective Way of Delivering a Train-the-Trainers Program: A Systematic Review

ERIC Educational Resources Information Center

Pearce, Jennifer; Mann, Mala K.; Jones, Caryl; van Buschbach, Susanne; Olff, Miranda; Bisson, Jonathan I.

2012-01-01

Introduction: Previous literature has shown that multifaceted, interactive interventions may be the most effective way to train health and social care professionals. A Train-the-Trainer (TTT) model could incorporate all these components. We conducted a systematic review to determine the overall effectiveness and optimal delivery of TTT programs.…

Training peers to deliver a church-based diabetes prevention program.

PubMed

Tang, Tricia S; Nwankwo, Robin; Whiten, Yolanda; Oney, Christina

2012-01-01

The purpose of this study was to examine the feasibility and acceptability of training peers to function as lifestyle coaches and to deliver a church-based lifestyle modification program. We recruited 6 African-American adults to participate in an 8-hour peer lifestyle coach (PLC) training program followed by a subsequent 2-hour booster session. The PLC training program addressed several key areas, including: (1) developing empowerment-based facilitation, active listening, and behavior change skills; (2) learning self-management strategies (eg, reading food labels, counting calories); (3) practicing session delivery; and (4) interpreting clinical lab results. Training evaluation was conducted retrospectively (immediately following the delivery of the diabetes prevention intervention rather than after the 8-hour training session) and measured program satisfaction and efficacy from the perspective of participants. Peer lifestyle coaches' confidence levels for performing core skills (eg, asking open-ended questions, 5-step behavioral goal-setting process) and advanced skills (eg, addressing resistance, discussing sensitive topics) were uniformly high. Similarly, PLCs were very satisfied with the length of training, balance between content and skills development, and preparation for leading group- and individual-based support activities. Findings suggest that it is feasible to customize a PLC training program that is acceptable to participants and that equips participants with the knowledge and skills to facilitate a church-based diabetes prevention intervention.

Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial.

PubMed

Bergström, M; Kieler, H; Waldenström, U

2009-08-01

To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers. Randomised controlled multicentre trial. Fifteen antenatal clinics in Sweden between January 2006 and May 2007. A total of 1087 nulliparous women and 1064 of their partners. Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery. Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire. The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings. Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education.

Impact Evaluation of PRONTO Mexico: A Simulation-Based Program in Obstetric and Neonatal Emergencies and Team Training

PubMed Central

Walker, Dilys M.; Cohen, Susanna R.; Fritz, Jimena; Olvera-García, Marisela; Zelek, Sarah T.; Fahey, Jenifer O.; Romero-Martínez, Martín; Montoya-Rodríguez, Alejandra; Lamadrid-Figueroa, Héctor

2016-01-01

Introduction Most maternal deaths in Mexico occur within health facilities, often attributable to suboptimal care and lack of access to emergency services. Improving obstetric and neonatal emergency care can improve health outcomes. We evaluated the impact of PRONTO, a simulation-based low-cost obstetric and neonatal emergency and team training program on patient outcomes. Methods We conducted a pair-matched hospital-based trial in Mexico from 2010 to 2013 with 24 public hospitals. Obstetric and neonatal care providers participated in PRONTO trainings at intervention hospitals. Control hospitals received no intervention. Outcome measures included hospital-based neonatal mortality, maternal complications, and cesarean delivery. We fitted mixed-effects negative binomial regression models to estimate incidence rate ratios and 95% confidence intervals using a difference-in-differences approach, cumulatively, and at follow-up intervals measured at 4, 8, and 12 months. Results There was a significant estimated impact of PRONTO on the incidence of cesarean sections in intervention hospitals relative to controls adjusting for baseline differences during all 12 months cumulative of follow-up (21% decrease, P = 0.005) and in intervals measured at 4 (16% decrease, P = 0.02), 8 (20% decrease, P = 0.004), and 12 months’ (20% decrease, P = 0.003) follow-up. We found no statistically significant impact of the intervention on the incidence of maternal complications. A significant impact of a 40% reduction in neonatal mortality adjusting for baseline differences was apparent at 8 months postintervention but not at 4 or 12 months. Conclusions PRONTO reduced the incidence of cesarean delivery and may improve neonatal mortality, although the effect on the latter might not be sustainable. Further study is warranted to confirm whether obstetric and neonatal emergency simulation and team training can have lasting results on patient outcomes. PMID:26312613

Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

PubMed Central

2011-01-01

Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied to other aspects of residency curriculum development. PMID:21781319

Association of Group Prenatal Care in US Family Medicine Residencies With Maternity Care Practice: A CERA Secondary Data Analysis.

PubMed

Barr, Wendy B; Tong, Sebastian T; LeFevre, Nicholas M

2017-03-01

Group prenatal care has been shown to improve both maternal and neonatal outcomes. With increasing adaption of group prenatal care by family medicine residencies, this model may serve as a potential method to increase exposure to and interest in maternity care among trainees. This study aims to describe the penetration, regional and program variations, and potential impacts on future maternity care practice of group prenatal care in US family medicine residencies. The CAFM Educational Research Alliance (CERA) conducted a survey of all US family medicine residency program directors in 2013 containing questions about maternity care training. A secondary data analysis was completed to examine relevant data on group prenatal care in US family medicine residencies and maternity care practice patterns. 23.1% of family medicine residency programs report provision of group prenatal care. Programs with group prenatal care reported increased number of vaginal deliveries per resident. Controlling for average number of vaginal deliveries per resident, programs with group prenatal care had a 2.35 higher odds of having more than 10% of graduates practice obstetrics and a 2.93 higher odds of having at least one graduate in the past 5 years enter an obstetrics fellowship. Residency programs with group prenatal care models report more graduates entering OB fellowships and practicing maternity care. Implementing group prenatal care in residency training can be one method in a multifaceted approach to increasing maternity care practice among US family physicians.

Training of midwives in advanced obstetrics in Liberia.

PubMed

Dolo, Obed; Clack, Alice; Gibson, Hannah; Lewis, Naomi; Southall, David P

2016-05-01

The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. The training took place in CB Dunbar Maternity Hospital. This rural hospital deals with approximately 2000 deliveries annually, many of which present complications. In February 2015 there were just 117 doctors available in Liberia. In the first 18 months of training, the trainees were involved with 236 caesarean sections, 35 manual evacuations of products of conception, 25 manual removals of placentas, 21 vaginal breech deliveries, 14 vacuum deliveries, four repairs of ruptured uteri, the management of four cases of shoulder dystocia, three hysterectomies, two laparotomies for ruptured ectopic pregnancies and numerous obstetric ultrasound examinations. The trainees also managed 41 cases of eclampsia or severe pre-eclampsia, 25 of major postpartum haemorrhage and 21 of shock. Although, initially they only assisted senior doctors, the trainees subsequently progressed from direct to indirect supervision and then to independent management. To compensate for a shortage of doctors able to undertake comprehensive emergency obstetric and neonatal care, experienced midwives can be taught to undertake advanced obstetric care and procedures. Their team work with doctors can be particularly valuable in rural hospitals in resource-poor countries.

Evaluation of a co-delivered training package for community mental health professionals on service user- and carer-involved care planning.

PubMed

Grundy, A C; Walker, L; Meade, O; Fraser, C; Cree, L; Bee, P; Lovell, K; Callaghan, P

2017-08-01

WHAT IS KNOWN ON THE SUBJECT?: There is consistent evidence that service users and carers feel marginalized in the process of mental health care planning. Mental health professionals have identified ongoing training needs in relation to involving service users and carers in care planning. There is limited research on the acceptability of training packages for mental health professionals which involve service users and carers as co-facilitators. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A co-produced and co-delivered training package on service user- and carer-involved care planning was acceptable to mental health professionals. Aspects of the training that were particularly valued were the co-production model, small group discussion and the opportunity for reflective practice. The organizational context of care planning may need more consideration in future training models. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses using co-production models of delivering training to other mental health professionals can be confident that such initiatives will be warmly welcomed, acceptable and engaging. On the basis of the results reported here, we encourage mental health nurses to use co-production approaches more often. Further research will show how clinically effective this training is in improving outcomes for service users and carers. Background There is limited evidence for the acceptability of training for mental health professionals on service user- and carer-involved care planning. Aim To investigate the acceptability of a co-delivered, two-day training intervention on service user- and carer-involved care planning. Methods Community mental health professionals were invited to complete the Training Acceptability Rating Scale post-training. Responses to the quantitative items were summarized using descriptive statistics (Miles, ), and qualitative responses were coded using content analysis (Weber, ). Results Of 350 trainees, 310 completed the questionnaire. The trainees rated the training favourably (median overall TARS scores = 56/63; median 'acceptability' score = 34/36; median 'perceived impact' score = 22/27). There were six qualitative themes: the value of the co-production model; time to reflect on practice; delivery preferences; comprehensiveness of content; need to consider organizational context; and emotional response. Discussion The training was found to be acceptable and comprehensive with participants valuing the co-production model. Individual differences were apparent in terms of delivery preferences and emotional reactions. There may be a need to further address the organizational context of care planning in future training. Implications for practice Mental health nurses should use co-production models of continuing professional development training that involve service users and carers as co-facilitators. © 2017 The Authors. Journal of Psychiatric and Mental Health Nursing Published by John Wiley & Sons Ltd.

Apros-based Kola 1 nuclear power plant compact training simulator

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

Porkholm, K.; Kontio, H.; Nurmilaukas, P.

1996-11-01

Imatran Voima Oy`s subsidiary IVO International Ltd (IVO IN) and the Technical Research Centre of Finland (VTT) in co-operation with Kola staff supplies the Kola Nuclear Power Plant in the Murmansk region of Russia with a Compact Training Simulator. The simulator will be used for the training of the plant personnel in managing the plant disturbance and accident situations. By means of the simulator is is also possible to test how the planned plant modifications will affect the plant operation. The simulator delivery is financed by the Finnish Ministry of Trade and Industry and the Ministry of Foreign Affairs. Themore » delivery is part of the aid program directed to Russia for the improvement of the nuclear power plant safety.« less

Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop.

PubMed

Spong, Catherine Y; Berghella, Vincenzo; Wenstrom, Katharine D; Mercer, Brian M; Saade, George R

2012-11-01

With more than one third of pregnancies in the United States being delivered by cesarean and the growing knowledge of morbidities associated with repeat cesarean deliveries, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Society for Maternal-Fetal Medicine, and the American College of Obstetricians and Gynecologists convened a workshop to address the concept of preventing the first cesarean delivery. The available information on maternal and fetal factors, labor management and induction, and nonmedical factors leading to the first cesarean delivery was reviewed as well as the implications of the first cesarean delivery on future reproductive health. Key points were identified to assist with reduction in cesarean delivery rates including that labor induction should be performed primarily for medical indication; if done for nonmedical indications, the gestational age should be at least 39 weeks or more and the cervix should be favorable, especially in the nulliparous patient. Review of the current literature demonstrates the importance of adhering to appropriate definitions for failed induction and arrest of labor progress. The diagnosis of "failed induction" should only be made after an adequate attempt. Adequate time for normal latent and active phases of the first stage, and for the second stage, should be allowed as long as the maternal and fetal conditions permit. The adequate time for each of these stages appears to be longer than traditionally estimated. Operative vaginal delivery is an acceptable birth method when indicated and can safely prevent cesarean delivery. Given the progressively declining use, it is critical that training and experience in operative vaginal delivery are facilitated and encouraged. When discussing the first cesarean delivery with a patient, counseling should include its effect on future reproductive health.

Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study

PubMed Central

2013-01-01

Background Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not facilitate their involvement. This qualitative study conducted in rural Western Kenya, explored men’s perceptions of antenatal and delivery care services and identified factors that facilitated or constrained their involvement. Methods Eight focus group discussions were conducted with 68 married men between 20-65 years of age in May 2011. Participants were of the Luo ethnic group residing in Asembo, western Kenya. The area has a high HIV-prevalence and polygamy is common. A topic guide was used to guide the discussions and a thematic framework approach for data analysis. Results Overall, men were positive in their views of antenatal and delivery care, as decision makers they often encouraged, some even ‘forced’, their wives to attend for antenatal or delivery care. Many reasons why it was beneficial to accompany their wives were provided, yet few did this in practice unless there was a clinical complication. The three main barriers relating to cultural norms identified were: 1) pregnancy support was considered a female role; and the male role that of provider; 2) negative health care worker attitudes towards men’s participation, and 3) couple unfriendly antenatal and delivery unit infrastructure. Conclusion Although men reported to facilitate their wives’ utilisation of antenatal and delivery care services, this does not translate to practice as adherence to antenatal-care schedules and facility based delivery is generally poor. Equally, reasons proffered why they should accompany their wives are not carried through into practice, with barriers outweighing facilitators. Recommendations to improve men involvement and potentially increase services utilisation include awareness campaigns targeting men, exploring promotion of joint HIV testing and counselling, staff training, and design of couple friendly antenatal and delivery units. PMID:23800139

Challenging the Courtesy Bias Interpretation of Favorable Clients' Perceptions of Family Planning Delivery

ERIC Educational Resources Information Center

Len, Federico R.; Lundgren, Rebecka; Huapaya, Ana; Sinai, Irit; Jennings, Victoria

2007-01-01

Favorable client perceptions of provider's interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients' courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three…

Do Conditional Reinforcers Count?

ERIC Educational Resources Information Center

Davison, Michael; Baum, William M.

2006-01-01

Six pigeons were trained on a procedure in which seven components arranged different food-delivery ratios on concurrent variable-interval schedules each session. The components were unsignaled, lasted for 10 food deliveries, and occurred in random order with a 60-s blackout between components. The schedules were arranged using a switching-key…

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

PubMed Central

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-01-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels—mobile outreach, social franchising, and clinics—to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users. PMID:25276564

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International.

PubMed

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-02-01

Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels-mobile outreach, social franchising, and clinics-to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users.

A Virtual Childhood Obesity Collaborative: Satisfaction With Online Continuing Education.

PubMed

Gance-Cleveland, Bonnie; Aldrich, Heather; Dandreaux, Danielle; Oetzel, Keri Bolton; Schmiege, Sarah

2015-01-01

This descriptive study evaluated school-based health center (SBHC) providers' satisfaction with Web-based continuing education as part of a virtual childhood obesity intervention. Thirty-six participants from 24 SBHCs in six states participated in the training modules. Modules were divided into four learning sessions, with a total of 17 training modules. Participants completed satisfaction surveys after each module, as well as an overall survey at the end of the training. Questions were rated on a 4-point Likert scale (4 = strongly agree, 3 = agree, 2 = disagree, 1 = strongly disagree). Participation in the first two learning sessions was higher than the last two. Provider satisfaction of training modules by question type and content area was quite high (μ = 3.66-3.33). Overall satisfaction means ranged from 3.76 to 3.24. Many providers also reported plans to make changes in their practice after completing the training. This study demonstrated that a virtual childhood obesity collaborative is an acceptable delivery method for continuing education. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Final Technical Report - DE-EE0003542

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

Haley, James D

Wind has provided energy for thousands of years: some of the earliest windmill engineering designs date back to ancient Babylonia and India where wind would be used as a source of irrigation. Today, wind is the quickest growing resource in Americas expanding energy infrastructure. However, to continue to positively diversify Americas energy portfolio and further reduce the countrys reliance of foreign oil, the industry must grow substantially over the next two decades in both turbine installations and skilled industrial manpower to support. The wind sector is still an emergent industry requiring maturation and development of its labor force: dedicated trainingmore » is needed to provide the hard and soft skills to support the increasingly complex wind turbine generators as the technology evolves. Furthermore, the American workforce is facing a steep decline in available labor resources as the baby boomer generation enters retirement age. It is therefore vital that a process is quickly created for supporting the next generation of wind technicians. However, the manpower growth must incorporate three key components. First, the safety and technical training curriculum must be standardized across the industry - current wind educational programs are disparate and dedicated standardization programs must be further refined and implemented. Second, it is essential that the wind sector avoid disrupting other energy production industries by cannibalizing workers, which would indirectly affect the rest of Americas energy portfolio. The future wind workforce must be created organically utilizing either young people entering the workforce or train personnel emerging from careers outside of energy production. Third, the training must be quick and efficient as large amounts of wind turbines are being erected each year and this growth is expected to continue until at least 2035. One source that matches these three requirements is personnel transitioning from military service to the civilian sector. Utilizing the labor pool of transitioning military personnel and a dedicated training program specifically tailored to military hard and soft skills, the wind workforce can rapidly expand with highly skilled personnel. A tailored training program also provides career opportunities to an underutilized labor force as the personnel return from active military duty. This projects goal was to create a Wind Workforce Development Program that streamlines the wind technician training process using industry-leading safety programs and building on existing military experience. The approach used was to gather data from the wind industry, develop the curriculum and test the process to ensure it provides adequate training to equip the technicians as they transition from the military into wind. The platform for the curriculum development is called Personal Qualification Standards (PQS), which is based on the program of the same name from the United States Navy. Not only would the program provide multiple delivery methods of training (including classroom, computer-based training and on-the-job training), but it also is a familiar style of training to many military men and women. By incorporating a familiar method of training, it encourages active participation in the training and reduces the time for personnel to grasp the concept and flow of the training requirements. The program was tested for thoroughness, schedule and efficacy using a 5-person pilot phase during the last two years. The results of the training were a reduction in time to complete training and increased customer satisfaction on client project sites. However, there were obstacles that surfaced and required adaptation throughout the project including method of delivery, curriculum development and project schedules and are discussed in detail throughout the report. There are several key recommendations in the report that discuss additional training infrastructure, scalability within additional alternative energy markets and organizational certification through standardization committees.« less

The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India

PubMed Central

2012-01-01

Background Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. Methods We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Results Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion) to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and expected them to have knowledge about the subject matter. Some had expectations regarding their demographic and personal characteristics, for example, preferring only females or those who are understanding/friendly. New components to address stigma were then added to the intervention, the collaborative nature of service provision was strengthened, a multi-level supervision system was developed, and delivery of components was made more flexible. Criteria were evolved for the selection and training of the health workers based on participants' expectations. Conclusions A multi-component community based intervention, targeting multiple outcomes, and delivered by trained lay health workers, supervised by mental health specialists, is an acceptable and feasible intervention for treating schizophrenia in India. PMID:22340662

Interprofessional mental health training in rural primary care: findings from a mixed methods study.

PubMed

Heath, Olga; Church, Elizabeth; Curran, Vernon; Hollett, Ann; Cornish, Peter; Callanan, Terrence; Bethune, Cheri; Younghusband, Lynda

2015-05-01

The benefits of interprofessional care in providing mental health services have been widely recognized, particularly in rural communities where access to health services is limited. There continues to be a need for more continuing interprofessional education in mental health intervention in rural areas. There have been few reports of rural programs in which mental health content has been combined with training in collaborative practice. The current study used a sequential mixed-method and quasi-experimental design to evaluate the impact of an interprofessional, intersectoral education program designed to enhance collaborative mental health capacity in six rural sites. Quantitative results reveal a significant increase in positive attitudes toward interprofessional mental health care teams and self-reported increases in knowledge and understanding about collaborative mental health care delivery. The analysis of qualitative data collected following completion of the program, reinforced the value of teaching mental health content within the context of collaborative practice and revealed practice changes, including more interprofessional and intersectoral collaboration. This study suggests that imbedding explicit training in collaborative care in content focused continuing professional education for more complex and chronic health issues may increase the likelihood that professionals will work together to effectively meet client needs.

An evaluation of Knowledge and Understanding Framework personality disorder awareness training: can a co-production model be effective in a local NHS mental health Trust?

PubMed

Davies, Julie; Sampson, Mark; Beesley, Frank; Smith, Debra; Baldwin, Victoria

2014-05-01

5 Boroughs Partnership NHS Foundation Trust, in the Northwest of England, has trained over 500 staff in the Knowledge and Understanding Framework, level 1 personality disorder awareness training. This is a 3-day nationally devised training programme delivered via an innovative co-production model (i.e. co-delivery and partnership working with service users who have lived experience). This paper provides quantitative and qualitative information on the effectiveness of training delivery and also serves to provide some insight into the impact of service-user involvement via such a co-production model. Information on 162 participants using the Knowledge and Understanding Framework bespoke questionnaire (Personality Disorder Knowledge, Attitudes and Skills Questionnaire) suggests that the training can be effectively delivered by and within a local NHS Mental Health Trust. Results immediately post-training suggest an improvement in levels of understanding and capability efficacy and a reduction in negative emotional reactions. Indications from a 3-month follow-up suggest that while understanding and emotional reaction remain improved, capability efficacy regresses back to pre-training levels, suggesting the need for ongoing supervision and/or support to consolidate skills. Discussion includes guidelines for the implementation of a truly integrated co-production model of training provision, as well as advice relating to the maximization of long-term benefits. Copyright © 2014 John Wiley & Sons, Ltd.

Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders.

PubMed

Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

2016-08-11

The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public-sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. The direct service delivery cost of Medicines360's LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product's non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation and provider training should be prioritized. Introducing a new, more affordable LNG IUS product could help expand choice for women in Kenya and increase use of long-acting reversible contraception. Further evaluation is needed to identify the full costs required for introduction-including the cost of demand creation-as well as research among potential and actual LNG IUS users, their partners, and health care providers to help inform scale-up of the method. © Rademacher et al.

The comparison the effect of training by means of simulation and oral method on midwives’ skill in management of shoulder dystocia

PubMed Central

Kordi, Masoumeh; Erfanian, Fatemeh; Fakari, Farzaneh Rashidi; Dastfan, Fatemeh; Nejad, Keivan Shariati

2017-01-01

INTRODUCTION: Shoulder dystocia is one of the obstetric emergencies that are accompanied to serious risks for mother and fetus. It necessitates making the method of training of shoulder dystocia management more efficient, i.e., better management and giving services with higher quality. Thus, this study was carried out to compare the impact of training by simulation and oral technique on the skill of the employed midwives in obstetric clinics at Mashhad city (Iran) in shoulder dystocia management during 2012. METHODS: The current research is a double-group clinical trial that was conducted on 51 members of the employed midwives in the obstetric clinic at Mashhad city in 2012. The questionnaire of personal specification and awareness about shoulder dystocia and practical examination (objective-structured clinical examination) were employed as tools for data collection. The learners were divided into two groups by randomized allocation. Training was done by the presentation of lecture in the oral content group and a short movie was displayed at the end of it. The shoulder dystocia management technique was simulated in another group and through role-playing of instructor application of moulage (station) training was conducted. The period of the training course (4 h) and content of the educational workshop was identical for both groups. The practical examination was held for the learners before and immediately after training course. The given data were analyzed by means of statistical descriptive tests including Mann–Whitney U-test and Wilcoxon test via SPSS software (version 16). The significance level was considered as (P < 0.05) in all cases. RESULTS: The total mean score was significantly increased for the variable of shoulder dystocia management skill after intervention in both groups (P < 0.0001). Similarly, the results of Mann–Whitney U-test statistical tests indicated that total mean score for the variable of shoulder dystocia management skill after the intervention was significantly greater in simulation group than in an oral group (P = 0.040). CONCLUSION: Training in simulated delivery room by means of role-playing is an efficient method for training shoulder dystocia management skill, so it is recommended to use this program in the training of this skill. PMID:28616417

Interdisciplinary simulation-based training to improve delivery room communication.

PubMed

Dadiz, Rita; Weinschreider, Joanne; Schriefer, Jan; Arnold, Christine; Greves, Cole D; Crosby, Erin C; Wang, Hongyue; Pressman, Eva K; Guillet, Ronnie

2013-10-01

Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams. Obstetric and pediatric teams participated in an SBT annually during 3 academic years, 2008-2011 (Y1-Y3), in a prospective, observational study. Eligible participants (n = 228) included attendings, fellows, house staff, midlevel providers, and nurses involved in delivery room care. Simulations were videotaped and evaluated using a validated 20-item checklist of best communication practices. Checklist scores were compared across years with the Kruskal-Wallis test. Providers were also surveyed annually regarding communication during actual deliveries using a standardized questionnaire. Ratings were analyzed using two-way analysis of covariance. At least 60% of eligible providers participated in 1 or more SBT sessions and completed surveys annually. Checklist scores on communication during SBT improved from Y1 (median, 6; interquartile range, 4) to Y3 (median, 11; interquartile range, 6) (P < 0.001). Survey results showed the perception of improvement over time in interteam communication during actual deliveries by obstetric (P < 0.005) and pediatric (P < 0.0001) providers. The obstetric team also perceived improved provider communication with the family (P < 0.05). Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.

Con: pediatric anesthesia training in developing countries is best achieved by out of country scholarships.

PubMed

Walker, Isabeau A

2009-01-01

Medical migration is damaging health systems in developing countries and anesthesia delivery is critically affected, particularly in sub-Saharan Africa. 'Within country' postgraduate anesthesia training needs to be supported to encourage more doctors into the specialty. Open-ended training programs to countries that do not share the same spectrum of disease should be discouraged. Donor agencies have an important role to play in supporting sustainable postgraduate training programs.

15 CFR 292.2 - Training development and deployment projects.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of the activity, and “customer satisfaction” measures of performance. (6) Management and... clearly defined and the proposal must demonstrate that it understands the population's training needs... implementation mechanisms. The proposal must set forth clearly defined, effective mechanisms for delivery and/or...

Nurse led versus lay educators support for those with asthma in primary care: a costing study

PubMed Central

2012-01-01

Background Regular review and support for asthma self-management is promoted in guidelines. A randomised controlled trial suggested that unscheduled health care usage was similar when patients were offered self management support by a lay-trainer or practice nurses. Methods Following the RCT, a costing study was undertaken using the trial data to account for the cost of delivery of the service under both strategies and the resulting impact on unscheduled healthcare (measure of effectiveness) in this trial. Results One year data (n = 418) showed that 29% (61/205) of the nurse group required unscheduled healthcare (177 events) compared with 30.5% (65/213) for lay-trainers (178 events). The training costs for the lay-trainers were greater than nurses (£36 versus £18 respectively per patient, p<0.001), however, the consultation cost for lay-trainers were lower than nurses (£6 per patient versus £24, p<0.001). If the cost of unscheduled healthcare are accounted for then the costs of nurses is £161, and £135 for lay-trainers (mean difference £25, [95% CI = −£97, £149, p = 0.681]). The total costs (delivery and unscheduled healthcare) were £202 per patient for nurses versus £178 for lay-trainers, (mean difference £24, [95%CI = −£100, £147, p = 0.707]). Conclusions There were no significant differences in the cost of training and healthcare delivery between nurse and lay trainers, and no significant difference in the cost of unscheduled health care use. PMID:22958541

Evaluation of different delivery modes of an interactive e-learning programme for teaching cultural diversity.

PubMed

Hawthorne, Kamila; Prout, Hayley; Kinnersley, Paul; Houston, Helen

2009-01-01

UK medical schools find it challenging to provide standardised teaching to expanding year intakes. In addition, developing and implementing diversity training can cause difficulties. This paper describes the evaluation of an interactive e-learning programme to raise awareness and understanding of communication difficulties in diversity consultations. The programme was part of an undergraduate portfolio-based community module. Three hundred and two students were assigned to one of three delivery methods--a large group setting, small groups with a facilitator, and as part of distance learning while on community placement. The evaluation included analysis of their coursework marks, a self-completed evaluation questionnaire, and small group discussions. Two hundred and twenty-three students took part in the evaluation. They were able to apply the concepts they learnt to clinical examples from their own experiences. Type of delivery did not affect coursework marks, but students tended to prefer the e-learning as part of a distance learning package. They offered helpful suggestions to improve its complexity and range. The acceptability and utility of this e-learning module both in face to face teaching and remote placement has been demonstrated, and evaluation by the students has provided valuable information for its further development. All medical schools should include some diversity training, and further research should concentrate on the effects of this type of learning on longer term outcomes such as attitude and performance tests. Such tools could reduce demands on staff time in facilitation of small groupwork, and their cost effectiveness could be increased by making them available to other medical schools.

Therapist tips for the brief behavioural activation therapy for depression - revised (BATD-R) treatment manual practical wisdom and clinical nuance

PubMed Central

CASSAR, Joanne; ROSS, Joanne; DAHNE, Jennifer; EWER, Philippa; TEESSON, Maree; HOPKO, Derek; LEJUEZ, Carl W.

2018-01-01

Objective This article aims to provide supportive guidance for clinicians using the brief behavioral activation treatment for depression - revised (BATD-R) manual. Expanding upon key points less explicitly addressed in the treatment manual, the goal is to convey practical wisdom and clinical nuance beyond that available in the manual, thereby enhancing therapist comfort with the approach and improving treatment delivery. Methods In preparation for a randomised control trial of behavioural activation treatment for depression among substance users (the Activate Study), Professor Carl Lejuez, an author on the manual, provided training to our research team. This occurred over four days in May 2013 at the National Drug and Alcohol Research Centre in Sydney, Australia and involved in-depth discussion about treatment delivery, often addressing important issues implied but not addressed in-depth in the manual. Reflections were discussed throughout training and subsequently collated into key themes. Results Intricacies associated with treatment delivery were identified. Seven key themes emerged, covering: provision of the treatment rationale; therapeutic alliance and self-disclosure; behaviour monitoring; values; angles and steps; contracts; and drawing from other therapeutic approaches. A detailed discussion of how to approach these themes in treatment forms the basis of this article. Conclusions The current article seeks to guide therapists and provide a supplement to the BATD-R manual that will enhance the flexibility and accessibility for therapists utilising this treatment. The suggestions made are useful for straightforward cases of depression and more complicated comorbid presentations, serving as a useful complement for therapists using the manual. PMID:29720886

Twin vaginal delivery: innovate or abdicate.

PubMed

Easter, Sarah Rae; Taouk, Laura; Schulkin, Jay; Robinson, Julian N

2017-05-01

Neonatal safety data along with national guidelines have prompted renewed interest in vaginal delivery of twins, particularly in the case of the noncephalic second twin. Yet, the rising rate of twin cesarean deliveries, coupled with the national decline in operative obstetrics, raises concerns about the availability of providers who are skilled in twin vaginal birth. Providers are key stakeholders for increasing rates of twin vaginal delivery. We surveyed a group of practicing obstetricians to explore potential barriers to the vaginal birth of twins with a focus on delivery of the noncephalic second twin. Among 107 responding providers, only 57% would deliver a noncephalic second twin by breech extraction. Providers who preferred breech extraction had a higher rate of maternal-fetal medicine subspecialty training (26.2% vs 4.3%; P<.01) and were more likely to be in an academic practice environment (36.1% vs 10.9%; P<.01) and to practice in high-volume centers that deliver >30 sets of twins annually (57.4% vs 34.8%; P=.02). Most providers (54.2%) were familiar with the findings from the recent randomized trial that demonstrated the safety of twin vaginal birth. However, knowledge of the trial was not associated statistically with a preference for breech extraction (62.3% vs 43.5%; P=.05). Providers who preferred breech extraction were more likely to agree with recent society guidelines that encourage the vaginal birth of twins (86.9% vs 63.0%; P<.01). In an adjusted analysis, the 46% of providers with a perceived need for more training were far less likely to prefer breech extraction for delivery of a noncephalic second twin (adjusted odds ratio, 0.38; 95% confidence interval, 0.16-0.95). Furthermore, 57% of providers who would not offer their patient breech extraction would be willing to consult a colleague for support with a noncephalic twin delivery. These results suggest that scientific evidence and society opinion are likely insufficient to reverse the national trends that favor cesarean delivery for twins. Instead, implementation of provider training and support programs is critical for increasing the rates of twin vaginal birth. Changing our national landscape of vaginal twin delivery may require innovation. Without novel provider-focused strategies, we may relinquish passively the requisite skills for not only our patients but also for future generations of obstetricians. Copyright © 2017 Elsevier Inc. All rights reserved.

Alternatives in Aural Rehabilitation: Provider Training of Nonaudiologists in the Delivery of Hearing-Aid Supportive Services to Older Persons with Hearing Loss.

ERIC Educational Resources Information Center

Patterson, Karen; Dancer, Jess

1987-01-01

Describes program in which American Speech-Language-Hearing Association certified audiologists train protocol providers to assist older hearing-aid users in adjusting to using hearing aids on a daily basis. Training emphasizes empathy, effective communication skills, knowledge of the interaction of aging and hearing loss, phases outlined in…

Training the Parents of Juvenile Offenders: State of the Art and Recommendations for Service Delivery

ERIC Educational Resources Information Center

Mulford, Carrie F.; Redding, Richard E.

2008-01-01

Parent training is consistently highlighted as one of the most effective means of preventing delinquency and treating young children with conduct problems, and it has proven to be one of the most cost-effective interventions for doing so. There is, however, far less evidence supporting the efficacy of parent-training programs with adolescents and…

Damage Control Surgery and the Joint Solution

DTIC Science & Technology

2017-06-01

IV. THE SERVICES ’ OPERATE, TRAIN AND EQUIP FOR DEPLOYMENT OF DCS 13 V. COURSES OF ACTION 20 VI. CONCLUSION...Figure 14: Notional Service Enlisted Specialty Training Timeline 25 Figure 15: Timeline of Events for Base Hospital #28...implications for casualty care. Lastly, a short excerpt on how each Service organizes, trains and equips their personnel for the delivery of damage control

The impact of Advanced Life Support in Obstetrics (ALSO) training in low-resource countries.

PubMed

Dresang, Lee T; González, María Mercedes Ancheta; Beasley, John; Bustillo, Maura Carolina; Damos, Jim; Deutchman, Mark; Evensen, Ann; de Ancheta, Norma González; Rojas-Suarez, José A; Schwartz, Jonathan; Sorensen, Bjarke L; Winslow, Diana; Leeman, Lawrence

2015-11-01

To examine the effects of the Advanced Life Support in Obstetrics (ALSO) program on maternal outcomes in four low-income countries. Data were obtained from single-center, longitudinal cohort studies in Colombia, Guatemala, and Honduras, and from an uncontrolled prospective trial in Tanzania. In Colombia, maternal morbidity and the number of near misses increased after ALSO training, but maternal mortality decreased. In Guatemala, sustained reductions in overall maternal mortality and mortality from postpartum hemorrhage (PPH) were recorded after ALSO implementation. In Honduras, there was a significant decrease in episiotomy rates, and increases in active management of the third stage of labor (AMTSL), vacuum-assisted delivery, and reported comfort managing obstetric emergencies. In Tanzania, the frequency of PPH and severe PPH decreased after training, while management improved. In low-income countries, ALSO training was associated with decreased in-hospital maternal mortality, episiotomy use, and PPH. AMTSL and vacuum-assisted vaginal delivery increased in frequency after ALSO training. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Resistance training during pregnancy and perinatal outcomes.

PubMed

White, Erin; Pivarnik, Jim; Pfeiffer, Karin

2014-08-01

Approximately 10% of women engage in resistance training during pregnancy; however there is limited research on this activity. The purpose of this study was to examine associations between resistance training and adverse outcomes. Women completed an online survey and recalled their exercise habits during each trimester of their most recent pregnancy within the previous 5 years. Women also reported pregnancy and birth outcomes. Participants were then categorized into 3 groups based on leisure-time exercise: 1) Resistance + aerobic training (RTAE), 2) Aerobic exercise only (AE), and 3) no exercise (NE). 284 women completed the survey. Women in the RTAE group resistance trained on average 2.9 days/ week for 27.3 minutes/session. The prevalences of hypertensive disorders (HD) and gestational diabetes mellitus (GDM) were significantly lower in the RTAE group when compared with the grouping of AE + NE women. Prepregnancy body mass index (BMI) was the strongest factor related to both GDM and HD. There was no difference in the risk of preterm labor, mode of delivery, or gestational age at delivery by exercise status. Our results suggest that women can safely engage in aerobic exercise and resistance training for muscular endurance 3 days/week for 30 minutes throughout gestation.

Results and implications of the EU-project CARERS ‘Content materials to raise employability and reinforce skills of carers’

PubMed Central

Weber, Germain; Zeilinger, Elisabeth; Oppenauer, Claudia; Brehmer, Barbara

2009-01-01

Purpose The population, and needs, of informal carers is changing, reflecting not only the changing demographics across Europe, but also the unequal challenges and opportunities for education and training—and official approval of competences—across Europe for people involved in the care sector, formal as well as informal carers. Theory The objective of this European project (Austria, France, Lithuania Luxembourg, Poland and Spain) was to create, offer and evaluate an education and training programme specifically aimed at informal carers (e.g. family members), providing answers to meet their real needs in their support work as well as for their own emotional well-being. Therefore, project partners produced six innovative, online supported training modules (total 60 hours) for face-to-face delivery. Methods The presentation will highlight the development and the content of one training Module for older people with ‘intellectual disabilities’ more detailed. Results and conclusions All trainings were evaluated by the participants through pre/post questionnaires. The results of the trainings will be presented. Discussion The importance of trainings and support for informal carers will be discussed with special emphasis given on the fact that informal carers represent a most substantial economic resource for every country and its care system.

The impact of leadership and team behavior on standard of care delivered during human patient simulation: a pilot study for undergraduate medical students.

PubMed

Carlson, Jim; Min, Elana; Bridges, Diane

2009-01-01

Methodology to train team behavior during simulation has received increased attention, but standard performance measures are lacking, especially at the undergraduate level. Our purposes were to develop a reliable team behavior measurement tool and explore the relationship between team behavior and the delivery of an appropriate standard of care specific to the simulated case. Authors developed a unique team measurement tool based on previous work. Trainees participated in a simulated event involving the presentation of acute dyspnea. Performance was rated by separate raters using the team behavior measurement tool. Interrater reliability was assessed. The relationship between team behavior and the standard of care delivered was explored. The instrument proved to be reliable for this case and group of raters. Team behaviors had a positive relationship with the standard of medical care delivered specific to the simulated case. The methods used provide a possible method for training and assessing team performance during simulation.

[Simulation in obstetrics and gynecology - a new method to improve the management of acute obstetric emergencies].

PubMed

Blum, Ronja; Gairing Bürglin, Anja; Gisin, Stefan

2008-11-01

In medical specialties, such as anaesthesia, the use of simulation has increased over the past 15 years. Medical simulation attempts to reproduce important clinical situations to practise team training or individual skills in a risk free environment. For a long time simulators have only been used by the airline industry and the military. Simulation as a training tool for practicing critical situations in obstetrics is not very common yet. Experience and routine are crucial to evaluate a medical emergency correctly and to take the appropriate measures. Nowadays the obstetrician requires a combination of manual and communication skills, fast emergency management and decision-making skills. Therefore simulation may help to attain these skills. This may not only satisfy the high expectations and demands of the patients towards doctors and midwives but would also help to keep calm in difficult situations and avoid mistakes. The goal is a risk free delivery for mother and child. Therefore we developed a simulation- based curricular unit for hands-on training of four different obstetric emergency scenarios. In this paper we describe our results about the feedback of doctors and midwives on their personal experiences due to this simulation-based curricular unit. The results indicate that simulation seems to be an accepted method for team training in emergency situations in obstetrics. Whether patient security increases after the regularly use of drill training needs to be investigated in further studies.

Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review.

PubMed

Mørkved, Siv; Bø, Kari

2014-02-01

Urinary incontinence (UI) is a common condition in women causing reduced quality of life and withdrawal from fitness and exercise activities. Pregnancy and childbirth are established risk factors. Current guidelines for exercise during pregnancy have no or limited focus on the evidence for the effect of pelvic floor muscle training (PFMT) in the prevention and treatment of UI. Systematic review to address the effect of PFMT during pregnancy and after delivery in the prevention and treatment of UI. PubMed, CENTRAL, Cochrane Library, EMBASE and PEDro databases and hand search of available reference lists and conference abstracts (June 2012). Randomised controlled trials (RCTs) and quasiexperimental trials published in the English language. Primiparous or multiparous pregnant or postpartum women. PFMT with or without biofeedback, vaginal cones or electrical stimulation. Both authors independently reviewed, grouped and qualitatively synthesised the trials. 22 randomised or quasiexperimental trials were found. There is a very large heterogeneity in the populations studied, inclusion and exclusion criteria, outcome measures and content of PFMT interventions. Based on the studies with relevant sample size, high adherence to a strength-training protocol and close follow-up, we found that PFMT during pregnancy and after delivery can prevent and treat UI. A supervised training protocol following strength-training principles, emphasising close to maximum contractions and lasting at least 8 weeks is recommended. PFMT is effective when supervised training is conducted. Further high-quality RCTs are needed especially after delivery. Given the prevalence of female UI and its impact on exercise participation, PFMT should be incorporated as a routine part of women's exercise programmes in general.

Motherhood: making it safer for Filipino women.

PubMed

Baylon, M C

1996-01-01

In November 1995, in the Philippines, the Department of Health implemented the Women's Health and Safe Motherhood Project. Its target audience is poor women in remote and underserved provinces. It addresses maternal health, reproductive tract infections (RTIs), sexually transmitted diseases (STDs), cervical cancer, domestic violence, and the desire to space births. It aims to improve the quality of women's health services through training of health providers, providing women with information to help them make informed choices, providing regular supplies and drugs, privacy and infection control at service delivery points, providing follow-up care, and improved cost-effective and technically-sound referral systems. The project also aims to ensure accessible service delivery points, well-equipped and maintained facilities, client and community feedback in managing service delivery, and information provision in order to increase acceptability of health services. The major components of the project include service delivery, institutional strengthening (via information, education, and communication; training of health providers; and improvement of the logistics system), community partnership for women's health development, and policy and operations research. The service delivery component will adopt a life-cycle approach to service delivery in Region 8 (urban and rural communities). It will pilot the syndromic approach in the management and detection of RTIs and STDs in 10 provinces. The biggest tasks of the project are upgrading referral networks from provincial and district hospitals to rural health units and barangay health stations and upgrading primary hospitals.

Incidence and risk factors of severe lacerations during forceps delivery in a single teaching hospital where simulation training is held annually.

PubMed

Sano, Yasuko; Hirai, Chihiro; Makino, Shintaro; Li, Xianglan; Takeda, Jun; Itakura, Atsuo; Takeda, Satoru

2018-04-01

This study was conducted to evaluate the incidence of severe lacerations during forceps delivery and the risk factors associated with such delivery in a hospital where simulation training is held annually. The medical records of 857 women who underwent forceps delivery at term with singleton cephalic presentation from 2010 to 2015 were reviewed. The relationship between clinical characteristics and birth canal trauma was analyzed. Birth canal trauma included third and fourth degree perineal lacerations. Univariable and multivariable models of logistic regression were employed to estimate the raw odds ratio and were adjusted for cofactors with 95% confidence intervals. Statistical significance was defined as P < 0.05. The incidence of severe lacerations was 10.1%. Birth weight, fetal head station, the rate of malrotation and the number of extractions were higher in women with severe lacerations (P < 0.01), whereas the use of obstetric anesthesia was lower in women with such lacerations (P < 0.01). Neither the indication for forceps delivery nor the qualifications of the operator had any influence on the incidence of severe lacerations. The incidence of severe lacerations was relatively low. Risk factors for severe lacerations with forceps delivery were identified as birth weight, fetal head station, malrotation and the number of extractions. Obstetric anesthesia may protect against severe lacerations. © 2018 Japan Society of Obstetrics and Gynecology.

BUILDING A WORKFORCE COMPETENCY-BASED TRAINING PROGRAM IN INFANT/EARLY CHILDHOOD MENTAL HEALTH.

PubMed

Priddis, Lynn E; Matacz, Rochelle; Weatherston, Deborah

2015-01-01

This article describes findings from a project conducted in Western Australia (Mental Health Commission WA, 2015) that investigated the education and training needs of the Infant/Early Childhood Mental Health (I/ECMH) workforce. We examined international training programs and models of delivery in infant mental health, including a review of the current training available in Australia. Data collected from over 60 interviews were analyzed, and a staged delivery model for I/ECMH training and supervision that aligned with the Michigan Association for Infant Mental Health (2014) Competency Guidelines was recommended. These findings led to the purchase of the Michigan Association for Infant Mental Health (2014) for use in Western Australia. In a very short time, use of the Michigan Competency Framework by the Australian Association for Infant Mental Health West Australian Branch Incorporated has begun to change the training and education opportunities for upskilling the infant and early childhood workforce in Western Australia. It has resulted in a map to guide and develop training in the I/ECMH field for individual practitioners and professionals as well as for workplaces that will ultimately benefit Western Australian infants, young children, and their families during the perinatal period and in the early years. © 2015 Michigan Association for Infant Mental Health.

The facilitators and impediment factors of structural empowerment in pregnancy and delivery care: achievement of power

PubMed Central

Janighorban, M; Yousefi, H; Yamani, N

2015-01-01

Background: The organizations essentially affect empowerment of personnel through the preparation of the needed grounds for them. Also, the students may acquire the required potentials and capabilities in the educational organizations when the possibility is provided to them to access power and opportunity in educational environments. Objective: The present study aimed to explain the facilitators and impediment factors of structural empowerment in pregnancy and delivery care. Methods: According to Kanter’s theory, this qualitative study was conducted with the participation of 15 superior midwifery students, ten academic teachers of midwifery, and two midwives employed in the educational hospitals. Data were collected by semi-structured interviews individually and in the group and analyzed by using a directed content analysis method. Results: To explain the facilitators and impediment factors of empowerment in pregnancy and delivery care in the power structure, the access was provided to a support formed by three broad categories of support from the instructors, support from personnel, and support from a classmate. The access to resources was created with three broad categories of access to the appropriate clinical environment, to the laboratory of clinical skills and to information sources, and to information, forming with two broad categories of awareness of the educational objectives as well as legal and legitimate issues. Conclusion: One could prepare the ground for the midwifery students to access this empowerment in pregnancy and delivery cares more than ever by providing equipped clinical environments and the presence of all-inclusive supportive climate in such environments. Along with the efficient training of students in the laboratory PMID:28316710

Effective Parenting Interventions to Reduce Youth Substance Use: A Systematic Review

PubMed Central

Garcia-Huidobro, Diego; Porta, Carolyn; Curran, Dorothy; Patel, Roma; Miller, Jonathan; Borowsky, Iris

2016-01-01

CONTEXT: Parenting interventions may prevent adolescent substance use; however, questions remain regarding the effectiveness of interventions across substances and delivery qualities contributing to successful intervention outcomes. OBJECTIVE: To describe the effectiveness of parent-focused interventions in reducing or preventing adolescent tobacco, alcohol, and illicit substance use and to identify optimal intervention targeted participants, dosage, settings, and delivery methods. DATA SOURCES: PubMed, PsycINFO, ERIC, and CINAHL. STUDY SELECTION: Randomized controlled trials reporting adolescent substance use outcomes, focusing on imparting parenting knowledge, skills, practices, or behaviors. DATA EXTRACTION: Trained researchers extracted data from each article using a standardized, prepiloted form. Because of study heterogeneity, a qualitative technique known as harvest plots was used to summarize findings. RESULTS: A total of 42 studies represented by 66 articles met inclusion criteria. Results indicate that parenting interventions are effective at preventing and decreasing adolescent tobacco, alcohol, and illicit substance use over the short and long term. The majority of effective interventions required ≤12 contact hours and were implemented through in-person sessions including parents and youth. Evidence for computer-based delivery was strong only for alcohol use prevention. Few interventions were delivered outside of school or home settings. LIMITATIONS: Overall risk of bias is high. CONCLUSIONS: This review suggests that relatively low-intensity group parenting interventions are effective at reducing or preventing adolescent substance use and that protection may persist for multiple years. There is a need for additional evidence in clinical and other community settings using an expanded set of delivery methods. PMID:27443357

Adapting the helpful responses questionnaire to assess communication skills involved in delivering contingency management: preliminary psychometrics.

PubMed

Hartzler, Bryan

2015-08-01

A paper/pencil instrument, adapted from Miller and colleagues' (1991) Helpful Responses Questionnaire (HRQ), was developed to assess clinician skill with core communicative aspects involved in delivering contingency management (CM). The instrument presents a single vignette consisting of six points of client dialogue to which respondents write 'what they would say next.' In the context of an implementation/effectiveness hybrid trial, 19 staff clinicians at an opiate treatment program completed serial training outcome assessments before, following, and three months after CM training. Assessments included this adaptation of the HRQ, a multiple-choice CM knowledge test, and a recorded standardized patient encounter scored for CM skillfulness. Study results reveal promising psychometric properties for the instrument, including strong scoring reliability, internal consistency, concurrent and predictive validity, test-retest reliability and sensitivity to training effects. These preliminary findings suggest the instrument is a viable, practical method to assess clinician skill in communicative aspects of CM delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

Use of medicines and adherence to standard treatment guidelines in rural community health centers, Timor-Leste.

PubMed

Higuchi, Michiyo; Okumura, Junko; Aoyama, Atsuko; Suryawati, Sri; Porter, John

2015-03-01

The use of medicines and nurses'/midwives' adherence to standard treatment guidelines (STGs) were examined in Timor-Leste during the early stage of the nation's new health system development. A cross-sectional study was conducted as the quantitative element of mixed methods research. Retrospective samples from patient registration books and prospective observations were obtained in 20 randomly selected rural community health centers. The medicines use indicators, in particular the level of injection use, in Timor-Leste did not suggest overprescription. Prescribers with clinical nurse training prescribed significantly fewer antibiotics than those without such training (P < .01). The adjusted odds ratio of prescribing adherence for clinical nurse training, after accounting for confounders and prescriber clustering, was 6.6 (P < .01). STGs for nonphysician health professionals at the primary health care level have potential value in basic health care delivery, including appropriate use of medicines, in resource-limited communities when strategically developed and introduced. © 2012 APJPH.

Surgical Robotics Research in Cardiovascular Disease

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

Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. Themore » high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery devices utilizes an open-loop configuration involving a team consisting of neurosurgeon, neurologist and neurophysiologist all present and participating in the decision process of delivery. We propose the development of an integrated system which provides for distributed decision making and tele-manipulation of the instrument delivery system.« less

30 CFR 46.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING TRAINING AND... part: (a) Act means the Federal Mine Safety and Health Act of 1977. (b) Competent person means a person...; delivery workers; customers (including commercial over-the-road truck drivers); vendors; or visitors. This...

Small Business Training Models for Community Growth.

ERIC Educational Resources Information Center

Jellison, Holly M., Ed.

Nine successful community college programs for small business management training are described in this report in terms of their college and economic context, purpose, offerings, delivery modes, operating and marketing strategies, community outreach, support services, faculty and staff, evaluation, and future directions. The model programs are…

A Study of Authoring Alternatives for Training-Oriented Videodiscs.

ERIC Educational Resources Information Center

Bunderson, C. Victor; And Others

This study examined eight areas that are related to the problems of authoring and producing training-oriented videodiscs: the delivery system itself; media selection during instructional systems development; instructional strategies; author mock-up and simulation prior to premastering; premastering; mastering and replication; composition of…

Research Fellowships Program of the National Center for Health Services Research and Development. Policies and Guidelines for Applicants.

ERIC Educational Resources Information Center

Health Services and Mental Health Administration (DHEW), Bethesda, MD.

The National Center for Health Services Research and Development supports individual research training in an institutional setting for the development of competence in research techniques relevant to the organization, delivery, quality, financing, utilization, and evaluation of health delivery systems. The evolution of health services science…

A Qualitative Evaluation of Clinical Audit in UK Dental Foundation Training.

PubMed

Thornley, Peter; Quinn, Alyson

2017-11-10

Clinical Audit (CA) has been recognized as a useful tool for tool for improving service delivery, clinical governance, and the education and performance of the dental team. This study develops the discussion by investigating its use as an educational tool within UK Dental Foundation Training (DFT). The aim was to investigate the views of Foundation Dentists (FDs) and Training Programme Directors (TPDs) on the CA module in their FD training schemes, to provide insight and recommendations for those supervising and undertaking CA. A literature review was conducted followed by a qualitative research methodology, using group interviews. The interviews were transcribed and thematically analyzed using NVIVO, a Computer-Assisted Qualitative Data Analysis tool. CA was found to be a useful tool for teaching management and professionalism and can bring some improvement to clinical practice, but TPDs have doubts about the long-term effects on service delivery. The role of the Educational Supervisor (ES) is discussed and recommendations are given for those supervising and conducting CA.

A Qualitative Evaluation of Clinical Audit in UK Dental Foundation Training

PubMed Central

Quinn, Alyson

2017-01-01

Clinical Audit (CA) has been recognized as a useful tool for tool for improving service delivery, clinical governance, and the education and performance of the dental team. This study develops the discussion by investigating its use as an educational tool within UK Dental Foundation Training (DFT). The aim was to investigate the views of Foundation Dentists (FDs) and Training Programme Directors (TPDs) on the CA module in their FD training schemes, to provide insight and recommendations for those supervising and undertaking CA. A literature review was conducted followed by a qualitative research methodology, using group interviews. The interviews were transcribed and thematically analyzed using NVIVO, a Computer-Assisted Qualitative Data Analysis tool. CA was found to be a useful tool for teaching management and professionalism and can bring some improvement to clinical practice, but TPDs have doubts about the long-term effects on service delivery. The role of the Educational Supervisor (ES) is discussed and recommendations are given for those supervising and conducting CA. PMID:29563436

The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

PubMed

Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

Towards reframing health service delivery in Uganda: the Uganda Initiative for Integrated Management of Non-Communicable Diseases.

PubMed

Schwartz, Jeremy I; Dunkle, Ashley; Akiteng, Ann R; Birabwa-Male, Doreen; Kagimu, Richard; Mondo, Charles K; Mutungi, Gerald; Rabin, Tracy L; Skonieczny, Michael; Sykes, Jamila; Mayanja-Kizza, Harriet

2015-01-01

The burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development. Integrated approaches to health service delivery and healthcare worker (HCW) training will be necessary in order to successfully combat the great challenge posed by NCDs. In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD), a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs. Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda.

Twenty cultural and learning principles to guide the development of pharmacy curriculum in Pacific Island countries.

PubMed

Brown, Andrew N; McCormack, Coralie

2014-01-01

A lack of education capacity to support the development of medical supply management competency is a major issue affecting Pacific Islands countries (PICs). Limited human resources and underdeveloped medicines supply management competency are two significant impediments to reaching the health-related Millennium Development Goals in many countries in this rural and remote region. Two recent review publications have provided relevant background documenting factors affecting learning and teaching. These articles have presented available information regarding competency and training requirements for health personnel involved in essential medicine supply management in the region. This background research has provided a platform from which tangible principles can be developed to aid educators and professionals in PICs in the development and delivery of appropriate pharmacy curriculum. Specifically the aim of the present article is to identify culturally meaningful learning and teaching principles to guide the development and delivery of pharmaceutical curriculum in PICs. Subsequently, this information will be applied to develop and trial new pedagogical approaches to the training of health personnel involved in essential medicines supply management, to improve medicine availability for patients in their own environment. This article forms part of a wider research project involving the United Nations Population Fund Suva subregional office, the University of Canberra, Ministry of Health officials and health personnel within identified PICs. Two previous reviews, investigating Pacific culture, learning approaches, and training requirements affecting pharmaceutical personnel, were synthesised into a set of principles that could be applied to the development of pharmaceutical curriculum. These principles were validated through focus groups of health personnel using action research methods. An initial set of 16 principles was developed from the synthesis of the two reviews. These principles were reviewed by two focus groups held in Fiji and the Solomon Islands to produce a set of 20 validated principles. These validated principles can be grouped under the headings of learning theory, structure and design, and learning and teaching methods. The 20 principles outlined in this article will be used to develop and trial culturally relevant training approaches for the development of medicine management competencies for various cadres of health personnel in PICs. These principles provide a practical framework for educators and health professionals to apply to health-based education and training in the Pacific, with potential application to other rural and remote environments.

Male engagement as a strategy to improve utilization and community-based delivery of maternal, newborn and child health services: evidence from an intervention in Odisha, India

PubMed Central

2015-01-01

Background In response to persistently poor levels of maternal, newborn and child health (MNCH) in rural India, the National Rural Health Mission (NRHM) was launched to support the provision of accessible, affordable and quality health care in deprived and underserved communities. The Accredited Social Health Activists (ASHAs), local women, are trained as health promoters to generate demand for, and facilitate access to MNCH care in their communities. While they are also expected to provide husbands of expectant women with information on MNCH care and family planning, their reach to the husbands is limited. The aim of this study is to describe the influence of a male engagement project on the utilization and community-based delivery of MNCH care in a rural district of the country. Methods We used qualitative data from the evaluation of a project which recruited and trained male Community Health Workers (CHWs) known as Male Health Activists (MHAs) to complement the work of ASHAs and target outreach to men. This paper uses data from in-depth interviews (IDIs) with ASHAs (n=11), Anganwadi Workers (AWWs) (n=4) and Auxiliary Nurse Midwives (ANMs) (n=2); with women who had delivered at home, community health center or district hospital in the few months preceding the date of the interview (n=11); and with husbands of these women (n=7). Results Participants’ responses are broadly organized around the facilitation of ASHAs’ work by MHAs, and male engagement activities undertaken by MHAs. More specifically, the narratives reflected gender-based divisions of work and space in three core areas of delivery and use of MNCH services: escorting women to health centers for facility-based deliveries; mobilizing women and children to attend Village Health and Nutrition Days and Immunization Days; and raising awareness among men on MNCH and family planning. Conclusion This study sheds light on male engagement as a strategy to improve the delivery, access and uptake of maternal, newborn and child health in the context of prevailing gender norms and gendered roles in rural India. Ultimately, it unveils the complementarity of male and female CHWs in the community-based delivery of, and increased demand for, MNCH services. PMID:26062910

Obstetrics service utilisation by the community in Lebowa, northern Transvaal.

PubMed

Uyirwoth, G P; Itsweng, M D; Mpai, S; Nchabeleng, E; Nkoane, H

1996-02-01

A cross sectional cluster survey was done in all health wards of Lebowa in May 1992. The study was based on a recall of antenatal, intrapartum and postnatal experience during the last pregnancy of 2940 mothers. Only mothers who delivered within 12 months before the date of interview were included. Antenatal coverage was high at 93.5%, the proportion of health facility deliveries was 74.6% while 26.3% of all births occurred at home. Inaccessibility of maternity services, lack of money, negative staff attitudes and lack of privacy were the common reasons given for preference of home delivery. Mothers who delivered at home were more likely to be of higher parity and unbooked than their counterparts who delivered in a health facility. Postnatal coverage was 50.7% with a 25.4% rate of utilisation of a method of childspacing. The proportion of births attended to by trained personnel needs to be increased.

The emotional wellbeing of lay HIV counselling and testing counsellors.

PubMed

Visser, Maretha; Mabota, Princess

2015-01-01

The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional wellbeing of lay HCT counsellors because this influences the quality of services they provide. A mixed methods approach was used. The emotional wellbeing, level of burnout, depression and coping style of 50 lay HCT counsellors working at the City of Tshwane clinics were assessed. Additionally, five focus group discussions were conducted. The results showed that HCT counsellors reported average emotional wellbeing, high levels of emotional exhaustion and depression. They had a sense of personal accomplishment and positive coping skills. The results revealed that they may have difficulty dealing with clients' emotional distress without adequate training and supervision. This creates a dilemma for service delivery. In the light of the important role they play in service delivery, the role of the lay HCT counsellor needs to be reconsidered. HCT should develop as a profession with specific training and supervision to develop their emotional competencies to conduct effective counselling sessions.

Non-medical prescribing in New Zealand: an overview of prescribing rights, service delivery models and training

PubMed Central

Raghunandan, Rakhee; Tordoff, June; Smith, Alesha

2017-01-01

Aim: In this paper, we aim to provide an updated source of information for nonmedical prescribing (NMP) in New Zealand (NZ). Methods: A variety of NZ sources were used to collect data: legislation, policy documents and information from professional and regulatory organizations, and education providers. Results: In NZ, the legal categories for prescribers include authorized, designated, and delegated prescribers. Authorized prescribers include dentists, midwives, nurse practitioners, and optometrist prescribers. Designated prescribers include pharmacist prescribers, registered nurse prescribers, and dietitian prescribers. There are no delegated prescribers in NZ at this time. There is variation in the regulation, educational programmes and prescribing competencies used by the different prescribing health professionals involved in NMP in NZ. Conclusion: This update collates relevant information relating to NMP in NZ into one consolidated document and provides policy makers with a current overview of prescribing rights, service delivery models, training requirements, and prescribing competencies used for NMP in NZ. As NMP in NZ continues to expand and evolve, this paper will form a baseline for future NMP research in NZ. NZ needs to develop overarching NMP policy to enable consistency in the various aspects of NMP, thereby delivering a safe and sustainable NMP service in NZ. PMID:29090084

Assessing Program Sustainability in an Eating Disorder Prevention Effectiveness Trial Delivered by College Clinicians

PubMed Central

Rohde, Paul; Shaw, Heather; Butryn, Meghan L.; Stice, Eric

2015-01-01

Sustainability of the Body Project, a dissonance-based selective eating disorder prevention program supported by efficacy and effectiveness trials, has not previously been examined. This mixed-methods study collected qualitative and quantitative data on training, supervision, and the intervention from 27 mental health clinicians from eight US universities who participated in an effectiveness trial and quantitative data on 2-year sustainability of program delivery. Clinicians, who were primarily masters-level mental health providers, had limited experience delivering manualized interventions. They rated the training and manual favorably, noting that they particularly liked the role-plays of session activities and intervention rationale, but requested more discussion of processes and group management issues. Clinicians were satisfied receiving emailed supervision based on videotape review. They reported enjoying delivering the Body Project but reported some challenges with the manualized format and time constraints. Most clinicians anticipated running more groups after the study ended but only four universities (50%) reported providing additional Body Project groups at the 1-year follow-up assessment and sustained delivery of the groups decreased substantially two years after study completion, with only one university (12%) continuing to deliver groups. The most commonly reported barriers for conducting additional groups were limited time and high staff turnover. PMID:26143559

Exploring the Reality of Using Patient Experience Data to Provide Resident Feedback: A Qualitative Study of Attending Physician Perspectives

PubMed Central

Campbell, Steffanie; Goltz, Heather Honoré; Njue, Sarah; Dang, Bich Ngoc

2016-01-01

Introduction: Little is known about the attitudes of faculty and residents toward the use of patient experience data as a tool for providing resident feedback. The purpose of this study was to explore the attitudes of teaching faculty surrounding patient experience data and how those attitudes may influence the feedback given to trainees. Methods: From July 2013 to August 2013, we conducted in-depth, face-to-face, semistructured interviews with 9 attending physicians who precept residents in internal medicine at 2 continuity clinics (75% of eligible attendings). Interviews were coded using conventional content analysis. Results: Content analysis identified six potential barriers in using patient experience survey data to provide feedback to residents: 1) perceived inability of residents to learn or to incorporate feedback, 2) punitive nature of feedback, 3) lack of training in the delivery of actionable feedback, 4) lack of timeliness in the delivery of feedback, 5) unclear benefit of patient experience survey data as a tool for providing resident feedback, and 6) lack of individualized feedback. Conclusion: Programs may want to conduct an internal review on how patient experience data is incorporated into the resident feedback process and how, if at all, their faculty are trained to provide such feedback. PMID:27400180

Development of Family Medicine training in Botswana: Views of key stakeholders in Ngamiland.

PubMed

Ogundipe, Radiance M; Mash, Robert

2018-08-31

Family Medicine training commenced in Botswana in 2011, and Maun was one of the two sites chosen as a training complex. If it is to be successful there has to be investment in the training programme by all stakeholders in healthcare delivery in the district. The aim of the study was to explore the attitudes of stakeholders to initiation of Family Medicine training and their perspectives on the future roles of family physicians in Ngami district, Botswana. Maun and the surrounding Ngami subdistrict of Botswana. Thirteen in-depth interviews were conducted with purposively selected key stakeholders in the district health services. Data were recorded, transcribed and analysed using the framework method. Participants welcomed the development of Family Medicine training in Maun and expect that this will result in improved quality of primary care. Participants expect the registrars and family physicians to provide holistic health care that is of higher quality and expertise than currently experienced, relevant research into the health needs of the community, and reduced need for referrals. Inadequate personal welfare facilities, erratic ancillary support services and an inadequate complement of mentors and supervisors for the programme were some of the gaps and challenges highlighted by participants. Family Medicine training is welcomed by stakeholders in Ngamiland. With proper planning introduction of the family physician in the district is expected to result in improvement of primary care.

For Whom the Bell Tolls: Neurocognitive Individual Differences in the Acute Stress-Reduction Effects of an Attention Bias Modification Game for Anxiety

PubMed Central

Dennis-Tiwary, Tracy; Egan, Laura J.; Babkirk, Sarah; Denefrio, Samantha

2016-01-01

The efficacy of attention bias modification training (ABMT) for anxiety is debated, in part because individual differences in task engagement and pre-training threat bias impact training efficacy. In the present study, an engaging, gamified ABMT mobile application, or “app,” was utilized in 42 (21 females) trait-anxious adults. EEG was recorded during pre- and post-training threat bias assessment to generate scalp-recorded event-related potentials (ERPs) reflecting neurocognitive responses to threat. Following app play (ABMT versus placebo), subjective anxiety and stress responses (observed and self-reported) were measured. ABMT, versus placebo, resulted in improved behavioral performance during the stress task for females only. No difference was found between training groups in self-reported anxiety. ABMT resulted in improved performance during the stress task among those evidencing specific pre-training ERP responses: decreased P1 amplitudes, suggesting less attention allocation, but potentiated N170 amplitudes, suggesting enhanced attention selection and discrimination. Individual differences in behavioral threat bias did not moderate training effects. Results suggest that efficient initial allocation of attention to threat combined with enhanced recruitment of sensory gain mechanisms may underlie positive ABMT effects on anxiety-related stress. Targeting neurocognitive responses to threat to personalize ABMT and develop more effective methods of treatment delivery, such as gamification, are discussed. PMID:26745621

The US Support Program to IAEA Safeguards Priority of Training and Human Resources

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

Queirolo,A.

2008-06-13

The U.S. Support Program to IAEA Safeguards (USSP) priority of training and human resources is aimed at providing the Department of Safeguards with an appropriate mixture of regular staff and extrabudgetary experts who are qualified to meet the IAEA's technical needs and to provide personnel with appropriate instruction to improve the technical basis and specific skills needed to perform their job functions. The equipment and methods used in inspection activities are unique, complex, and evolving. New and experienced safeguards inspectors need timely and effective training to perform required tasks and to learn new skills prescribed by new safeguards policies ormore » agreements. The role of the inspector has changed from that of strictly an accountant to include that of a detective. New safeguards procedures are being instituted, and therefore, experienced inspectors must be educated on these new procedures. The USSP also recognizes the need for training safeguards support staff, particularly those who maintain and service safeguards equipment (SGTS), and those who perform information collection and analysis (SGIM). The USSP is committed to supporting the IAEA with training to ensure the effectiveness of all staff members and will continue to offer its assistance in the development and delivery of basic, refresher, and advanced training courses. This paper will discuss the USSP ongoing support in the area of training and IAEA staffing.« less

Building capacity in health facility management: guiding principles for skills transfer in Liberia

PubMed Central

2010-01-01

Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership) delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9%) reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1) use a short-course format focusing on four key skill areas with practical tools; 2) include didactic training, on-site projects, and on-site mentoring; 3) collaborate with an in-country academic institution, willing and able to scale-up and maintain the training; 4) provide training for the in-country academic faculty; and 5) secure Ministry-level support to ensure participation. Conclusion Our findings demonstrate key elements for scaling up and replicating educational initiatives that address management skills essential for long-term health systems strengthening in resource-poor settings. PMID:20298565

The organisation of interagency training to safeguard children in England: a case study using realistic evaluation

PubMed Central

Patsios, Demi; Carpenter, John

2010-01-01

Background Joint training for interagency working is carried out by Local Safeguarding Children Boards in England to promote effective local working to safeguard and promote the welfare of children. Purpose This paper reports on the findings of the outputs and outcomes of interagency training to safeguard children in eight Local Safeguarding Children Boards. Methods A review of Local Safeguarding Children Board documentation, observations of Local Safeguarding Children Board training sub-group meetings and a series of interviews with training key stakeholders in each Local Safeguarding Children Board were used to assess how partner agencies in the Local Safeguarding Children Boards carried out their statutory responsibilities to organise interagency training. ‘Realistic Evaluation’ was used to evaluate the mechanisms by which a central government mandate produced particular inter-agency training outputs (number of courses, training days) and joint working outcomes (effective partnerships), within particular Local Safeguarding Children Board contexts. Results The ‘mandated partnership’ imposed on Local Safeguarding Children Boards by central government left little choice but for partner agencies to work together to deliver joint training, which in turn affected the dynamics of working partnerships across the various sites. The effectiveness of the training sub group determined the success of the organisation and delivery of training for joint working. Despite having a central mandate, Local Safeguarding Children Boards had heterogeneous funding and training arrangements. These resulted in significant variations in the outputs in terms of the number of courses per ‘children in need’ in the locality and in the cost per course. Conclusions Interagency training which takes account of the context of the Local Safeguarding Children Board is more likely to produce better trained staff, effective partnership working, and lead to better integrated safeguarding children services. PMID:21290000

A qualitative analysis of health professionals' job descriptions for surgical service delivery in Uganda.

PubMed

Buwembo, William; Munabi, Ian G; Galukande, Moses; Kituuka, Olivia; Luboga, Samuel A

2014-01-01

The ever increasing demand for surgical services in sub-Saharan Africa is creating a need to increase the number of health workers able to provide surgical care. This calls for the optimisation of all available human resources to provide universal access to essential and emergency surgical services. One way of optimising already scarce human resources for health is by clarifying job descriptions to guide the scope of practice, measuring rewards/benefits for the health workers providing surgical care, and informing education and training for health professionals. This study set out to determine the scope of the mandate to perform surgical procedures in current job descriptions of surgical care health professionals in Uganda. A document review was conducted of job descriptions for the health professionals responsible for surgical service delivery in the Ugandan Health care system. The job descriptions were extracted and subjected to a qualitative content data analysis approach using a text based RQDA package of the open source R statistical computing software. It was observed that there was no explicit mention of assignment of delivery of surgical services to a particular cadre. Instead the bulk of direct patient related care, including surgical attention, was assigned to the lower cadres, in particular the medical officer. Senior cadres were assigned to perform predominantly advisory and managerial roles in the health care system. In addition, a no cost opportunity to task shift surgical service delivery to the senior clinical officers was identified. There is a need to specifically assign the mandate to provide surgical care tasks, according to degree of complexity, to adequately trained cadres of health workers. Health professionals' current job descriptions are not explicit, and therefore do not adequately support proper training, deployment, defined scope of practice, and remuneration for equitable surgical service delivery in Uganda. Such deliberate assignment of mandates will provide a means of increasing surgical service delivery through further optimisation of the available human resources for health.

Future Research, Research Futures. Proceedings of the National Conference of the Australian Vocational Education and Training Research Association (AVETRA) (3rd, Canberra, Australia, March 23-24, 2000).

ERIC Educational Resources Information Center

Australian Vocational Education and Training Research Association, Alexandria.

These proceedings consist of 66 conference papers on these themes: changing nature of work; emerging technologies; internationalization of vocational education and training (VET); enterprise and educational innovation; flexible delivery approaches; and research and technology and using technology in research. The papers are "Training Needs of…

Dental care professionals: their training and clinical practice in the UK.

PubMed

Hartridge, Sarah

2010-12-01

Since the event of compulsory registration, Dental Care Professionals now make up approximately 60% of the dental workforce. This article outlines training for all groups of Dental Care Professionals and discusses their clinical practice, emphasizing the importance of their involvement in the delivery of holistic patient care. To promote understanding of training and the current roles and responsibilities of the wider dental team.

Technology Options for Multimedia in Distance Learning. A Report for the Commission of the European Communities--Task Force Human Resources, Education, Training, and Youth.

ERIC Educational Resources Information Center

Sherwood-Roberts, P.; Vervest, P.

This report focuses on interactive multimedia delivery platforms available for distance education. An introduction addresses the role of distance education and open learning in covering training needs and advantages of interactive multimedia in training. Chapter 2 proposes a multimedia skills evaluation framework and examines the elements of this…

Computerized Memory Training Leads to Sustained Improvement in Visuospatial Short-Term Memory Skills in Children with Down Syndrome

ERIC Educational Resources Information Center

Bennett, Stephanie J.; Holmes, Joni; Buckley, Sue

2013-01-01

This study evaluated the impact of a computerized visuospatial memory training intervention on the memory and behavioral skills of children with Down syndrome. Teaching assistants were trained to support the delivery of a computerized intervention program to individual children over a 10-16 week period in school. Twenty-one children aged 7-12…

Job Training Partnership Act: Participants, Services, and Outcomes. Statement before the Committee on Education and Labor, United States House of Representatives.

ERIC Educational Resources Information Center

Thompson, Lawrence H.

The U.S. General Accounting Office studied the characteristics of individual participants in training provided by the Job Training Partnership Act (JTPA), the kinds and intensity of services they received, and the occupations in which they were employed after leaving the program. Visits to 63 randomly selected service delivery areas provided…