Farm Management and Leadership. Numeracy. Level 1. Level 2. Level 3. Support Materials for Agricultural Training.

ERIC Educational Resources Information Center

Batman, Kangan; Gadd, Nick; Lucas, Michele

This publication contains the three numeracy units of the three levels of Support Materials for Agricultural Training (SMAT) in farm management and leadership: Level 1 (starting), 2 (continuing), and 3 (completing). The units are designed to help the learner improve his or her numeracy skills needed to deal with farm management. SMAT materials can…

Training in Tobacco Treatments in Psychiatry: A National Survey of Psychiatry Residency Training Directors

ERIC Educational Resources Information Center

Prochaska, Judith J.; Fromont, Sebastien C.; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2006-01-01

Objective: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and is a leading cause of death and disability. This study examines training in tobacco treatment in psychiatry residency programs across the United States. Method: The authors recruited training directors to complete a survey of their…

B-52 and KC-135 Mission Qualification and Continuation Training: A review and Analysis

DTIC Science & Technology

1991-08-01

physical resources for completing the training requirements. Training is developed, scheduled, verified, and tracked primarily by the unit DOT, in...experienced EWs to develop their programs. To date, standard academic materials to support them, such as coursebooks , have not been produced. Due to

Addressing Adolescent Depression in Schools: Evaluation of an In-Service Training for School Staff in the United States

ERIC Educational Resources Information Center

Valdez, Carmen R.; Budge, Stephanie L.

2012-01-01

This study evaluated an adolescent depression in-service training for school staff in the United States. A total of 252 school staff (e.g., teachers, principals, counselors) completed assessments prior to and following the in-service and a subsample of these staff participated in focus groups following the in-service and three months later.…

Training Matters: Vocational Education and Training in the Retail Sector.

ERIC Educational Resources Information Center

Forrester, K. P.; And Others

Available vocational education and training in the United Kingdom's retail sector were examined in an employee-centered study during which data were collected primarily from two sources: questionnaires completed by 1,974 from a random sample of approximately 6,000 British retail employees who were surveyed, and semistructured face-to-face…

30 CFR 75.1502 - Mine emergency evacuation and firefighting program of instruction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... through a realistic SCSR training unit or device that provides the sensation of SCSR airflow resistance... of approval, the operator shall conduct training in accordance with the revised program. (b) New or... self-rescue devices, including hands-on training in the complete donning and transferring of all types...

30 CFR 75.1502 - Mine emergency evacuation and firefighting program of instruction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... through a realistic SCSR training unit or device that provides the sensation of SCSR airflow resistance... of approval, the operator shall conduct training in accordance with the revised program. (b) New or... self-rescue devices, including hands-on training in the complete donning and transferring of all types...

30 CFR 75.1502 - Mine emergency evacuation and firefighting program of instruction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... through a realistic SCSR training unit or device that provides the sensation of SCSR airflow resistance... of approval, the operator shall conduct training in accordance with the revised program. (b) New or... self-rescue devices, including hands-on training in the complete donning and transferring of all types...

Community health training for Family and Community Health Nursing residents in a Multiprofessional Teaching Unit. Three years of experience.

PubMed

Torrecilla-Abril, Maravillas; Crespo-Mateos, Ana Patricia; Cartagena-Martínez, Esther; Oyarzabal-Arocena, Milagros; Pérez-Ortiz, Clara Isabel

2018-05-30

To determine the interest of nursing residents in the training areas of Family and Community Nursing (EFyC) at the beginning of their training, to evaluate community activities in health centres and to determine satisfaction with the training received and activities carried out. We present the experience of training in the public and community health competencies of EFyC Nursing from 2014 to 2017 in a multiprofessional teaching unit. The training was divided into 3theoretical modules. The training was completed with 2activities: the design and development of a health education programme and an asset mapping in the basic health area. A questionnaire was completed on satisfaction with the course and the activities carried out. During this period, 27 residents received training. As part of the training process, 26 health education programmes and 17 asset mappings were conducted in accredited health centres. The areas of intervention addressed were: lifestyles, life transitions and health problems. The overall satisfaction with the course was 4.5 ±.1 out of 5. The results show a high degree of interest in this area, as well as high evaluation of the activities carried out and the training received. Training in community health and health education during the period of residence is essential to include these competencies in the professional role. The dedication and involvement of the multiprofessional teaching units is essential in the development of these competences, training the residents through the integration of a biopsychosocial approach, community health and teamwork in primary care. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

A primer on medical education in the United States through the lens of a current resident physician.

PubMed

Mowery, Yvonne M

2015-10-01

Physician training and standards for medical licensure differ widely across the globe. The medical education process in the United States (US) typically involves a minimum of 11 years of formal training and multiple standardized examinations between graduating from secondary school and becoming an attending physician with full medical licensure. Students in the US traditionally enter a 4-year medical school after completing an undergraduate bachelor's degree, in contrast to most other countries where medical training begins after graduation from high school. Medical school seniors planning to practice medicine in the US must complete postgraduate clinical training, referred to as residency, within the specialty of their choosing. The duration of residency varies depending on specialty, typically lasting between 3 and 7 years. For subspecialty fields, additional clinical training is often required in the form of a fellowship. Many experts have called for changes in the medical education system to shorten medical training in the US, and reforms are ongoing in some institutions. However, physician education in the US generally remains a progression from undergraduate premedical coursework to 4 years of medical school, followed by residency training with an optional subspecialty fellowship.

A primer on medical education in the United States through the lens of a current resident physician

PubMed Central

2015-01-01

Physician training and standards for medical licensure differ widely across the globe. The medical education process in the United States (US) typically involves a minimum of 11 years of formal training and multiple standardized examinations between graduating from secondary school and becoming an attending physician with full medical licensure. Students in the US traditionally enter a 4-year medical school after completing an undergraduate bachelor’s degree, in contrast to most other countries where medical training begins after graduation from high school. Medical school seniors planning to practice medicine in the US must complete postgraduate clinical training, referred to as residency, within the specialty of their choosing. The duration of residency varies depending on specialty, typically lasting between 3 and 7 years. For subspecialty fields, additional clinical training is often required in the form of a fellowship. Many experts have called for changes in the medical education system to shorten medical training in the US, and reforms are ongoing in some institutions. However, physician education in the US generally remains a progression from undergraduate premedical coursework to 4 years of medical school, followed by residency training with an optional subspecialty fellowship. PMID:26623123

A primer on medical education in the United States through the lens of a current resident physician

PubMed Central

2015-01-01

Physician training and standards for medical licensure differ widely across the globe. The medical education process in the United States (US) typically involves a minimum of 11 years of formal training and multiple standardized examinations between graduating from secondary school and becoming an attending physician with full medical licensure. Students in the US traditionally enter a 4-year medical school after completing an undergraduate bachelor’s degree, in contrast to most other countries where medical training begins after graduation from high school. Medical school seniors planning to practice medicine in the US must complete postgraduate clinical training, referred to as residency, within the specialty of their choosing. The duration of residency varies depending on specialty, typically lasting between 3 and 7 years. For subspecialty fields, additional clinical training is often required in the form of a fellowship. Many experts have called for changes in the medical education system to shorten medical training in the US, and reforms are ongoing in some institutions. However, physician education in the US generally remains a progression from undergraduate premedical coursework to 4 years of medical school, followed by residency training with an optional subspecialty fellowship. PMID:26605316

Alaska Native Weatherization Training and Jobs Program First Steps Toward Tribal Weatherization – Human Capacity Development

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

Wiita, Joanne

The Alaska Native Weatherization Training and Jobs Project expanded weatherization services for tribal members’ homes in southeast Alaska while providing weatherization training and on the job training (OJT) for tribal citizens that lead to jobs and most probably careers in weatherization-related occupations. The program resulted in; (a) 80 Alaska Native citizens provided with skills training in five weatherization training units that were delivered in cooperation with University of Alaska Southeast, in accordance with the U.S. Department of Energy Core Competencies for Weatherization Training that prepared participants for employment in three weatherizationrelated occupations: Installer, Crew Chief, and Auditor; (b) 25 paidmore » OJT training opportunities for trainees who successfully completed the training course; and (c) employed trained personnel that have begun to rehab on over 1,000 housing units for weatherization.« less

Indian medical students' views on immigration for training and practice.

PubMed

Rao, Nyapati R; Rao, Uttam K; Cooper, Richard A

2006-02-01

To assess the attitudes of medical students in India about participating in graduate medical education in the United States and other countries and in subsequent clinical practice in those countries. A total of 240 students who were attending their final year at two medical schools in Bangalore, India, were surveyed during 2004. Surveys were completed by 166 (69%) of the students. Among the responding students, 98 (59%) thought of leaving India for further training abroad. Of those who wished to leave, 41 (42%) preferred the United States, 42 (43%) preferred the United Kingdom, and 9 (9%) preferred Canada, Australia or New Zealand. Only two students preferred the Middle East. Most who favored training in the United States indicated that they intended to remain after training, whereas fewer than 20% of those who favored training in the United Kingdom had such intentions. While more than 60% perceived greater professional opportunities in the United States than in India, approximately 75% were concerned that the United States had become less welcoming after the terrorist attacks of 9/11, and similar numbers were concerned about the examination administered by the Educational Commission on Foreign Medical Graduates. Conversely, the majority of respondents felt that opportunities for physicians in India were improving. While optimism about future medical careers in India is increasing, the interest of Indian medical students in training and subsequently practicing in the United States remains high.

A position paper of the North American Society for Pediatric Gastroenterology and Nutrition. Pediatric gastroenterology Workforce Survey and future supply and demand.

PubMed

Colletti, R B; Winter, H S; Sokol, R J; Suchy, F J; Klish, W J; Durie, P R

1998-01-01

The North American Society for Pediatric Gastroenterology and Nutrition (NASPGN) performed a Workforce Survey to determine the current number and distribution of pediatric gastroenterologists in the United States and Canada and to estimate the supply and demand in the future in the United States. The response rate was more than 90%. There were 624 pediatric gastroenterologists in the United States, and 48 in Canada. There were 2.4 pediatric gastroenterologists per million population in the United States, ranging from 3.1 per million in the Northeast to 1.9 per million in the West, and 1.6 per million in Canada. In the United States, fewer than 5 pediatric gastroenterologists retire each year, but more than 40 fellows per year complete training. In the United States, 30% of pediatric gastroenterologists believe there is already an excess supply; only 12% believe there is a shortage (p < 0.001). If the number of fellows who complete training each year remains unchanged, in 10 years there will be more than 950 pediatric gastroenterologists in the United States (3.3 per million population). At the same time, if the demand for pediatric gastroenterologists remains 2.4 per million population, there will be a demand for only 675. If these assumptions are correct, it is necessary to reduce the number of fellows to be trained. Although it is difficult to predict future workforce needs reliably, we recommend that the number of fellowship positions in training programs in the United States be reduced by 50% to 75%. Changes in health care in the coming years will be challenging, and effective planning is necessary for pediatric gastroenterologists to achieve their clinical, research, and educational missions.

Future directions in training veterinarians for careers in toxicological pathology in the United Kingdom.

PubMed

Scudamore, Cheryl L; Smith, Sionagh H

2007-01-01

There is currently a global shortage of veterinary pathologists in all sectors of the discipline, and recruitment of toxicological pathologists is a particular problem for the pharmaceutical industry. Efforts to encourage veterinarians to consider alternative career paths to general practice must start at the undergraduate level, with provision of structured career guidance and strong role models from pathology and research disciplines. It is also imperative that both the importance of biomedical research and the role of animal models be clearly understood by both university staff and undergraduates. Traditionally, much post-graduate training in toxicological pathology is done "on the job" in the United Kingdom, but completion of a residency and/or PhD program is recognized as a good foundation for a career in industry and for successful completion of professional pathology examinations. New models of residency training in veterinary pathology must be considered in the United Kingdom to enable a more tailored approach to training toward specific career goals. A modular approach to residency training would allow core skills to be maintained, while additional training would target specific training requirements in toxicological pathology. Exposure to laboratory-animal pathology, toxicology, research methodology, and management skills would all be of benefit as an introduction to a career in toxicological pathology. However, long-term funding for UK residencies remains a problem that must be resolved if future recruitment needs in veterinary pathology are to be met.

Foreign Students: Catalyst for Reducing Parochialism.

ERIC Educational Resources Information Center

Mauch, James E.

Foreign students make up an important, and growing, segment of higher education in the United States. Reasons why foreign students come to the United States to study include the following: (1) the United States offers a serious approach to higher education in which students receive appropriate training and generally are able to complete the…

Suicide Prevention Training: Policies for Health Care Professionals Across the United States as of October 2017.

PubMed

Graves, Janessa M; Mackelprang, Jessica L; Van Natta, Sara E; Holliday, Carrie

2018-06-01

To identify and compare state policies for suicide prevention training among health care professionals across the United States and benchmark state plan updates against national recommendations set by the surgeon general and the National Action Alliance for Suicide Prevention in 2012. We searched state legislation databases to identify policies, which we described and characterized by date of adoption, target audience, and duration and frequency of the training. We used descriptive statistics to summarize state-by-state variation in suicide education policies. In the United States, as of October 9, 2017, 10 (20%) states had passed legislation mandating health care professionals complete suicide prevention training, and 7 (14%) had policies encouraging training. The content and scope of policies varied substantially. Most states (n = 43) had a state suicide prevention plan that had been revised since 2012, but 7 lacked an updated plan. Considerable variation in suicide prevention training for health care professionals exists across the United States. There is a need for consistent polices in suicide prevention training across the nation to better equip health care providers to address the needs of patients who may be at risk for suicide.

Training cardiovascular outcomes researchers: A survey of mentees and mentors to identify critical training gaps and needs.

PubMed

Khazanie, Prateeti; Al-Khatib, Sana M; Wang, Tracy Y; Crowley, Matthew J; Kressin, Nancy R; Krumholz, Harlan M; Kiefe, Catarina I; Wells, Barbara L; O'Brien, Sean M; Peterson, Eric D; Sanders, Gillian D

2018-02-01

Many young investigators are interested in cardiovascular (CV) outcomes research; however, the current training experience of early investigators across the United States is uncertain. From April to November 2014, we surveyed mentees and mentors of early-stage CV outcomes investigators across the United States. We contacted successful grantees of government agencies, members of professional organizations, and trainees in CV outcomes training programs. A total of 185 (of 662) mentees and 76 (of 541) mentors completed the survey. Mentees were equally split by sex; most had completed training >3 years before completing the survey and were clinicians. Mentors were more likely women, mostly ≥20 years posttraining, and at an associate/full professor rank. Mentors reported devoting more time currently to clinical work than when they were early in their career and mentoring 2-4 people simultaneously. More than 80% of mentees started training to become academicians and completed training with the same goal. More than 70% of mentees desired at least 50% research time in future jobs. More than 80% of mentors believed that future investigators would need more than 50% time dedicated to research. Most mentees (80%) were satisfied with their relationship with their mentor and reported having had opportunities to develop independently. Mentors more frequently than mentees reported that funding cutbacks had negatively affected mentees' ability to succeed (84% vs 58%). Across funding mechanisms, mentees were more optimistic than mentors about securing funding. Both mentees and mentors reported greatest preparedness for job/career satisfaction (79% for both) and publications (84% vs 92%) and least preparedness for future financial stability (48% vs 46%) and work-life balance (47% vs 42%). Survey findings may stimulate future discourse and research on how best to attract, train, and retain young investigators in CV outcomes research. Insights may help improve existing training programs and inform the design of new ones. Copyright © 2017. Published by Elsevier Inc.

Psychiatry training in the United Kingdom--part 2: the training process.

PubMed

Christodoulou, N; Kasiakogia, K

2015-01-01

In the second part of this diptych, we shall deal with psychiatric training in the United Kingdom in detail, and we will compare it--wherever this is meaningful--with the equivalent system in Greece. As explained in the first part of the paper, due to the recently increased emigration of Greek psychiatrists and psychiatric trainees, and the fact that the United Kingdom is a popular destination, it has become necessary to inform those aspiring to train in the United Kingdom of the system and the circumstances they should expect to encounter. This paper principally describes the structure of the United Kingdom's psychiatric training system, including the different stages trainees progress through and their respective requirements and processes. Specifically, specialty and subspecialty options are described and explained, special paths in training are analysed, and the notions of "special interest day" and the optional "Out of programme experience" schemes are explained. Furthermore, detailed information is offered on the pivotal points of each of the stages of the training process, with special care to explain the important differences and similarities between the systems in Greece and the United Kingdom. Special attention is given to The Royal College of Psychiatrists' Membership Exams (MRCPsych) because they are the only exams towards completing specialisation in Psychiatry in the United Kingdom. Also, the educational culture of progressing according to a set curriculum, of utilising diverse means of professional development, of empowering the trainees' autonomy by allowing initiative-based development and of applying peer supervision as a tool for professional development is stressed. We conclude that psychiatric training in the United Kingdom differs substantially to that of Greece in both structure and process. Τhere are various differences such as pure psychiatric training in the United Kingdom versus neurological and medical modules in Greece, in-training exams in the United Kingdom versus an exit exam in Greece, and of course the three years of higher training, which prepares trainees towards functioning as consultants. However, perhaps the most important difference is one of mentality; namely a culture of competency- based training progression in the United Kingdom, which further extends beyond training into professional revalidation. We believe that, with careful cultural adaptation, the systems of psychiatric training in the United Kingdom and Greece may benefit from sharing some of their features. Lastly, as previously clarified, this diptych paper is meant to be informative, not advisory.

Factors Affecting Recruitment into Child and Adolescent Psychiatry Training

ERIC Educational Resources Information Center

Shaw, Jon A.; Lewis, John E.; Katyal, Shalini

2010-01-01

Objective: The authors studied the factors affecting the recruitment into child and adolescent psychiatry training in the United States. Methods: Medical students (n = 154) and general and child and adolescent psychiatry residents (n = 111) completed a questionnaire to evaluate career choice in child psychiatry (n = 265). Results: Compared with…

Why Students Withdraw from Initial Teacher Training.

ERIC Educational Resources Information Center

Chambers, Gary M.; Roper, Tom

2000-01-01

Describes a research project that investigated: why preservice teachers in the United Kingdom withdrew from initial teacher training; how those reasons correlated with the views of schools where students completed student teaching; and measures administrators could take to reduce withdrawal rates (e.g., focus on how to change the interview process…

Having a Low Level of Education in Europe: An At-Risk Situation.

ERIC Educational Resources Information Center

Descy, Pascaline

2002-01-01

International Adult Literacy Survey data from Europe and the United States correlate literacy scores and educational attainment with unemployment rates and participation in training. Substantial numbers who have not completed secondary education and/or have lower literacy levels are unemployed, participate least in training, and have few…

Neurophysiology training in the Neurology Specialist Education Program in Spain.

PubMed

Rodríguez-Antigüedad, A; Matías-Guiu, J; Hernández-Pérez, M A; Jiménez Hernández, M D; Martín González, M R; Morales Ortiz, A; Delgado, G; Frank, A; López de Silanes, C; Martínez-Vila, E

2011-06-01

The training period in neurophysiology is a substantial part of the Neurology Specialist Program in Spain. The National Neurology Committee (La Comisión Nacional de Neurología (CNN), which is the body reporting to the Ministries of Health and Education, must ensure compliance to the Program. During the first trimester of 2008, the CNN sent a questionnaire, in which there was a question asking about this training period, to each of the managers of the 69 teaching units accredited for neurology training in Spain, for them to answer. Of the 69 questionnaires issued, 49 were received completed, which was a response rate of 71%. The neurophysiology training period of the neurology specialist program in Spain was carried out in the same hospital in 44 teaching unit (90%): the remaining 5 sent their neurology trainees to 4 different hospitals. The Unit that carried out the neurophysiology training period was incorporated into the Neurology Department in 27 (55%) cases, and the formula was mixed in 3 (6%). A total of 69% of tutors were satisfied with the training, but was 90% in the hospitals where the unit was integrated into Neurology, and was 65% where this relationship did not exist. The neurologists in training were informed about EEG in 49% of education units, performed EMG/ENG 57%, and informed about evoked potentials in 35% after their training period. Although the level of satisfaction is high, the level of responsibility assumed by the neurologists in training during their rotation into neurophysiology does not appear to comply to the demands laid out in the training program, particularly in these units not integrated into Neurology Departments. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Modification of Prim’s algorithm on complete broadcasting graph

NASA Astrophysics Data System (ADS)

Dairina; Arif, Salmawaty; Munzir, Said; Halfiani, Vera; Ramli, Marwan

2017-09-01

Broadcasting is an information dissemination from one object to another object through communication between two objects in a network. Broadcasting for n objects can be solved by n - 1 communications and minimum time unit defined by ⌈2log n⌉ In this paper, weighted graph broadcasting is considered. The minimum weight of a complete broadcasting graph will be determined. Broadcasting graph is said to be complete if every vertex is connected. Thus to determine the minimum weight of complete broadcasting graph is equivalent to determine the minimum spanning tree of a complete graph. The Kruskal’s and Prim’s algorithm will be used to determine the minimum weight of a complete broadcasting graph regardless the minimum time unit ⌈2log n⌉ and modified Prim’s algorithm for the problems of the minimum time unit ⌈2log n⌉ is done. As an example case, here, the training of trainer problem is solved using these algorithms.

An overlooked source of physician-scientists.

PubMed

Puljak, Livia

2007-12-01

A shortage of physician-scientists in the United States is an ongoing problem. Various recommendations have been made to address this issue; however, none of them have ameliorated the situation. Foreign medical school graduates with postdoctoral training in the United States are an overlooked and untapped resource for combating the dearth of physician-scientists. Evaluation of the scientific staff at the University of Texas Southwestern Medical Center revealed that 11% of all postdoctoral fellows were international medical graduates. Interestingly, a survey taken by these individuals revealed a lack of institutional and/or mentor support for career development and preparation for becoming physician-scientists. Foreign postdoctoral fellows with medical degrees are not even eligible for physician-scientist grants and awards since they are not US citizens. Although physicians educated in the United States usually matriculate from medical school with high educational debt that prevents most of them from entering into scientific careers, doctors trained outside the United States generally have minimal, if any, debt. Furthermore, many of them have a keen interest in remaining in the United States once they complete their postdoctoral training. Thus, foreign-trained medical professionals who have pursued scientific training in the United States can be one of the solutions for the current dearth of physician-scientists.

40 CFR 60.2740 - What records must I keep?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (b)(1) through (6) of this section: (1) The CISWI unit charge dates, times, weights, and hourly... showing the names of the CISWI operators who have completed the operator training requirements under § 60... under § 60.2650 or § 60.2655. Records must include documentation of training, the dates of the initial...

Urban Education and Training for American Indian Students: Some Correlates of Success.

ERIC Educational Resources Information Center

Champagne, Duane; Query, Joy M. N.

1980-01-01

Relocated Reservation Indians' adjustment to an occupational/educational school in a North Dakota city was studied. The study found that marital status, motor coordination, number of children living with parent, and military service were the best indicators of successful completion of the United Tribes Educational Training Center (UTEC) program.…

Extravehicular Mobility Unit Training Suit Symptom Study Report

NASA Technical Reports Server (NTRS)

Strauss, Samuel

2004-01-01

The purpose of this study was to characterize the symptoms and injuries experienced by NASA astronauts during extravehicular activity (space walk) spacesuit training at the Neutral Buoyancy Laboratory at Ellington Field, Houston, Texas. We identified the frequency and incidence rates of symptoms by each general body location and characterized mechanisms of injury and effective countermeasures. Based on these findings a comprehensive list of recommendations was made to improve training, test preparation, and current spacesuit components, and to design the next -generation spacesuit. At completion of each test event a comprehensive questionnaire was produced that documented suit symptom comments, identified mechanisms of injury, and recommended countermeasures. As we completed our study we found that most extravehicular mobility unit suit symptoms were mild, self-limited, and controlled by available countermeasures. Some symptoms represented the potential for significant injury with short- and long-term consequences regarding astronaut health and interference with mission objectives. The location of symptoms and injuries that were most clinically significant was in the hands, shoulders, and feet. Correction of suit symptoms issues will require a multidisciplinary approach to improve prevention, early medical intervention, astronaut training, test planning, and suit engineering.

Survey of minimally invasive general surgery fellows training in robotic surgery.

PubMed

Shaligram, Abhijit; Meyer, Avishai; Simorov, Anton; Pallati, Pradeep; Oleynikov, Dmitry

2013-06-01

Minimally invasive surgery fellowships offer experience in robotic surgery, the nature of which is poorly defined. The objective of this survey was to determine the current status and opportunities for robotic surgery training available to fellows training in the United States and Canada. Sixty-five minimally invasive surgery fellows, attending a fundamentals of fellowship conference, were asked to complete a questionnaire regarding their demographics and experiences with robotic surgery and training. Fifty-one of the surveyed fellows completed the questionnaire (83 % response). Seventy-two percent of respondents had staff surgeons trained in performing robotic procedures, with 55 % of respondents having general surgery procedures performed robotically at their institution. Just over half (53 %) had access to a simulation facility for robotic training. Thirty-three percent offered mechanisms for certification and 11 % offered fellowships in robotic surgery. One-third of the minimally invasive surgery fellows felt they had been trained in robotic surgery and would consider making it part of their practice after fellowship. However, most (80 %) had no plans to pursue robotic surgery fellowships. Although a large group (63 %) felt optimistic about the future of robotic surgery, most respondents (72.5 %) felt their current experience with robotic surgery training was poor or below average. There is wide variation in exposure to and training in robotic surgery in minimally invasive surgery fellowship programs in the United States and Canada. Although a third of trainees felt adequately trained for performing robotic procedures, most fellows felt that their current experience with training was not adequate.

The Role 3 Multinational Medical Unit at Kandahar Airfield 2005–2010

PubMed Central

Brisebois, Ronald; Hennecke, Peter; Kao, Raymond; McAlister, Vivian; Po, Joseph; Stiegelmar, Rob; Tien, Homer

2011-01-01

In late 2005, Canadian Forces Health Services (CFHS) was tasked with the command of the NATO Role 3 Multinational Medical Unit (R3MMU) on Kandahar Airfield in southern Afghanistan. Preparations drew on past experience and planning. Eight complete hospital contingents were trained and deployed in rotation. Near-reality simulation training was undertaken with the combat brigade, including complete deployment of the field hospital in the exercise area. Standard operating procedures (SOP) were developed and applied by each rotation so successfully that they were adopted by the new command in late 2009. The Canadian period at R3MMU had the highest survival rate ever recorded for victims of war. Lessons learned are being applied among victims of the conflict and trauma. The experience of the R3MMU was used to successfully deploy a hospital as part of the earthquake relief effort in Haiti in 2010. The training protocols and SOP are being applied to disaster preparedness in Canadian civilian hospitals. PMID:22099325

The Role 3 Multinational Medical Unit at Kandahar Airfield 2005-2010.

PubMed

Brisebois, Ronald; Hennecke, Peter; Kao, Raymond; McAlister, Vivian; Po, Joseph; Stiegelmar, Rob; Tien, Homer

2011-12-01

In late 2005, Canadian Forces Health Services (CFHS) was tasked with the command of the NATO Role 3 Multinational Medical Unit (R3MMU) on Kandahar Airfield in southern Afghanistan. Preparations drew on past experience and planning. Eight complete hospital contingents were trained and deployed in rotation. Near-reality simulation training was undertaken with the combat brigade, including complete deployment of the field hospital in the exercise area. Standard operating procedures (SOP) were developed and applied by each rotation so successfully that they were adopted by the new command in late 2009. The Canadian period at R3MMU had the highest survival rate ever recorded for victims of war. Lessons learned are being applied among victims of the conflict and trauma. The experience of the R3MMU was used to successfully deploy a hospital as part of the earthquake relief effort in Haiti in 2010.The training protocols and SOP are being applied to disaster preparedness in Canadian civilian hospitals.

40 CFR 60.2910 - What site-specific documentation is required?

Code of Federal Regulations, 2011 CFR

2011-07-01

... paragraphs (a)(1) through (9) of this section. You must maintain this information and the training records...) Records showing the names of OSWI unit operators who have completed review of the information in paragraph... review and all subsequent annual reviews. (2) Records showing the names of the OSWI unit operators who...

40 CFR 60.2910 - What site-specific documentation is required?

Code of Federal Regulations, 2012 CFR

2012-07-01

... paragraphs (a)(1) through (9) of this section. You must maintain this information and the training records...) Records showing the names of OSWI unit operators who have completed review of the information in paragraph... review and all subsequent annual reviews. (2) Records showing the names of the OSWI unit operators who...

The Clinical Quality Fellowship Program: Developing Clinical Quality Leadership in the Greater New York Region.

PubMed

Bhalla, Rohit; Jalon, Hillary S; Ryan, Lorraine

The Institute of Medicine has noted that a key factor underlying patient safety problems in the United States is a paucity of quality and safety training programs for clinicians. The Greater New York Hospital Association and United Hospital Fund created the Clinical Quality Fellowship Program (CQFP) to develop quality improvement leaders in the New York region. The goals of this article are to describe the CQFP's structure and curriculum, program participants' perceived value, improvement projects, and career paths. Eighty-seven participants completed the CQFP from 2010 to 2014. Among program participants completing self-assessment evaluations, significant improvements were observed across all quality improvement skill areas. Capstone project categories included inpatient efficiency, transitional care, and hospital infection. Fifty-six percent of participants obtained promotions following program completion. A training program emphasizing diverse curricular elements, varied learning approaches, and applied improvement projects increased participants' self-perceived skills, generated diverse improvement initiatives, and was associated with career advancement.

40 CFR 60.2640 - When must the operator training course be completed?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Operator...

40 CFR 60.2640 - When must the operator training course be completed?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Operator...

Introduction to MacDraft. High-Technology Training Module.

ERIC Educational Resources Information Center

Traxler, Gene

This training module on MacDraft is part of a computer drafting skills unit on communications technology for grades 9-12. The objective is for each student to complete a drawing on the MacIntosh computer using the MacDraft software program. This drawing is to be dimensioned with a dual system and is to include a border and title block. This module…

[Impact of an |A|B|S|-training initiative on |A|B|S|-structural quality of participating hospitals].

PubMed

Christoph, Anna; Ehm, Christine; de With, Katja

2015-01-01

The "ABS-training initiative" was funded by the German Ministry of Health as part of the German Antimicrobial Resistance Strategy (Deutsche Antibiotika-Resistenz-Strategie, DART) from 2009 until early 2014. The initiative was designed for clinicians and clinical pharmacists and contains several training units covering antiinfectives, infectious diseases and ABS strategies including the conduction of a research project at the participants' hospital. Participants who complete the four-weeks training initiative will become a certified "ABS Expert". 281 ABS Experts were asked to take part in a survey (staff for ABS, surveillance data about agents and consumption, ABS activity) to estimate the influence of the ABS-training initiative on the ABS-structural quality. The evaluation was performed using GrafStat (V 4.255), statistical software package for the evaluation of surveys. Ninety-two ABS Experts representing 92 hospitals participated in a questionnaire-based survey before and after completing the training initiative. Forty (44 %) hospitals appointed an ABS representative (+22 %) after completing the training initiative. Antibiotic surveillance data available as a report increased from 34 (40 %) to 54 (60 %) and correct data presentation (DDD or RDD/100 days) from 7 (8 %) to 40 (43 %). Proactive auditing of antiinfective prescribing improved from 54 (60 %) to 71 (78 %) in intensive care units, and from 28 (31 %) to 53 (58 %) on normal wards. Availability of local guidelines increased from 36 (39 %) to 52 (57 %). The "ABS Training Initiative" had a positive impact on ABS-structural quality regarding nomination of ABS-teams, surveillance data of antibiotic consumption, implementation of proactive auditing of antiinfective prescribing and availability of local guidelines. However, there is optimization potential in many sectors. The short time period between pre- and post-assessment and the ongoing personnel or time constraints need to be taken into account. Copyright © 2015. Published by Elsevier GmbH.

Creating a gold medal Olympic and Paralympics health care team: a satisfaction survey of the mobile medical unit/polyclinic team training for the Vancouver 2010 winter games

PubMed Central

2013-01-01

Background The mobile medical unit/polyclinic (MMU/PC) was an essential part of the medical services to support ill or injured Olympic or Paralympics family during the 2010 Olympic and Paralympics winter games. The objective of this study was to survey the satisfaction of the clinical staff that completed the training programs prior to deployment to the MMU. Methods Medical personnel who participated in at least one of the four training programs, including (1) week-end sessions; (2) web-based modules; (3) just-in-time training; and (4) daily simulation exercises were invited to participate in a web-based survey and comment on their level of satisfaction with training program. Results A total of 64 (out of 94 who were invited) physicians, nurses and respiratory therapists completed the survey. All participants reported favorably that the MMU/PC training positively impacted their knowledge, skills and team functions while deployed at the MMU/PC during the 2010 Olympic Games. However, components of the training program were valued differently depending on clinical job title, years of experience, and prior experience in large scale events. Respondents with little or no experience working in large scale events (45%) rated daily simulations as the most valuable component of the training program for strengthening competencies and knowledge in clinical skills for working in large scale events. Conclusion The multi-phase MMU/PC training was found to be beneficial for preparing the medical team for the 2010 Winter Games. In particular this survey demonstrates the effectiveness of simulation training programs on teamwork competencies in ad hoc groups. PMID:24225074

Double Fellowships in Radiology: A Survey of 2014 Graduating Fellows.

PubMed

Wong, Thomas Y; Moriarity, Andrew; Lall, Neil; Hoffmann, Jason C; Katz, Douglas S; Flug, Jonathan A

Radiology fellowship training has evolved from being an uncommon option to being a near requisite for post-training employment in the United States. A subset of fellows elect to pursue second fellowships with potentially substantial implications on both the private sector and academic radiology workforce. The purpose of this study was to assess the proportion of current radiology fellows pursuing multiple years of post-residency fellowship training. After obtaining IRB approval, an anonymous web-based survey was emailed to 1,269 radiology fellows listed as "completing fellowship" in the American College of Radiology database in June 2014. Questions were asked regarding current fellowship training, post-fellowship employment plans, and individual experience pursuing employment. Results were analyzed using the survey analytical software. There were 219 responses received, representing a 17.3% response rate. Ten-percent of respondents were currently completing their second radiology fellowship. Of those completing their first year of fellowship training, 11% indicated plans to complete a second radiology fellowship. This survey provides a snapshot of the percentage of radiology trainees who pursue a second year of fellowship training, currently in the range of 10%. Pursuing a second radiology fellowship may represent a safety net to a substantial subset of fellows who are not able to obtain satisfactory employment following training. Academic programs who rely heavily on fellows should be aware of the proportion of fellows pursuing two fellowships and should be prepared to adapt should this change over time. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of Mandatory Unit and Individual Physical Training on Fitness in Military Men and Women.

PubMed

Anderson, Morgan K; Grier, Tyson; Canham-Chervak, Michelle; Bushman, Timothy T; Nindl, Bradley C; Jones, Bruce H

2017-09-01

The purpose of this study was to look at the effect of additional individual physical training (PT) in addition to mandatory unit PT as well as other risk factors on physical fitness. A cross-sectional design. This study was conducted on a US military installation. Participants were 6290 male and 558 female active duty US Army soldiers in 3 light infantry brigades. Participants completed self-administered questionnaires asking about individual characteristics, PT, and physical fitness. Cut points were established for soldiers scoring within the top 33% for each of the 3 Army Physical Fitness Test events (2-mile run, sit-ups, and push-ups) and top 50% in each of the tests combined for overall performance. Odds ratios and 95% confidence intervals from multivariate analyses were calculated. Variables impacting physical fitness performance of men and women included increased body mass index, leading unit PT sessions, and individual distance running mileage. Other variables impacting physical performance for men included increased age, smoking, and individual resistance training. Soldiers performing additional individual PT demonstrated a positive influence on fitness compared to unit PT participation alone. Increased age and being overweight/obese negatively influenced physical fitness. To enhance fitness performance through unit PT, running by ability groups and resistance training should be encouraged by leadership.

Advanced Training Course for School Bus Drivers. A Manual for Instructors.

ERIC Educational Resources Information Center

New York State Education Dept., Albany.

This manual provides the basis for a 10-hour advanced course of instruction to be offered for those school bus drivers who have successfully completed a basic course. The course is composed of five units. The pupil control unit attempts to develop in the school bus driver an understanding of the functions of discipline and his relationship to the…

Performance characteristics and statistics of a laser initiated microdetonator

NASA Technical Reports Server (NTRS)

Yang, L. C.

1979-01-01

The test results of 320 units of the laser initiated microdetonator are summarized. The commercially fabricated units used a lead styphnate/lead azide/HMX (1 mg/17.5 mg/13.5 mg) explosive train design contained in a miniature aluminum can and completed with a glass-metal seal window. The test parameters were the high and low laser energy, high and low temperature, laser pulse duration, laser wavelength and nuclear radiation (5 x 10 to the 6th rads of 1 MeV gamma ray). The performance parameters were the laser energy for ignition and the actuation response time. Included also is a description of the development of a flexible, continuously advanced train of explosive devices by using the units, miniature optics and fiber optics.

Dental manpower development in the Pacific: case study in the Republic of the Marshall Islands.

PubMed

Tut, Ohnmar K; Langidrik, Justina R; Milgrom, Peter M

2007-03-01

This case study reports the ongoing progress and results of a manpower development program to expand indigenous dental personnel at four levels in the Republic of the Marshall Islands. The program was designed to: 1) increase the number of Marshallese students who successfully complete dentistry training; 2) recruit and train a group of Marshallese high school graduates in dental assisting for service in new preventive outreach programs within the community; 3) enhance the dental training of health assistants providing primary medical care to outer islands away from the main population centers of Majuro and Ebeye; and 4) provide in-service training on tooth decay prevention for Head Start teachers. The program resulted in the training of one Marshallese dentist and two Marshallese dental therapist, 16 primary care health aides who received oral health training for work in the outer island dispensaries, and 200 Head Start and kindergarten teachers who completed in-service training in oral health. Additional expertise was shared with other United States Affiliated Pacific Islands (USAPI) to enhance the dental workforce throughout the Pacific.

Innovations in occupational health nursing education, including a distance learning approach.

PubMed

Lowis, A; Ellington, H

1991-07-01

The results of a survey in the United Kingdom in the late 1980s indicated that many occupational health nurses were not being sent for formal training because of the length of time nurses needed to be away from their employment and the difficulty employers had in finding nurse replacements during training. To meet the needs of occupational health nurses and their employers, the Robert Gordon Institute of Technology (RGIT) instituted a modular training course that offers full time attendance or distance learning options. RGIT's course consists of six modules over a 1 to 3 year period, which students can take in any order after completing a short Return to Study course. Using the innovative distance learning option, occupational health nurses can earn a Diploma in Occupational Health Nursing while completing most of their courses at the workplace, thus avoiding conflicts between training and work schedules.

Using a virtual training program to train community neurologist on EEG reading skills.

PubMed

Ochoa, Juan; Naritoku, Dean K

2012-01-01

EEG training requires iterative exposure of different patterns with continuous feedback from the instructor. This training is traditionally acquired through a traditional fellowship program, but only 28% of neurologists in training plan to do a fellowship in EEG. The purpose of this study was to determine the value of online EEG training to improve EEG knowledge among general neurologists. The participants were general neurologists invited through bulk e-mail and paid a fee to enroll in the virtual EEG program. A 40-question pretest exam was performed before training. The training included 4 online learning units about basic EEG principles and 40 online clinical EEG tutorials. In addition there were weekly live teleconferences for Q&A sessions. At the end of the program, the participants were asked to complete a posttest exam. Fifteen of 20 participants successfully completed the program and took both the pre- and posttest exams. All the subjects scored significantly higher in the posttest compared to their baseline score. The average score in the pretest evaluation was 61.7% and the posttest average was 87.8% (p = .0002, two-tailed). Virtual EEG training can improve EEG knowledge among community neurologists.

Description and comparison of pharmacy technician training programs in the United States.

PubMed

Anderson, Douglas C; Draime, Juanita A; Anderson, Timothy S

2016-01-01

To describe pharmacy technician training programs in the United States and to compare pharmacy technician program characteristics between programs with and without a pharmacist on faculty and between programs with different accreditation status. Descriptive, cross-sectional study. Not applicable. United States pharmacy technician programs. Not applicable. Student class size, faculty credentials, coursework components, program length, tuition rates, and admission criteria. Currently, there are more than 698 pharmacy technician programs across 1114 campuses, with complete data available for 216 programs. Programs varied widely in terms of class sizes, faculty credentials, and admission criteria. Programs with pharmacists on faculty were significantly less expensive than were those without pharmacists (P = 0.009). Accreditation had no impact on tuition prices. This is the first study of its kind to describe and characterize pharmacy technician training programs. There is relatively little control of technician training by the profession of pharmacy. The quality of these programs in terms of student outcomes is unknown, and it should be explored. Rigorous debate and discussion is needed regarding the future of pharmacy technician roles and the training required for those roles. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Department of Defense Manpower Requirements Report, FY 1985. Volume III. Force Readiness Report.

DTIC Science & Technology

1984-02-01

forces are made up of a variety of different types of units. Each unit has associated with it a collection of positions that must be filled by...available inventory, accession arid separation predictions, fiscal constraints, manpower ceilings--the list seems endless. The collection of positions that...units complete collective training and remain in FORSCOM for 18 months if deploying to a long-tour area such as Europe; or for 24 months if pre- paring

A Cross-Cultural Comparison of Knowledge and Stigma Associated with Autism Spectrum Disorder Among College Students in Lebanon and the United States.

PubMed

Obeid, Rita; Daou, Nidal; DeNigris, Danielle; Shane-Simpson, Christina; Brooks, Patricia J; Gillespie-Lynch, Kristen

2015-11-01

Although misconceptions associated with ASD are apparent worldwide, they may differ across cultures. This study compares knowledge and stigma associated with ASD in a country with limited autism resources, Lebanon, and a country with substantial autism resources, the United States (US). College students in the US (N = 346) and Lebanon (N = 329) completed assessments of knowledge and stigma associated with ASD before and after an online ASD training. Although students in the US exhibited higher overall knowledge and lower stigma towards ASD, certain misconceptions were more apparent in the US than in Lebanon. Participation in the training was associated with decreased stigma and increased knowledge in both countries. Thus, online training may be useful for increasing understanding about ASD internationally.

Postdoctoral Professional Fellowships in Laboratory Medicine.

PubMed

Straseski, Joely A

2013-04-01

Doctoral level scientists often pursue a traditional academic route, focusing their efforts on research and education. However, additional options exist for those that are interested in using their laboratory and research skills in a clinical setting. Clinical laboratory directors serve as the interface between the clinical laboratory and the users of laboratory test results. This article describes these career paths options for PhD scientists. Clinical laboratory directors are primarily trained via one of two routes: physicians that have been trained in clinical pathology or non-physician doctoral scientists that have completed professional fellowship training. This article will focus on the latter of these 2 routes. In the United States, completing a postdoctoral fellowship in laboratory-specific professional fields qualifies non-physician doctoral scientists as laboratory directors and consultants. Their expert consultation provides invaluable insight into testing procedures such as possible sources of interference or inaccurate test results, preferred testing for specific clinical situations, and confirmatory methods. They must also be knowledgeable about current instrumentation, assay limitations, and the newest available technologies. One of the older and more developed professional fellowships in the United States, clinical chemistry, encompasses many laboratory disciplines and will be highlighted in detail. Training information specific to clinical immunology, clinical microbiology, and clinical genetics is also discussed.

Does Formal Research Training Lead to Academic Success in Plastic Surgery? A Comprehensive Analysis of U.S. Academic Plastic Surgeons.

PubMed

Lopez, Joseph; Ameri, Afshin; Susarla, Srinivas M; Reddy, Sashank; Soni, Ashwin; Tong, J W; Amini, Neda; Ahmed, Rizwan; May, James W; Lee, W P Andrew; Dorafshar, Amir

2016-01-01

It is currently unknown whether formal research training has an influence on academic advancement in plastic surgery. The purpose of this study was to determine whether formal research training was associated with higher research productivity, academic rank, and procurement of extramural National Institutes of Health (NIH) funding in plastic surgery, comparing academic surgeons who completed said research training with those without. This was a cross-sectional study of full-time academic plastic surgeons in the United States. The main predictor variable was formal research training, defined as completion of a postdoctoral research fellowship or attainment of a Doctor of Philosophy (PhD). The primary outcome was scientific productivity measured by the Hirsh-index (h-index, the number of publications, h that have at least h citations each). The secondary outcomes were academic rank and NIH funding. Descriptive, bivariate, and multiple regression statistics were computed. A total of 607 academic surgeons were identified from 94 Accreditation Council for Graduate Medical Education-accredited plastic surgery training programs. In all, 179 (29.5%) surgeons completed formal research training. The mean h-index was 11.7 ± 9.9. And, 58 (9.6%) surgeons successfully procured NIH funding. The distribution of academic rank was the following: endowed professor (5.4%), professor (23.9%), associate professor (23.4%), assistant professor (46.0%), and instructor (1.3%). In a multiple regression analysis, completion of formal research training was significantly predictive of a higher h-index and successful procurement of NIH funding. Current evidence demonstrates that formal research training is associated with higher scientific productivity and increased likelihood of future NIH funding. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Psychotherapists as Patient Suicide Survivors: A Review of the Literature on Psychiatrists and Psychologists, Including Those in Training.

ERIC Educational Resources Information Center

VanLith, Clinten David

It has been estimated that completed suicides in the United States leave behind 750,000 survivors every year. Many times, individuals who complete suicide had been seeing a mental health practitioner, who then must face the turmoil of losing a client to suicide. This paper reviews the literature on the frequency, impact, and recovery of…

The development and efficacy of safety training for commercial fishermen.

PubMed

Dzugan, Jerry

2010-10-01

Commercial fishing is still the most dangerous occupation in the United States. Efforts to have more stringent safety regulations in this industry beginning in the 1960s, culminated in the Commercial Fishing Vessel Safety Act of 1988. The purpose of this paper is to provide a short history of the development of safety training in the United States and the current training infrastructure. This paper will also review studies available regarding the effectiveness of safety training in reducing fatalities among fishermen. The lack of familiarity and practice with marine survival equipment such as life rafts, immersion suits, and emergency-locating beacons has been noted in National Transportation Safety Board and US Coast Guard casualty reports as a contributing factor in fatalities. These reports have demonstrated the importance of not just having survival equipment onboard, but training in how to use it effectively in an emergency. There is evidence that safety training has made a measurable impact in surviving an emergency at sea and that recent training (within 5 years) is most effective in saving lives. More recently, studies have been completed to understand how skills may diminish over time since initial training.

The impact of fellowships on surgical resident training in a multispecialty cohort in Australia and New Zealand.

PubMed

Petrushnko, Wilson; Perry, Will; Fraser-Kirk, Grant; Ctercteko, Grahame; Adusumilli, Sanjay; O'Grady, Gregory

2015-12-01

Fellowships in surgery are increasing in number, and concerns have been raised regarding their impact on resident training. Although fellows may contribute to resident education and training, they also compete for operative and other experience. This study aimed to quantify the impact of fellowships on resident training in a binational multispecialty cohort. The operative case volumes and primary operator rates of surgery trainees (residents) in Australia and New Zealand were compared between units with and without fellows. Trainees also were surveyed using Likert Scales to assess quality of operative and other experience in units with and without fellows. Data from 911 trainees over 2 terms was analyzed; survey response rate 42%. Of all trainees, 42% worked with fellows. Trainees in units without fellows were involved in more major (P = .03) and minor (P < .0001) cases. Primary operator rates were comparable, but trainees in units without fellows were less often assistants, reported an increased quality of elective operating experience, and reported more favorable completion of learning objectives (all P < .05). These findings were consistent between tertiary and nontertiary hospitals. Thematic analysis showed positive benefits of fellows in teaching, training and mentorship, but negative impacts on case exposure, competition for operating, and clinical experience. Fellows may assist in the teaching and training of residents, but residents working with fellows experience a decreased quantity of operative experience that may impact several aspects of the quality of training. Surgical educators must actively balance the learning needs of fellows and residents. Copyright © 2015 Elsevier Inc. All rights reserved.

Accelerated Training of Skilled Birth Attendants in a Marginalized Population on the Thai-Myanmar Border: A Multiple Methods Program Evaluation.

PubMed

White, Adrienne Lynne; Min, Thaw Htwe; Gross, Mechthild M; Kajeechiwa, Ladda; Thwin, May Myo; Hanboonkunupakarn, Borimas; Than, Hla Hla; Zin, Thet Wai; Rijken, Marcus J; Hoogenboom, Gabie; McGready, Rose

2016-01-01

To evaluate a skilled birth attendant (SBA) training program in a neglected population on the Thai-Myanmar border, we used multiple methods to show that refugee and migrant health workers can be given effective training in their own environment to become SBAs and teachers of SBAs. The loss of SBAs through resettlement to third countries necessitated urgent training of available workers to meet local needs. All results were obtained from student records of theory grades and clinical log books. Qualitative evaluation of both the SBA and teacher programs was obtained using semi-structured interviews with supervisors and teachers. We also reviewed perinatal indicators over an eight-year period, starting prior to the first training program until after the graduation of the fourth cohort of SBAs. Four SBA training programs scheduled between 2009 and 2015 resulted in 79/88 (90%) of students successfully completing a training program of 250 theory hours and 625 supervised clinical hours. All 79 students were able to: achieve pass grades on theory examination (median 80%, range [70-89]); obtain the required clinical experience within twelve months; achieve clinical competence to provide safe care during childbirth. In 2010-2011, five experienced SBAs completed a train-the-trainer (TOT) program and went on to facilitate further training programs. Perinatal indicators within Shoklo Malaria Research Unit (SMRU), such as place of birth, maternal and newborn outcomes, showed no significant differences before and after introduction of training or following graduate deployment in the local maternity units. Confidence, competence and teamwork emerged from qualitative evaluation by senior SBAs working with and supervising students in the clinics. We demonstrate that in resource-limited settings or in marginalized populations, it is possible to accelerate training of skilled birth attendants to provide safe maternity care. Education needs to be tailored to local needs to ensure evidence-based care of women and their families.

Accelerated Training of Skilled Birth Attendants in a Marginalized Population on the Thai-Myanmar Border: A Multiple Methods Program Evaluation

PubMed Central

White, Adrienne Lynne; Min, Thaw Htwe; Gross, Mechthild M.; Kajeechiwa, Ladda; Thwin, May Myo; Hanboonkunupakarn, Borimas; Than, Hla Hla; Zin, Thet Wai; Rijken, Marcus J.; Hoogenboom, Gabie; McGready, Rose

2016-01-01

Background To evaluate a skilled birth attendant (SBA) training program in a neglected population on the Thai-Myanmar border, we used multiple methods to show that refugee and migrant health workers can be given effective training in their own environment to become SBAs and teachers of SBAs. The loss of SBAs through resettlement to third countries necessitated urgent training of available workers to meet local needs. Methods and Findings All results were obtained from student records of theory grades and clinical log books. Qualitative evaluation of both the SBA and teacher programs was obtained using semi-structured interviews with supervisors and teachers. We also reviewed perinatal indicators over an eight-year period, starting prior to the first training program until after the graduation of the fourth cohort of SBAs. Results Four SBA training programs scheduled between 2009 and 2015 resulted in 79/88 (90%) of students successfully completing a training program of 250 theory hours and 625 supervised clinical hours. All 79 students were able to: achieve pass grades on theory examination (median 80%, range [70–89]); obtain the required clinical experience within twelve months; achieve clinical competence to provide safe care during childbirth. In 2010–2011, five experienced SBAs completed a train-the-trainer (TOT) program and went on to facilitate further training programs. Perinatal indicators within Shoklo Malaria Research Unit (SMRU), such as place of birth, maternal and newborn outcomes, showed no significant differences before and after introduction of training or following graduate deployment in the local maternity units. Confidence, competence and teamwork emerged from qualitative evaluation by senior SBAs working with and supervising students in the clinics. Conclusions We demonstrate that in resource-limited settings or in marginalized populations, it is possible to accelerate training of skilled birth attendants to provide safe maternity care. Education needs to be tailored to local needs to ensure evidence-based care of women and their families. PMID:27711144

The Fall of Fort Eben Emael: The Effects of Emerging Technologies on the Successful Completion of Military Objectives

DTIC Science & Technology

2004-06-18

the leadership and training of the German unit assigned the mission at Fort Eben Emael. Lastly, this study examines administration and personnel...conventional charge. Further, the German unit’s training and leadership was exemplary and contributed more to the mission’s success than the...the interwar period. Within Belgium, debate over the defense strategy ensued. The Belgian Army leadership accepted the French plan and began

77 FR 38608 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

..., professional qualifications and skills, training courses completed, certifications received, level of education... Activity Unit Identification Code (UIC).'' Safeguards: Delete entry and replace with ``The NTMPS servers.... All data transferred is encrypted. The interface server is protected from attempts to penetrate the...

On the Edge of Life, II: House Officer Struggles Recorded in an Intensive Care Unit Journal

PubMed Central

Sekeres, Mikkael A.; Stern, Theodore A.

2002-01-01

Background: In a general hospital, few clinical settings match the intensity of the intensive care unit (ICU) experience. Clinical rotations in ICUs elicit and emphasize the struggles house officers face on a daily basis throughout their training. Method: These struggles were recorded by hundreds of residents in a journal maintained in one Medical ICU for the past 20 years. We systematically reviewed these unsolicited entries to develop categories that define and illustrate common stressors. Results: Stressors for house officers include isolation, insecurity, care for the terminally ill, sleep deprivation, and long work weeks. Conclusion: By placing the struggles of house staff in context, trainees and their residency training programs can be prepared for the intensity of the experience and for work in clinical practice settings that follows completion of training. PMID:15014706

Automated external defibrillator availability and CPR training among state police agencies in the United States.

PubMed

Hirsch, Lior M; Wallace, Sarah K; Leary, Marion; Tucker, Kathryn D; Becker, Lance B; Abella, Benjamin S

2012-07-01

Access to automated external defibrillators and cardiopulmonary resuscitation (CPR) training are key determinants of cardiac arrest survival. State police officers represent an important class of cardiac arrest first responders responsible for the large network of highways in the United States. We seek to determine accessibility of automated external defibrillators and CPR training among state police agencies. Contact was attempted with all 50 state police agencies by telephone and electronic mail. Officers at each agency were guided to complete a 15-question Internet-based survey. Descriptive statistics of the responses were performed. Attempts were made to contact all 50 states, and 46 surveys were completed (92% response rate). Most surveys were filled out by police leadership or individuals responsible for medical programs. The median agency size was 725 (interquartile range 482 to 1,485) state police officers, with 695 (interquartile range 450 to 1,100) patrol vehicles ("squad cars"). Thirty-three percent of responding agencies (15/46) reported equipping police vehicles with automated external defibrillators. Of these, 53% (8/15) equipped less than half of their fleet with the devices. Regarding emergency medical training, 78% (35/45) of state police agencies reported training their officers in automated external defibrillator usage, and 98% (44/45) reported training them in CPR. One third of state police agencies surveyed equipped their vehicles with automated external defibrillators, and among those that did, most equipped only a minority of their fleet. Most state police agencies reported training their officers in automated external defibrillator usage and CPR. Increasing automated external defibrillator deployment among state police represents an important opportunity to improve first responder preparedness for cardiac arrest care. Copyright © 2012. Published by Mosby, Inc.

Arthroscopic training resources in orthopedic resident education.

PubMed

Koehler, Ryan; John, Tamara; Lawler, Jeffrey; Moorman, Claude; Nicandri, Gregg

2015-02-01

The purpose of this study was to determine the frequency of use, perceived effectiveness, and preference for arthroscopic surgical skill training resources. An electronic survey was sent to orthopedics residents, residency program directors, and orthopedic sports medicine attending physicians in the United States. The frequency and perceived effectiveness of 10 types of adjunctive arthroscopic skills training was assessed. Residents and faculty members were asked to rate their confidence in resident ability to perform common arthroscopic procedures. Surveys were completed by 40 of 152 (26.3%) orthopedic residency program directors, 70 of 426 (16.4%) sports medicine faculty, and 235 of 3,170 (7.4%) orthopedic residents. The use of adjunctive methods of training varied from only 9.8% of programs with virtual reality training to 80.5% of programs that used reading of published materials to develop arthroscopic skill. Practice on cadaveric specimens was viewed as the most effective and preferred adjunctive method of training. Residents trained on cadaveric specimens reported increased confidence in their ability to perform arthroscopic procedures. The resources for developing arthroscopic surgical skill vary considerably across orthopedic residency programs in the United States. Adjunctive training methods were perceived to be effective at supplementing traditional training in the operating room. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Business Management & Ownership.

ERIC Educational Resources Information Center

Lyon, Barbara Jean

Designed for use with secondary and postsecondary students who have completed one year of distributive education/marketing general instruction, this curriculum guide provides a competency-based core of instruction for training supervisory managers in a one-year, cooperative program. Seven sections and 22 instructional units are included. Each unit…

Getting Our Partners Airborne: Training Air Advisors and Their Impact In-Theater

DTIC Science & Technology

2014-06-01

perform, over time, their roles and responsi- bilities independent of US assistance. This approach is now mature in Iraq, and if the United States...Afghan airframes has begun to bear fruit . Three AAF classes have completed their pilot training in Afghanistan and, on 23 June 2013, the fourth class...launched the KA-350 program and, after it matured , transitioned operations and maintenance to full control of the IqAF. May–June 2014 Air & Space

Taking the Bite Out of Dental Readiness: Assessing Readiness in the National Guard and the Reserves

DTIC Science & Technology

2009-04-01

around the world.2 High medical readiness of our forces helps prevent unexpected medical or dental emergencies during training and operational deployments...share of untimely dental emergencies both during training and actual deployments. Seven percent of medical evacuations from US Navy ships and submarines...General for Dental Services, units are required to be ready to deploy. If a reserve airman fails to have the required DFC 3 treatment completed , it

Stigma associated with autism among college students in Japan and the United States: An online training study.

PubMed

Someki, Fumio; Torii, Miyuki; Brooks, Patricia J; Koeda, Tatsuya; Gillespie-Lynch, Kristen

2018-05-01

Misconceptions and stigma associated with autism vary across cultures and may be influenced by various factors. Undergraduates in Japan (N = 212) and the United States (US) (N = 365) completed an online autism training, with pre- and posttest surveys assessing autism-related stigma (i.e., social distance) and knowledge. Aims were to examine differences in autism stigma and knowledge in Japan and the US, while extending prior research demonstrating benefits of an online autism training in the US and Lebanon to Japan. The results revealed that Japanese students indicated greater autism-related stigma than US students, which was not attributable to differences in autism knowledge, prior experience with autism, or college major. In both countries, students majoring in "helping professions" exhibited greater willingness to engage with people with autism. Japanese and US students varied in their misconceptions about autism, with significant differences on about half of the knowledge items. Japanese students showed decreased stigma after completing the autism training, yet continued to exhibit greater social distance towards people with autism relative to US students. Future research should focus on identifying specific cultural factors (e.g., conformity to social norms and homogeneity within communities) that contribute to fear and exclusion of people with autism in different societies. Copyright © 2018 Elsevier Ltd. All rights reserved.

No improvement in race performance by naps in male ultra-endurance cyclists in a 600-km ultra-cycling race.

PubMed

Knechtle, Beat; Wirth, Andrea; Knechtle, Patrizia; Rüst, Christoph Alexander; Rosemann, Thomas; Lepers, Romuald

2012-04-30

Ultra-endurance performance is of increasing popularity. We investigated the associations between anthropometry, training and support during racing, with race performance in 67 male recreational ultra-endurance cyclists participating in the 'Swiss Cycling Marathon' over 600 kilometres, an official qualifier for the cycling ultra-marathon 'Paris-Brest-Paris'. The 54 finishers showed no differences in anthropometry and did not train differently compared to the 13 non-finishers. During the race, the finishers were significantly more frequently racing alone than being followed by a support crew. After bivariate analysis, percent body fat (r = 0.43), the cycling distance per training unit (r = -0.36), the duration per training unit (r = -0.31) and the sleep time during the race (r = 0.50) were related to overall race time. The 23 non-sleepers in the finisher group completed the race within (mean and IQR) 1,567 (1,453-1,606) min, highly significantly faster than the 31 sleepers with 1,934 (1,615-2,033) min (P = 0.0003). No variable of support during the race was associated with race time. After multivariate analysis, percent body fat (P = 0.026) and duration per training unit (P = 0.005) remained predictor variables for race time. To summarize, for a successful finish in a cycling ultra-marathon over 600 kilometres such as the 'Swiss Cycling Marathon', percent body fat and duration per training unit were related to race time whereas equipment and support during the race showed no association. Athletes with naps were highly significantly slower than athletes without naps.

Ethics and professionalism education during neonatal-perinatal fellowship training in the United States.

PubMed

Cummings, C L; Geis, G M; Kesselheim, J C; Sayeed, S

2015-10-01

The objectives of this study were to determine the perceived adequacy of ethics and professionalism education for neonatal-perinatal fellows in the United States, and to measure confidence of fellows and recent graduates when navigating ethical issues. Neonatal-Perinatal Fellowship Directors, fellows and recent graduates were surveyed regarding the quality and type of such education during training, and perceived confidence of fellows/graduates in confronting ethical dilemmas. Forty-six of 97 Directors (47%) and 82 of 444 fellows/graduates (18%) completed the surveys. Over 97% of respondents agreed that ethics training is 'important/very important'. Only 63% of Directors and 37% of fellows/graduates rated ethics education as 'excellent/very good' (P=0.004). While 96% of Directors reported teaching of ethics, only 70% of fellows/graduates reported such teaching (P<0.001). Teaching methods and their perceived effectiveness varied widely. Training in ethics and professionalism for fellows is important, yet currently insufficient; a more standardized curriculum may be beneficial to ensure that trainees achieve competency.

Neurocritical Care Education During Residency: Opinions (NEURON) Study.

PubMed

Lerner, David P; Kim, Jennifer; Izzy, Saef

2017-02-01

The American Academy of Neurology (AAN) has established a core curriculum of topics for residency training in neurocritical care. At present there is limited data evaluating neurology residency education within the neurological intensive care unit. This study evaluates learner concerns with the neurological intensive care unit. The Communication Committee and Resident & Fellow Taskforce within the Neurocritical Care Society (NCS) developed an online survey that consisted of 20 selection and free-text based questions. The survey was distributed to NCS members and then to neurology residency program directors. Statistical analysis of neurocritical care exposure were completed with t or Fisher exact test with p-value <0.05 considered significant. A total of 95 individuals from 32 different residency programs (36.5 % response rate) responded to the questionnaire. Most individuals train with neurocritical care attendings, fellows and advanced practitioners and have neurocritical care exposure during multiple years of residency training. 54 % of responders cite improvement in education as a means to improve neurocritical care training. Those that raised concern had no difference in time in the neurocritical care unit (9.4 weeks vs 8.8 weeks), exposure to trained neurointensivists, neurocritical care fellows or advanced providers (p value 0.53, 0.19, 0.83, respectively). There is significant learner concern regarding education within the neurointensive care unit. Although there are educational guidelines and focused neurocritical care educational materials, these alone do not satisfy residents' educational needs. This study demonstrates the need for educational changes, but it does not assess best strategies nor curricular content.

Building Capacity: Creating Curriculum Pathways

ERIC Educational Resources Information Center

Richie, D.

2016-01-01

The nation has made an unprecedented investment in community colleges to simultaneously increase college completion and stimulate economic recovery. One of the most substantial investments was the Trade Adjustment Act Community College and Career Training (TAACCCT) program of the United States Department of Labor (U.S. DOL). Beginning October…

24 CFR 585.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... who has dropped out of high school,” “institution of higher education,” “limited-English proficiency... (including States, units of general local government, and Indian Tribes) eligible to provide education and... who have completed the full-time education/on-site training components of a Youthbuild program and who...

24 CFR 585.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... who has dropped out of high school,” “institution of higher education,” “limited-English proficiency... (including States, units of general local government, and Indian Tribes) eligible to provide education and... who have completed the full-time education/on-site training components of a Youthbuild program and who...

Enhanced Healing of Segmental Bone Defects by Modulation of the Mechanical Environment

DTIC Science & Technology

2013-10-01

Employment opportunities received based upon experience/ training supported by this award Partly based upon her research during the completion of...School, Coventry CV4 7AL, United Kingdom References 1. Stevenson S. Enhancement of fracture healing with autogenous and allogeneic bone grafts. Clin

Provision of training in chronic pain management for specialist registrars in the United Kingdom.

PubMed

Huggins, L J; Ward, S P; Stannard, C F

1999-08-01

A study published in 1992 highlighted wide variations in the provision of training in pain management. In this survey, data were collected from both pain clinicians and Programme Directors of the Schools of Anaesthesia to see if there had been any changes in training patterns since the introduction of the Calman training scheme. There did not seem to be a uniform improvement in the provision of training in pain management for Specialist Registrars and many may reach their Certificate of Completion of Specialist Training without a basic knowledge of chronic pain. It is thought that at the present time there will be few Specialist Registrars with sufficient training to take up consultant posts in pain management unless they compete for the much sought after, and often not fully funded, pain fellowships outside their rotations.

Initial Localization of the Memory Trace for a Basic Form of Learning

NASA Astrophysics Data System (ADS)

McCormick, David A.; Clark, Gregory A.; Lavond, David G.; Thompson, Richard F.

1982-04-01

Electrophysiological recording of neuronal unit activity during paired training trials from various regions of the ipsilateral cerebellum in rabbits well trained in the classically conditioned eyelid/nictitating membrane response have revealed both stimulus-evoked responses and responses that form an amplitude/temporal model of the learned behavioral response. Ablation of the ipsilateral, lateral cerebellum completely and permanently abolished the behavioral conditioned response in well-trained animals but had no effect at all on the unconditioned reflex response. In marked contrast, conditioned responses were easily trained in the eye contralateral to the cerebellar lesion. We suggest that at least part of the essential neuronal plasticity that codes the learned response may be localized to the cerebellum.

Training oncoplastic breast surgeons: the Canadian fellowship experience

PubMed Central

Maxwell, J.; Arnaout, A.; Hanrahan, R.; Brackstone, M.

2017-01-01

Background Oncoplastic breast surgery combines traditional oncologic breast conservation with plastic surgery techniques to achieve improved aesthetic and quality-of-life outcomes without sacrificing oncologic safety. Clinical uptake and training remain limited in the Canadian surgical system. In the present article, we detail the current state of oncoplastic surgery (ops) training in Canada, the United States, and worldwide, as well as the experience of a Canadian clinical fellow in ops. Methods The clinical fellow undertook a 9-month audit of breast surgical cases. All cases performed during the fellow’s ops fellowship were included. The fellowship ran from October 2015 to June 2016. Results During the 9 months of the fellowship, 67 mastectomies were completed (30 simple, 17 modified radical, 12 skin-sparing, and 8 nipple-sparing). The fellow participated in 13 breast reconstructions. Of 126 lumpectomies completed, 79 incorporated oncoplastic techniques. Conclusions The experience of the most recent ops clinical fellow suggests that Canadian ops training is feasible and achievable. Commentary on the current state of Canadian ops training suggests areas for improvement. Oncoplastic surgery is an important skill for breast surgical oncologists, and access to training should be improved for Canadian surgeons. PMID:29089810

40 CFR 60.2655 - How do I renew my lapsed operator qualification?

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Operator Training...) For a lapse of less than 3 years, you must complete a standard annual refresher course described in...

40 CFR 60.2655 - How do I renew my lapsed operator qualification?

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and Compliance Times for Commercial and Industrial Solid Waste Incineration Units Model Rule-Operator Training...) For a lapse of less than 3 years, you must complete a standard annual refresher course described in...

International Teachers' Judgment of Gifted Mathematics Student Characteristics

ERIC Educational Resources Information Center

Ficici, Abdullah; Siegle, Del

2008-01-01

Teachers play a key role in the identification and training of talented mathematicians, and their attitudes are important in improving math instruction for gifted students. We surveyed secondary mathematics teachers from South Korea, Turkey, and the United States. These teachers completed a survey instrument called the Teachers' Judgments of…

Building Capacity: Expanding Student Support Services

ERIC Educational Resources Information Center

Kirby, C. L.

2016-01-01

The nation has made an unprecedented investment in community colleges to simultaneously increase college completion and stimulate economic recovery. One of the most substantial investments was the Trade Adjustment Act Community College and Career Training (TAACCCT) program of the United States Department of Labor (U.S.DOL). Beginning October 2011,…

Building Capacity: Creating and Leveraging Partnerships

ERIC Educational Resources Information Center

Richie, D.

2016-01-01

The nation has made an unprecedented investment in community colleges to simultaneously increase college completion and stimulate economic recovery. One of the most substantial investments was the Trade Adjustment Act Community College and Career Training (TAACCCT) program of the United States Department of Labor (U.S.DOL). Beginning October 2011,…

Community College Student Motivation and Persistence to Goals

ERIC Educational Resources Information Center

Savi, Kai Alina

2011-01-01

Community colleges in the United States serve a vital educational role in job training, preparation for transfer to a four-year institution, granting academic degrees and certificates as well as offering opportunities for personal growth and development. Persistence has traditionally been measured by degree completion or by transfer rates.…

Predicting Burnout and Career Choice Satisfaction in Counseling Psychology Graduate Students

ERIC Educational Resources Information Center

Clark, Heddy Kovach; Murdock, Nancy L.; Koetting, Kristin

2009-01-01

Counseling psychology doctoral students (N = 284) from 53 training programs throughout the United States anonymously completed online measures of burnout, career choice satisfaction, global stress, role conflict, social support (from family/friends, advisors, other students) and psychological sense of community (SOC) in the doctoral program. Two…

Application of Neural Networks to Predict UH-60L Electrical Generator Condition using (IMD-HUMS) Data

DTIC Science & Technology

2006-12-01

Data transfer unit ( DTU ) • Remote data concentrator (RDC) • Main processor unit (MPU) • 2 junction boxes (JB1/JB2) • 20 drive train and...NETWORKS TO PREDICT UH-60L ELECTRICAL GENERATOR CONDITION USING (IMD-HUMS) DATA by Evangelos Tourvalis December 2006 Thesis Advisor...including the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the

Research Plan of the Department of Systems Engineering and the Operations Research Center for Academic Year 2007

DTIC Science & Technology

2006-10-01

high probability for success. Estimated Time to Complete: 31 May 2007. 4. Support and Upgrade of Armed Forces-CARES to integrate Chaplin ...Excellence (ORCEN) is to provide a small, full- time analytical capability to both the Academy and the United States Army and the Department of...complete significant research projects in this time as they usually require little train-up as they are exposed to many military and academic

Staff confidence in dealing with aggressive patients: a benchmarking exercise.

PubMed

McGowan, S; Wynaden, D; Harding, N; Yassine, A; Parker, J

1999-09-01

Interacting with potentially aggressive patients is a common occurrence for nurses working in psychiatric intensive care units. Although the literature highlights the need to educate staff in the prevention and management of aggression, often little, or no, training is provided by employers. This article describes a benchmarking exercise conducted in psychiatric intensive care units at two Western Australian hospitals to assess staff confidence in coping with patient aggression. Results demonstrated that staff in the hospital where regular training was undertaken were significantly more confident in dealing with aggression. Following the completion of a safe physical restraint module at the other hospital staff reported a significant increase in their level of confidence that either matched or bettered the results of their benchmark colleagues.

Postdeployment military mental health training: cross-national evaluations.

PubMed

Foran, Heather M; Garber, Bryan G; Zamorski, Mark A; Wray, Mariane; Mulligan, Kathleen; Greenberg, Neil; Castro, Carl Andrew; Adler, Amy B

2013-05-01

Deployments increase risk for adjustment problems in service members. To mitigate this increased risk, mental health training programs have been developed and implemented in several nations. As part of a coordinated effort, three nations adapted a U.S. mental health training program that had been validated by a series of group randomized trials demonstrating improvement in postdeployment adjustment. Implementation of evidence-based programs in a new context is challenging: How much of the original program needs to remain intact in order to retain its utility? User satisfaction rates can provide essential data to assess how well a program is accepted. This article summarizes service member ratings of postdeployment mental health training and compares ratings from service members across four nations. The participating nations (Canada, New Zealand, United Kingdom, and the United States) administered mental health training to active duty military personnel in their respective nations. Following the training, military personnel completed an evaluation of the training. Overall, across the four nations, more than 70% of military personnel agreed or strongly agreed that they were satisfied with the mental health training. Although some differences in evaluations were observed across nations, components of training that were most important to overall satisfaction with the training were strikingly similar across nations. Fundamentally, it appears feasible that despite cultural and organizational differences, a mental health training program developed in one nation can be successfully adapted for use in other nations. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Intensive communication skills teaching for specialist training in palliative medicine: development and evaluation of an experiential workshop.

PubMed

Clayton, Josephine M; Adler, Jonathan L; O'Callaghan, Anne; Martin, Peter; Hynson, Jenny; Butow, Phyllis N; Laidsaar-Powell, Rebekah C; Arnold, Robert M; Tulsky, James A; Back, Anthony L

2012-05-01

The Australasian Chapter of the Palliative Medicine (AChPM) Curriculum Development Group identified communication as a core skill that trainees in palliative medicine need to acquire, and proposed the development of a communication skills workshop that should become a compulsory part of training to achieve accreditation as a palliative medicine specialist in Australia and New Zealand. This paper describes the development and subsequent evaluation of this module. A three-day communication workshop was developed in collaboration with expert communication skills facilitators from the United States and Australia. The teaching consists of: (1) brief plenary presentations providing an evidence-based framework for communication and a demonstration of suggested strategies; (2) small group experiential learning providing opportunities to practice communication skills with clinically relevant simulated patients, self-appraisal, constructive feedback, and reflective exercises; and (3) accompanying course-specific written material. Participants completed de-identified questionnaires before, after, and three months following completion of the workshop. Forty-one participants completed the training in two workshops held in 2008 and 2009. Participants said in their questionnaire responses that the training was useful, would be helpful for their communication with patients, and that they would recommend the training to others. Qualitative feedback was highly positive. Self-assessed confidence in communication skills significantly increased following the workshop (p<.001) and was sustained at three months (p<.001). The training is highly valued by participants and increases confidence in communication skills. Facilitator training and capacity planning will be critical for the ongoing success of the communication workshop.

Low cost, high yield: simulation of obstetric emergencies for family medicine training.

PubMed

Magee, Susanna R; Shields, Robin; Nothnagle, Melissa

2013-01-01

Simulation is now the educational standard for emergency training in residency and is particularly useful on a labor and delivery unit, which is often a stressful environment for learners given the frequency of emergencies. However, simulation can be costly. This study aimed to assess the feasibility and effectiveness of low-cost simulated obstetrical emergencies in training family medicine residents. The study took place in a community hospital in an urban underserved setting in the northeast United States. Low-cost simulations were developed for postpartum hemorrhage (PPH) and preeclampsia/eclampsia (PEC). Twenty residents were randomly assigned to the intervention (simulated PPH or PEC followed by debriefing) or control (lecture on PPH or PEC) group, and equal numbers of residents were assigned to each scenario. All participants completed a written test at baseline and an oral exam 6 months later on the respective scenario to which they were assigned. The participants provided written feedback on their respective teaching interventions. We compared performance on pretests and posttests by group using Wilcoxon Rank Sum. Twenty residents completed the study. Both groups performed similarly on baseline tests for both scenarios. Compared to controls, intervention residents scored significantly higher on the examination on the management of PPH but not for PEC. All intervention group participants reported that the simulation training was "extremely useful," and most found it "enjoyable." We demonstrated the feasibility and acceptability of two low-cost obstetric emergency simulations and found that they may result in persistent increases in trainee knowledge.

Medical student sexuality: how sexual experience and sexuality training impact U.S. and Canadian medical students' comfort in dealing with patients' sexuality in clinical practice.

PubMed

Shindel, Alan W; Ando, Kathryn A; Nelson, Christian J; Breyer, Benjamin N; Lue, Tom F; Smith, James F

2010-08-01

To determine factors associated with students' comfort in addressing patients' sexuality in the clinical context. The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses. The authors' analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as "other" gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients' sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues. Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students' difficulty in addressing patients' sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients' sexuality and should be a priority for medical education.

Influence of Military Training and Standardized Nutrition in Military Unit on Soldiers' Nutritional Status and Physical Fitness.

PubMed

Tomczak, Andrzej; Bertrandt, Jerzy; Kłos, Anna; Kłos, Krzysztof

2016-10-01

Tomczak, A, Bertrandt, J, Kłos, A, and Kłos, K. Influence of military training and standardized nutrition in military unit on soldiers' nutritional status and physical fitness. J Strength Cond Res 30(10): 2774-2780, 2016-Despite suspension of conscription in Polish Army, trainings of soldiers are still carried out. It is expected that they will be effective and will contribute to obtaining optimum level of psychophysical efficiency that enables fulfillment of military tasks. Total of 60 soldiers took part in the study. During the 9-month military service, soldiers had 200 hours of physical training and basic military training (shooting, drill, anti-chemical training, topography, general tactics, and military equipment operation). The training lasted 8 hours everyday. To assess fitness level, 4 trials were done: long jump, pull-ups, sit-ups, and 1,000 m run. Evaluation of food was based on the analysis of full board menus using the "Tables of composition and nutritional value of food products." Energy value was assessed, and content of basic nutrients was calculated. Assessment of nutritional status was based on anthropometric measurements, such as body height, body mass, and thickness of 4 selected skinfolds. Body height and body mass were the basis for the body mass index calculation. Soldiers serving in the mechanized infantry unit, after completing the training, got better results only in 1,000 m run (from 250.3 to 233.61 seconds). During the research, an average energy value of a daily food ration planned for consumption was 4,504 kcal. This value consisted of 13.2% of energy from protein, 31.9% of energy from fat, and 54.9% from carbohydrates. In the course of military service, percentage of subjects indicating overweight increased from 10.2 to 25.4%.

Physician training in critical care in the United States: Update 2018.

PubMed

Napolitano, Lena M; Rajajee, Venkatakrishna; Gunnerson, Kyle J; Maile, Michael D; Quasney, Michael; Hyzy, Robert C

2018-06-01

Critical care fellowship training in the United States differs based on specific specialty and includes medicine, surgery, anesthesiology, pediatrics, emergency medicine, and neurocritical care training pathways. We provide an update regarding the number and growth of US critical care fellowship training programs, on-duty residents and certified diplomates, and review the different critical care physician training pathways available to residents interested in pursuing a fellowship in critical care. Data were obtained from the Accreditation Council for Graduate Medical Education and specialty boards (American Board of Internal Medicine, American Board of Surgery, American Board of Anesthesiology, American Board of Pediatrics American Board of Emergency Medicine) and the United Council for Neurologic Subspecialties for the last 16 years (2001-2017). The number of critical care fellowship training programs has increased 22.6%, with a 49.4% increase in the number of on-duty residents annually, over the last 16 years. This is in contrast to the period of 1995 to 2000 when the number of physicians enrolled in critical care fellowship programs had decreased or remained unchanged. Although more than 80% of intensivists in the US train in internal medicine critical care Accreditation Council for Graduate Medical Education-approved fellowships, there has been a significant increase in the number of residents from surgery, anesthesiology, pediatrics, emergency medicine, and other specialties who complete specialty fellowship training and certification in critical care. Matriculation in neurocritical care fellowships is rapidly rising with 60 programs and over 1,200 neurocritical care diplomates. Critical care is now an increasingly popular fellowship in all specialties. This rapid growth of all critical care specialties highlights the magnitude of the heterogeneity that will exist between intensivists in the future.

Minding the Gaps in Cancer Pain Management Education: A Multicenter Study of Clinical Residents and Fellows in a Low- Versus High-Resource Setting.

PubMed

Odonkor, Charles Amoatey; Osei-Bonsu, Ernest; Tetteh, Oswald; Haig, Andy; Mayer, Robert Samuel; Smith, Thomas J

2016-12-01

Inadequate pain management training has been reported as a major cause of undertreatment of cancer pain. Yet, past research has not comprehensively compared the quality of cancer pain management education among physicians in training in high-resource countries (HRCs) with those in low-resource countries (LRCs). The purpose of this study was to examine and compare gaps in cancer pain management education among physician trainees in an HRC (United States) versus an LRC (Ghana). A cross section of physicians at four major academic medical centers completed surveys about the adequacy of cancer pain training. Participation in the study was completely voluntary, and paper or online surveys were completed anonymously. The response rate was 60% (N = 120). Major gaps were identified in cancer pain management education across the spectrum of medical school training. Training was rated as inadequate (by approximately 80% of trainees), although approximately 10% more trainees in HRCs versus LRCs felt this way; 35% said residency training was inadequate in both settings; and 50% in LRCs versus 44% in HRCs said fellowship training was less than good. On the basis of the lowest group means, the three key areas of perceived deficits included interventional pain procedures (2.34 ± 1.12), palliative care interventions (2.39 ± 1.12), and managing procedural and postoperative pain (2.94 ± 0.97), with significant differences in the distribution of deficits in 15 cancer-pain competencies between LRCs and HRCs ( P < .05). This study identifies priority areas that could be targeted synergistically by LRCs and HRCs to advance cancer care globally. The findings underscore differential opportunities to broaden and improve competencies in cancer pain management via exchange training, in which physicians from HRCs spend time in LRCs and vice versa.

Analytic institutes: A guide to training in the United States

NASA Astrophysics Data System (ADS)

Blanken, Terry G.

This investigation was inspired by the researcher's desire to pursue psychoanalytic training subsequent to completion of her PhD in clinical psychology and the discovery that no comprehensive resource existed to assist prospective psychoanalytic candidates with identifying or evaluating psychoanalytic training opportunities. This dissertation therefore aspires to provide a comprehensive guide to analytic training in the United States today. The researcher presents the expanding horizons of depth-oriented training leading to certification as an analyst, including training based on those schools of thought that resulted from early splits with Freud (Adlerian and Jungian) as well as training based on thought that has remained within the Freudian theoretical umbrella (e.g., classical, object relations, self psychology, etc.). Employing a heuristic approach and using hermeneutics and systems theory methodologies, the study situates analytic training in its historical context, explores contemporary issues, and considers its future. The study reviews the various analytic schools of thought and traces the history of psychoanalytic theory from its origins with Freud through its many permutations. It then discusses the history of psychoanalytic training and describes political, social, and economic factors influencing the development of training in this country. The centerpiece of the dissertation is a guidebook offering detailed information on each of 107 training institutes in the United States. Tables provide contact data and information which differentiate the institutes in terms of such parameters as size; length of program, theoretical orientation, and accreditation. A narrative of each institute summarizes the unique aspects of the program, including its admissions policy, the requirements for the training analysis and supervised clinical work, and the didactic curriculum, along with lists of courses offered. Child and adolescent psychoanalytic training is also discussed for institutes offering this option. A discussion of the contemporary world of analytic training emerges from the results of the analysis of individual institutes. Both the variations and convergences among institutes are explored. Current problems and issues in training, accreditation, and licensing are addressed. Finally, the future of psychoanalytic training is considered; concluding with an assessment of needed reforms and presentation of a model for the ideal analytic training institute of the future.

Barriers to the implementation and uptake of simulation-based training programs in general surgery: a multinational qualitative study.

PubMed

Hosny, Shady G; Johnston, Maximilian J; Pucher, Philip H; Erridge, Simon; Darzi, Ara

2017-12-01

Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis. All data were anonymized and results pooled. A total of 37 individuals participated in the study. Seventeen experts (Program Directors and Surgical Attendings with an interest in surgical education) and 20 residents drawn from the United States, Canada, United Kingdom, France, and Japan were interviewed. Barriers to simulation-based training were identified based on key themes including financial cost, access, and translational benefit. Participants described cost (89%) and access (76%) as principal barriers to uptake. Common facilitators included a mandatory requirement to complete simulation training (78%) and on-going assessment of skills (78%). Participants felt that simulation training could improve patient outcomes (76%) but identified a lack of evidence to demonstrate benefit (38%). There was a consensus that simulation training has not been widely implemented (70%). There are multiple barriers to the implementation of surgical simulation training programs, however, there is agreement that these programs could potentially improve patient outcomes. Identifying these barriers enable the targeted use of facilitators to deliver simulation training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

Implications for Educational Leaders as They Consider Technology Development

ERIC Educational Resources Information Center

Sorensen, Bret J.; Shepherd, Craig E.; Range, Bret G.

2013-01-01

This study examined the make-up and training of school technology assistants who directly help teachers to integrate technology in K-12 classrooms. Fifty-six respondents from one school district in the western United States completed a questionnaire about technology assistance they provide, whether they provide this assistance on a full or part…

Perceived Stress, Wellness, and Mattering: A Profile of First-Year Citadel Cadets

ERIC Educational Resources Information Center

Gibson, Donna M.; Myers, Jane E.

2006-01-01

Cadets (N = 234) at The Citadel (a military college for males and females in the Southeast United States) completed measures of wellness, perceived stress, and mattering during their first semester of training. Overall, wellness scores were negatively skewed. Although there were no differences in perceived stress or mattering between The Citadel…

Stackable Credentials and Career/college Pathways in Culinary Arts at Kingsborough Community College, CUNY

ERIC Educational Resources Information Center

Audant, Anne Babette

2016-01-01

Discussions of workforce development emphasize stackable training, and assume linear advancement and alignment, through college and career paths. Stackable credentials have become a best practice for community colleges across the United States as they struggle to advance the college completion agenda and ensure that students graduate with the…

Suicide and Drug Abuse in the Medical Community

ERIC Educational Resources Information Center

Bressler, Bernard

1976-01-01

In the United States each year the equivalent of an average-size medical school graduating class commits suicide, with the highest incidence occurring in the decade following the completion of training. Of these suicides, 20 percent to 30 percent are associated with drug abuse and 40 percent with alcoholism. Various problem areas are considered.…

Integration of international medical graduates in u.s. Psychiatry: the role of acculturation and social support.

PubMed

Atri, Ashutosh; Matorin, Anu; Ruiz, Pedro

2011-01-01

the authors investigated whether social support and acculturation could predict the mental health of international medical graduates pursuing psychiatric residencies in the United States. a 55-item online survey was assembled by combining three validated instruments for mental health, social support, and acculturation. A link to the survey was e-mailed to training directors of all psychiatric residency and fellowship programs. Directors were requested to forward the survey to their international medical graduate residents for completion between December 2008 and February 2009. one hundred eight international medical graduates from 70 different psychiatric residencies and fellowships completed the entire survey. Respondents' mental health scores were normally distributed. The vast majority scored very high on survey items related to mental health. Acculturation, social support, and postgraduate training year were significant predictors of mental health. residency training programs should attempt to incorporate measures that would help boost the social support and acculturation of international medical graduates (especially junior-level trainees). Acculturation could be improved by language training and courses in American history, culture, and customs, and social support could be expanded by mentoring relationships.

Rolling-refresher simulation improves performance and retention of paediatric intensive care unit nurse code cart management.

PubMed

Singleton, Marcy N; Allen, Kimberly F; Li, Zhongze; McNerney, Kevin; Naber, Urs H; Braga, Matthew S

2018-04-01

Paediatric Intensive Care Unit Nurses (PICU RNs) manage the code cart during paediatric emergencies at the Children's Hospital at Dartmouth-Hitchcock. These are low -frequency, high-stakes events. An uncontrolled intervention study with 6-month follow-up. A collaboration of physician and nursing experts developed a rolling-refresher training programme consisting of five simulated scenarios, including 22 code cart skills, to establish nursing code cart competency. The cohort of PICU RNs underwent a competency assessment in training 1. To achieve competence, the participating RN received immediate feedback and instruction and repeated each task until mastery during training 1. The competencies were repeated 6 months later, designated training 2. Thirty-two RNs participated in training 1. Sixteen RNs (50%) completed the second training. Our rolling-refresher training programme resulted in a 43% reduction in the odds of first attempt failures between training 1 and training 2 (p=0.01). Multivariate linear regression evaluating the difference in first attempt failure between training 1 and training 2 revealed that the following covariates were not significantly associated with this improvement: interval Paediatric Advanced Life Support training, interval use of the code cart or defibrillator (either real or simulated) and time between training sessions. Univariate analysis between the two trainings revealed a statistically significant reduction in first attempt failures for: preparing an epinephrine infusion (72% vs 41%, p=0.04) and providing bag-mask ventilation (28% vs 0%, p=0.02). Our rolling-refresher training programme demonstrated significant improvement in performance for low-frequency, high-risk skills required to manage a paediatric code cart with retention after initial training.

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

PubMed

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

2013-10-01

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

Interview with Sanofi's Dr Tunde Falode.

PubMed

Falode, Tunde

2017-01-01

Dr Tunde Falode speaks to Elena Conroy, Commissioning Editor: Dr Tunde Falode is General Manager for the Diabetes and Cardiovascular Business Unit in the UK and Ireland at Sanofi, a global pharmaceutical company. Following graduation from the University of Jos Medical School in Nigeria, he secured a basic surgical training post through Guy's and St Thomas' hospitals in London, eventually specializing in cardiac and thoracic surgery, before changing his career path. In addition to his current role at Sanofi, he recently completed his specialist training in pharmaceutical medicine and has a keen interest in sports.

Survey of Kidney Biopsy Clinical Practice and Training in the United States.

PubMed

Yuan, Christina M; Nee, Robert; Little, Dustin J; Narayan, Rajeev; Childs, John M; Prince, Lisa K; Raghavan, Rajeev; Oliver, James D

2018-05-07

Practicing clinical nephrologists are performing fewer diagnostic kidney biopsies. Requiring biopsy procedural competence for graduating nephrology fellows is controversial. An anonymous, on-line survey of all Walter Reed training program graduates ( n =82; 1985-2017) and all United States nephrology program directors ( n =149; August to October of 2017), regarding kidney biopsy practice and training, was undertaken. Walter Reed graduates' response and completion rates were 71% and 98%, respectively. The majority felt adequately trained in native kidney biopsy (83%), transplant biopsy (82%), and tissue interpretation (78%), with no difference for ≤10 versus >10 practice years. Thirty-five percent continued to perform biopsies (13% did ≥10 native biopsies/year); 93% referred at least some biopsies. The most common barriers to performing biopsy were logistics (81%) and time (74%). Program director response and completion rates were 60% and 77%. Seventy-two percent cited ≥1 barrier to fellow competence. The most common barriers were logistics (45%), time (45%), and likelihood that biopsy would not be performed postgraduation (41%). Fifty-one percent indicated that fellows should not be required to demonstrate minimal procedural competence in biopsy, although 97% agreed that fellows should demonstrate competence in knowing/managing indications, contraindications, and complications. Program directors citing ≥1 barrier or whose fellows did <50 native biopsies/year in total were more likely to think that procedural competence should not be required versus those citing no barriers ( P =0.02), or whose fellows performed ≥50 biopsies ( P <0.01). Almost two-thirds of graduate respondents from a single military training program no longer perform biopsy, and 51% of responding nephrology program directors indicated that biopsy procedural competence should not be required. These findings should inform discussion of kidney biopsy curriculum requirements. Copyright © 2018 by the American Society of Nephrology.

Development and evaluation of targeted psychological skills training for oncology nurses in managing stressful patient and family encounters.

PubMed

Traeger, Lara; Park, Elyse R; Sporn, Nora; Repper-DeLisi, Jennifer; Convery, Mary Susan; Jacobo, Michelle; Pirl, William F

2013-07-01

To reduce workplace stress by developing a brief psychological skills training for nurses and to evaluate program feasibility, acceptability, and preliminary efficacy in decreasing burnout and stress. Intervention development and evaluation. Outpatient chemotherapy unit at a comprehensive cancer center. 26 infusion nurses and oncology social workers. Focus groups were conducted with nurses. Results informed the development and evaluation of training for nurses. Participants completed the Maslach Burnout Inventory and Perceived Stress Scale post-training. Burnout and stress. Focus groups indicated strong commitment among nurses to psychosocial care and supported the idea that relationships with patients and families were sources of reward and stress. Stressors included factors that interfered with psychosocial care such as difficult family dynamics, patient behaviors and end-of-life care issues. Psychological skills training was developed to address these stressors. Evaluations suggested that the program was feasible and acceptable to nurses. At two months, participants showed reductions in emotional exhaustion (p = 0.02) and stress (p = 0.04). Psychological skills training for managing difficult encounters showed feasibility, acceptability, and potential benefit in reducing emotional exhaustion and stress. Brief training that targets sources of clinical stress may be useful for nurses in outpatient chemotherapy units. Specific stressors in relationships with patients and families present challenges to nurses' therapeutic use of self. Targeted psychological skills training may help nurses problem-solve difficult encounters while taking care of themselves. System-level strategies are needed to support and promote training participation.

Training health and safety committees to use control banding: lessons learned and opportunities for the United States.

PubMed

Bracker, Anne L; Morse, Timothy F; Simcox, Nancy J

2009-05-01

Control banding (CB) is a control-focused risk management model that has received international attention. CB strategies are designed to control workplace chemical exposures after the completion of a qualitative risk assessment. Connecticut was one of the first states to provide training on how to use this control-focused tool. Joint labor/management teams and individuals from 34 workplaces attended a control banding workshop and learned how to use one CB model, the United Kingdom (UK) Health and Safety Executive's Control of Substances Hazardous to Health (COSHH) Essentials Toolkit. After the initial training program the investigators used follow-up workshops, questionnaires, site visit data, and case studies to evaluate the training curriculum and assess the utility and effectiveness of this CB strategy. We found that the model is easily learned, although several areas for improvement were identified. Participants from 10 workplaces used COSHH Essentials to evaluate at least one task. The training curriculum was effective in that the agreement between the exposure variables coded by these workplaces and one of the workshop instructors, a certified industrial hygienist (CIH), were highly concordant. The training curriculum and the model promoted a discussion of risk between workers and managers and resulted in the implementation of improvements in the work environment. The model agreed with both the CIH's and the worksites' qualitative risk assessments 65% of the time, and likely over-controlled for 71% (5/7) of the cases of nonagreement. Feedback from workshop participants benefits the current dialogue on the implications of implementing CB in the United States.

The Effect of Emotion Regulation Training on Occupational Stress of Critical Care Nurses

PubMed Central

Saedpanah, Darya; Moghaddam, Ladan Fattah

2016-01-01

Introduction Occupational stress is a common, serious and costly health problem in work environment. Nursing is a very stressful job high level of stress in this job affects nurses’ physical and mental health. Aim To investigate the effect of emotion regulation training of occupational stress on critical care nurses in two teaching hospitals in Sanandaj, Iran. Materials and Methods This interventional study was conducted on 60 nurses working in the Intensive Care Unit (ICU) and Critical Care Unit (CCU) in two teaching hospitals in Sanandaj, Iran. Data were collected using Expanded Nursing Stress Scale (ENSS) questionnaire. The questionnaire in both intervention and control groups before and after the training sessions of emotion regulation training were completed. Data were analysed using SPSS Version 20. Statistical indices such as frequency, percentage, mean and standard deviation and also t-test, Chi-square test and paired t-test were used. Results Mean occupation stress score in the intervention group before emotion regulation training was 136.6±24.6 and after training was 113.02±16.2 (p = 0.001). Occupational stress dimensions including; conflict with physicians, problems with peers, workload, uncertainty concerning treatment and problems related to patients and their families in the intervention group compared with the control group was statistically significant (p <0.05). Conclusion Emotion regulation training is effective in reducing occupation stress of critical care nurses. PMID:28208981

Shallow-Water Nitrox Diving, the NASA Experience

NASA Technical Reports Server (NTRS)

Fitzpatrick, Daniel T.

2009-01-01

NASA s Neutral Buoyancy Laboratory (NBL) contains a 6.2 million gallon, 12-meter deep pool where astronauts prepare for space missions involving space walks (extravehicular activity EVA). Training is conducted in a space suit (extravehicular mobility unit EMU) pressurized to 4.0 - 4.3 PSI for up to 6.5 hours while breathing a 46% NITROX mix. Since the facility opened in 1997, over 30,000 hours of suited training has been completed with no occurrence of decompression sickness (DCS) or oxygen toxicity. This study examines the last 5 years of astronaut suited training runs. All suited runs are computer monitored and data is recorded in the Environmental Control System (ECS) database. Astronaut training runs from 2004 - 2008 were reviewed and specific data including total run time, maximum depth and average depth were analyzed. One hundred twenty seven astronauts and cosmonauts completed 2,231 training runs totaling 12,880 exposure hours. Data was available for 96% of the runs. It was revealed that the suit configuration produces a maximum equivalent air depth of 7 meters, essentially eliminating the risk of DCS. Based on average run depth and time, approximately 17% of the training runs exceeded the NOAA oxygen maximum single exposure limits, with no resulting oxygen toxicity. The NBL suited training protocols are safe and time tested. Consideration should be given to reevaluate the NOAA oxygen exposure limits for PO2 levels at or below 1 ATA.

Beliefs regarding the Impact of Accent within Speech-Language Pathology Practice Areas

ERIC Educational Resources Information Center

Levy, Erika S.; Crowley, Catherine J.

2012-01-01

With the demographic shifts in the United States, it is increasingly the case that speech-language pathologists (SLPs) come from different language backgrounds from those of their clients and have nonnative accents in their languages of service. An anonymous web-based survey was completed by students and clinic directors in SLP training programs…

Fifty Years in Child and Adolescent Psychiatry

ERIC Educational Resources Information Center

Werry, John

2013-01-01

John Werry completed training in child and adolescent psychiatry at McGill University in Montreal, and has been a world renowned leader in children's mental health. Drawing on a half century of work in Canada, the United States, and his native New Zealand, he shares his reflections and vision for the future in the interview given for this…

Follower Attributional Biases and Assessments of Female and Male Leaders' Performance.

ERIC Educational Resources Information Center

Adams, Jerome; And Others

Attitudes toward the role of women in the army do not introduce a consistent and strong bias into the way male and female leaders are judged by their subordinates. Male and female cadets at the U.S. Military Academy completed questionnaires describing their unit leaders at two training activities. Results showed that egalitarian followers and…

Safety and Health for Industrial/Vocational Education; for Supervisors and Instructors.

ERIC Educational Resources Information Center

Firenze, Robert J.; Walters, James B.

This course is designed to enable industrial/vocational education supervisors and instructors to establish and administer effective safety and health programs in their schools. Although the course is intended as complete training to be given over a 3-day period, it may be divided into individual units for presentation over longer periods of time.…

Completing PhDs: The Perils and Enduring Promise of Deep Study

ERIC Educational Resources Information Center

Butler, Jon

2009-01-01

What is a PhD? People answer this question too often by succumbing to the bureaucratic lure. They describe formal processes, "outcomes", time to degree, funding, training in teaching--indeed, almost everything except central intellectual attraction and personal focus of the PhD enterprise: deep study. Certainly in United States PhD programs, the…

Medical Student Sexuality: How Sexual Experience and Sexuality Training Impact U.S. and Canadian Medical Students’ Comfort in Dealing with Patients’ Sexuality in Clinical Practice

PubMed Central

Shindel, Alan W.; Ando, Kathryn A.; Nelson, Christian J.; Breyer, Benjamin N.; Lue, Tom F.; Smith, James F.

2013-01-01

Purpose To determine factors associated with students’ comfort in addressing patients’ sexuality in the clinical context. Method The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses. Results The authors’ analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as “other” gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients’ sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues. Conclusions Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students’ difficulty in addressing patients’ sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients’ sexuality and should be a priority for medical education. PMID:20671459

An evaluation of the critical care assistant role within an acute NHS Trust Critical Care Unit.

PubMed

McGloin, Sarah; Knowles, Judie

2005-01-01

This study provides an evaluation of a training programme designed for developing six critical care assistants to work alongside registered nurses to care for patients within the critical care environment. The programme was run as a pilot funded from the Department of Health's 'critical care bid'. At 18 months long, the programme incorporated a foundation programme, and National Vocational Qualification (NVQ) level 3 in care and adapted Operating Department Practitioner (ODP) NVQ units. Six critical care assistants successfully completed the programme; however, they all then left the unit to undertake further study for pre-registration nursing qualifications. Upon evaluation, a number of key issues were identified. Clear definition of the critical care assistants's role is essential as are dedicated practice development staff, who focus purely on developing the critical care assistant role. More importantly, however, with such key changes in the staffing structure within critical care units, appropriate change management techniques should be employed, ensuring that all staff contributing to the training and development are fully involved from the start.

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

PubMed

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

2016-10-01

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

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

PubMed

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

2016-07-01

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

Professional profile of pediatric intensivists in Rio de Janeiro, southeastern Brazil.

PubMed

Lacerda, Jandra Corrêa de; Barbosa, Arnaldo Prata; Cunha, Antonio José Ledo Alves da

2011-12-01

This study described the sociodemographic profile and professional qualifications of pediatric intensive care physicians in the State of Rio de Janeiro (RJ), southeastern Brazil. This investigation was an observational, cross-sectional and descriptive study that was conducted in neonatal, pediatric and mixed intensive care units in the State of Rio de Janeiro. Physicians working in the participating intensive care units voluntarily completed a semistructured and anonymous questionnaire. Questionnaires that were not returned within 30 days were considered lost, and questionnaires with less than 75% questions completed were excluded. The differences in neonatal and pediatric intensive care physicians' medical training were compared using the Chi-squared test with a 5% significance level. A total of 410 physicians were included in this study: 84% female, 48% between 30 and 39 years old and 45% with monthly incomes between US $1,700 to 2,700. Forty percent of these physicians worked exclusively in this specialty, and 72% worked in more than one intensive care unit. Only 50% of the participants had received specific training (either medical residency or specialization) in neonatology, and only 33% were board-certified specialists in this area. Only 27% of the physicians had received specific training in pediatric intensive care medicine, and only 17% were board-certified specialists (p < 0.0005 for both comparisons). Most (87%) physicians had participated in scientific events within the past 5 years, and 55% used the internet for continued medical education. However, only 25% had participated in any research. Most (63%) physicians were dissatisfied with their professional activity; 49% were dissatisfied due to working conditions, 23% due to low incomes and 18% due to training-related issues. These results suggested that the medical qualifications of neonatal and pediatric intensive care physicians in the State of Rio de Janeiro, Brazil are inadequate, especially in pediatric intensive care medicine. A high level of dissatisfaction was reported, which may jeopardize the quality of medical assistance that is provided by these professionals.

Training on Kielland's forceps: A survey of trainees' opinions.

PubMed

Al Wattar, B H; Mahmud, A; Janjua, A; Parry-Smith, W; Ismail, K M

2017-04-01

We conducted a cross-sectional survey including specialist trainees in obstetrics and gynaecology in the Health Education West Midlands region, UK, to capture their views and assess training opportunities on the use of Kielland's forceps. Half of the trainees in the region completed the survey (87/172, 50%). Only 31% of our trainees worked in units that supported the training on these forceps (27/87, 31%). The majority reported that they did not get enough exposure to using Kielland's forceps (53/87, 60.9%). Only a minority (5.7%, 5/87) felt confident to perform a Kielland's rotational delivery independently. The majority (64.3%, 56/87) were keen to continue using Kielland's forceps in the future if competent. More than two-thirds (86.2%, 75/87) felt that simulation could aid their training. There was large enthusiasm for training on the safe use of Kielland's forceps among trainees in obstetrics and gynaecology in the West Midlands region. A national assessment of training resources is needed to better plan training recourses on this complex skill.

Internal medicine in the United States and Germany: mutual influences from 1870 to today.

PubMed

Schulte-Bockolt, Arnd; Soergel, Konrad H; Stein, Juergen

2016-11-01

Over the past 140 years, the close academic and clinical interactions in Internal Medicine between German-speaking countries and the United States have been through three distinct stages. From 1870 until the First World War, German medical research, teaching, and university organization served as a model for U.S. medical schools and practice. However, after World War I, medical education reforms were implemented in the U.S., and due also to radical economic and political changes at home, German medicine lost its pioneering role. Furthermore, many scientists and clinicians were forced to emigrate in the face of racial and political persecution in Germany and Austria. Since the Second World War, American medicine has grown further to become the world leader in research, training, and clinical practice. The earlier trend of American physicians studying abroad was thus reversed, with many of today's foremost German physicians completing clinical and research training in the United States.

Cardiopulmonary Resuscitation Training Disparities in the United States.

PubMed

Blewer, Audrey L; Ibrahim, Said A; Leary, Marion; Dutwin, David; McNally, Bryan; Anderson, Monique L; Morrison, Laurie J; Aufderheide, Tom P; Daya, Mohamud; Idris, Ahamed H; Callaway, Clifton W; Kudenchuk, Peter J; Vilke, Gary M; Abella, Benjamin S

2017-05-17

Bystander cardiopulmonary resuscitation (CPR) is associated with increased survival from cardiac arrest, yet bystander CPR rates are low in many communities. The overall prevalence of CPR training in the United States and associated individual-level disparities are unknown. We sought to measure the national prevalence of CPR training and hypothesized that older age and lower socioeconomic status would be independently associated with a lower likelihood of CPR training. We administered a cross-sectional telephone survey to a nationally representative adult sample. We assessed the demographics of individuals trained in CPR within 2 years (currently trained) and those who had been trained in CPR at some point in time (ever trained). The association of CPR training and demographic variables were tested using survey weighted logistic regression. Between September 2015 and November 2015, 9022 individuals completed the survey; 18% reported being currently trained in CPR, and 65% reported training at some point previously. For each year of increased age, the likelihood of being currently CPR trained or ever trained decreased (currently trained: odds ratio, 0.98; 95% CI, 0.97-0.99; P <0.01; ever trained: OR, 0.99; 95% CI, 0.98-0.99; P =0.04). Furthermore, there was a greater then 4-fold difference in odds of being currently CPR trained from the 30-39 to 70-79 year old age groups (95% CI, 0.10-0.23). Factors associated with a lower likelihood of CPR training were lesser educational attainment and lower household income ( P <0.01 for each of these variables). A minority of respondents reported current training in CPR. Older age, lesser education, and lower income were associated with reduced likelihood of CPR training. These findings illustrate important gaps in US CPR education and suggest the need to develop tailored CPR training efforts to address this variability. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Early Mentoring of Medical Students and Junior Doctors on a Path to Academic Cardiothoracic Surgery.

PubMed

Fricke, Tyson A; Lee, Melissa G Y; Brink, Johann; d'Udekem, Yves; Brizard, Christian P; Konstantinov, Igor E

2018-01-01

In 2005 the Department of Cardiothoracic Surgery at The Royal Children's Hospital started an early academic mentoring program for medical students and junior doctors with the aim of fostering an interest in academic surgery. Between 2005 and 2015, 37 medical students and junior doctors participated in research in the Department of Cardiothoracic Surgery at The Royal Children's Hospital. Each was given an initial project on which to obtain ethics approval, perform a literature review, data collection, statistical analysis, and prepare a manuscript for publication. A search of the names of these former students and doctors was conducted on PubMed to identify publications. A total of 113 journal articles were published in peer-reviewed journals with an average impact factor of 4.1 (range, 1.1 to 19.9). Thirty (30 of 37, 81%) published at least one article. A mean of 4.3 journal articles was published per student or junior doctor (range, 0 to 29). Eleven (11 of 37, 30%) received scholarships for their research. Nine (9 of 37, 24%) have completed or are enrolled in higher research degrees with a cardiothoracic surgery focus. Of these 9, 2 have completed doctoral degrees while in cardiothoracic surgery training. Five will complete their cardiothoracic surgery training with a doctoral degree and the other 2 are pursuing training in cardiology. A successful early academic mentoring program in a busy cardiothoracic surgery unit is feasible. Mentoring of motivated individuals in academic surgery benefits not only their medical career, but also helps maintain high academic output of the unit. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Spreading a medication administration intervention organizationwide in six hospitals.

PubMed

Kliger, Julie; Singer, Sara; Hoffman, Frank; O'Neil, Edward

2012-02-01

Six hospitals from the San Francisco Bay Area participated in a 12-month quality improvement project conducted by the Integrated Nurse Leadership Program (INLP). A quality improvement intervention that focused on improving medication administration accuracy was spread from two pilot units to all inpatient units in the hospitals. INLP developed a 12-month curriculum, presented in a combination of off-site training sessions and hospital-based training and consultant-led meetings, to teach clinicians the key skills needed to drive organizationwide change. Each hospital established a nurse-led project team, as well as unit teams to address six safety processes designed to improve medication administration accuracy: compare medication to the medication administration record; keep medication labeled throughout; check two patient identifications; explain drug to patient (if applicable); chart immediately after administration; and protect process from distractions and interruptions. From baseline until one year after project completion, the six hospitals improved their medication accuracy rates, on average, from 83.4% to 98.0% in the spread units. The spread units also improved safety processes overall from 83.1% to 97.2%. During the same time, the initial pilot units also continued to improve accuracy from 94.0% to 96.8% and safety processes overall from 95.3% to 97.2%. With thoughtful planning, engaging those doing the work early and focusing on the "human side of change" along with technical knowledge of improvement methodologies, organizations can spread initiatives enterprisewide. This program required significant training of frontline workers in problem-solving skills, leading change, team management, data tracking, and communication.

Epidemiology of metatarsal stress fractures versus tibial and femoral stress fractures during elite training.

PubMed

Finestone, Aharon; Milgrom, Charles; Wolf, Omer; Petrov, Kaloyan; Evans, Rachel; Moran, Daniel

2011-01-01

The training of elite infantry recruits takes a year or more. Stress fractures are known to be endemic in their basic training and the clinical presentation of tibial, femoral, and metatarsal stress fractures are different. Stress fracture incidence during the subsequent progressively more demanding training is not known. The study hypothesis was that after an adaptation period, the incidence of stress fractures during the course of 1 year of elite infantry training would fall in spite of the increasingly demanding training. Seventy-six male elite infantry recruits were followed for the development of stress fractures during a progressively more difficult training program composed of basic training (1 to 14 weeks), advanced training (14 to 26 weeks), and unit training (26 to 52 weeks). Subjects were reviewed regularly and those with clinical suspicion of stress fracture were assessed using bone scan and X-rays. The incidence of stress fractures was 20% during basic training, 14% during advanced training and 23% during unit training. There was a statistically significant difference in the incidence of tibial and femoral stress fractures versus metatarsal stress fractures before and after the completion of phase II training at week 26 (p=0.0001). Seventy-eight percent of the stress fractures during phases I and II training were either tibial or femoral, while 91% of the stress fractures in phase III training were metatarsal. Prior participation in ball sports (p=0.02) and greater tibial length (p=0.05) were protective factors for stress fracture. The study hypothesis that after a period of soldier adaptation, the incidence of stress fractures would decrease in spite of the increasingly demanding elite infantry training was found to be true for tibial and femoral fractures after 6 months of training but not for metatarsal stress fractures. Further studies are required to understand the mechanism of this difference but physicians and others treating stress fractures should be aware of this pattern.

Body-Machine Interfaces after Spinal Cord Injury: Rehabilitation and Brain Plasticity.

PubMed

Seáñez-González, Ismael; Pierella, Camilla; Farshchiansadegh, Ali; Thorp, Elias B; Wang, Xue; Parrish, Todd; Mussa-Ivaldi, Ferdinando A

2016-12-19

The purpose of this study was to identify rehabilitative effects and changes in white matter microstructure in people with high-level spinal cord injury following bilateral upper-extremity motor skill training. Five subjects with high-level (C5-C6) spinal cord injury (SCI) performed five visuo-spatial motor training tasks over 12 sessions (2-3 sessions per week). Subjects controlled a two-dimensional cursor with bilateral simultaneous movements of the shoulders using a non-invasive inertial measurement unit-based body-machine interface. Subjects' upper-body ability was evaluated before the start, in the middle and a day after the completion of training. MR imaging data were acquired before the start and within two days of the completion of training. Subjects learned to use upper-body movements that survived the injury to control the body-machine interface and improved their performance with practice. Motor training increased Manual Muscle Test scores and the isometric force of subjects' shoulders and upper arms. Moreover, motor training increased fractional anisotropy (FA) values in the cingulum of the left hemisphere by 6.02% on average, indicating localized white matter microstructure changes induced by activity-dependent modulation of axon diameter, myelin thickness or axon number. This body-machine interface may serve as a platform to develop a new generation of assistive-rehabilitative devices that promote the use of, and that re-strengthen, the motor and sensory functions that survived the injury.

Core strengthening and synchronized swimming: TRX® suspension training in young female athletes.

PubMed

Tinto, Amalia; Campanella, Marta; Fasano, Milena

2017-06-01

Developing muscle strength and full body stability is essential for the efficient execution of technical moves in synchronized swimming. However, many swimmers find it difficult to control body stability while executing particular figures in water. We evaluated the effects of TRX® suspension training (2 sessions weekly for 6 months on core strength and core stability in young female. Twenty synchronized swimmers (Beginners A category, mean age 10±1 years) are divided in experimental group (EG; N.=10 athletes) and control group (CG; N.=10 athletes). EG received suspension training twice weekly (each session lasting about 15 min) as dryland exercises for 6 months in addition to routine training. CG completed routine training with conventional dryland exercises. Before (T1) and after (T2) completion of the study oblique and transversus abdominis muscle force was measured using a Stabilizer Pressure Biofeedback unit, in prone and supine positions, and isotonic muscle endurance was evaluated with the McGill Test. Non-parametric statistical analysis showed a significant increase (P<0.0001) in the majority of the parameters in the experimental group. The study results provide evidence for the benefit of integrating TRX® suspension training in dryland exercises for muscle strengthening in young athletes practicing synchronized swimming, and in general reiterates the importance of strengthening the core area to ensure stability and specific adaptations, improve the quality of the movement and prevent against injury.

Evaluation of a training curriculum for prehospital trauma ultrasound.

PubMed

Press, Gregory M; Miller, Sara K; Hassan, Iman A; Blankenship, Robert; del Junco, Deborah; Camp, Elizabeth; Holcomb, John B

2013-12-01

In the United States, ultrasound has rarely been incorporated into prehospital care, and scant descriptions of the processes used to train prehospital providers are available. Our objective was to evaluate the effectiveness of an extended focused assessment with sonography for trauma (EFAST) training curriculum that incorporated multiple educational modalities. We also aimed to determine if certain demographic factors predicted successful completion. All aeromedical prehospital providers (APPs) for a Level I trauma center took a 25-question computer-based test to ascertain baseline knowledge. Questions were categorized by content and format. Training over a 2-month period included a didactic course, a hands-on training session, proctored scanning sessions in the Emergency Department, six Internet-based training modules, pocket flashcards, a review session, and remedial training. At the conclusion of the training curriculum, the same test and an objective structured clinical examination were administered to evaluate knowledge gained. Thirty-three of 34 APPs completed training. The overall pre-test and post-test means and all content and format subsets showed significant improvement (p < 0.0001 for all). No APP passed the pre-test, and 28 of 33 passed the post-test with a mean score of 78%. No demographic variable predicted passing the post-test. Twenty-seven of 33 APPs passed the objective structured clinical examination, and the only predictive variable was passing the post-test (odds ratio 1.21, 95% confidence interval 1.00-1.25, p = 0.045). The implementation of a multifaceted EFAST prehospital training program is feasible. Significant improvement in overall and subset testing scores suggests that the test instrument was internally consistent and sufficiently sensitive to capture knowledge gained as a result of the training. Demographic variables were not predictive of test success. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform.

PubMed

Pennington, Kelly M; Dong, Yue; Coville, Hongchuan H; Wang, Bo; Gajic, Ognjen; Kelm, Diana J

2018-12-01

The current study examines the feasibility and potential effects of long distance, remote simulation training on team dynamics. The study design was a prospective study evaluating team dynamics before and after remote simulation. Study subjects consisted of interdisciplinary teams (attending physicians, physicians in training, advanced care practitioners, and/or nurses). The study was conducted at nine training sites in eight countries. Study subjects completed 2-3 simulation scenarios of acute crises before and after training with the Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN). Pre- and post-CERTAIN training simulations were evaluated by two independent reviewers utilizing the Team Emergency Assessment Measure (TEAM), which is a 11-item questionnaire that has been validated for assessing teamwork in the intensive care unit. Any discrepancies of greater than 1 point between the two reviewers on any question on the TEAM assessment were sent to a third reviewer to judge. The score that was deemed discordant by the third judge was eliminated. Pre- and post-CERTAIN training TEAM scores were averaged and compared. Of the nine teams evaluated, six teams demonstrated an overall improvement in global team performance following CERTAIN virtual training. For each of the 11 TEAM assessments, a trend toward improvement following CERTAIN training was noted; however, no assessment had universal improvement. 'Team composure and control' had the least absolute score improvement following CERTAIN training. The greatest improvement in the TEAM assessment scores was in the 'team's ability to complete tasks in a timely manner' and in the 'team leader's communication to the team'. The assessment of team dynamics using long distance, virtual simulation training appears to be feasible and may result in improved team performance during simulated patient crises; however, language and video quality were the two largest barriers noted during the review process.

Resilience training with soldiers during basic combat training: randomisation by platoon.

PubMed

Adler, Amy B; Williams, Jason; McGurk, Dennis; Moss, Andrew; Bliese, Paul D

2015-03-01

Resilience Training has the potential to mitigate mental health symptoms when provided during initial military training. The present study examined the impact of Resilience Training on US soldier well-being and attitudes during Basic Combat Training. Platoons were randomly assigned to Resilience Training or Military History provided during the first few days of Basic Combat Training. Surveys were conducted at baseline, post-intervention, and 3, 6, and 9 weeks. The sample resulted in a total of 1,939 soldiers who completed at least the baseline and one follow-up survey. There were no significant differences between conditions in terms of depression symptoms, anxiety symptoms, or sleep problems. However, while anxiety decreased in both conditions, the rate of decrease was faster in the Resilience Training condition. In contrast, Resilience Training had a slower rate of increase in group cohesion over time than the Military History condition. In addition, Resilience Training was associated with greater confidence in helping others and received more positive ratings than Military History. Findings demonstrate that the brief Resilience Training studied here may have some utility in supporting mental health and peer support but may not benefit unit climate. © 2014 The International Association of Applied Psychology.

W5″ Test: A simple method for measuring mean power output in the bench press exercise.

PubMed

Tous-Fajardo, Julio; Moras, Gerard; Rodríguez-Jiménez, Sergio; Gonzalo-Skok, Oliver; Busquets, Albert; Mujika, Iñigo

2016-11-01

The aims of the present study were to assess the validity and reliability of a novel simple test [Five Seconds Power Test (W5″ Test)] for estimating the mean power output during the bench press exercise at different loads, and its sensitivity to detect training-induced changes. Thirty trained young men completed as many repetitions as possible in a time of ≈5 s at 25%, 45%, 65% and 85% of one-repetition maximum (1RM) in two test sessions separated by four days. The number of repetitions, linear displacement of the bar and time needed to complete the test were recorded by two independent testers, and a linear encoder was used as the criterion measure. For each load, the mean power output was calculated in the W5″ Test as mechanical work per time unit and compared with that obtained from the linear encoder. Subsequently, 20 additional subjects (10 training group vs. 10 control group) were assessed before and after completing a seven-week training programme designed to improve maximal power. Results showed that both assessment methods correlated highly in estimating mean power output at different loads (r range: 0.86-0.94; p < .01) and detecting training-induced changes (R(2): 0.78). Good to excellent intra-tester (intraclass correlation coefficient (ICC) range: 0.81-0.97) and excellent inter-tester (ICC range: 0.96-0.99; coefficient of variation range: 2.4-4.1%) reliability was found for all loads. The W5″ Test was shown to be a valid, reliable and sensitive method for measuring mean power output during the bench press exercise in subjects who have previous resistance training experience.

Interprofessional simulation to improve safety in the epilepsy monitoring unit.

PubMed

Dworetzky, Barbara A; Peyre, Sarah; Bubrick, Ellen J; Milligan, Tracey A; Yule, Steven J; Doucette, Heidi; Pozner, Charles N

2015-04-01

Patient safety is critical for epilepsy monitoring units (EMUs). Effective training is important for educating all personnel, including residents and nurses who frequently cover these units. We performed a needs assessment and developed a simulation-based team training curriculum employing actual EMU sentinel events to train neurology resident-nurse interprofessional teams to maximize effective responses to high-acuity events. A mixed-methods design was used. This included the development of a safe-practice checklist to assess team response to acute events in the EMU using expert review with consensus (a modified Delphi process). All nineteen incoming first-year neurology residents and 2 nurses completed a questionnaire assessing baseline knowledge and attitudes regarding seizure management prior to and following a team training program employing simulation and postscenario debriefing. Four resident-nurse teams were recorded while participating in two simulated scenarios. Employing retrospective video review, four trained raters used the newly developed safe-practice checklist to assess team performance. We calculated the interobserver reliability of the checklist for consistency among the raters. We attempted to ascertain whether the training led to improvement in performance in the actual EMU by comparing 10 videos of resident-nurse team responses to seizures 4-8months into the academic year preceding the curricular training to 10 that included those who received the training within 4-8months of the captured video. Knowledge in seizure management was significantly improved following the program, but confidence in seizure management was not. Interrater agreement was moderate to high for consistency of raters for the majority of individual checklist items. We were unable to demonstrate that the training led to sustainable improvement in performance in the actual EMU by the method we used. A simulated team training curriculum using a safe-practice checklist to improve the management of acute events in an EMU may be an effective method of training neurology residents. However, translating the results into sustainable benefits and confidence in management in the EMU requires further study. Copyright © 2015 Elsevier Inc. All rights reserved.

Minding the Gaps in Cancer Pain Management Education: A Multicenter Study of Clinical Residents and Fellows in a Low- Versus High-Resource Setting

PubMed Central

Osei-Bonsu, Ernest; Tetteh, Oswald; Haig, Andy; Mayer, Robert Samuel; Smith, Thomas J.

2016-01-01

Purpose Inadequate pain management training has been reported as a major cause of undertreatment of cancer pain. Yet, past research has not comprehensively compared the quality of cancer pain management education among physicians in training in high-resource countries (HRCs) with those in low-resource countries (LRCs). The purpose of this study was to examine and compare gaps in cancer pain management education among physician trainees in an HRC (United States) versus an LRC (Ghana). Methods A cross section of physicians at four major academic medical centers completed surveys about the adequacy of cancer pain training. Participation in the study was completely voluntary, and paper or online surveys were completed anonymously. Results The response rate was 60% (N = 120). Major gaps were identified in cancer pain management education across the spectrum of medical school training. Training was rated as inadequate (by approximately 80% of trainees), although approximately 10% more trainees in HRCs versus LRCs felt this way; 35% said residency training was inadequate in both settings; and 50% in LRCs versus 44% in HRCs said fellowship training was less than good. On the basis of the lowest group means, the three key areas of perceived deficits included interventional pain procedures (2.34 ± 1.12), palliative care interventions (2.39 ± 1.12), and managing procedural and postoperative pain (2.94 ± 0.97), with significant differences in the distribution of deficits in 15 cancer-pain competencies between LRCs and HRCs (P < .05). Conclusion This study identifies priority areas that could be targeted synergistically by LRCs and HRCs to advance cancer care globally. The findings underscore differential opportunities to broaden and improve competencies in cancer pain management via exchange training, in which physicians from HRCs spend time in LRCs and vice versa. PMID:28717725

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

PubMed

Beastall, Graham H

2008-07-01

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

Effects of computer-based stress management training on psychological well-being and work performance in japanese employees: a cluster randomized controlled trial.

PubMed

Umanodan, Rino; Shimazu, Akihito; Minami, Masahide; Kawakami, Norito

2014-01-01

This study evaluated the effectiveness of a computer-based stress management training (SMT) program in improving employees' psychological well-being and work performance. A total of 12 work units (N=263) were randomly assigned to either an intervention group (8 work units, n=142) or to a wait-list control group (4 work units, n=121). All participants were requested to answer online questionnaires assessing psychological well-being as a primary outcome, and coping style, social support, and knowledge about stress management as secondary outcomes at baseline (T0), immediately after the intervention (T1), and 2 months after the intervention (T2). The group × time interaction was tested using a mixed-model repeated measures ANOVA. Results showed a group × time interaction for "knowledge about stress management" in the entire sample. Among participants who had more than 3 d of training, a significant group × time interaction was observed for "problem-solving" and "avoidance and suppression" as well as "knowledge about stress management." Our computer-based stress management program was effective for improving knowledge about stress management. It was also effective for improving coping skills in instances where participants had enough time (at least 3 d) to complete all sessions.

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

PubMed Central

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

2016-01-01

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

Are neurology residents interested in headache?

PubMed

Gago-Veiga, A B; Santos-Lasaosa, S; Viguera Romero, J; Pozo-Rosich, P

The years of residency are the pillars of the subsequent practice in every medical specialty. The aim of our study is to evaluate the current situation, degree of involvement, main interests, and perceived quality of the training received by Spanish residents of neurology, specifically in the area of headache. A self-administered survey was designed by the Headache Study Group of the Spanish Society of Neurology (GECSEN) and was sent via e-mail to all residents who were members of the Society as of May 2015. Fifty-three residents completed the survey (N = 426, 12.4%): 6% were first year residents, 25.5% second year, 23.5% third year, and 45% fourth year residents, all from 13 different Spanish autonomous communities. The areas of greatest interest are, in this order: Vascular neurology, headache, and epilepsy. Of them, 85% believe that the area of headache is undervalued. More than half of residents (52.8%) do not rotate in specific Headache Units and only 35.8% complete their training dominating anaesthetic block and toxin infiltration techniques. Of them, 81.1% believe that research is scarce or absent; 69.8% have never made a poster/presentation, 79.3% have not published and only 15% collaborate on research projects in this area. Lastly, 40% believe that they have not received adequate training. Headache is among the areas that interest our residents the most; however, we believe that we must improve their training both at a patient healthcare level and as researchers. Thus, increasing the number of available courses, creating educational web pages, involving residents in research, and making a rotation in a specialised unit mandatory are among the fundamental objectives of the GECSEN. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Status of women in urology: based on a report to the Society of University Urologists.

PubMed

Lightner, Deborah J; Terris, Martha K; Tsao, Alice K; Naughton, Cathy K; Lohse, Christine M

2005-02-01

Written responses from American trained women in urological surgery were obtained to evaluate practice patterns, career choices and workplace satisfaction. A 3-page unblinded questionnaire was mailed in March 2003 to American trained women in urological surgery available through the databases of the Society of Women in Urology with subsequent statistical analysis. The response rate was 60% but inclusive of all women in current academic practice in the United States. A total of 61% reported working 51 or more hours a week whereas 2% have left practice due to retirement or medical infirmity. There were 41% who had completed fellowships including 87% reporting active practice within their subspecialty, whereas 62% of fellowship trained surgeons remained in an academic practice. Among United States women in academic urological practice, academic progression has occurred in a third of this cohort. Threats to successful practice, consistent with other workplace surveys of physicians and professional women including gender based role limitation and inadequate mentoring, were commonly reported. These correctable workplace deficiencies represent an opportunity for American urology to enhance the professional workplace for all urologists regardless of gender.

Measuring the influence of a mental health training module on the therapeutic optimism of advanced nurse practitioner students in the United Kingdom.

PubMed

Hemingway, Steve; Rogers, Melanie; Elsom, Stephen

2014-03-01

To evaluate the influence of a mental health training module on the therapeutic optimism of advanced nurse practitioner (ANP) students in primary care (family practice). Three cohorts of ANPs who undertook a Mental Health Problems in Primary Care Module as part of their MSc ANP (primary care) run by the University of Huddersfield completed the Elsom Therapeutic Optimism Scale (ETOS), in a pre- and postformat. The ETOS is a 10-item, self-administered scale, which has been used to evaluate therapeutic optimism previously in mental health professionals. All three cohorts who completed the scale showed an improvement in their therapeutic optimism scores. With stigma having such a detrimental effect for people diagnosed with a mental health problem, ANPs who are more mental health literate facilitated by education and training in turn facilitates them to have the skills and confidence to engage and inspire hope for the person diagnosed with mental health problems. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Attitudes and views on chiropractic: a survey of United States midwives.

PubMed

Mullin, Linda; Alcantara, Joel; Barton, Derek; Dever, Lydia

2011-08-01

A survey of midwives' knowledge and views about chiropractic. Cross-sectional descriptive survey. An anonymous on-line self-administered survey. United States midwives. Respondent demographics, professional training, personal and professional clinical experience, opinions on safety of chiropractic, and scope of chiropractic practice. A total of 187 midwife respondents completed the questionnaire resulting in a superficial response rate of 2.1%. Responders were certified nurse-midwives and had some form of training regarding chiropractic. The responders were aware that chiropractors worked with "birthing professionals" and attended to patients with both musculoskeletal and non-musculoskeletal disorders. A vast majority indicated a positive personal and professional clinical experience with chiropractic and that chiropractic was safe for pregnant patients and children. There is great awareness of and positive personal and professional experience with chiropractic on the part of midwives who participated in this survey. We encourage further research in this field. Copyright © 2010 Elsevier Ltd. All rights reserved.

The classic. The biology of functional restoration.

PubMed

Steindler, A

1983-01-01

In 1902, when Americans were traveling to Austria and Germany for postgraduate training, Arthur Steindler (1878-1959) emigrated from his native Austria to the middlewestern United States to complete his education. After graduating from the renowned University of Austria in 1902 and completing postgraduate orthopedic training under Lorenz in 1907, he continued clinical work in Chicago under Ridlon until 1910. Ridlon recognized his scholarly qualities and recommended him for a professorship, first at Drake University and then at the University of Iowa, where from 1913 to 1949 he organized the most advanced statewide crippled children's service in the country. Steindler pioneered the application of biomechanics to orthopedic problems and wrote the first comprehensive book on the mechanics of locomotion. He educated more than 300 resident orthopedic surgeons from all parts of the world. He may have been the first to write long-term end-result statistics for each operation in a textbook on orthopedic surgery.

Operator's Manual, Boiler Room Operations and Maintenance. Supplement A, Air Pollution Training Institute Self-Instructional Course SI-466.

ERIC Educational Resources Information Center

Environmental Protection Agency, Research Triangle Park, NC. Air Pollution Training Inst.

This Operator's Manual is a supplement to a self-instructional course prepared for the United States Environmental Protection Agency. This publication is the Boiler Room Handbook for operating and maintaining the boiler and the boiler room. As the student completes this handbook, he is putting together a manual for running his own boiler. The…

Molokai Farm Project. An Agricultural Training Program of the Maui Community College, University of Hawaii. Report for Fiscal Year 1982-83.

ERIC Educational Resources Information Center

Hawaii State Dept. of Agriculture, Honolulu.

The Molokai Farm Project at Maui Community College grew out of a grant for a Youth Agricultural Entrepreneurship Demonstration Program. The program, which can lead either to an associate degree or to a certification of completion for any number of smaller units of course work, is designed to develop students' managerial proficiency and the…

[Innovation in healthcare processes and patient safety using clinical simulation].

PubMed

Rojo, E; Maestre, J M; Díaz-Mendi, A R; Ansorena, L; Del Moral, I

2016-01-01

Many excellent ideas are never implemented or generalised by healthcare organisations. There are two related paradigms: thinking that individuals primarily change through accumulating knowledge, and believing that the dissemination of that knowledge within the organisation is the key element to facilitate change. As an alternative, a description and evaluation of a simulation-based inter-professional team training program conducted in a Regional Health Service to promote and facilitate change is presented. The Department of Continuing Education completed the needs assessment using the proposals presented by clinical units and management. Skills and behaviors that could be learned using simulation were selected, and all personnel from the units participating were included. Experiential learning principles based on clinical simulation and debriefing, were used for the instructional design. The Kirkpatrick model was used to evaluate the program. Objectives included: a) decision-making and teamwork skills training in high prevalence diseases with a high rate of preventable complications; b) care processes reorganisation to improve efficiency, while maintaining patient safety; and, c) implementation of new complex techniques with a long learning curve, and high preventable complications rate. Thirty clinical units organised 39 training programs in the 3 public hospitals, and primary care of the Regional Health Service during 2013-2014. Over 1,559 healthcare professionals participated, including nursing assistants, nurses and physicians. Simulation in healthcare to train inter-professional teams can promote and facilitate change in patient care, and organisational re-engineering. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

[Management of patients under 18years of age by adult intensive care unit professionals: Level of training, workload, and specific challenges].

PubMed

Brossier, D; Villedieu, F; Letouzé, N; Pinto Da Costa, N; Jokic, M

2017-03-01

In routine practice, intensive care physicians rarely have to manage children under 18years of age, particularly those under 15. This study's objectives were to assess the quality of training in pediatrics of adult intensive care teams, to document the workload generated by care of pediatric patients, and to identify the difficulties encountered in managing minors as patients. A survey was administered in Lower Normandy from 4 April 2012 to 1 September 2012. Physicians, residents, nurses, and nurses' aides practicing in one of the nine intensive care units of Lower Normandy were asked to complete an electronic or paper format questionnaire. This questionnaire assessed their level of pediatric training, the workload management of pediatric patients entailed, and the challenges posed by these patients. One hundred and nine questionnaires were returned (by 26 attending physicians, 18 residents, 38 nurses, and 27 nurses' aides). Eighty-three of the respondents (76%) had no experience in a pediatric unit of any kind. Forty-two percent thought that the pediatric age range lies between 3months and 15years of age. However, more than 50% of respondents would like the upper limit to be 16years or even older. Ninety-three respondents (85%) estimated having some exposure to pediatric patients in their routine practice, but this activity remained quite low. Seventy-three (67%) reported difficulties with the management of these young patients. This survey provides current information regarding the level of training of adult intensive care unit professionals and their concerns about managing patients under 18years of age, both in terms of workload and specific challenges. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Culturally Relevant Human Subjects Protection Training: A Case Study in Community-Engaged Research in the United States.

PubMed

Kue, Jennifer; Szalacha, Laura A; Happ, Mary Beth; Crisp, Abigail L; Menon, Usha

2018-02-01

Non-academic members of research teams, such as community members, can perceive traditional human subjects protection training as lacking in cultural relevance. We present a case exemplar of the development of a human subjects protection training for research staff with limited English proficiency and/or no or limited research experience. Seven modules were adapted for language, cultural examples, etc., from the standard Collaborative Institutional Training Initiative (CITI) human subjects protection training. Non-academic research staff completed a day-long training in human subjects protection (six modules) and our research protocol (one module). We assessed comprehension of content with PowerPoint slides and module quizzes. All participants successfully passed each module quiz with ≥ 80% correct. Questions answered incorrectly were discussed before proceeding to the next module. To meet the increasing demand for collaborative community-engaged research with underserved minority populations, human subjects protection training protocols can be adapted successfully to reflect real-world situations and provide culturally relevant materials to help non-academic research staff better understand the importance and necessity of research ethics.

Rates of cardiopulmonary resuscitation training in the United States.

PubMed

Anderson, Monique L; Cox, Margueritte; Al-Khatib, Sana M; Nichol, Graham; Thomas, Kevin L; Chan, Paul S; Saha-Chaudhuri, Paramita; Fosbol, Emil L; Eigel, Brian; Clendenen, Bill; Peterson, Eric D

2014-02-01

Prompt bystander cardiopulmonary resuscitation (CPR) improves the likelihood of surviving an out-of-hospital cardiac arrest. Large regional variations in survival after an out-of-hospital cardiac arrest have been noted. To determine whether regional variations in county-level rates of CPR training exist across the United States and the factors associated with low rates in US counties. We used a cross-sectional ecologic study design to analyze county-level rates of CPR training in all US counties from July 1, 2010, through June 30, 2011. We used CPR training data from the American Heart Association, the American Red Cross, and the Health & Safety Institute. Using multivariable logistic regression models, we examined the association of annual rates of adult CPR training of citizens by these 3 organizations (categorized as tertiles) with a county's geographic, population, and health care characteristics. Completion of CPR training. Rate of CPR training measured as CPR course completion cards distributed and CPR training products sold by the American Heart Association, persons trained in CPR by the American Red Cross, and product sales data from the Health & Safety Institute. RESULTS During the study period, 13.1 million persons in 3143 US counties received CPR training. Rates of county training ranged from 0.00% to less than 1.29% (median, 0.51%) in the lower tertile, 1.29% to 4.07% (median, 2.39%) in the middle tertile, and greater than 4.07% or greater (median, 6.81%) in the upper tertile. Counties with rates of CPR training in the lower tertile were more likely to have a higher proportion of rural areas (adjusted odds ratio, 1.12 [95% CI, 1.10-1.15] per 5-percentage point [PP] change), higher proportions of black (1.09 [1.06-1.13] per 5-PP change) and Hispanic (1.06 [1.02-1.11] per 5-PP change) residents, a lower median household income (1.18 [1.04-1.34] per $10 000 decrease), and a higher median age (1.28 [1.04-1.58] per 10-year change). Counties in the South, Midwest, and West were more likely to have rates of CPR training in the lower tertile compared with the Northeast (adjusted odds ratios, 7.78 [95% CI, 3.66-16.53], 5.56 [2.63-11.75], and 5.39 [2.48-11.72], respectively). Annual rates of US CPR training are low and vary widely across communities. Counties located in the South, those with higher proportions of rural areas and of black and Hispanic residents, and those with lower median household incomes have lower rates of CPR training than their counterparts. These data contribute to known geographic disparities in survival of cardiac arrest and offer opportunities for future community interventions.

Influence of an injury reduction program on injury and fitness outcomes among soldiers

PubMed Central

Knapik, J; Bullock, S; Canada, S; Toney, E; Wells, J; Hoedebecke, E; Jones, B

2004-01-01

Objective: This study evaluated the influence of a multiple injury control intervention on injury and physical fitness outcomes among soldiers attending United States Army Ordnance School Advanced Individual Training. Methods: The study design was quasiexperimental involving a historical control group (n = 2559) that was compared to a multiple intervention group (n = 1283). Interventions in the multiple intervention group included modified physical training, injury education, and a unit based injury surveillance system (UBISS). The management responsible for training independently formed an Injury Control Advisory Committee that examined surveillance reports from the UBISS and recommended changes to training. On arrival at school, individual soldiers completed a demographics and lifestyle questionnaire and took an army physical fitness test (APFT: push-ups, sit-ups, and two mile run). Injuries among soldiers were tracked by a clinic based injury surveillance system that was separate from the UBISS. Soldiers completed a final APFT eight weeks after arrival at school. Results: Cox regression (survival analysis) was used to examine differences in time to the first injury while controlling for group differences in demographics, lifestyle characteristics, and physical fitness. The adjusted relative risk of a time loss injury was 1.5 (95% confidence interval 1.2 to 1.8) times higher in the historical control men and 1.8 (95% confidence interval 1.1 to 2.8) times higher in the historical control women compared with the multiple intervention men and women, respectively. After correcting for the lower initial fitness of the multiple intervention group, there were no significant differences between the multiple intervention and historical control groups in terms of improvements in push-ups, sit-ups, or two mile run performance. Conclusions: This multiple intervention program contributed to a reduction in injuries while improvements in physical fitness were similar to a traditional physical training program previously used at the school. PMID:14760025

Blood Pressure Directed Booster Trainings Improve Intensive Care Unit Provider Retention of Excellent Cardiopulmonary Resuscitation Skills.

PubMed

Wolfe, Heather; Maltese, Matthew R; Niles, Dana E; Fischman, Elizabeth; Legkobitova, Veronika; Leffelman, Jessica; Berg, Robert A; Nadkarni, Vinay M; Sutton, Robert M

2015-11-01

Brief, intermittent cardiopulmonary resuscitation (CPR) training sessions, "Booster Trainings," improve CPR skill acquisition and short-term retention. The objective of this study was to incorporate arterial blood pressure (ABP) tracings into Booster Trainings to improve CPR skill retention. We hypothesized that ABP-directed CPR "Booster Trainings" would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining. A CPR manikin creating a realistic relationship between chest compression depth and ABP was used for training/testing. Thirty-six ICU providers were randomized to brief, bedside ABP-directed CPR manikin skill retrainings: (1) Booster Plus (ABP visible during training and testing) versus (2) Booster Alone (ABP visible only during training, not testing) versus (3) control (testing, no intervention). Subjects completed skill tests pretraining (baseline), immediately after training (acquisition), and then retention was assessed at 12 hours, 3 and 6 months. The primary outcome was retention of excellent CPR skills at 3 months. Excellent CPR was defined as systolic blood pressure of 100 mm Hg or higher and compression rate 100 to 120 per minute. Overall, 14 of 24 (58%) participants acquired excellent CPR skills after their initial training (Booster Plus 75% vs 50% Booster Alone, P = 0.21). Adjusted for age, ABP-trained providers were 5.2× more likely to perform excellent CPR after the initial training (95% confidence interval [95% CI], 1.3-21.2; P = 0.02), and to retain these skills at 12 hours (adjusted odds ratio, 4.4; 95% CI, 1.3-14.9; P = 0.018) and 3 months (adjusted odds ratio, 4.1; 95% CI, 1.2-13.9; P = 0.023) when compared to baseline performance. The ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.

Keeping in time: Issues affecting the sustainability of obstetric emergency simulation training in outer metropolitan, rural and remote centres in Western Australia.

PubMed

Whitelaw, Claire; Calvert, Katrina; Epee, Mathias

2018-02-01

Obstetric emergency simulation training is an evidence-based intervention for the reduction of perinatal and maternal morbidity. In Western Australia, obstetric emergency training has been run using the In Time course since 2006. The study aimed to determine if the provision of In Time train the trainer courses to outer metro, rural and remote units in Western Australia had led to sustained ongoing training in those units. Ten years following the introduction of the course, we performed a survey to examine which units are continuing to run In Time, what are the perceived benefits in units still utilising In Time, and what were the barriers to training in units that had discontinued. A link to an online survey was sent to the units where In Time training had occurred. Telephone enquiries were additionally used to ensure a good response rate. The survey response rate was 100%. Six of the 11 units where training had been provided continue to run In Time. Units where training had discontinued had done so in order to take up alternatives, or as a result of trainers leaving. Of the units who had discontinued training, one wished to recommence In Time. Local in situ training in obstetric emergencies as exemplified by the In Time course remains a popular and valued training intervention across Western Australia. This training may be of particular benefit to small and remote units, but these are the areas in which training is hardest to sustain. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Disaster Education: A Survey Study to Analyze Disaster Medicine Training in Emergency Medicine Residency Programs in the United States.

PubMed

Sarin, Ritu R; Cattamanchi, Srihari; Alqahtani, Abdulrahman; Aljohani, Majed; Keim, Mark; Ciottone, Gregory R

2017-08-01

The increase in natural and man-made disasters occurring worldwide places Emergency Medicine (EM) physicians at the forefront of responding to these crises. Despite the growing interest in Disaster Medicine, it is unclear if resident training has been able to include these educational goals. Hypothesis This study surveys EM residencies in the United States to assess the level of education in Disaster Medicine, to identify competencies least and most addressed, and to highlight effective educational models already in place. The authors distributed an online survey of multiple-choice and free-response questions to EM residency Program Directors in the United States between February 7 and September 24, 2014. Questions assessed residency background and details on specific Disaster Medicine competencies addressed during training. Out of 183 programs, 75 (41%) responded to the survey and completed all required questions. Almost all programs reported having some level of Disaster Medicine training in their residency. The most common Disaster Medicine educational competencies taught were patient triage and decontamination. The least commonly taught competencies were volunteer management, working with response teams, and special needs populations. The most commonly identified methods to teach Disaster Medicine were drills and lectures/seminars. There are a variety of educational tools used to teach Disaster Medicine in EM residencies today, with a larger focus on the use of lectures and hospital drills. There is no indication of a uniform educational approach across all residencies. The results of this survey demonstrate an opportunity for the creation of a standardized model for resident education in Disaster Medicine. Sarin RR , Cattamanchi S , Alqahtani A , Aljohani M , Keim M , Ciottone GR . Disaster education: a survey study to analyze disaster medicine training in emergency medicine residency programs in the United States. Prehosp Disaster Med. 2017;32(4):368-373.

Kinematics effectively delineate accomplished users of endovascular robotics with a physical training model.

PubMed

Duran, Cassidy; Estrada, Sean; O'Malley, Marcia; Lumsden, Alan B; Bismuth, Jean

2015-02-01

Endovascular robotics systems, now approved for clinical use in the United States and Europe, are seeing rapid growth in interest. Determining who has sufficient expertise for safe and effective clinical use remains elusive. Our aim was to analyze performance on a robotic platform to determine what defines an expert user. During three sessions, 21 subjects with a range of endovascular expertise and endovascular robotic experience (novices <2 hours to moderate-extensive experience with >20 hours) performed four tasks on a training model. All participants completed a 2-hour training session on the robot by a certified instructor. Completion times, global rating scores, and motion metrics were collected to assess performance. Electromagnetic tracking was used to capture and to analyze catheter tip motion. Motion analysis was based on derivations of speed and position including spectral arc length and total number of submovements (inversely proportional to proficiency of motion) and duration of submovements (directly proportional to proficiency). Ninety-eight percent of competent subjects successfully completed the tasks within the given time, whereas 91% of noncompetent subjects were successful. There was no significant difference in completion times between competent and noncompetent users except for the posterior branch (151 s:105 s; P = .01). The competent users had more efficient motion as evidenced by statistically significant differences in the metrics of motion analysis. Users with >20 hours of experience performed significantly better than those newer to the system, independent of prior endovascular experience. This study demonstrates that motion-based metrics can differentiate novice from trained users of flexible robotics systems for basic endovascular tasks. Efficiency of catheter movement, consistency of performance, and learning curves may help identify users who are sufficiently trained for safe clinical use of the system. This work will help identify the learning curve and specific movements that translate to expert robotic navigation. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

STS 61-B crewmembers training on the KC-135 in zero-G

NASA Image and Video Library

1985-08-21

STS 61-B crewmembers training on the KC-135 in zero-G. Views include Payload specialist Charles D. Walker attempting to down the lower torso of his extravehicular mobility unit (EMU) in zero-G in the KC-135. He is being assisted by other participants in the training (39135); Payload specialist Rodolfo Neri floating in midair during training in the KC-135 (39136,39138); Mission specialist Mary L. Cleave floating in midair during her training aboard the KC-135 (39137); Astronaut Bryan D. O'Connor assists Astronaut Sherwood C. Spring in completing his donning of the EMU in the KC-135 (39139); Technicians aid Spring with his EMU in the KC-135 (39140); O'Connor appears to be leaping up in zero-G aboard the KC-135 (39141); Astronaut Brewster Shaw is assisted by a technician to don his EMU (39142); Shaw is attempting to don the EMU gloves while O'Connor watches (39143); Shaw does jumping jacks while Neri attempts to travel down a rope guideline (39144).

Strength training for a child with suspected developmental coordination disorder.

PubMed

Menz, Stacy M; Hatten, Kristin; Grant-Beuttler, Marybeth

2013-01-01

Children with developmental coordination disorder (DCD) demonstrate difficulty with feedforward motor control and use varied compensatory strategies. To examine gross motor function changes following strength training in a child with motor control difficulties. A girl aged 6 years 11 months, with apraxia and hypotonia, and demonstrating motor delays consistent with DCD. Twenty-four strength training sessions were completed using a universal exercise unit. Postintervention scores significantly improved on the Bruininks-Oseretsky test of motor proficiency, second edition, and the Canadian occupational performance measure scores and raised the developmental coordination disorder questionnaire, revised 2007, scores above the range where DCD is suspected. Nonsignificant changes in strength were observed. Improved function and significant gains in manual coordination were observed following blocked practice of isolated, simple joint movements during strength training. Improved motor skills may be because of effective use of feedforward control and improved stabilization. Strength training does not rehearse skills using momentum, explaining nonsignificant changes in locomotor or locomotion areas.

Emotional intelligence: A unique group training in a hematology-oncology unit.

PubMed

Tadmor, Tamar; Dolev, Niva; Attias, Dina; Lelong, Ayalla Reuven; Rofe, Amnon

2016-01-01

Emotional intelligence (EI) is increasingly viewed as one of the important skills required for a successful career and personal life. Consequently, efforts have been made to improve personal and group performance in EI, mostly in commercial organizations. However, these programs have not been widely applied in the health field. The aim of this study is to assess the impact of a unique special EI interventional process within the framework of an active hematology-oncology unit in a general hospital. This investigation employed a pre- and post-training design using the Bar-On Emotional Quotient Inventory (EQ-i) measure of EI, both before and after completion of training 10 months later. The training included personal and group EI assessments and 10 EI workshops, each 2 weeks apart and each lasting approximately 2 h. Results were compared to a control group of medical staff who did not undergo any EI training program during the same time period. Average total Bar-On EQ-i level at baseline for the group was 97.9, which increased significantly after the interventional process to a score of 105.6 (P = 0.001). There were also significant increases in all five main EQ-i scales, as well as for 12 of the 15 subscales. In contrast, the control group showed no significant differences in general EI level, in any of the five main scales or 15 EI subscale areas. This pilot study demonstrated the capability of a group intervention to improve EI of medical staff working in a hematology-oncological unit. The results are encouraging and suggest that the model program could be successfully applied in a large-scale interventional program.

Comparison of Plastic Surgery Residency Training in United States and China.

PubMed

Zheng, Jianmin; Zhang, Boheng; Yin, Yiqing; Fang, Taolin; Wei, Ning; Lineaweaver, William C; Zhang, Feng

2015-12-01

Residency training is internationally recognized as the only way for the physicians to be qualified to practice independently. China has instituted a new residency training program for the specialty of plastic surgery. Meanwhile, plastic surgery residency training programs in the United States are presently in a transition because of restricted work hours. The purpose of this study is to compare the current characteristics of plastic surgery residency training in 2 countries. Flow path, structure, curriculum, operative experience, research, and evaluation of training in 2 countries were measured. The number of required cases was compared quantitatively whereas other aspects were compared qualitatively. Plastic surgery residency training programs in 2 countries differ regarding specific characteristics. Requirements to become a plastic surgery resident in the United States are more rigorous. Ownership structure of the regulatory agency for residency training in 2 countries is diverse. Training duration in the United States is more flexible. Clinical and research training is more practical and the method of evaluation of residency training is more reasonable in the United States. The job opportunities after residency differ substantially between 2 countries. Not every resident has a chance to be an independent surgeon and would require much more training time in China than it does in the United States. Plastic surgery residency training programs in the United States and China have their unique characteristics. The training programs in the United States are more standardized. Both the United States and China may complement each other to create training programs that will ultimately provide high-quality care for all people.

Special Programs in Medical Library Education, 1957-1971: Part I: Definition of the Problem and Research Design *

PubMed Central

Roper, Fred W.

1973-01-01

This report discusses the background and design of a study on special programs of education for medical librarianship in the United States. Between 1957 and 1971, 238 persons completed special programs in medical librarianship. Since little information has been available concerning the occupational success of these individuals, the study was undertaken (1) to determine the nature and distinguishing characteristics of the special programs of education for medical librarianship in the United States and (2) to provide some quantitative evidence of the value of those programs by studying a group of professional medical librarians who have had specialized training and a group of practicing medical librarians who have not had specialized training and comparing and correlating the data with regard to selected characteristics. The findings of the study will be presented in three future reports: (1) a descriptive analysis of the programs; (2) a description of the characteristics of all former trainees in medical librarianship who responded to a questionnaire and a discussion of their reactions to their training programs; and (3) a comparison, based on selected characteristics, of a group of former trainees who are currently employed in medical libraries with a group of medical librarians who did not go through special training programs. PMID:4702806

Cultural desire need not improve with cultural knowledge: A cross-sectional study of student nurses.

PubMed

Isaacs, Anton Neville; Raymond, Anita; Jacob, Elisabeth; Jones, Janet; McGrail, Matthew; Drysdale, Marlene

2016-07-01

Cultural desire is considered to be a prerequisite for developing cultural competence. This study explored cultural desire among student nurses towards Aboriginal peoples and its association with participation in a one-semester unit on Aboriginal health through a cross-sectional survey. Our main outcome, cultural desire, was measured using two items level of agreement with Aboriginal health being an integral component of the nursing curriculum and an expressed interest in Aboriginal health. 220 (74.58%) student nurses completed the survey. Completing the Aboriginal Health and wellbeing unit did not influence students' opinions on inclusion of the unit as part of the nursing curriculum (odds ratio OR 0.73, 95% CI 0.43-1.29) or their overall cultural desire (mean difference = -0.69, 95% CI -1.29 to -0.08, p = 0.026). Students who completed the unit reported a higher understanding of Aboriginal health (OR = 2.35, 95% CI = 1.35-4.08) but lower interest levels in the subject (OR = 0.45, 95% CI: 0.24-0.84). Further research is necessary to explore how and when cultural desire might develop in nurses who are trained in cultural competence particularly in the contexts of post-colonial disparities and political conflict. Copyright © 2016 Elsevier Ltd. All rights reserved.

25 CFR 26.32 - What constitutes a complete Job Training Program application?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What constitutes a complete Job Training Program... JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.32 What constitutes a complete Job Training Program application? A request for training includes: (a) Intake and application data; (b) Feasible...

The Impact of Resident Training on Communication with Families in the Intensive Care Unit. Resident and Family Outcomes.

PubMed

Sullivan, Amy M; Rock, Laura K; Gadmer, Nina M; Norwich, Diana E; Schwartzstein, Richard M

2016-04-01

In high-acuity settings such as intensive care units (ICUs), the quality of communication with patients' families is a particularly important component of care. Evidence shows that ICU communication is often inadequate and can negatively impact family outcomes. To assess the impact of a communication training program on resident skills in communicating with families in an ICU and on family outcomes. We conducted a prospective, single-site educational intervention study. The intervention featured a weekly required communication training program (4 h total) during the ICU rotation, which included interactive discussion, and role play with immediate feedback from simulated family members. All internal medicine residents on ICU rotation between July 2012 and July 2014 were invited to participate in the study. Family members who had a meeting with an enrolled resident were approached for a survey or interview. The primary outcome was family ratings of how well residents met their informational and emotional needs. The response rate for the resident baseline survey was 93% (n = 149 of 160), and it was 90% at postcourse and 84% at 3-month follow-up. Of 303 family members approached, 237 were enrolled. Enrolled family members who had a confirmed meeting with a resident were eligible to complete a survey or interview. The completion rate was 86% (n = 82 of 95). Family members were more likely to describe residents as having "fully met" (average rating of 10/10 on 0-10 scale) their informational and emotional needs when the resident had completed two or three course sessions (84% of family members said conversation with these residents "fully met" their needs), as compared with residents who had taken one session or no sessions (25% of family members said needs were "fully met") (P < 0.0001). Residents described improvements across all domains. All differences are statistically significant, most with large effect sizes. At our institution, an on-site communication training program designed for integration into medical residency programs was associated with strongly positive family member outcomes and significant improvements in residents' perceived skills. This intervention may serve to prepare residents for optimal communications with patients and family members in ICUs and elsewhere.

Survey to child/adolescent psychiatry and developmental/behavioral pediatric training directors to expand psychiatric-mental health training to nurse practitioners.

PubMed

Schwartz, Richard H; O'Laughlen, Mary C; Kim, Joshua

2017-06-01

There is an ongoing shortage of child mental health professionals. Nurse practitioners (NPs) who completed behavioral and mental health training have proven that they can diagnose and manage many pediatric problems. To ask the training directors of both child/adolescent psychiatry (CAP) and developmental/behavioral pediatric (DBP) programs about their receptivity and willingness to give additional training for NPs who provide care to children with behavioral and mental health issues and examine the main obstacles to the development of such programs. A survey was sent to 151 CAP and DBP training directors in the United States. The return rate was 67% (N = 101). Only 12% expressed objection to the concept of additional NP training in CAP or DBP, but only 53% of training directors currently reported having sufficient faculty to do so. Some training directors reported already having advanced behavioral and mental health training programs for NPs (31%) and most (82%) would consider expanding, if funded. There is support for advanced training for NPs, but funding is needed to make this a reality. Expansion of such programs might rapidly improve accessibility and reduce waiting time of mental health providers for children and adolescents. ©2017 American Association of Nurse Practitioners.

The n-by-T Target Discharge Strategy for Inpatient Units.

PubMed

Parikh, Pratik J; Ballester, Nicholas; Ramsey, Kylie; Kong, Nan; Pook, Nancy

2017-07-01

Ineffective inpatient discharge planning often causes discharge delays and upstream boarding. While an optimal discharge strategy that works across all units at a hospital is likely difficult to identify and implement, a strategy that provides a reasonable target to the discharge team appears feasible. We used observational and retrospective data from an inpatient trauma unit at a Level 2 trauma center in the Midwest US. Our proposed novel n-by-T strategy-discharge n patients by the Tth hour-was evaluated using a validated simulation model. Outcome measures included 2 measures: time-based (mean discharge completion and upstream boarding times) and capacity-based (increase in annual inpatient and upstream bed hours). Data from the pilot implementation of a 2-by-12 strategy at the unit was obtained and analyzed. The model suggested that the 1-by-T and 2-by-T strategies could advance the mean completion times by over 1.38 and 2.72 h, respectively (for 10 AM ≤ T ≤ noon, occupancy rate = 85%); the corresponding mean boarding time reductions were nearly 11% and 15%. These strategies could increase the availability of annual inpatient and upstream bed hours by at least 2,469 and 500, respectively. At 100% occupancy rate, the hospital-favored 2-by-12 strategy reduced the mean boarding time by 26.1%. A pilot implementation of the 2-by-12 strategy at the unit corroborated with the model findings: a 1.98-h advancement in completion times (P<0.0001) and a 14.5% reduction in boarding times (P = 0.027). Target discharge strategies, such as the n-by-T, can help substantially reduce discharge lateness and upstream boarding, especially during high unit occupancy. To sustain implementation, necessary commitment from the unit staff and physicians is vital, and may require some training.

Hand Robotic Therapy in Children with Hemiparesis: A Pilot Study.

PubMed

Bishop, Lauri; Gordon, Andrew M; Kim, Heakyung

2017-01-01

The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly. Assessments were repeated on completion of training. Results showed significant improvements after training on the Assisting Hand Assessment (mean difference, 2.0 Assisting Hand Assessment units; P = 0.011) and on the upper-extremity component of the Fugl-Meyer scale (raw score mean difference, 4.334; P = 0.001). No significant improvements between pretest and posttest were noted on the Jebsen-Taylor Test of Hand Function, the Quality of Upper Extremity Skills Test, or the Pediatric Evaluation of Disability Inventory after intervention. Total active mobility of digits and grip strength also failed to demonstrate significant changes after training. Participants tolerated training with the hand robotic device, and significant improvements in bimanual hand use, as well as impairment-based scales, were noted. Improvements were carried over into bimanual skills during play. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand key components of neuroplasticity; (2) Discuss the benefits of robotic therapy in the recovery of hand function in pediatric patients with hemiplegia; and (3) Appropriately incorporate robotic therapy into the treatment plan of pediatric patients with hemiplegia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Principles to Consider in Defining New Directions in Internal Medicine Training and Certification

PubMed Central

Turner, Barbara J; Centor, Robert M; Rosenthal, Gary E

2006-01-01

SGIM endoreses seven principles related to current thinking about internal medicine training: 1) internal medicine requires a full three years of residency training before subspecialization; 2) internal medicine residency programs must dramatically increase support for training in the ambulatory setting and offer equivalent opportunities for training in both inpatient and outpatient medicine; 3) in settings where adequate support and time are devoted to ambulatory training, the third year of residency could offer an opportunity to develop further expertise or mastery in a specific type or setting of care; 4) further certification in specific specialties within internal medicine requires the completion of an approved fellowship program; 5) areas of mastery in internal medicine can be demonstrated through modified board certification and recertification examinations; 6) certification processes throughout internal medicine should focus increasingly on demonstration of clinical competence through adherence to validated standards of care within and across practice settings; and 7) regardless of the setting in which General Internists practice, we should unite to promote the critical role that this specialty serves in patient care. PMID:16637826

Education Research: Neurology training reassessed

PubMed Central

Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

2012-01-01

Objective: To assess the strengths and weaknesses of neurology resident education using survey methodology. Methods: A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Results: Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Conclusions: Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training. PMID:23091077

Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

PubMed

Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

2012-10-23

To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

Preparing Facilitators From Community-Based Organizations for Evidence-Based Intervention Training in Second Life

PubMed Central

Valladares, Angel Felix; Tschannen, Dana; Villarruel, Antonia Maria

2014-01-01

Background A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. Objective The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. Methods We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Results Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Conclusions Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is an important contribution to developing cost-effective and accessible training options for evidence-based interventions. PMID:25270991

Preparing facilitators from community-based organizations for evidence-based intervention training in Second Life.

PubMed

Valladares, Angel Felix; Aebersold, Michelle; Tschannen, Dana; Villarruel, Antonia Maria

2014-09-30

A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is an important contribution to developing cost-effective and accessible training options for evidence-based interventions.

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses.

PubMed

Han, Myong-Ja; Lee, Ju-Ry; Shin, Yu-Jung; Son, Jeong-Suk; Choi, Eun-Joo; Oh, Yun-Hee; Lee, Soon-Haeng; Choi, Hye-Ran

2017-12-21

To examine the effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units. A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared. After education, there was a significant improvement in the nurses' self-efficacy and clinical performance in emergency airway management situations. Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education. © 2017 Japan Academy of Nursing Science.

An Overview of the Cooperative Effort between the United States Department of Energy and the China Atomic Energy Authority to Enhance MPC&A Inspections for Civil Nuclear Facilities in China

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

Ahern, Keith; Daming, Liu; Hanley, Tim

The United States Department of Energy, National Nuclear Security Administration (DOE/NNSA) and the China Atomic Energy Authority (CAEA) are cooperating to enhance the domestic regulatory inspections capacity for special nuclear material protection, control and accounting (MPC&A) requirements for civil nuclear facilities in China. This cooperation is conducted under the auspices of the Agreement between the Department of Energy of the United States of America and the State Development and Planning Commission of the People s Republic of China on Cooperation Concerning Peaceful Uses of Nuclear Technology. This initial successful effort was conducted in three phases. Phase I focused on introducingmore » CAEA personnel to DOE and U. S. Nuclear Regulatory Commission inspection methods for U. S. facilities. This phase was completed in January 2008 during meetings in Beijing. Phase II focused on developing physical protection and material control and accounting inspection exercises that enforced U. S. inspection methods identified during Phase 1. Hands on inspection activities were conducted in the United States over a two week period in July 2009. Simulated deficiencies were integrated into the inspection exercises. The U. S. and Chinese participants actively identified and discussed deficiencies noted during the two week training course. The material control and accounting inspection exercises were conducted at the Paducah Gaseous Diffusion Plant (PGDP) in Paducah, KY. The physical protection inspection exercises were conducted at the Oak Ridge National Laboratory (ORNL) in Oak Ridge, TN. Phase III leveraged information provided under Phase I and experience gained under Phase II to develop a formal inspection guide that incorporates a systematic approach to training for Chinese MPC&A field inspectors. Additional hands on exercises that are applicable to Chinese regulations were incorporated into the Phase III training material. Phase III was completed in May 2010 at the China Institute of Atomic Energy (CIAE) in Beijing. This paper provides details of the successful cooperation between DOE/NNSA and CAEA for all phases of the cooperative effort to enhance civil domestic MPC&A inspections in China.« less

Results of the American Academy of Neurology resident survey.

PubMed

Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R

2011-03-29

To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter. A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007. Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence. Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

Sexual assault training in the military: evaluating efforts to end the "invisible war".

PubMed

Holland, Kathryn J; Rabelo, Verónica Caridad; Cortina, Lilia M

2014-12-01

Sexual assault is an insidious problem in the United States military. In 2005 the Department of Defense (DoD) created the Sexual Assault Prevention and Response Office, which centralizes responsibility for sexual assault training. However, this training initiative has undergone little evaluation by outside researchers. Addressing this need, we analyzed responses from over 24,000 active duty personnel who completed the 2010 DoD Workplace and Gender Relations Survey. We assessed whether sexual assault training exposure (None, Minimal, Partial, or Comprehensive) predicted accurate knowledge of sexual assault resources and protocols. Using a social-ecological framework, we investigated whether institutional and individual factors influenced Service members' training exposure and judgment of training effectiveness. According to our results, exposure to comprehensive training predicted lower sexual assault incidence and superior knowledge. However, comprehensive training differed as a function of military branch, rank, gender, and sexual assault history. Judgments of training effectiveness also varied across these dimensions. Our results highlight the importance of considering context, gender, and victimization history when evaluating institutional efforts to end sexual violence. The DoD's 2010 annual report on military sexual assault concluded that "most Active Duty members receive effective training on sexual assault" (p. 104). Our results cast doubt on that assertion.

High-intensity interval training: Modulating interval duration in overweight/obese men.

PubMed

Smith-Ryan, Abbie E; Melvin, Malia N; Wingfield, Hailee L

2015-05-01

High-intensity interval training (HIIT) is a time-efficient strategy shown to induce various cardiovascular and metabolic adaptations. Little is known about the optimal tolerable combination of intensity and volume necessary for adaptations, especially in clinical populations. In a randomized controlled pilot design, we evaluated the effects of two types of interval training protocols, varying in intensity and interval duration, on clinical outcomes in overweight/obese men. Twenty-five men [body mass index (BMI) > 25 kg · m(2)] completed baseline body composition measures: fat mass (FM), lean mass (LM) and percent body fat (%BF) and fasting blood glucose, lipids and insulin (IN). A graded exercise cycling test was completed for peak oxygen consumption (VO2peak) and power output (PO). Participants were randomly assigned to high-intensity short interval (1MIN-HIIT), high-intensity interval (2MIN-HIIT) or control groups. 1MIN-HIIT and 2MIN-HIIT completed 3 weeks of cycling interval training, 3 days/week, consisting of either 10 × 1 min bouts at 90% PO with 1 min rests (1MIN-HIIT) or 5 × 2 min bouts with 1 min rests at undulating intensities (80%-100%) (2MIN-HIIT). There were no significant training effects on FM (Δ1.06 ± 1.25 kg) or %BF (Δ1.13% ± 1.88%), compared to CON. Increases in LM were not significant but increased by 1.7 kg and 2.1 kg for 1MIN and 2MIN-HIIT groups, respectively. Increases in VO2peak were also not significant for 1MIN (3.4 ml·kg(-1) · min(-1)) or 2MIN groups (2.7 ml · kg(-1) · min(-1)). IN sensitivity (HOMA-IR) improved for both training groups (Δ-2.78 ± 3.48 units; p < 0.05) compared to CON. HIIT may be an effective short-term strategy to improve cardiorespiratory fitness and IN sensitivity in overweight males.

High-intensity interval training: Modulating interval duration in overweight/obese men

PubMed Central

Smith-Ryan, Abbie E.; Melvin, Malia N.; Wingfield, Hailee L.

2015-01-01

Introduction High-intensity interval training (HIIT) is a time-efficient strategy shown to induce various cardiovascular and metabolic adaptations. Little is known about the optimal tolerable combination of intensity and volume necessary for adaptations, especially in clinical populations. Objectives In a randomized controlled pilot design, we evaluated the effects of two types of interval training protocols, varying in intensity and interval duration, on clinical outcomes in overweight/obese men. Methods Twenty-five men [body mass index (BMI) > 25 kg·m2] completed baseline body composition measures: fat mass (FM), lean mass (LM) and percent body fat (%BF) and fasting blood glucose, lipids and insulin (IN). A graded exercise cycling test was completed for peak oxygen consumption (VO2peak) and power output (PO). Participants were randomly assigned to high-intensity short interval (1MIN-HIIT), high-intensity interval (2MIN-HIIT) or control groups. 1MIN-HIIT and 2MIN-HIIT completed 3 weeks of cycling interval training, 3 days/week, consisting of either 10 × 1 min bouts at 90% PO with 1 min rests (1MIN-HIIT) or 5 × 2 min bouts with 1 min rests at undulating intensities (80%–100%) (2MIN-HIIT). Results There were no significant training effects on FM (Δ1.06 ± 1.25 kg) or %BF (Δ1.13% ± 1.88%), compared to CON. Increases in LM were not significant but increased by 1.7 kg and 2.1 kg for 1MIN and 2MIN-HIIT groups, respectively. Increases in VO2peak were also not significant for 1MIN (3.4 ml·kg−1·min−1) or 2MIN groups (2.7 ml·kg−1·min−1). IN sensitivity (HOMA-IR) improved for both training groups (Δ −2.78 ± 3.48 units; p < 0.05) compared to CON. Conclusion HIIT may be an effective short-term strategy to improve cardiorespiratory fitness and IN sensitivity in overweight males. PMID:25913937

Phase transitions in restricted Boltzmann machines with generic priors

NASA Astrophysics Data System (ADS)

Barra, Adriano; Genovese, Giuseppe; Sollich, Peter; Tantari, Daniele

2017-10-01

We study generalized restricted Boltzmann machines with generic priors for units and weights, interpolating between Boolean and Gaussian variables. We present a complete analysis of the replica symmetric phase diagram of these systems, which can be regarded as generalized Hopfield models. We underline the role of the retrieval phase for both inference and learning processes and we show that retrieval is robust for a large class of weight and unit priors, beyond the standard Hopfield scenario. Furthermore, we show how the paramagnetic phase boundary is directly related to the optimal size of the training set necessary for good generalization in a teacher-student scenario of unsupervised learning.

[Specific neurology emergency training of medical residents in Spain].

PubMed

Morales Ortiz, A; Martín González, M R; Frank García, A; Hernández Pérez, M A; Rodríguez-Antigüedad, A; Jiménez Hernández, M D; Delgado Bona, G; Peinazo Arias, M; Gallardo Corral, E; Martínez Vila, E; Martínez Villa, E; Matias Guiu, J

2010-01-01

Training in emergency neurological illness is very important for the neurologist today. The Neurology National Commission has decided to obtain information on the work duties of neurologist residents in the different neurology units of the hospitals of our country and the supervision of the training in urgent pathology. A survey of adult neurology program directors to find out if their hospital fulfils the program criteria for the residents duty work. A response rate of 98.5% was obtained. In 47% of the neurology training units a neurologist supervised resident duty work 24 hours a day. In the rest of the neurology training units they did not fulfil all the training program criteria. We analysed the differences between the neurologist training units, and there are great differences between the hospitals and all regions and communities in our country. Only 65% of neurology residents do their education in neurology units who fulfill the national program criteria on training on urgent neurology pathology There is too much diversity in resident duty work in neurologist training units and not all the units meet the national training program requirements. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Effects of a Staff Training Intervention on Seclusion Rates on an Adult Inpatient Psychiatric Unit.

PubMed

Newman, Julie; Paun, Olimpia; Fogg, Louis

2018-06-01

The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national average. Although the project's primary outcome compared patient seclusion rates before and after the intervention, anonymous staff surveys measured several secondary outcomes. Seclusion rates were reduced from a 6-month pre-intervention average of 2.95 seclusion hours per 1,000 patient hours to a 6-month post-intervention average of 0.29 seclusion hours per 1,000 patient hours, a 90.2% reduction. Completed staff surveys showed significant staff knowledge gains, non-significant changes in staff attitudes about seclusion, non-significant changes in staff de-escalation skill confidence, and use of the new resource sheet by only 17% of staff. The key study implication is that time-limited, focused staff training interventions can have a measurable impact on reducing inpatient seclusion rates. [Journal of Psychosocial Nursing and Mental Health Services, 56(6), 23-30.]. Copyright 2018, SLACK Incorporated.

Small Arms Ammunition Production and Acquisition Strategy for the U.S. Army

DTIC Science & Technology

2009-12-11

to the following people for their assistance in preparing and completing this project: First of all to my wife, Christie, for her patience... prepared to meet the small arms ammunition needs of the US Army. Background The United States continues to conduct full spectrum operations in two...theaters of operation, contingencies around the world, and prepare and train for war. In January 2007, President Bush requested an authorization from

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

Bryngelson, R.H.

Describes installation of 3 wet, diver-assist trees, in the Espoir field offshore Ivory Coast, as part of Phillips Petroleum's plans to use 5 satellite wells with downhole completion equipment and subsea production trees. Simplicity in design and attention to training has resulted in an installation time of about 3 weeks for one of the largest subsea trees in the industry. Presents diagram showing the converted jackup, Dan Duke drilling unit, which supports equipment to handle production from subsea wells.

Training the Neglected Core of Army Leadership- Troop-Leading Procedures

DTIC Science & Technology

2007-06-01

tactical operations center ( TOC ) to reconnoiter, using the MDMP to complete their plans, etc. TLP are considered procedures, and the Army’s previous...and establishing an effective and responsive Prevention of Sexual Haras- sment (POSH)/Equal Opportunity (EO) program. Since dedicated citizen...8. One unit posted signs all over its TOC that read, “Who else needs to know!” 03A - COE/Full-Spectrum Operations/Why We Fight 03C - Perform Cultural

Korean standard nuclear plant ex-vessel neutron dosimetry program Ulchin 4

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

Duo, J.I.; Chen, J.; Kulesza, J.A.

2011-07-01

A comprehensive ex-vessel neutron dosimetry (EVND) surveillance program has been deployed in 16 pressurized water reactors (PWR) in South Korea and EVND dosimetry sets have already been installed and analyzed in Westinghouse reactor designs. In this paper, the unique features of the design, training, and installation in the Korean standard nuclear plant (KSNP) Ulchin Unit 4 are presented. Ulchin Unit 4 Cycle 9 represents the first dosimetry analyzed from the EVND design deployed in KSNP plants: Yonggwang Units 3 through 6 and Ulchin Units 3 through 6. KSNP's cavity configuration precludes a conventional installation from the cavity floor. The solution,more » requiring the installation crew to access the cavity at an elevation of the active core, places a premium on rapid installation due to high area dose rates. Numerous geometrical features warranted the use of a detailed design in true 3D mechanical design software to control interferences. A full-size training mockup maximized the crew ability to correctly install the instrument in minimum time. The analysis of the first dosimetry set shows good agreements between measurement and calculation within the associated uncertainties. A complete EVND system has been successfully designed, installed, and analyzed for a KNSP plant. Current and future EVND analyses will continue supporting the successful operation of PWR units in South Korea. (authors)« less

Effects of selection and training on unit-level performance over time: a latent growth modeling approach.

PubMed

Van Iddekinge, Chad H; Ferris, Gerald R; Perrewé, Pamela L; Blass, Fred R; Heetderks, Thomas D; Perryman, Alexa A

2009-07-01

Surprisingly few data exist concerning whether and how utilization of job-related selection and training procedures affects different aspects of unit or organizational performance over time. The authors used longitudinal data from a large fast-food organization (N = 861 units) to examine how change in use of selection and training relates to change in unit performance. Latent growth modeling analyses revealed significant variation in both the use and the change in use of selection and training across units. Change in selection and training was related to change in 2 proximal unit outcomes: customer service performance and retention. Change in service performance, in turn, was related to change in the more distal outcome of unit financial performance (i.e., profits). Selection and training also affected financial performance, both directly and indirectly (e.g., through service performance). Finally, results of a cross-lagged panel analysis suggested the existence of a reciprocal causal relationship between the utilization of the human resources practices and unit performance. However, there was some evidence to suggest that selection and training may be associated with different causal sequences, such that use of the training procedure appeared to lead to unit performance, whereas unit performance appeared to lead to use of the selection procedure.

Surgeon migration between developing countries and the United States: train, retain, and gain from brain drain.

PubMed

Hagander, Lars E; Hughes, Christopher D; Nash, Katherine; Ganjawalla, Karan; Linden, Allison; Martins, Yolanda; Casey, Kathleen M; Meara, John G

2013-01-01

The critical shortage of surgeons in many low- and middle-income countries (LMICs) prevents adequate responses to surgical needs, but the factors that affect surgeon migration have remained incompletely understood. The goal of this study was to examine the importance of personal, professional, and infrastructural factors on surgeon migration from LMICs to the United States. We hypothesized that the main drivers of surgeon migration can be addressed by providing adequate domestic surgical infrastructure, surgical training programs, and viable surgical career paths. We conducted an internet-based nationwide survey of surgeons living in the US who originated from LMICs. 66 surgeons completed the survey. The most influential factors for primary migration were related to professional reasons (p ≤ 0.001). Nonprofessional factors, such as concern for remuneration, family, and security were significantly less important for the initial migration decisions, but adopted a more substantial role in deciding whether or not to return after training in the United States. Migration to the United States was initially considered temporary (44 %), and a majority of the surveyed surgeons have returned to their source countries in some capacity (56 %), often on multiple occasions (80 %), to contribute to clinical work, research, and education. This study suggests that surgically oriented medical graduates from LMICs migrate primarily for professional reasons. Initiatives to improve specialist education and surgical infrastructure in LMICs have the potential to promote retention of the surgical workforce. There may be formal ways for LMICs to gain from the international pool of relocated surgeons.

Diagnosis of Child Maltreatment: A Family Medicine Physician's Dilemma.

PubMed

Eniola, Kehinde; Evarts, Lori

2017-05-01

Cases of child maltreatment (CM) in the United States remain high, and primary care providers lack the confidence and training to diagnose these cases. This study provides recommendations to improve family medicine physicians' confidence in diagnosing CM. We e-mailed an electronic survey to family medicine residents and physicians practicing in the United States. Responses were collected during August and September 2015. Respondents were asked about their familiarity and competence level regarding the diagnosis of CM. They also were asked about the frequency of their correctly diagnosing CM, timeliness of diagnosis, barriers to a diagnosis or early diagnosis of CM, and receipt of adequate CM training. Of the 420 surveys emailed, 258 (61%) were completed. The majority of respondents stated their self-reported level of competence in diagnosing CM as average or below average, with few (8%) indicating a competence level of above average. A timely diagnosis of child maltreatment was reported by 46% of respondents, whereas 54% were either late (19.2%) in diagnosing or could not recall (34.6%). The barriers to diagnosis cited by responders were inexperience (58%), lack of confidence and certainty (50%), lack of diagnosis protocol (43.3%), lack of confidence in communicating with parents (38.3%), and inadequate training (34.9%). The introduction of CM training into the family medicine residency training curriculum, coupled with the development of a standardized CM diagnosis protocol, may improve self-reported family medicine physicians' confidence and competence levels in diagnosing CM.

The fetal heart rate collaborative practice project: situational awareness in electronic fetal monitoring-a Kaiser Permanente Perinatal Patient Safety Program Initiative.

PubMed

MacEachin, S Rachel; Lopez, Connie M; Powell, Kimberly J; Corbett, Nancy L

2009-01-01

Electronic fetal monitoring has historically been interpreted with wide variation between and within disciplines on the obstetric healthcare team. This leads to inconsistent decision making in response to tracing interpretation. To implement a multidisciplinary electronic fetal monitoring training program, utilizing the best evidence available, enabling standardization of fetal heart rate interpretation to promote patient safety. Local multidisciplinary expertise along with an outside consultant collaborated over a series of meetings to create a multimedia instructional electronic fetal monitoring training program. After production was complete, a series of conferences attended by nurses, certified nurse midwives, and physician champions, from each hospital, attended to learn how to facilitate training at their own perinatal units. All healthcare personnel across the Kaiser Permanente perinatal program were trained in NICHD nomenclature, emergency response, interpretation guidelines, and how to create local collaborative practice agreements. Metrics for program effectiveness were measured through program evaluations from attendees, the Safety Attitudes Questionnaire. Program evaluations rendered very positive scores from both physicians and clinicians. Comparing baseline to 4 years later, the perception of safety from the staff has increased over 10% in 5 out of the 6 factors analyzed. Active participation from all disciplines in this training series has highlighted the importance of teamwork and communication. The Fetal Heart Rate Collaborative Practice Project continues to evolve utilizing other educational modalities, such as online EFM education and unit-based interdisciplinary tracing reviews.

Effectiveness of the UNICEF/WHO 20-hour course in improving health professionals' knowledge, practices, and attitudes to breastfeeding: before/after study of 5 maternity facilities in Croatia.

PubMed

Zakarija-Grkovic, Irena; Burmaz, Tea

2010-10-01

To evaluate knowledge, practices, and attitudes to breastfeeding among Croatian health professionals before and after the United Nations International Children's Emergency Fund/World Health Organization (UNICEF/WHO) 20-hour course. Study included 5 of 9 maternity hospitals in southern Croatia, which had completed the UNICEF/WHO 20-hour breastfeeding training course between December 2007 and February 2009. An anonymous questionnaire testing knowledge and practices, and attitudes was distributed to 424 health professionals before training and to 308 health professionals afterwards. Health professionals' attitudes were assessed using the validated Iowa Infant Feeding Attitude Scale. The pre-training response rate was >90%, but only 53% of data were analyzed; the post-training response rate was 69%. Only one-fifth of health professionals prior to training knew that breast preparation in pregnancy was unnecessary, but this increased to 57% after training (P<0.001). The proportion of health professionals who recognized hospital practices that support breastfeeding and signs of poor positioning when breastfeeding nearly doubled after training (P<0.001). The proportion of health professionals correctly recommending immediate "skin-to-skin" contact post-Cesarean section under local anesthesia did not improve significantly, and stratification analyses showed that younger respondents (<36 years) were more likely to support this practice. Although the proportion of health professionals who correctly managed mastitis improved significantly as a result of the training, the proportion of those who after training inappropriately recommended partial or complete cessation of breastfeeding remained high at 47%. The number of staff with positive attitudes toward breastfeeding increased from 65% to 79%, whereas the number of staff with neutral attitudes dropped from 26.6% to 9.9% (P<0.001). Even after training, a substantial proportion of health professionals showed uncertainty in their attitude toward alcohol consumption and breastfeeding. The UNICEF/WHO 20-hour course appears to be an effective tool for improving health professionals' breastfeeding knowledge, attitudes, and practices.

An evaluation of a data linkage training workshop for research ethics committees.

PubMed

Tan, Kate M; Flack, Felicity S; Bear, Natasha L; Allen, Judy A

2015-03-04

In Australia research projects proposing the use of linked data require approval by a Human Research Ethics Committee (HREC). A sound evaluation of the ethical issues involved requires understanding of the basic mechanics of data linkage, the associated benefits and risks, and the legal context in which it occurs. The rapidly increasing number of research projects utilising linked data in Australia has led to an urgent need for enhanced capacity of HRECs to review research applications involving this emerging research methodology. The training described in this article was designed to respond to an identified need among the data linkage units in the Australian Population Health Research Network (PHRN) and HREC members in Australia. Five one-day face to face workshops were delivered in the study period to a total of 98 participants. Participants in the workshops represented all six categories of HREC membership composition listed in the National Health and Medical Research Centres' (NHMRC) National Statement on Ethical Conduct in Human Research. Participants were assessed at three time points, prior to the training (T1), immediately after the training (T2) and 8 to 17 months after the training (T3). Ninety participants completed the pre and post questionnaires; 58 of them completed the deferred questionnaire. Participants reported significant improvements in levels of knowledge, understanding and skills in each of the eight areas evaluated. The training was beneficial for those with prior experience in the area of ethics and data linkage as well as those with no prior exposure. Our preliminary work in this area demonstrates that the provision of intensive face to face ethics training in data linkage is feasible and has a significant impact on participant's confidence in reviewing HREC applications.

Restriction of ACGME fellowships to candidates completing US and Canadian accredited residencies: level of support and expected consequences.

PubMed

Orru', Emanuele; Arenson, Ronald A; Schaefer, Pamela W; Mukherji, Suresh K; Yousem, David M

2014-08-01

The aim of this study was to determine the level of support for the proposal to restrict ACGME-accredited fellowships to candidates who completed residencies accredited by the ACGME or the Royal College of Physicians and Surgeons of Canada. Perceptions of foreign-trained international medical graduates during and after fellowships were also assessed. An e-mail survey was sent to the members of the organizations that represent academic chairpersons (the Society of Chairs of Academic Radiology Departments) and radiology residency and fellowship program directors (the Association of Program Directors in Radiology) and to the program directors of the largest American radiology subspecialty society (the American Society of Neuroradiology). Results were analyzed separately for each of the 3 societies interviewed and then as a composite report for all 3 societies. Approximately 60% of the respondents said that they have offered at least one fellowship or faculty position to foreign-trained applicants in the past 5 years. More than 70% of the respondents said that these doctors performed equally to or better than American-trained ones both clinically and academically. The majority of members of all 3 societies responding opposed enactment of the rule, with the American Society of Neuroradiology being the most disapproving. The main concerns of those supporting the new rule were the inhomogeneous and sometimes unknown levels of training of the foreign-trained doctors and the need to favor American graduates. Those opposed were mostly worried about diminishing the quality of fellowship candidates, programs being unable to fill their positions, and a decrease in academic-oriented people. Most respondents opposed the proposed rule. The majority were supportive of foreign-trained physicians continuing their training in the United States. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

25 CFR 26.32 - What constitutes a complete Job Training Program application?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What constitutes a complete Job Training Program application? 26.32 Section 26.32 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.32 What constitutes a complete Job Training...

25 CFR 26.32 - What constitutes a complete Job Training Program application?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false What constitutes a complete Job Training Program application? 26.32 Section 26.32 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.32 What constitutes a complete Job Training...

25 CFR 26.32 - What constitutes a complete Job Training Program application?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false What constitutes a complete Job Training Program application? 26.32 Section 26.32 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.32 What constitutes a complete Job Training...

25 CFR 26.32 - What constitutes a complete Job Training Program application?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true What constitutes a complete Job Training Program application? 26.32 Section 26.32 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.32 What constitutes a complete Job Training...

Developing strong response capacity: training volunteers in the medical reserve corps.

PubMed

Ye, Jiali; Stanford, Stacy; Gousse, Tahlia; Tosatto, Robert J

2014-12-01

The success of the Medical Reserve Corps (MRC) is dependent on the ability of volunteers to respond in a timely and effective manner. This study aimed to assess the current status of MRC volunteer training and to examine the association between MRC characteristics and provision of training. The data for this study were drawn from the 2013 Network Profile Survey of the MRC, which was administered to active MRC unit leaders or designated alternates of 962 units across the country in April to May of 2013. Over 80% of MRCs had a training plan. Ninety-one percent of MRCs offered one or more training courses to volunteers, and 73% indicated requirements for mandatory training. Approximately 84% of MRC units collaborated with other organizations to conduct trainings. Units with more volunteers (>150) were 3 times as likely to have a plan for volunteer training as were those with fewer volunteers (≤50). Compared to units with a full-time leader, those with leaders who were volunteers were only 0.57 times as likely to have a training plan. An overwhelming majority of MRC units provide critical training to their volunteers prior to an emergency deployment. To further strengthen the overall MRC capacities, it is important for MRC units to have a training plan tailored to their community needs and features, make full use of available training resources, and collaborate with partner organizations.

ICU fire evacuation preparedness in London: a cross-sectional study.

PubMed

Murphy, G R F; Foot, C

2011-05-01

Hospital fires present a sporadic but significant threat to patients and staff. This is especially so within an intensive care unit (ICU) setting, due to the complexity of moving acutely unwell patients reliant on invasive monitoring and organ support. Despite an average of 500 in-hospital fires reported to the UK department of health per annum, causing 65 injuries and 1-2 fatalities, the readiness of ICUs for urgent evacuation has not been assessed. A cross-sectional survey of all 50 adult and paediatric ICUs within the London Postgraduate Deanery was conducted; neonatal units were excluded. The senior nurse at each unit was asked to complete a 90-question structured questionnaire, covering unit patient characteristics, design, equipment, training, and their evacuation plan. Thirty-five of 50 (70%) responded within 2 months of the study. Significant weaknesses were reported in unit design, equipment, and planning. Unit design was compromised by inadequate fire doors (20%), ventilation cut-outs (17%), and escape routes (up to 60%). The ability to evacuate multiple patients simultaneously may be limited by a lack of portable monitoring equipment (49% of beds) and emergency drug supplies (20% of beds). Evacuation plans were often limited in their scope (96% expected to remain on their floor; 14% had plans to obtain medications after evacuation), and not rehearsed (60%). Staff training, while well provided for permanent staff, is less so for temporary staff (34%). Forward planning for an urgent evacuation can be improved.

Intercomparison of principal hydrometric instruments; Third phase, Evaluation of ultrasonic velocity meters for flow measurement in streams, canals, and estuaries

USGS Publications Warehouse

Melching, Charles S.; Meno, Michael W.

1998-01-01

As part of the World Meteorological Organization (WMO) project Intercomparison of Principal Hydrometric Instruments, Third Phase, a questionnaire was prepared by the U.S. Geological Survey (USGS) on the application of Ultrasonic Velocity Meters (UVM's) for flowmeasurement in streams, canals, and estuaries. In 1996, this questionnaire was distributed internationally by the WMO and USGS, and distributed within the United States by the USGS. Completed questionnaires were returned by 26 agencies in 7 countries (Canada, France, Germany, The Netherlands, Switzerland, the United Kingdom, and the United States). The completed questionnaires described geometric and streamflow conditions, system configurations, and reasons for applying UVM systems for 260 sites, thus providing information on the applicability of UVM systems throughout the world. The completed questionnaires also provided information on operational issues such as (1) methods used to determine and verify UVM ratings, (2) methods used to determine the mean flow velocity for UVM systems, (3) operational reliability of UVM systems, (4) methods to estimate missing data, (5) common problems with UVM systems and guidelines to mitigate these problems, and (6) personnel training issues. The completed questionnaires also described a few unique or novel applications of UVM systems. In addition to summarizing the completed questionnaires, this report includes a brief overview of UVM application and operation, and a short summary of current (1998) information from UVM system manufacturers regarding system cost and capabilities. On the basis of the information from the completed questionnaires and provided by the manufacturers, the general applicability of UVM systems is discussed. In the finalisation of this report the financial support provided by the US National Committee for Scientific Hydrology is gratefully acknowledged.

Global Diversity and Academic Success of Foreign-Trained Academic Neurosurgeons in the United States.

PubMed

Mistry, Akshitkumar M; Ganesh Kumar, Nishant; Reynolds, Rebecca A; Hale, Andrew T; Wellons, John C; Naftel, Robert P

2017-08-01

To quantify the proportion of academic neurosurgeons practicing in the United States who acquired residency training outside of the United States and compare their training backgrounds and academic success with those who received their residency training in the United States. We identified 1338 clinically active academic neurosurgeons from 104 programs that participated in the neurosurgery residency match in the United States in January-February 2015. Their training backgrounds, current academic positions, and history of National Institutes of Health (NIH) grant awards between 2005 and 2014 were retrieved from publicly accessible sources. Eighty-four U.S. academic neurosurgeons (6.3%) received their residency training in 20 different countries outside of the United States/Puerto Rico, representing all major regions of the world. The majority trained in Canada (n = 48). We found no major differences between the foreign-trained and U.S.-trained neurosurgeons in male:female ratio, year of starting residency, proportion with positions in medical schools ranked in the top 15 by the U.S. News and World Report, general distribution of academic positions, and proportion with an NIH grant. Compared with U.S.-trained academic neurosurgeons, foreign-trained academic neurosurgeons had a significantly higher proportion of Ph.D. degrees (32.1% vs. 12.3%; P < 0.0001) and held more associate professorships (34.5% vs. 23.1%; P = 0.02). The academic practices of the foreign-trained neurosurgeons were widely distributed throughout the United States. A small group of U.S. academic neurosurgeons (6.3%) have acquired residency training outside of the United States, representing all major regions of the world. Their general demographic data and academic accomplishments are comparable to those of U.S.-trained neurosurgeons. Copyright © 2017 Elsevier Inc. All rights reserved.

Applied Meteorology Unit (AMU) Quarterly Report - Fourth Quarter FY-10

NASA Technical Reports Server (NTRS)

Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

2010-01-01

Three AMU tasks were completed in this Quarter, each resulting in a forecast tool now being used in operations and a final report documenting how the work was done. AMU personnel completed the following tasks (1) Phase II of the Peak Wind Tool for General Forecasting task by delivering an improved wind forecasting tool to operations and providing training on its use; (2) a graphical user interface (GUI) she updated with new scripts to complete the ADAS Update and Maintainability task, and delivered the scripts to the Spaceflight Meteorology Group on Johnson Space Center, Texas and National Weather Service in Melbourne, Fla.; and (3) the Verify MesoNAM Performance task after we created and delivered a GUI that forecasters will use to determine the performance of the operational MesoNAM weather model forecast.

Motor unit recruitment strategies and muscle properties determine the influence of synaptic noise on force steadiness

PubMed Central

Dideriksen, Jakob L.; Negro, Francesco; Enoka, Roger M.

2012-01-01

Motoneurons receive synaptic inputs from tens of thousands of connections that cause membrane potential to fluctuate continuously (synaptic noise), which introduces variability in discharge times of action potentials. We hypothesized that the influence of synaptic noise on force steadiness during voluntary contractions is limited to low muscle forces. The hypothesis was examined with an analytical description of transduction of motor unit spike trains into muscle force, a computational model of motor unit recruitment and rate coding, and experimental analysis of interspike interval variability during steady contractions with the abductor digiti minimi muscle. Simulations varied contraction force, level of synaptic noise, size of motor unit population, recruitment range, twitch contraction times, and level of motor unit short-term synchronization. Consistent with the analytical derivations, simulations and experimental data showed that force variability at target forces above a threshold was primarily due to low-frequency oscillations in neural drive, whereas the influence of synaptic noise was almost completely attenuated by two low-pass filters, one related to convolution of motoneuron spike trains with motor unit twitches (temporal summation) and the other attributable to summation of single motor unit forces (spatial summation). The threshold force above which synaptic noise ceased to influence force steadiness depended on recruitment range, size of motor unit population, and muscle contractile properties. This threshold was low (<10% of maximal force) for typical values of these parameters. Results indicate that motor unit recruitment and muscle properties of a typical muscle are tuned to limit the influence of synaptic noise on force steadiness to low forces and that the inability to produce a constant force during stronger contractions is mainly attributable to the common low-frequency oscillations in motoneuron discharge rates. PMID:22423000

Improved Training Method for Rapid Rehabilitation of Amputees

DTIC Science & Technology

2015-05-01

Falls Overall Project Summary This report describes a four year research effort to develop and test a novel training technique aimed at increasing...month post training assessment. One subject moved after completing the training and did not return for follow-up. Three subjects failed to respond to...training (n=5) Reasons: Moved, revisions, suicide attempt, time conflict Completed Training (n= 20) Completed post - testing (n=20). Lost to

Targeted neonatal echocardiography services: need for standardized training and quality assurance.

PubMed

Finan, Emer; Sehgal, Arvind; Khuffash, Afif El; McNamara, Patrick J

2014-10-01

Targeted neonatal echocardiography refers to a focused assessment of myocardial performance and hemodynamics directed by a specific clinical question. It has become the standard of care in many parts of the world, but practice is variable, and there has been a lack of standardized training and evaluation to date. Targeted neonatal echocardiography was first introduced to Canada in 2006. The purpose of this study was to examine the characteristics of targeted neonatal echocardiography practice and training methods in Canadian neonatal intensive care units (NICUs). A total of 142 Canadian neonatologists were invited to participate in an online survey, which was conducted in September 2010. The survey consisted of questions related to the availability of targeted neonatal echocardiography, clinical indications, benefits and risks, and training methods. The overall survey response rate was 65%. Forty-eight respondents (34%) indicated that targeted neonatal echocardiography was available in their units, and the program was introduced within the preceding 1 to 5 years. In centers where it was unavailable, lack of on-site echocardiography expertise was cited as the major barrier to implementation. The most common indications for targeted neonatal echocardiography included evaluation of a hemodynamically significant ductus arteriosus, systemic or pulmonary blood flow, and response to cardiovascular treatments. Only 27% of respondents, working in centers where targeted neonatal echocardiography existed, actually performed the studies themselves; most individuals completed 11 to 20 studies per month. Almost half of the respondents said that training was available in their institutions, but methods of training and evaluation were inconsistent. Eighty-seven percent of respondents reported no formalized process for assessment of ongoing competency after the initial training period. Targeted neonatal echocardiography is becoming more widely available and is gaining acceptance in Canadian NICUs. Although training is provided in many institutions, the process is not well established, and formal evaluation is rarely performed. This study emphasizes the need for development of standards for formalized training, evaluation, and quality assurance. © 2014 by the American Institute of Ultrasound in Medicine.

Autogenic training to reduce anxiety in nursing students: randomized controlled trial.

PubMed

Kanji, Nasim; White, Adrian; Ernst, Edzard

2006-03-01

This paper reports a study to determine the effectiveness of autogenic training in reducing anxiety in nursing students. Nursing is stressful, and nursing students also have the additional pressures and uncertainties shared with all academic students. Autogenic training is a relaxation technique consisting of six mental exercises and is aimed at relieving tension, anger and stress. Meta-analysis has found large effect sizes for autogenic trainings intervention comparisons, medium effect sizes against control groups, and no effects when compared with other psychological therapies. A controlled trial with 50 nursing students found that the number of certified days off sick was reduced by autogenic training compared with no treatment, and a second trial with only 18 students reported greater improvement in Trait Anxiety, but not State Anxiety, compared with untreated controls. A randomized controlled trial with three parallel arms was completed in 1998 with 93 nursing students aged 19-49 years. The setting was a university college in the United Kingdom. The treatment group received eight weekly sessions of autogenic training, the attention control group received eight weekly sessions of laughter therapy, and the time control group received no intervention. The outcome measures were the State-Trait Anxiety Inventory, the Maslach Burnout Inventory, blood pressure and pulse rate completed at baseline, 2 months (end of treatment), and 5, 8, and 11 months from randomization. There was a statistically significantly greater reduction of State (P<0.001) and Trait (P<0.001) Anxiety in the autogenic training group than in both other groups immediately after treatment. There were no differences between the groups for the Maslach Burnout Inventory. The autogenic training group also showed statistically significantly greater reduction immediately after treatment in systolic (P<0.01) and diastolic (P<0.05) blood pressure, and pulse rate (P<0.002), than the other two groups. CONCLUSION. Autogenic training has at least a short-term effect in alleviating stress in nursing students.

Training pharmacy technicians to administer immunizations.

PubMed

McKeirnan, Kimberly C; Frazier, Kyle R; Nguyen, Maryann; MacLean, Linda Garrelts

To evaluate the effectiveness of an immunization training program for pharmacy technicians on technicians' self-reported confidence, knowledge, and number of vaccines administered. A one-group pre- and posttest study was conducted with certified pharmacy technicians from Albertsons and Safeway community pharmacies in Idaho. Thirty pharmacy technicians were recruited to participate in an immunization administration training program comprising a 2-hour home study and a 2-hour live training. Pharmacy technician scores on a 10-question knowledge assessment, responses on a pre- and posttraining survey, and number of immunizations administered in the 6-month period following the training were collected. Twenty-five pharmacy technicians completed the home study and live portions of the immunization training program. All 29 pharmacy technicians who took the home study assessment passed with greater than 70% competency on the first attempt. Technicians self-reported increased confidence with immunization skills between the pretraining survey and the posttraining survey. From December 2016 to May 2017, the technicians administered 953 immunizations with 0 adverse events reported. For the first time, pharmacy technicians have legally administered immunizations in the United States. Trained pharmacy technicians demonstrated knowledge of vaccination procedures and self-reported improved confidence in immunization skills and administered immunizations after participating in a 4-hour training program. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

The Sociology of Army Reserves: An Organizational Assessment

DTIC Science & Technology

1990-07-01

enlisted people , especially NPS, the major stated reason to enlist was educational benefits. (Educational benefits also seemed to be a socially...dimension to one’s life: the camaraderie of the unit, the outdoor life of annual training, the challenge fo leading young people , and a way of breaking...that only one in five reservists completes the initial six-year obligation. A large part of this attrition, to be sure, is simply caused by people moving

United States European Command

Science.gov Websites

service members from 13 nations gathered in 7th Army Training Command's Hohenfels Training Area in NATO nations. Units will conduct training alongside our NATO allies to strengthen interoperability and Eastern European NATO nations. Units will conduct training alongside our NATO allies to strengthen

[Legal framework of postgraduate nursing education in spain].

PubMed

Fernández, B M

1996-01-01

Being part of the first report of the SEEIUC Forum on the training of nurses in critical care units, this article shows the different postgraduation training paths which Spanish legislation establishes. The "Titulos Oficiales de Especialización Profesional" ("Official Degrees on Professional Specialization") settle the seven nursing specialties regulated by the Decreto 992/1987. Following a second path, "Titulos de Postgraduado no Oficiales" ("Non-official postgraduation degrees"), every University acknowledged by the LRU and creating them as their Own Degrees, may organize Master courses, University experts, University specialists and Postgraduation university degrees, according to their autonomy. So that this autonomous offer is as homogeneous as possible, there is an interuniversity agreement which encompasses 24 national universities and gathers the general criteria for the academic organization of such courses. The report is completed by an analysis of the training offer for critical care nursing, developed during the 1995/1996 course in Spain.

Arthroscopic Training Courses Improve Trainee Arthroscopy Skills: A Simulation-Based Prospective Trial.

PubMed

Martin, Kevin D; Patterson, David P; Cameron, Kenneth L

2016-11-01

To evaluate the correlation between timed task performance on an arthroscopy shoulder simulator and participation in a standardized expert shoulder arthroscopy educational course. Orthopaedic trainees were voluntarily recruited from over 25 residency programs throughout the United States and Canada. Each trainee was tested on arrival at the Arthroscopy Association of North America orthopaedic learning center on a virtual reality arthroscopy shoulder simulator, and his or her performance was objectively scored. Each trainee's postgraduate year level was recorded, as was his or her experience in residency with shoulder arthroscopy as measured by Accreditation Council for Graduate Medical Education case-log totals. After the focused 4-day training curriculum consisting of didactics and cadaveric experience, each trainee was re-evaluated on the same simulator. Statistical analysis was performed to determine if participation in the course was associated with changes in simulation performance from before to after assessment. Forty-eight trainees completed the testing. On completion of the course, trainees showed significant improvements in all objective measures recorded by the simulator. Total probe distance needed to complete the task decreased by 42% (from 420.4 mm to 245.3 mm, P < .001), arthroscope tip distance traveled decreased by 59% (from 194.1 mm to 80.2 mm, P < .001), and time to completion decreased by 38% (from 66.8 seconds to 41.6 seconds, P < .001). Highly significant improvements in all 3 measures suggest improved instrument handling, anatomic recognition, and arthroscopy-related visual-spatial ability. This study shows objective improvement in orthopaedic trainee basic arthroscopy skill and proficiency after a standardized 4-day arthroscopy training curriculum. The results validate the Arthroscopy Association of North America resident training course and its curriculum with objective evidence of benefit. Level III, prospective study of nonconsecutive participants. Published by Elsevier Inc.

Factors associated with successful matching to dermatology residency programs by reapplicants and other applicants who previously graduated from medical school.

PubMed

Stratman, Erik J; Ness, Rachel M

2011-02-01

To identify factors associated with and not associated with successful matching and matriculation (hereinafter "matching") to dermatology residency programs for applicants who previously graduated from medical school and to distinguish which factors are within applicants' control. Observational cohort study. Six accredited academic dermatology residency training programs in the United States. A total of 221 residency applicants who previously graduated from medical school and who applied through standardized electronic application to 1 or more of the participating residency training programs. Matriculation to a dermatology residency program by August 2008 following the 2006 residency application period. Forty-six of 221 former medical school graduates included in this study matched to a dermatology residency program. Factors strongly associated with matching included United States Medical Licensing Examination Step 3 score; submission of letters written by dermatologists from institutions that train dermatology residents; completion of preliminary medicine internships rather than transitional or other internship types; listing of research experience; publishing of medical manuscripts; and completion of non-Accreditation Council for Graduate Medical Examination dermatology fellowships. Factors not associated with increased matching included volunteer work; PhD status; sex; number of posters or presentations at dermatology conferences; quality of journal publications; and first authorship. Most successful applicants limited personal statements to 1 page and did not mention previously failing to match. The study sample represented at least 86% of such nontraditional applicants who matched in 2006. For candidates seeking to match into dermatology residency programs after graduating from medical school, there are factors within their control that are associated with higher rates of match success. This study provides evidence to assist mentors who counsel such candidates. ©2011 American Medical Association. All rights reserved.

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

PubMed

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

2017-12-01

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

Training adaptations in the behavior of human motor units.

PubMed

Duchateau, Jacques; Semmler, John G; Enoka, Roger M

2006-12-01

The purpose of this brief review is to examine the neural adaptations associated with training, by focusing on the behavior of single motor units. The review synthesizes current understanding on motor unit recruitment and rate coding during voluntary contractions, briefly describes the techniques used to record motor unit activity, and then evaluates the adaptations that have been observed in motor unit activity during maximal and submaximal contractions. Relatively few studies have directly compared motor unit behavior before and after training. Although some studies suggest that the voluntary activation of muscle can increase slightly with strength training, it is not known how the discharge of motor units changes to produce this increase in activation. The evidence indicates that the increase is not attributable to changes in motor unit synchronization. It has been demonstrated, however, that training can increase both the rate of torque development and the discharge rate of motor units. Furthermore, both strength training and practice of a force-matching task can evoke adaptations in the discharge characteristics of motor units. Because the variability in discharge rate has a significant influence on the fluctuations in force during submaximal contractions, the changes produced with training can influence motor performance during activities of daily living. Little is known, however, about the relative contributions of the descending drive, afferent feedback, spinal circuitry, and motor neuron properties to the observed adaptations in motor unit activity.

An Analysis of United States Marine Corps Enlisted Entry-Level Training Using Supply Chain and Operations Management

DTIC Science & Technology

2010-12-01

An Analysis of United States Marine Corps Enlisted Entry-Level Training Using Supply Chain and Operations Management ______________________________________ By...Report 4. TITLE AND SUBTITLE: An Analysis of United States Marine Corps Enlisted Entry-Level Training Using Supply Chain and Operations Management 6...Level Training; United States Marine Corps; Operations Management ; Supply Chain Management; Process Analysis 16. PRICE CODE 17. SECURITY

Adjustments in motor unit properties during fatiguing contractions after training.

PubMed

Vila-Chã, Carolina; Falla, Deborah; Correia, Miguel Velhote; Farina, Dario

2012-04-01

The objective of the study was to investigate the effect of strength and endurance training on muscle fiber membrane properties and discharge rates of low-threshold motor units of the vasti muscles during fatiguing contractions. Twenty-five sedentary healthy men (age (mean ± SD) = 26.3 ± 3.9 yr) were randomly assigned to one of three groups: strength training, endurance training, or a control group. Conventional endurance and strength training was performed 3 d·wk⁻¹, during a period of 6 wk. Motor unit conduction velocity and EMG amplitude of the vastus medialis obliquus and lateralis muscles and biceps femoris were measured during sustained isometric knee extensions at 10% and 30% of the maximum voluntary contraction before and immediately after training. After 6 wk of training, the reduction in motor unit conduction velocity during the sustained contractions at 30% of the maximum voluntary force occurred at slower rates compared with baseline (P < 0.05). However, the rate of decrease was lower after endurance training compared with strength training (P < 0.01). For all groups, motor unit discharge rates declined during the sustained contraction (P < 0.001), and their trend was not altered by training. In addition, the biceps femoris-vasti coactivation ratio declined after the endurance training. Short-term strength and endurance training induces alterations of the electrophysiological membrane properties of the muscle fiber. In particular, endurance training lowers the rate of decline of motor unit conduction velocity during sustained contractions more than strength training.

Video-Only Cardiopulmonary Resuscitation Education for High-Risk Families Before Hospital Discharge: A Multicenter Pragmatic Trial.

PubMed

Blewer, Audrey L; Putt, Mary E; Becker, Lance B; Riegel, Barbara J; Li, Jiaqi; Leary, Marion; Shea, Judy A; Kirkpatrick, James N; Berg, Robert A; Nadkarni, Vinay M; Groeneveld, Peter W; Abella, Benjamin S

2016-11-01

Cardiopulmonary resuscitation (CPR) training rates in the United States are low, highlighting the need to develop CPR educational approaches that are simpler, with broader dissemination potential. The minimum training required to ensure long-term skill retention remains poorly characterized. We compared CPR skill retention among laypersons randomized to training with video-only (VO; no manikin) with those trained with a video self-instruction kit (VSI; with manikin). We hypothesized that VO training would be noninferior to the VSI approach with respect to chest compression (CC) rate. We performed a prospective, cluster randomized trial of CPR education for family members of patients with high-risk cardiac conditions on hospital cardiac units, using a multicenter pragmatic design. Eight hospitals were randomized to offer either VO or VSI training before discharge using volunteer trainers. CPR skills were assessed 6 months post training. Mean CC rate among those trained with VO compared with those trained with VSI was assessed with a noninferiority margin set at 8 CC per min; as a secondary outcome, mean differences in CC depth were assessed. From February 2012 to May 2015, 1464 subjects were enrolled and 522 subjects completed a skills assessment. The mean CC rates were 87.7 (VO) CC per min and 89.3 (VSI) CC per min; we concluded noninferiority for VO based on a mean difference of -1.6 (90% confidence interval, -5.2 to 2.1). The mean CC depth was 40.2 mm (VO) and 45.8 mm (VSI) with a mean difference of -5.6 (95% confidence interval, -7.6 to -3.7). Results were similar after multivariate regression adjustment. In this large, prospective trial of CPR skill retention, VO training yielded a noninferior difference in CC rate compared with VSI training. CC depth was greater in the VSI group. These findings suggest a potential trade-off in efforts for broad dissemination of basic CPR skills; VO training might allow for greater scalability and dissemination, but with a potential reduction in CC depth. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01514656. © 2016 American Heart Association, Inc.

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

PubMed

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

2016-11-01

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

Hispanic construction workers and assertiveness training.

PubMed

Shrestha, Pramen P; Menzel, Nancy N

2014-01-01

Hispanic (Latino) construction workers experience disparities in occupational death and injury rates in the United States. The cultural value of respect for those in authority may hinder these workers from requesting safe working conditions from supervisors. To evaluate whether Hispanic construction workers in Las Vegas, Nevada found assertiveness training more useful than non-Hispanic trainees and whether or not they practiced this behavior at work after the training. An assertiveness training simulation was part of fall prevention classes offered to area construction workers. Eight weeks after the training, participants were interviewed by telephone about class topics they found most useful and whether or not they had made any subsequent behavior changes at work. More than half of the 760 fall prevention trainees completed telephone interviews. A smaller proportion of Hispanic trainees found assertiveness training to be useful (11%) than non-Hispanics (28%) (p⩽ 0.001). Only 2% of both groups identified practicing assertiveness at work. A large proportion of Hispanic trainees valued other knowledge more highly. They may weigh job security as more important than speaking up about safety issues, which might threaten their employment. Interventions to improve safety should focus instead on improving work safety climate and engineering controls.

14 CFR 382.143 - When must carriers complete training for their personnel?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false When must carriers complete training for their personnel? 382.143 Section 382.143 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... TRAVEL Training and Administrative Provisions § 382.143 When must carriers complete training for their...

14 CFR 382.143 - When must carriers complete training for their personnel?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false When must carriers complete training for their personnel? 382.143 Section 382.143 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... TRAVEL Training and Administrative Provisions § 382.143 When must carriers complete training for their...

14 CFR 382.143 - When must carriers complete training for their personnel?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false When must carriers complete training for their personnel? 382.143 Section 382.143 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... TRAVEL Training and Administrative Provisions § 382.143 When must carriers complete training for their...

14 CFR 382.143 - When must carriers complete training for their personnel?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false When must carriers complete training for their personnel? 382.143 Section 382.143 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... TRAVEL Training and Administrative Provisions § 382.143 When must carriers complete training for their...

14 CFR 382.143 - When must carriers complete training for their personnel?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false When must carriers complete training for their personnel? 382.143 Section 382.143 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... TRAVEL Training and Administrative Provisions § 382.143 When must carriers complete training for their...

Communication Skills Training in Ophthalmology: Results of a Needs Assessment and Pilot Training Program.

PubMed

Mishra, Anuradha; Browning, David; Haviland, Miriam J; Jackson, Mary Lou; Luff, Donna; Meyer, Elaine C; Talcott, Katherine; Kloek, Carolyn E

To conduct a needs assessment to identify gaps in communication skills training in ophthalmology residency programs and to use these results to pilot a communication workshop that prepares residents for difficult conversations. A mixed-methods design was used to perform the needs assessment. A pre-and postsurvey was administered to workshop participants. Mass Eye and Ear Infirmary, Harvard Medical School (HMS), Department of Ophthalmology. HMS ophthalmology residents from postgraduate years 2-4 participated in the needs assessment and the workshop. Ophthalmology residency program directors in the United States participated in national needs assessment. Ophthalmology program directors across the United States were queried on their perception of resident communication skills training through an online survey. A targeted needs assessment in the form of a narrative exercise captured resident perspectives on communication in ophthalmology from HMS residents. A group of HMS residents participated in the pilot workshop and a pre- and postsurvey was administered to participants to assess its effectiveness. The survey of program directors yielded a response rate of 40%. Ninety percent of respondents agreed that the communication skills training in their programs could be improved. Fifteen of 24 residents (62%) completed the needs assessment. Qualitative analysis of the narrative material revealed four themes; (1) differing expectations, (2) work role and environment, (3) challenges specific to ophthalmology, and (4) successful strategies adopted. Nine residents participated in the workshop. There was a significant improvement post-workshop in resident reported scores on their ability to manage their emotions during difficult conversations (p = 0.03). There is an opportunity to improve communication skills training in ophthalmology residency through formalized curriculum. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Impact of Subspecialty Fellowship Training on Research Productivity Among Academic Plastic Surgery Faculty in the United States.

PubMed

Sood, Aditya; Therattil, Paul J; Chung, Stella; Lee, Edward S

2015-01-01

The impact of subspecialty fellowship training on research productivity among academic plastic surgeons is unknown. The authors' aim of this study was to (1) describe the current fellowship representation in academic plastic surgery and (2) evaluate the relationship between h-index and subspecialty fellowship training by experience and type. Academic plastic surgery faculty (N = 590) were identified through an Internet-based search of all ACGME-accredited integrated and combined residency programs. Research output was measured by h-index from the Scopus database as well as a number of peer-reviewed publications. The Kruskal-Wallis test, with a subsequent Mann-Whitney U test, was used for statistical analysis to determine correlations. In the United States, 72% (n = 426) of academic plastic surgeons had trained in 1 or more subspecialty fellowship program. Within this cohort, the largest group had completed multiple fellowships (28%), followed by hand (23%), craniofacial (22%), microsurgery (15%), research (8%), cosmetic (3%), burn (2%), and wound healing (0.5%). Higher h-indices correlated with a research fellowship (12.5; P < .01) and multiple fellowships (10.4; P < .01). Craniofacial-trained plastic surgeons demonstrated the next highest h-index (9.8), followed by no fellowship (8.4), microsurgery (8.3), hand (7.7), cosmetic (5.2), and burn (5.1). Plastic surgeons with a research fellowship or at least 2 subspecialty fellowships had increased academic productivity compared with their colleagues. Craniofacial-trained physicians also demonstrated a higher marker for academic productivity than multiple other specialties. In this study, we show that the type and number of fellowships influence the h-index and further identification of such variables may help improve academic mentorship and productivity within academic plastic surgery.

Short-term perceptual learning in visual conjunction search.

PubMed

Su, Yuling; Lai, Yunpeng; Huang, Wanyi; Tan, Wei; Qu, Zhe; Ding, Yulong

2014-08-01

Although some studies showed that training can improve the ability of cross-dimension conjunction search, less is known about the underlying mechanism. Specifically, it remains unclear whether training of visual conjunction search can successfully bind different features of separated dimensions into a new function unit at early stages of visual processing. In the present study, we utilized stimulus specificity and generalization to provide a new approach to investigate the mechanisms underlying perceptual learning (PL) in visual conjunction search. Five experiments consistently showed that after 40 to 50 min of training of color-shape/orientation conjunction search, the ability to search for a certain conjunction target improved significantly and the learning effects did not transfer to a new target that differed from the trained target in both color and shape/orientation features. However, the learning effects were not strictly specific. In color-shape conjunction search, although the learning effect could not transfer to a same-shape different-color target, it almost completely transferred to a same-color different-shape target. In color-orientation conjunction search, the learning effect partly transferred to a new target that shared same color or same orientation with the trained target. Moreover, the sum of transfer effects for the same color target and the same orientation target in color-orientation conjunction search was algebraically equivalent to the learning effect for trained target, showing an additive transfer effect. The different transfer patterns in color-shape and color-orientation conjunction search learning might reflect the different complexity and discriminability between feature dimensions. These results suggested a feature-based attention enhancement mechanism rather than a unitization mechanism underlying the short-term PL of color-shape/orientation conjunction search.

Impact of Subspecialty Fellowship Training on Research Productivity Among Academic Plastic Surgery Faculty in the United States

PubMed Central

Therattil, Paul J.; Chung, Stella; Lee, Edward S.

2015-01-01

Purpose: The impact of subspecialty fellowship training on research productivity among academic plastic surgeons is unknown. The authors’ aim of this study was to (1) describe the current fellowship representation in academic plastic surgery and (2) evaluate the relationship between h-index and subspecialty fellowship training by experience and type. Methods: Academic plastic surgery faculty (N = 590) were identified through an Internet-based search of all ACGME-accredited integrated and combined residency programs. Research output was measured by h-index from the Scopus database as well as a number of peer-reviewed publications. The Kruskal-Wallis test, with a subsequent Mann-Whitney U test, was used for statistical analysis to determine correlations. Results: In the United States, 72% (n = 426) of academic plastic surgeons had trained in 1 or more subspecialty fellowship program. Within this cohort, the largest group had completed multiple fellowships (28%), followed by hand (23%), craniofacial (22%), microsurgery (15%), research (8%), cosmetic (3%), burn (2%), and wound healing (0.5%). Higher h-indices correlated with a research fellowship (12.5; P < .01) and multiple fellowships (10.4; P < .01). Craniofacial-trained plastic surgeons demonstrated the next highest h-index (9.8), followed by no fellowship (8.4), microsurgery (8.3), hand (7.7), cosmetic (5.2), and burn (5.1). Conclusion: Plastic surgeons with a research fellowship or at least 2 subspecialty fellowships had increased academic productivity compared with their colleagues. Craniofacial-trained physicians also demonstrated a higher marker for academic productivity than multiple other specialties. In this study, we show that the type and number of fellowships influence the h-index and further identification of such variables may help improve academic mentorship and productivity within academic plastic surgery. PMID:26664673

A survey of oral medicine education, training and practice among dermatologists in the UK and Ireland.

PubMed

Heelan, K; McKenna, D

2016-01-15

Oral mucocutaneous diseases are common and patients with these conditions are frequently assessed by dermatologists. An accurate and comprehensive oral examination is important for a complete dermatological assessment. The aim of this study was to assess education and training, knowledge, and clinical practice of oral medicine among dermatologists in the United Kingdom (UK) and Ireland. A cross-sectional survey was conducted by means of an internet-based survey tool. This was available to British Association of Dermatology (BAD) members in UK and Ireland on the association's website. Members were asked to respond to a 10-part questionnaire that enquired about their knowledge of oral diseases, training in oral medicine, performing an oral examination and oral biopsy. Completed responses were received from 95 dermatologists. The majority of respondents were consultant dermatologists (72%) who were university based. While the majority reported that knowledge of oral diseases was important, only 52% were confident in recognising the normal variants of the oral cavity. Just 55% were confident in recognising oral malignancy and even less (42%) the different forms of oral ulceration. Over three-quarters had never attended an oral medicine clinic or attended an external oral medicine course as part of their training. Two thirds had not been taught normal oral anatomy or how to perform an oral examination. The majority reported that their training in oral medicine was not adequate to perform their job. This study shows that in this, albeit small, group of dermatology specialists and trainees most appear ill-equipped to recognise and diagnose diseases of the oral cavity due to a lack of training in oral medicine.

Effectiveness of battlefield-ethics training during combat deployment: a programme assessment.

PubMed

Warner, Christopher H; Appenzeller, George N; Mobbs, Angela; Parker, Jessica R; Warner, Carolynn M; Grieger, Thomas; Hoge, Charles W

2011-09-03

Breakdowns in the ethical conduct of soldiers towards non-combatants on the battlefield are of grave concern in war. Evidence-based training approaches to prevent unethical conduct are scarce. We assessed the effectiveness of battlefield-ethics training and factors associated with unethical battlefield conduct. The training package, based on movie vignettes and leader-led discussions, was administered 7 to 8 months into a 15-month high-intensity combat deployment in Iraq, between Dec 11, 2007, and Jan 30, 2008. Soldiers from an infantry brigade combat team (total population about 3500) were randomly selected, on the basis of company and the last four digits of each soldier's social security number, and invited to complete an anonymous survey 3 months after completion of the training. Reports of unethical behaviour and attitudes in this sample were compared with a randomly selected pre-training sample from the same brigade. The response patterns for ethical behaviour and reporting of ethical violations were analysed with chi-square analyses. We developed two logistic regression models using self-reported unethical behaviours as dependent variables. Factors associated with unethical conduct, including combat experiences and post-traumatic stress disorder (PTSD), were assessed with validated scales. Of 500 randomly selected soldiers 421 agreed to participate in the anonymous post-training survey. A total of 397 soldiers of the same brigade completed the pre-training survey. Training was associated with significantly lower rates of unethical conduct of soldiers and greater willingness to report and address misconduct than in those before training. For example, reports of unnecessary damage or destruction of private property decreased from 13·6% (54 of 397; 95% CI 10·2-17·0) before training to 5·0% (21 of 421; 2·9-7·1) after training (percent difference -63·2%; p<0·0001), and willingness to report a unit member for mistreatment of a non-combatant increased from 36·0% (143 of 397; 31·3-40·7) to 58·9% (248 of 421; 54·2-63·6; percent difference 63·6; p<0·0001). Nearly all participants (410 [97%]) reported that training made it clear how to respond towards non-combatants. Combat frequency and intensity was the strongest predictor of unethical behaviour; PTSD was not a significant predictor of unethical behaviour after controlling for combat experiences. Leader-led battlefield ethics training positively influenced soldiers' understanding of how to interact with and treat non-combatants, and reduced reports of ethical misconduct. Unethical battlefield conduct was associated with high-intensity combat but not with PTSD. None. Copyright © 2011 Elsevier Ltd. All rights reserved.

Measuring the Impact of Cultural Competence Training for Dental Hygiene Students.

PubMed

Daugherty, Heather N; Kearney, Rachel C

2017-10-01

Purpose: The purpose of this study was to measure the change in levels of knowledge of providing culturally competent care and self-assessed cultural competence of senior level dental hygiene students after the implementation of an online cultural competence training module. Methods: Twenty-eight members of the senior class of 31 dental hygiene students (N=28) volunteered to participate in this IRB approved study at the Ohio State University School of Dentistry. The students took the online Inventory for Assessing the Process of Cultural Competence- Student Version (IAPCC-SV), to assess their self-perceived cultural competence. Upon completion of the pre-test, students then completed the United States Department of Health and Human Services (HHS) Office of Minority Health (OMH) Cultural Competency Program for Oral Health Professionals; a three-module online training program designed to measure increased knowledge of cultural competence. Three weeks following the initial pre-test and upon completion of the Cultural Competency Program for Oral Health Professionals online learning modules, students re-took the IAPCC-SV. Results: Twenty-eight senior dental hygiene students completed the IAPCC-SV pre-test, the OMH e-learning modules and the IAPCC-SV post-test. The average score on the pre-test was 55.14±7.54 and the average score on the post-test was 61.33±7.86. There was a significant difference in pre-test and post-test scores (p<0.001). There were also significant differences in the constructs of knowledge of cultural competence (p<0.001) and skill (p<0.001). Conclusion: The HHS OMH Cultural Competency Program for Oral Health Professionals was effective for increasing dental hygiene students' levels of knowledge of cultural competence. Copyright © 2017 The American Dental Hygienists’ Association.

Training the next generation of physician researchers - Vanderbilt Medical Scholars Program.

PubMed

Brown, Abigail M; Chipps, Teresa M; Gebretsadik, Tebeb; Ware, Lorraine B; Islam, Jessica Y; Finck, Luke R; Barnett, Joey; Hartert, Tina V

2018-01-04

As highlighted in recent reports published by the Physician-Scientist Workforce Working Group at the National Institutes of Health, the percentage of physicians conducting research has declined over the past decade. Various programs have been put in place to support and develop current medical student interest in research to alleviate this shortage, including The Vanderbilt University School of Medicine Medical Scholars Program (MSP). This report outlines the long-term program goals and short-term outcomes on career development of MSP alumni, to shed light on the effectiveness of research training programs during undergraduate medical training to inform similar programs in the United States. MSP alumni were asked to complete an extensive survey assessing demographics, accomplishments, career progress, future career plans, and MSP program evaluation. Fifty-five (81%) MSP alumni responded, among whom 12 had completed all clinical training. The demographics of MSP alumni survey respondents are similar to those of all Vanderbilt medical students and medical students at all other Association of American Medical College (AAMC) medical schools. MSP alumni published a mean of 1.9 peer-reviewed manuscripts (95% CI:1.2, 2.5), and 51% presented at national meetings. Fifty-eight percent of respondents reported that MSP participation either changed their career goals or helped to confirm or refine their career goals. Results suggest that the MSP program both prepares students for careers in academic medicine and influences their career choices at an early juncture in their training. A longer follow-up period is needed to fully evaluate the long-term outcomes of some participants.

The Army Needs to Improve Individual Soldier Training in Its Units. Report to the Congress by the Comptroller General of the United States.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

A study was conducted to determine whether unit level individual skill training is being provided to prepare Army enlisted personnel to perform critical job tasks within their military occupational specialty (MOS). The General Accounting Office reviewed the Army's skill training programs at 10 active units in the continental United States and five…

Geriatrics. Exemplary Prevocational Programs for the Handicapped in Mississippi. PVO Unit XII--Miniunits 1-14.

ERIC Educational Resources Information Center

Chandler, David, Comp.; And Others

This unit is part of a Mississippi program designed to provide exploratory experiences and training for handicapped students, to determine if these students are capable of further vocational training or are poor risks for further occupational training, and to train students for basal skill occupations. The materials included in this unit on…

46 CFR 11.301 - Requirements for STCW officer endorsements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... specialist. (vii) Workshop skills training: Documentation of successful completion of assessments or... engineering—as appropriate. (ii) Training ship experience: Documentation of successful completion of an approved training program involving formal training and assessment onboard a training ship. (iii) Simulator...

Current practices in library/informatics instruction in academic libraries serving medical schools in the Western United States: a three-phase action research study.

PubMed

Eldredge, Jonathan D; Heskett, Karen M; Henner, Terry; Tan, Josephine P

2013-09-04

To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and teaching skills, and that they need to continually adapt to changes in curricula. This study offers a long overdue, systematic view of current practices of library/informatics training at Western U.S. medical schools. Medical educators, particularly curricular leaders, will find opportunities in this study's results for more productive collaborations with the librarians responsible for library and informatics training at their medical schools.

Natural Growth Goals and Short-Term Training: A Boomerang Effect.

ERIC Educational Resources Information Center

Pace, R. Wayne; Regan, Les; Miller, Peter; Dunn, Lee

1998-01-01

Undergraduates were divided into four groups: 76 received training and completed the Natural Growth Goals Inventory and Organizational Learning Survey as pre- and posttests; 76 completed the NGGI only; 30 the OLS only; and 75 were trained and completed posttests. Both pretesting and training had a negative or boomerang effect on perceptions of the…

25 CFR 26.36 - What follow-up service is available after I complete training?

Code of Federal Regulations, 2010 CFR

2010-04-01

... training? 26.36 Section 26.36 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES JOB PLACEMENT AND TRAINING PROGRAM Training Services § 26.36 What follow-up service is available after I complete training? Job Placement assistance may follow training. ...

Space Operations Training Concepts Benchmark Study (Training in a Continuous Operations Environment)

NASA Technical Reports Server (NTRS)

Johnston, Alan E.; Gilchrist, Michael; Underwood, Debrah (Technical Monitor)

2002-01-01

The NASA/USAF Benchmark Space Operations Training Concepts Study will perform a comparative analysis of the space operations training programs utilized by the United States Air Force Space Command with those utilized by the National Aeronautics and Space Administration. The concentration of the study will be focused on Ground Controller/Flight Controller Training for the International Space Station Payload Program. The duration of the study is expected to be five months with report completion by 30 June 2002. The U.S. Air Force Space Command was chosen as the most likely candidate for this benchmark study because their experience in payload operations controller training and user interfaces compares favorably with the Payload Operations Integration Center's training and user interfaces. These similarities can be seen in the dynamics of missions/payloads, controller on-console requirements, and currency/proficiency challenges to name a few. It is expected that the report will look at the respective programs and investigate goals of each training program, unique training challenges posed by space operations ground controller environments, processes of setting up controller training programs, phases of controller training, methods of controller training, techniques to evaluate adequacy of controller knowledge and the training received, and approaches to training administration. The report will provide recommendations to the respective agencies based on the findings. Attached is a preliminary outline of the study. Following selection of participants and an approval to proceed, initial contact will be made with U.S. Air Force Space Command Directorate of Training to discuss steps to accomplish the study.

Provider practices in the primary care behavioral health (PCBH) model: an initial examination in the Veterans Health Administration and United States Air Force.

PubMed

Funderburk, Jennifer S; Dobmeyer, Anne C; Hunter, Christopher L; Walsh, Christine O; Maisto, Stephen A

2013-12-01

The goals of this study were to identify characteristics of both behavioral health providers (BHPs) and the patients seen in a primary care behavioral health (PCBH) model of service delivery using prospective data obtained from BHPs. A secondary objective was to explore similarities and differences between these variables within the Veterans Health Administration (VHA) and United States Air Force (USAF) primary care clinics. A total of 159 VHA and 23 USAF BHPs, representing almost every state in the United States, completed the study, yielding data from 403 patient appointments. BHPs completed a web-based questionnaire that assessed BHP and setting characteristics, and a separate questionnaire after each patient seen on one day of clinical service. Data demonstrated that there are many similarities between the VHA and USAF BHPs and practices. Both systems tend to use well-trained psychologists as BHPs, had systems that support the BHP being in close proximity to the primary care providers, and have seamless operational elements (i.e., shared record, one waiting room, same-day appointments, and administrative support for BHPs). Comorbid anxiety and depression was the most common presenting problem in both systems, but overall rates were higher in VHA clinics, and patients were significantly more likely to meet diagnostic criteria for mental health conditions. This study provides the first systematic, prospective examination of BHPs and practices within a PCBH model of service delivery in two large health systems with well over 5 years of experience with behavioral health integration. Many elements of the PCBH model were implemented in a manner consistent with the model, although some variability exists within both settings. These data can help guide future implementation and training efforts.

The Impact of Listening to Music During a High-Intensity Exercise Endurance Test in People With COPD.

PubMed

Lee, Annemarie L; Dolmage, Thomas E; Rhim, Matthew; Goldstein, Roger S; Brooks, Dina

2018-05-01

In people with COPD, dyspnea is the primary symptom limiting exercise tolerance. One approach to reducing dyspnea during exercise is through music listening. A constant speed endurance test reflects a high-intensity aerobic exercise training session, but whether listening to music affects endurance time is unknown. This study aimed to determine the effects of listening to music during a constant speed endurance test in COPD. Participants with COPD completed two endurance walk tests, one with and one without listening to self-selected music throughout the test. The primary outcome was the difference in endurance time between the two conditions. Heart rate, percutaneous oxygen saturation, dyspnea, and rate of perceived exertion were measured before and after each test. Nineteen participants (mean [SD]: age, 71 [8] years; FEV 1 , 47 [19] % predicted) completed the study. Endurance time was greater (1.10 [95% CI, 0.41-1.78] min) while listening to music (7.0 [3.1] min) than without (5.9 [2.6] min), and reduced end-test dyspnea (1.0 [95% CI, -2.80 to -1.80] units) (with music, 4.6 [1.7] units; vs without music, 5.6 [1.4] units, respectively). There was not a significant difference in heart rate, percutaneous oxygen saturation, or leg fatigue. There were no adverse events under either condition. In COPD, dyspnea was less while listening to music and was accompanied by an increased tolerance of high-intensity exercise demonstrated by greater endurance time. Practically, the effect was modest but may represent an aid for exercise training of these patients. Australian New Zealand Clinical Trials Registry; No. ACTRN12617001217392. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

The U.S. Navy’s Military Sealift Command 2009 in Review

DTIC Science & Technology

2009-01-01

USNS Shughart (T- AKR 295) USNS Yano (T- AKR 297) *Long-term charter 31 S E A L I F T M MSC large, medium- speed , roll-on/roll-off ship , USNS Seay conducts...Dry cargo /ammunition ship USNS Lewis and Clark completed a 10-month deployment supporting operations Iraqi Freedom and Enduring Freedom and U.S...Unit Two personnel. High - speed vessel HSV 2 Swift supported Southern Partnership Station, a training mission to Central America, SouthAmerica and the

Risk Mitigation during Human Electromuscular Incapacitation Research

DTIC Science & Technology

2015-04-30

that simulated different arrest conditions.Error! Bookmark not defined. Group 1 completed a 150 meter sprint followed by a 44-inch wall hurdle...mL thousandth (milli) of a liter mm thousandths (milli) of a meter mM/L thousandths (milli) of a mole per liter NAMRU-SA Naval Medical... sprint plus a 44-inch hurdle, 45 seconds of striking a heavy bag, a 10-second TASER X-25 EMI exposure, sprinting from a trained K-9 unit while wearing a

Evaluation of Opportunities to Improve Hematopathology Diagnosis for Vietnam Pathologists.

PubMed

Dayton, Vanessa; Nguyen, Chi Kim; Van, Trinh Thu; Thanh, Nguyen Van; To, Ta Van; Hung, Nguyen Phi; Dung, Nguyen Ngoc; Milner, Danny A

2017-11-20

We evaluate the need for, feasibility of, and impediments to improving hematopathology diagnoses for cancer hospitals in Vietnam. Two hematopathologists from the United States visited three major cancer treatment hospitals in Vietnam to workshop a sampling of difficult hematopathology cases. With Vietnamese pathologists, they toured histopathology, immunohistochemistry, and ancillary laboratory facilities. Automated tissue processors and slide staining equipment were documented for each of the three hospitals. Between seven and 11 hematopathology cases were reviewed for each hospital. Exact/complete diagnostic concordance was 50% or less for all three laboratories. The major impediments to accurate specific diagnoses were limitations of immunohistochemical stains, limited stains available in house, and, for one of the hospitals, difficulty with interpretation of the immunohistochemistry. Vietnamese pathologists would benefit from hematopathology training or opportunities to consult with hematopathologists in the United States. Expert hematopathology consultation services are currently unavailable within Vietnam, as postgraduate training for laboratory physicians consists of residency training in anatomic pathology only. Limitations in the quality of histopathology and immunohistochemistry could impose a barrier to success of efforts to improve hematopathology diagnosis. Implementation of a histopathology and immunohistochemistry quality improvement program might overcome this limitation. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The Role of Title IX Coordinators on College and University Campuses

PubMed Central

Wiersma-Mosley, Jacquelyn D.; DiLoreto, James

2018-01-01

The purpose of this study was to better understand the role of Title IX coordinators and their policies across four-year universities and two-year community colleges in the United States (U.S.). There is little information regarding Title IX coordinators’ training, background, and policies on how they handle Title IX investigations regarding sexual violence. The data come from an online survey that included 692 Title IX coordinators across four-year (private and public) and two-year campuses and represented 42 different states in the US. The current study found that most Title IX coordinators were in part-time positions with less than three years of experience. Most of the coordinators and their investigators were trained in Title IX policies. Most coordinators provide Title IX training for their students and faculty, and most have completed a campus climate survey; however, 15% had not completed a survey. The findings suggest that the majority of campuses are continuing to increase their Title IX visibility; however, there are several recommendations for campuses to improve their policies. The current study was able to shed light on how Title IX coordinators do their jobs and the role they play in helping with the challenging issues surrounding sexual violence at institutions across the nation. PMID:29621177

Strength training, but not endurance training, reduces motor unit discharge rate variability.

PubMed

Vila-Chã, Carolina; Falla, Deborah

2016-02-01

This study evaluates and compares the effects of strength and endurance training on motor unit discharge rate variability and force steadiness of knee extensor muscles. Thirty sedentary healthy men (age, 26.0±3.8yrs) were randomly assigned to strength training, endurance training or a control group. Conventional endurance and strength training was performed 3days per week, over a period of 6weeks. Maximum voluntary contraction (MVC), time to task failure (at 30% MVC), coefficient of variation (CoV) of force and of the discharges rates of motor units from the vastus medialis obliquus and vastus lateralis were determined as subjects performed 20% and 30% MVC knee extension contractions before and after training. CoV of motor unit discharges rates was significantly reduced for both muscles following strength training (P<0.001), but did not change in the endurance (P=0.875) or control group (P=0.995). CoV of force was reduced after the strength training intervention only (P<0.01). Strength training, but not endurance training, reduces motor unit discharge rate variability and enhances force steadiness of the knee extensors. These results provide new insights into the neuromuscular adaptations that occur with different training methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

Computerized Cognitive Training in Children With Autism and Intellectual Disabilities: Feasibility and Satisfaction Study

PubMed Central

Benyakorn, Songpoom; Calub, Catrina A; Riley, Steven J; Schneider, Andrea; Iosif, Ana-Maria; Solomon, Marjorie; Hessl, David

2018-01-01

Background Researchers are increasingly interested in testing and developing computerized cognitive training interventions for individuals with autism spectrum disorder due to the limited accessibility of treatments for this disorder. Understanding the feasibility of testing cognitive interventions for this population is critical, especially for individuals with ASD who have low to moderate intellectual ability. Objective The aim of the study was to evaluate the feasibility of computerized cognitive training as measured by attrition rate and a parent satisfaction survey. Methods A total of 26 participants aged 8-17 years with an autism spectrum disorder diagnosis and significant intellectual impairment were enrolled (mean age 11.1 years). They were instructed to complete 25 sessions of Cogmed Working Memory Training in 5 to 6 weeks with coach assistance. Attrition rate and parent satisfaction surveys were measured after the completion of training. Results Most participants (96%, 25/26) completed the training and indicated high satisfaction (>88%). However, among the participants who completed the training, 5 participants (19%) were unable to finish in 6 weeks, the recommended training period by Cogmed. Parents noted various positive (eg, voice-overs) and negative (eg, particular graphic and sounds associated with a stimulus) features of the game that they thought affected their child’s response. Conclusions Children with autism spectrum disorder and intellectual impairments can successfully participate in computerized cognitive training interventions but may require additional weeks to complete the training beyond the time needed for children without intellectual impairments. The overall completion rate, with extended time to complete the training, was high. Developers of cognitive training programs for this population should take into account potential issues regarding the noise level of stimuli and characteristics of the visual graphics. PMID:29802090

14 CFR 135.338 - Qualifications: Flight instructors (aircraft) and flight instructors (simulator).

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Has satisfactorily completed the training phases for the aircraft, including recurrent training, that... satisfactorily completed the appropriate training phases for the aircraft, including recurrent training, that are... AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Training § 135.338 Qualifications: Flight...

Endoscopy services in KwaZulu-Natal Province, South Africa, are insufficient for the burden of disease: Is patient care compromised?

PubMed

Loots, E; Clarke, D L; Newton, K; Mulder, C J

2017-10-31

Endoscopy services are central to the diagnosis and management of many gastrointestinal (GI) diseases. To evaluate the adequacy of endoscopy services in the public sector hospitals of KwaZulu-Natal (KZN) Province, South Africa, in 2016. A cross-sectional study was performed using a questionnaire completed by the clinical heads of endoscopy units in the public hospitals in KZN. The heads of 11 of the 12 endoscopy units responded. Two units were in tertiary-level hospitals and nine in regional hospitals. A total of 22 353 endoscopic procedures were performed annually, averaging 2 032 cases per annum per centre; they were performed by 89 endoscopists, of whom 72 (80.1%) were general surgeons. There were 0.06 registered gastroenterologists (GEs) per 100 000 population. Each endoscopist performed an average of 263 endoscopies per annum. There were 1.18 endoscopy rooms available per unit, and two units had on-site fluoroscopy available. The average waiting period for an upper endoscopy was 27 (range 7 - 60) days, for colonoscopy 29 (range 7 - 90) days and for duodenoscopy/endoscopic retrograde cholangiopancreatography 13 (range 4 - 20) days. This included patients with alarm symptoms for GI cancers. Equipment breakages interrupted most services, except for one hospital that had a service contract. Unit heads cited lack of equipment, trained staff and maintenance contracts as major shortcomings. Endoscopy units in KZN are not adequately equipped to deal with the endoscopy workload and services are plagued by frequent disruptions, which impact negatively on service delivery. There is a need to train more GEs. Patient care is compromised in these public hospitals.

Effect of Strength Training on Oxidative Stress and the Correlation of the Same with Forearm Vasodilatation and Blood Pressure of Hypertensive Elderly Women: A Randomized Clinical Trial

PubMed Central

Dantas, Filipe Fernandes Oliveira; Batista, Rafael Marinho Falcão; do Nascimento, Leone Severino; Castellano, Lúcio Roberto Cançado; Ritti-Dias, Raphael Mendes; Lima, Kenio Costa

2016-01-01

The aim of the study was to evaluate the effect of strength training on oxidative stress and the correlation of the same with forearm vasodilatation and mean blood pressure of hypertensive elderly women, at rest (basal) and during a static handgrip exercise. Insufficiently active hypertensive elderly women (N = 25; mean age = 66.1 years) were randomized into a 10 week strength training group (n = 13) or control (n = 12) group. Plasma malondialdehyde (MDA), total antioxidant capacity (TAC), plasma nitrite (NO2-), forearm blood flow (FBF), mean blood pressure (MBP) and vascular conductance ([FBF / MBP] x 100) were evaluated before and after the completion of the interventions. The strength training group increased the TAC (pre: Median = 39.0; Interquartile range = 34.0–41.5% vs post: Median = 44.0; Interquartile range = 38.0–51.5%; p = 0.006) and reduced the MDA (pre: 4.94 ± 1.10 μM vs post: 3.90 ± 1.35 μM; p = 0.025; CI-95%: -1.92 –-0.16 μM). The strength training group increased basal vascular conductance (VC) (pre: 3.56 ±0.88 units vs post: 5.21 ±1.28 units; p = 0.001; CI-95%: 0.93–2.38 units) and decreased basal MBP (pre: 93.1 ±6.3 mmHg vs post: 88.9 ±5.4 mmHg; p = 0.035; CI-95%: -8.0 –-0.4 mmHg). Such changes were also observed during static handgrip exercise. A moderate correlation was observed between changes in basal VC and MBP with changes in NO2- (ΔVC → r = -0.56, p = 0.047; ΔMBP → r = -0.41, p = 0.168) and MDA (ΔVC → r = 0.64, p = 0.019; ΔMBP → r = 0.31, p = 0.305). The strength training program reduced the oxidative stress of the hypertensive elderly women and this reduction was moderately correlated with their cardiovascular benefits. Trial Registration: ensaiosclinicos.gov.br RBR-48c29w PMID:27529625

Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit.

PubMed

Cohen, Elaine R; Feinglass, Joe; Barsuk, Jeffrey H; Barnard, Cynthia; O'Donnell, Anna; McGaghie, William C; Wayne, Diane B

2010-04-01

Interventions to reduce preventable complications such as catheter-related bloodstream infections (CRBSI) can also decrease hospital costs. However, little is known about the cost-effectiveness of simulation-based education. The aim of this study was to estimate hospital cost savings related to a reduction in CRBSI after simulation training for residents. This was an intervention evaluation study estimating cost savings related to a simulation-based intervention in central venous catheter (CVC) insertion in the Medical Intensive Care Unit (MICU) at an urban teaching hospital. After residents completed a simulation-based mastery learning program in CVC insertion, CRBSI rates declined sharply. Case-control and regression analysis methods were used to estimate savings by comparing CRBSI rates in the year before and after the intervention. Annual savings from reduced CRBSIs were compared with the annual cost of simulation training. Approximately 9.95 CRBSIs were prevented among MICU patients with CVCs in the year after the intervention. Incremental costs attributed to each CRBSI were approximately $82,000 in 2008 dollars and 14 additional hospital days (including 12 MICU days). The annual cost of the simulation-based education was approximately $112,000. Net annual savings were thus greater than $700,000, a 7 to 1 rate of return on the simulation training intervention. A simulation-based educational intervention in CVC insertion was highly cost-effective. These results suggest that investment in simulation training can produce significant medical care cost savings.

Progressive shortfall in open aneurysm experience for vascular surgery trainees with the impact of fenestrated and branched endovascular technology.

PubMed

Dua, Anahita; Koprowski, Steven; Upchurch, Gilbert; Lee, Cheong J; Desai, Sapan S

2017-01-01

In 2014, we published a series of articles in the Journal of Vascular Surgery that detailed the decrease in volume of open aneurysm repair (OAR) completed for abdominal aortic aneurysm (AAA) by vascular surgery trainees. At that time, only data points from 2000 through 2011 were available, and reliable predictions could only be made through 2015. Lack of data on endovascular aneurysm repair (EVAR) using fenestrated (FEVAR) and branched (BrEVAR) endografts also affected our findings. Despite these limitations, our predictions for OAR completed by vascular trainees were accurate for 2012 to 2014. This report uses updated data points through 2014 in conjunction with data on FEVAR and BrEVAR obtained from industry to predict trends in OAR and how it will affect vascular surgery training through 2020. An S-curve modified logistic function was used to model the effect of introducing new technologies (EVAR, FEVAR, BrEVAR) on the standard management of AAA with OAR starting in the year 2000, similar to the technique that we have previously described. Weighted samples and data from the United States Census Bureau were used in conjunction with volume estimates derived from the National Inpatient Sample, State Inpatient Databases, and industry sources to determine trends in OAR and EVAR. The number of cases completed at teaching hospitals was calculated using the National Inpatient Sample, and Accreditation Council for Graduate Medical Education case logs were used to forecast the number of cases completed by vascular surgery trainees through 2020. Sensitivity analysis and trend analysis were completed. Approximately 45,000 AAA repairs are completed annually in the United States, but only 15% of these are now completed using OAR compared with >50% just a decade ago. Further, with the accelerating adoption of FEVAR and BrEVAR, and expanding indications for standard EVAR, our model predicts that <3000 OARs will be completed annually by 2020. Because only a subset of these cases are completed at teaching institutions, our model predicts that a vascular surgery trainee in a fellowship program will complete only one to two OARs, whereas trainees in a 0+5 program may complete two to three OARs. Our initial prediction in the 2014 report was that vascular trainees would complete approximately five OARs by 2020. After incorporating new data on BrEVAR, FEVAR, and the accelerating pace of EVAR use between 2012 and 2014, it now appears that vascular trainees will complete one to three OARs during their training. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Lack of coordination between health policy and medical education: a contributing factor to the resignation of specialist trainees in Fiji?

PubMed

Oman, Kimberly M; Usher, Kim; Moulds, Rob

2009-03-13

Specialist training was established in Fiji in 1998. This study explored whether health policy, and in particular mismatches between existing policy and the new realities of local specialist training, contributed to decisions by many trainees to ultimately leave the public sectors, often to migrate. Data was collected on the whereabouts of all specialist trainees. Semi-structured interviews were carried out with 36 of 66 Fiji trainees in order to explore reasons for continuing or not completing training, as well as the reasons behind subsequent career choices. Overall, 54.5% of doctors remained in the public sectors or were temporarily overseas. Completion of specialist training was particularly associated with improved retention. Policies that contributed to frustration and sometimes resignations included a lack of transparency in the selection of doctors to enter training pathways, and unreliable career progression following completion of training. Doctors who left training before completion mentioned family stresses, which were exacerbated by delayed age at entry into training and a lack of certainty in regards to the timing of improved working conditions through career advancement. Policy adjustments to expedite entry into training, as well as to establish predictable career progression as a reward for training may increase training completions and overall retention.

Development Studies for a Novel Wet Oxidation Process

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

Delphi Research

1999-09-30

DETOX is a catalyzed wet oxidation process that destroys organic materials in an acidic water solution of iron at 373 to 473 K. The solution can be used repeatedly to destroy great amounts of organic materials. Since the process is conducted in a contained vessel, air emissions from the process can be well controlled. The solution is also capable of dissolving and concentrating many heavy and radioactive metals for eventual stabilization and disposal. The Phase III effort for this project is fabrication, assembly, and installation of the DETOX demonstration unit, preparation of documentation and training to meet site requirements formore » operation, followed by system run-in and shakedown testing of the unit prior to demonstration testing. The Title III design was completed and the unit was fabricated according to standards set forth by OSHA, EPA, the American Petroleum Institute (i.e., chemical and petroleum industry standards), and the ASME B-313 Piping Code requirements as agreed to in preliminary design meetings with primary stakeholders. The unit was assembled in three modules and two trailers and then shipped to the TNX facility at the Savannah River Site in September and october of 1996. On-going site integration tasks were address while delays in installation arose due to funding sources and costs. In March of 1997, Delphi was authorized to proceed with the installation of the unit, making electrical and mechanical connections necessary to operate the unit. All installation tasks were completed in August of 1997. Results of an Operational Readiness Review conducted in August 1997 verified that Delphi's procedures and documentation met the necessary requirements to operate the unit at SRS. Completion of the final checklist of WSRC requirements was then addressed including the Owner's Independent Inspection Report, verifying all components of the unit met B-31.3 standards. Final hydraulic and pneumatic tests were completed in November to satisfy the B-31.3 requirement. During the month of December, the control system and heating and cooling systems were then prepared to initiate system startup and conduct the run-in tests. Shakedown tests were combined with the Phase IV tasks due to DOE funding constraints, i.e., tests formerly planned to be conducted with oil and solid materials were deferred to Phase IV and combined with similar testing. Once run-in testing has been completed, the primary objectives of Phase III will have been achieved and the project will be ready to proceed to demonstration testing (Phase IV).« less

37th Training Wing > Units > Inter-American Air Forces Academy

Science.gov Websites

37th Training Wing 37th Training Wing Join the Air Force Home News Commentaries Features Photos Art Information CAC/ID Card Information Units 37th Training Group 341st Training Squadron 344th Training Squadron 37th Training Wing Staff Agency 737th Training Group Defense Language Institute English Language Center

EMU Shoulder Injury Tiger Team Report

NASA Technical Reports Server (NTRS)

Williams, David R.; Johnson, Brian J.

2003-01-01

The number and complexity of extravehicular activities required for the completion and maintenance of the International Space Station is unprecedented. It is not surprising that training to perform these space walks presents a risk of overuse musculoskeletal injuries. The goal of this tiger team, created in December 2002, was to identify the different factors contributing to the risk of EVA training-related shoulder injury in the Neutral Buoyancy Lab at the Sonny Carter Training Facility and to make recommendations that would either significantly reduce or eliminate those risks. Since 1999, concerns have been expressed about the risk of shoulder injury associated with EVA training at the NBL, particularly in inverted body positions (McMonigal, 1999). A survey was developed and administered to 42 astronauts and astronaut candidates; the results suggest a causal relationship between EVA training at the NBL and the observed injuries. Also, during the tiger team review, it became evident that training in the extravehicular mobility unit may also result in other types of injuries, including fingernail delamination, elbow pain, knee pain, foot pain, and nerve compression leading to transient loss of sensation in certain areas of the upper or lower extremity. A multi-directorate team to detect, evaluate and respond to the medical issues associated with EVA training should be implemented immediately and given the appropriate resources and authority to reduce the risk of injury to crew during training to a level as low as reasonably achievable.

Computerized Training in Critical Thinking (CT)2: A Skill-Based Program for Army Personnel

DTIC Science & Technology

2008-06-01

15-minute break, and then completed the Skill 8 posttest . After completing the Skill 8 pretest , the experimental group completed the Skill training...including pretests , training modules, and posttests for each of eight CT skills. The pretests and training modules are highly interactive, include...usability evaluations .....................................26 Table 6: Pretest and posttest means and standard deviations by group, investigation 1

Effects of specified performance criterion and performance feedback on staff behavior: a component analysis.

PubMed

Hardesty, Samantha L; Hagopian, Louis P; McIvor, Melissa M; Wagner, Leaora L; Sigurdsson, Sigurdur O; Bowman, Lynn G

2014-09-01

The present study isolated the effects of frequently used staff training intervention components to increase communication between direct care staff and clinicians working on an inpatient behavioral unit. Written "protocol review" quizzes developed by clinicians were designed to assess knowledge about a patient's behavioral protocols. Direct care staff completed these at the beginning of each day and evening shift. Clinicians were required to score and discuss these protocol reviews with direct care staff for at least 75% of shifts over a 2-week period. During baseline, only 21% of clinicians met this requirement. Completing and scoring of protocol reviews did not improve following additional in-service training (M = 15%) or following an intervention aimed at decreasing response effort combined with prompting (M = 28%). After implementing an intervention involving specified performance criterion and performance feedback, 86% of clinicians reached the established goal. Results of a component analysis suggested that the presentation of both the specified performance criterion and supporting contingencies was necessary to maintain acceptable levels of performance. © The Author(s) 2014.

Assessment of radiation awareness training in immersive virtual environments

NASA Astrophysics Data System (ADS)

Whisker, Vaughn E., III

The prospect of new nuclear power plant orders in the near future and the graying of the current workforce create a need to train new personnel faster and better. Immersive virtual reality (VR) may offer a solution to the training challenge. VR technology presented in a CAVE Automatic Virtual Environment (CAVE) provides a high-fidelity, one-to-one scale environment where areas of the power plant can be recreated and virtual radiation environments can be simulated, making it possible to safely expose workers to virtual radiation in the context of the actual work environment. The use of virtual reality for training is supported by many educational theories; constructivism and discovery learning, in particular. Educational theory describes the importance of matching the training to the task. Plant access training and radiation worker training, common forms of training in the nuclear industry, rely on computer-based training methods in most cases, which effectively transfer declarative knowledge, but are poor at transferring skills. If an activity were to be added, the training would provide personnel with the opportunity to develop skills and apply their knowledge so they could be more effective when working in the radiation environment. An experiment was developed to test immersive virtual reality's suitability for training radiation awareness. Using a mixed methodology of quantitative and qualitative measures, the subjects' performances before and after training were assessed. First, subjects completed a pre-test to measure their knowledge prior to completing any training. Next they completed unsupervised computer-based training, which consisted of a PowerPoint presentation and a PDF document. After completing a brief orientation activity in the virtual environment, one group of participants received supplemental radiation awareness training in a simulated radiation environment presented in the CAVE, while a second group, the control group, moved directly to the assessment phase of the experiment. The CAVE supplied an activity-based training environment where learners were able to use a virtual survey meter to explore the properties of radiation sources and the effects of time and distance on radiation exposure. Once the training stage had ended, the subjects completed an assessment activity where they were asked to complete four tasks in a simulated radiation environment in the CAVE, which was designed to provide a more authentic assessment than simply testing understanding using a quiz. After the practicum, the subjects completed a post-test. Survey information was also collected to assist the researcher with interpretation of the collected data. Response to the training was measured by completion time, radiation exposure received, successful completion of the four tasks in the practicum, and scores on the post-test. These results were combined to create a radiation awareness score. In addition, observational data was collected as the subjects completed the tasks. The radiation awareness scores of the control group and the group that received supplemental training in the virtual environment were compared. T-tests showed that the effect of the supplemental training was not significant; however, calculation of the effect size showed a small-to-medium effect of the training. The CAVE group received significantly less radiation exposure during the assessment activity, and they completed the activities on an average of one minute faster. These results indicate that the training was effective, primarily for instilling radiation sensitivity. Observational data collected during the assessment supports this conclusion. The training environment provided by the immersive virtual reality recreated a radiation environment where learners could apply knowledge they had been taught by computer-based training. Activity-based training has been shown to be a more effective way to transfer skills because of the similarity between the training environment and the application environment. Virtual reality enables the training environment to look and feel like the application environment. Because of this, radiation awareness training in an immersive virtual environment should be considered by the nuclear industry, which is supported by the results of this experiment.

14 CFR 121.433 - Training required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... airplane of the same group may serve in the same crewmember capacity upon completion of transition training..., respectively, upon completion of upgrade training for that airplane as provided in § 121.415. (b) Differences... airplane of a type for which differences training is included in the certificate holder's approved training...

Low colony counts of asymptomatic group B streptococcus bacteriuria: a survey of practice patterns.

PubMed

Aungst, Matthew; King, Jeremy; Steele, Andrew; Gordon, Michael

2004-10-01

The purpose of this study was to survey expert opinion on the management of low colony counts (< 100,000 colony forming units/mL) of asymptomatic group B streptococcus (GBS) bacteriuria discovered in the first trimester. A survey was sent to the 241 senior obstetricians affiliated with each of the Obstetrics and Gynecology training programs in the United States on July 10, 2002. Surveys received by the deadline (September 1, 2002) were included in the dataset. Eighty-five completed surveys were returned for a response rate of 35%. Seventy-seven percent reported treating low colony counts of asymptomatic GBS bacteriuria in the first trimester at the time of diagnosis, whereas 23% stated they did not treat prior to labor (margin of error 7.5% with 95% confidence). Nine percent stated that their institution had a written protocol for the treatment of low colony counts of asymptomatic GBS bacteriuria. Two physicians indicated that they screened for asymptomatic GBS bacteriuria at 28 weeks. Currently, no generally accepted protocol for the management of low colony counts of asymptomatic GBS bacteriuria exists. This survey indicates that most of the responding senior obstetricians at United States training programs treat low colony counts of asymptomatic GBS bacteriuria in the first trimester.

Evaluation of COSTAR mass handling characteristics in an environment. A simulation of the Hubble Space Telescope service mission

NASA Technical Reports Server (NTRS)

Rajulu, Sudhakar L.; Klute, Glenn K.; Fletcher, Lauren

1994-01-01

The STS-61 Shuttle mission, which took place in December 1993, was solely aimed at servicing the Hubble Space Telescope (HST). Successful completion of this mission was critical to NASA since it was necessary to rectify a flaw in the HST mirror. In addition, NASA had never scheduled a mission with such a high quantity of complex extravehicular activity. To meet the challenge of this mission, the STS-61 crew trained extensively in the Weightless Environment Test Facility at the Johnson Space Center and in the Neutral Buoyancy Simulator at the Marshall Space Flight Center. However, it was suspected that neutral buoyancy training might induce negative training by virtue of the viscous damping effect present in water. The mockups built for this training also did not have the mass properties of the actual orbital replacement units (ORUs). It was felt that the crew should be further trained on mockups with similar mass characteristics. A comprehensive study was designed to address these issues. The study was quantitative, and instrumentation was set up to measure and quantify the forces and moments experienced during ORU mass handling and remote manipulator system run conditions.

Key role of staff competencies for patient and donor safety in a bone marrow transplantation unit: design and implementation of an accredited training and self-assessment program.

PubMed

Lamanna, C; Baroni, M; Bisin, S; Gianassi, S; Bambi, F; Caselli, D; Aricò, M

2010-01-01

Human resources represent at the moment the most critical factor in an hospital setting characterized by a high rate of staff turnover. It is important to ensure a consistent level of expertise and knowledge of professionals who work in health care facilities to provide quality services and simultaneously support the implementation of strategies for patient safety. Unfortunately, the development of effective interventions for training newly added staff and self-evaluation of skills possessed by trained staff are closely related to understanding critical aspects of the organization. At the new Center for Bone Marrow Transplantation and Blood Transfusion Service in Meyer Hospital, during the last year, a group of professional nurses and technicians completed a specific plan to train new staff and, at the same time, a program of self-assessment of skills for experienced staff. The main purpose of this project was to promote skills development by newly added as well as experienced staff, to identify areas of weaknesses, and to correct them with training (organized by the hospital, departmental, or individual) designed to improve performance. Copyright 2010 Elsevier Inc. All rights reserved.

Communication skills training in English alone can leave Arab medical students unconfident with patient communication in their native language.

PubMed

Mirza, D M; Hashim, M J

2010-08-01

Communications skills curricula and pedagogy for medical students are often exported to non-English speaking settings. It is assumed that after learning communication skills in English, doctors will be able to communicate effectively with patients in their own language. We distributed a questionnaire to third year Emirati students at a medical school within the United Arab Emirates. We assessed their confidence in interviewing patients in Arabic after communication skills training in English. Of the 49 students in the sample, 36 subjects (73.5%) completed and returned the questionnaire. Nearly three-quarters (72.2%) of students said they felt confident in taking a history in English, while 27.8% of students expressed confidence in taking a history in Arabic. Half of students anticipated that after their training they would be communicating with their patients primarily in Arabic, and only 8.3% anticipated they would be communicating in English. Communication skills training purely in English can leave Arab medical students ill equipped to communicate with patients in their own communities and tongue.

OASIS connections: results from an evaluation study.

PubMed

Czaja, Sara J; Lee, Chin Chin; Branham, Janice; Remis, Peggy

2012-10-01

The objectives of this study were to evaluate a community-based basic computer and Internet training program designed for older adults, provide recommendations for program refinement, and gather preliminary information on program sustainability. The program was developed by the OASIS Institute, a nonprofit agency serving older adults and implemented in 4 cities by community trainers across the United States. One hundred and ninety-six adults aged 40-90 years were assigned to the training or a wait-list control group. Knowledge of computers and the Internet, attitudes toward computers, and computer/Internet use were assessed at baseline, posttraining, and 3 months posttraining. The program was successful in increasing the computer/Internet skills of the trainees. The data indicated a significant increase in computer and Internet knowledge and comfort with computers among those who received the training. Further, those who completed the course reported an increase in both computer and Internet use 3 months posttraining. The findings indicate that a community-based computer and Internet training program delivered by community instructors can be effective in terms of increasing computer and Internet skills and comfort with computer technology among older adults.

40 CFR 60.3014 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... and qualification requirements? (a) No OSWI unit can be operated unless a fully trained and qualified... trained and qualified OSWI unit operator may operate the OSWI unit directly or be the direct supervisor of...

40 CFR 60.3014 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... and qualification requirements? (a) No OSWI unit can be operated unless a fully trained and qualified... trained and qualified OSWI unit operator may operate the OSWI unit directly or be the direct supervisor of...

40 CFR 60.3014 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... and qualification requirements? (a) No OSWI unit can be operated unless a fully trained and qualified... trained and qualified OSWI unit operator may operate the OSWI unit directly or be the direct supervisor of...

40 CFR 60.3014 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... and qualification requirements? (a) No OSWI unit can be operated unless a fully trained and qualified... trained and qualified OSWI unit operator may operate the OSWI unit directly or be the direct supervisor of...

40 CFR 60.3014 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... and qualification requirements? (a) No OSWI unit can be operated unless a fully trained and qualified... trained and qualified OSWI unit operator may operate the OSWI unit directly or be the direct supervisor of...

Reserve Component Training under CAPSTONE

DTIC Science & Technology

1989-03-15

that promotes aggressive, bold, initiative-seeking performances by their sub- ordinates and units. Emphasis on innovative training must continue to...their subordinates and units. Emphasis on innovative training must continue to ensure winning results on tomorrow’s battlefield. CAPSTONE, a Total Army...Department of the Army (HQDA) managed program that brings units up to a designated structure by filling organizational voids with units from a different

Is there a minimum intensity threshold for resistance training-induced hypertrophic adaptations?

PubMed

Schoenfeld, Brad J

2013-12-01

In humans, regimented resistance training has been shown to promote substantial increases in skeletal muscle mass. With respect to traditional resistance training methods, the prevailing opinion is that an intensity of greater than ~60 % of 1 repetition maximum (RM) is necessary to elicit significant increases in muscular size. It has been surmised that this is the minimum threshold required to activate the complete spectrum of fiber types, particularly those associated with the largest motor units. There is emerging evidence, however, that low-intensity resistance training performed with blood flow restriction (BFR) can promote marked increases in muscle hypertrophy, in many cases equal to that of traditional high-intensity exercise. The anabolic effects of such occlusion-based training have been attributed to increased levels of metabolic stress that mediate hypertrophy at least in part by enhancing recruitment of high-threshold motor units. Recently, several researchers have put forth the theory that low-intensity exercise (≤50 % 1RM) performed without BFR can promote increases in muscle size equal, or perhaps even superior, to that at higher intensities, provided training is carried out to volitional muscular failure. Proponents of the theory postulate that fatiguing contractions at light loads is simply a milder form of BFR and thus ultimately results in maximal muscle fiber recruitment. Current research indicates that low-load exercise can indeed promote increases in muscle growth in untrained subjects, and that these gains may be functionally, metabolically, and/or aesthetically meaningful. However, whether hypertrophic adaptations can equal that achieved with higher intensity resistance exercise (≤60 % 1RM) remains to be determined. Furthermore, it is not clear as to what, if any, hypertrophic effects are seen with low-intensity exercise in well-trained subjects as experimental studies on the topic in this population are lacking. Practical implications of these findings are discussed.

Australian Vocational Education and Training Statistics: Student Outcomes, 2006. Summary

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2006

2006-01-01

This publication provides information regarding the training outcomes for students who completed their vocational education and training (VET) during 2005. The findings presented relate to students who are awarded a qualification (graduates), or who successfully complete part of a course and then leave the VET system (module completers). This…

Are oral and maxillofacial surgery residents being adequately trained to care for pediatric patients?

PubMed

Abramowicz, Shelly; Kaban, Leonard B; Wurtzel, Andrew S; Roser, Steven M

2017-09-01

To evaluate whether current oral and maxillofacial surgery (OMS) residents are receiving adequate training and experience to perform specific surgical procedures and anesthesia for pediatric patients. A 17-question survey was sent electronically to fellows of the American Academy of Craniomaxillofacial Surgeons. Descriptive data for individual surgeons, their associated residency programs, and the quantity of specific pediatric procedures they performed were collected. Resident case load for inpatient and outpatient procedures and overall experience in medical, surgical, and anesthetic management of pediatric OMS patients were explored. Surveys were sent to 110 active fellows; 64 completed the questionnaire (58%). There were 59 male fellows and 5 female fellows, with a mean age of 50.4 years. Of those, 68.8% practice in an academic setting. Specifically, 93.8% take after-hours emergency calls covering adult and pediatric patients and 98.4% have admitting privileges at a children's hospital or a pediatric unit in an adult hospital. Their affiliated residency programs include required rotations in pediatrics or pediatric subspecialties. In their opinion, >90% of graduating OMS residents have the appropriate skill set to perform dentoalveolar procedures, outpatient anesthesia, orthognathic procedures, and alveolar bone grafts. However, residents have limited ability to reconstruct pediatric ramus-condyle unit with a costochondral graft. Results of this study indicate that, in the opinion of the respondents, graduates of OMS residency programs have adequate training to perform dentoalveolar procedures, outpatient anesthesia, orthognathic surgery, and alveolar bone grafts in pediatric procedures, but have limited experience with reconstruction of pediatric ramus-condyle unit via costochondral graft. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

Al-Bustani, Saif; Halvorson, Eric G

2016-06-01

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

Hyper-Realistic, Team-Centered Fleet Surgical Team Training Provides Sustained Improvements in Performance.

PubMed

Hoang, Tuan N; Kang, Jeff; Siriratsivawong, Kris; LaPorta, Anthony; Heck, Amber; Ferraro, Jessica; Robinson, Douglas; Walsh, Jonathan

2016-01-01

The high-stress, fast-paced environment of combat casualty care relies on effective teamwork and communication which translates into quality patient care. A training course was developed for U.S. Navy Fleet Surgical Teams to address these aspects of patient care by emphasizing efficiency and appropriate patient care. An effective training course provides knowledge and skills to pass the course evaluation and sustain the knowledge and skills acquired over time. The course included classroom didactic hours, and hands-on simulation sessions. A pretest was administered before the course, a posttest upon completion, and a sustainment test 5 months following course completion. The evaluation process measured changes in patient time to disposition and critical errors made during patient care. Naval Base San Diego, with resuscitation and surgical simulations carried out within the shipboard medical spaces. United States Navy medical personnel including physicians of various specialties, corpsmen, nurses, and nurse anesthetists deploying aboard ships. Time to disposition improved significantly, 11 ± 3 minutes, from pretest to posttest, and critical errors improved by 4 ± 1 errors per encounter. From posttest to sustainment test, time to disposition increased by 3 ± 1, and critical errors decreased by 1 ± 1. This course showed value in improving teamwork and communication skills of participants, immediately upon completion of the course, and after 5 months had passed. Therefore, with ongoing sustainment activities within 6 months, this course can substantially improve trauma care provided by shipboard deployed Navy medical personnel to wounded service members. Published by Elsevier Inc.

Effects of hydraulic resistance circuit training on physical fitness components of potential relevance to +Gz tolerance.

PubMed

Jacobs, I; Bell, D G; Pope, J; Lee, W

1987-08-01

Recent studies carried out in the United States and Sweden have demonstrated that strength training can improve +Gz acceleration tolerance. Based on these findings, the Canadian Forces have introduced a training program for aircrew of high performance aircraft. This report describes the changes in physical fitness components considered relevant to +Gz tolerance after 12 weeks of training with this program. Prior to beginning training, 45 military personnel were tested, but only 20 completed a minimum of 24 training sessions. The following variables were measured in these 20 subjects before and after training: maximal strength of several large muscle groups during isokinetic contractions, maximal aerobic power and an endurance fitness index, maximal anaerobic power, anthropometric characteristics, and maximal expiratory pressure generated during exhalation. Training involved hydraulic resistance circuit training 2-4 times/week. The circuit consisted of 3 consecutive sets at each of 8 stations using Hydra-Gym equipment. The exercise:rest ratio was 20:40 s for the initial 4 training weeks and was then changed to 30:50. After training the changes in anthropometric measurements suggested that lean body mass was increased. Small, but significant, increases were also measured in muscle strength during bench press, biceps curls, squats, knee extension, and knee flexion. Neither maximal anaerobic power (i.e. muscular endurance) nor maximal expiratory pressure were changed after the training. Indices of endurance fitness were also increased in the present study. The relatively small increases in strength are probably due to the design of the exercise:rest ratio which resulted in improved strength and aerobic fitness.(ABSTRACT TRUNCATED AT 250 WORDS)

Transfer after process-based object-location memory training in healthy older adults.

PubMed

Zimmermann, Kathrin; von Bastian, Claudia C; Röcke, Christina; Martin, Mike; Eschen, Anne

2016-11-01

A substantial part of age-related episodic memory decline has been attributed to the decreasing ability of older adults to encode and retrieve associations among simultaneously processed information units from long-term memory. In addition, this ability seems to share unique variance with reasoning. In this study, we therefore examined whether process-based training of the ability to learn and remember associations has the potential to induce transfer effects to untrained episodic memory and reasoning tasks in healthy older adults (60-75 years). For this purpose, the experimental group (n = 36) completed 30 sessions of process-based object-location memory training, while the active control group (n = 31) practiced visual perception on the same material. Near (spatial episodic memory), intermediate (verbal episodic memory), and far transfer effects (reasoning) were each assessed with multiple tasks at four measurements (before, midway through, immediately after, and 4 months after training). Linear mixed-effects models revealed transfer effects on spatial episodic memory and reasoning that were still observed 4 months after training. These results provide first empirical evidence that process-based training can enhance healthy older adults' associative memory performance and positively affect untrained episodic memory and reasoning abilities. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Factors affecting the decision to pursue glaucoma fellowship training.

PubMed

Gedde, Steven J; Budenz, Donald L; Haft, Payman; Lee, Yunhee; Quigley, Harry A

2007-01-01

To identify factors associated with the choice to pursue glaucoma fellowship training by graduating ophthalmology residents. An anonymous survey was sent to each graduating ophthalmology resident in the United States in February 2003. Demographic data and information relating to residency training, career goals, and factors influencing career choices were collected from the surveys. Surveys were completed by 215 (49.2%) residents, including 135 (62.8%) who were pursuing fellowships. Among residents undertaking fellowship training, 17 (12.6%) selected glaucoma and 118 (87.4%) chose other subspecialties. Residents entering glaucoma fellowships performed more glaucoma filtering procedures (P=0.006), and they were less likely to publish a paper (P=0.05) and have time allocated for research (P=0.04) than residents seeking fellowships in other subspecialties. Factors that were rated as less important to those choosing glaucoma fellowships included interest in challenging diagnostic problems (P=0.009), types of patient problems (P=0.015), an academic career (P=0.03), and working with new technology (P=0.04). The decision to pursue fellowship training was made later by residents entering glaucoma compared with those choosing other subspecialties (P=0.001). A variety of factors affect the decision to pursue fellowship training. There are differences in how these factors are weighed among residents seeking fellowships in glaucoma and other subspecialties.

Pre-Medical Preparation in Microbiology among Applicants and Matriculants in Osteopathic Medical School in the United States

PubMed Central

Ramos, Raddy L.; Guercio, Erik; Martinez, Luis R.

2017-01-01

It is recognized that medical school curricula contain significant microbiology-related content as part of the training of future physicians who will be responsible stewards of antimicrobials. Surprisingly, osteopathic and allopathic medical schools do not require pre-medical microbiology coursework, and the extent to which medical students have completed microbiology coursework remains poorly understood. In this report, we show that fewer than 3% of applicants and matriculants to osteopathic medical school (OMS) have completed an undergraduate major or minor in microbiology, and fewer than 17% of applicants and matriculants to OMS have completed one or more microbiology-related courses. These data demonstrate limited pre-medical microbiology-related knowledge among osteopathic medical students, which may be associated with an increase in perceived stress when learning this content or during clinical rotations as well as a potential lack of interest in pursuing a career in infectious diseases. PMID:29854054

Pre-Medical Preparation in Microbiology among Applicants and Matriculants in Osteopathic Medical School in the United States.

PubMed

Ramos, Raddy L; Guercio, Erik; Martinez, Luis R

2017-01-01

It is recognized that medical school curricula contain significant microbiology-related content as part of the training of future physicians who will be responsible stewards of antimicrobials. Surprisingly, osteopathic and allopathic medical schools do not require pre-medical microbiology coursework, and the extent to which medical students have completed microbiology coursework remains poorly understood. In this report, we show that fewer than 3% of applicants and matriculants to osteopathic medical school (OMS) have completed an undergraduate major or minor in microbiology, and fewer than 17% of applicants and matriculants to OMS have completed one or more microbiology-related courses. These data demonstrate limited pre-medical microbiology-related knowledge among osteopathic medical students, which may be associated with an increase in perceived stress when learning this content or during clinical rotations as well as a potential lack of interest in pursuing a career in infectious diseases.

National Interim Energy-Consumption Survey. Part VI. Energy assessment

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

Not Available

The goal of energy assessment of the housing unit is to obtain physical information which can be combined with other survey results to give a more complete picture of the residential environment. A limited pretest of an energy assessment procedure was carried out in April-June 1979 with a subsample of 44 households that had been originally interviewed in the National Interim Energy Consumption Survey. In order to gain experience under a variety of environmental conditions, the pretest sites included locations in the Northeast, North Central, and South regions. As developed for the pretest, the energy assessment was a 90-minute inspectionmore » of the housing unit by a trained technician. Data collected during the inspection included square footage of the unit; age, make, and characteristics of appliances; insulation characteristics, characteristics of siting and apertures; and detailed information on the heating and cooling systems in the unit. The report describes the data collection procedures for the pretest.« less

[Oral and maxillofacial surgery residency training in the United States: what can we learn].

PubMed

Ren, Y F

2017-04-09

China is currently in the process of establishing formal residency training programs in oral and maxillofacial surgery and other medical and dental specialties. Regulatory agencies, and educational and academic institutions in China are exploring mechanisms, goals and standards of residency training that meet the needs of the Chinese healthcare system. This article provides an introduction of residency training in oral and maxillofacial surgery in the United States, with emphasis on the accreditation standard by the Commission on Dental Accreditation. As there are fundamental differences in the medical and dental education systems between China and United States, the training standards in the United States may not be entirely applicable in China. A competency-based training model that focus on overall competencies in medical knowledge, clinical skills and values at the time of graduation should be taken into consideration in a Chinese residency training program in oral and maxillofacial surgery.

The Barriers and Facilitators to Transfer of Ultrasound-Guided Central Venous Line Skills From Simulation to Practice: Exploring Perceptions of Learners and Supervisors.

PubMed

Mema, Briseida; Harris, Ilene

2016-01-01

PHENOMENON: Ultrasound-guided central venous line insertion is currently the standard of care. Randomized controlled trials and systematic reviews show that simulation is superior to apprenticeship training. The purpose of this study is to explore, from the perspectives of participants in a simulation-training program, the factors that help or hinder the transfer of skills from simulation to practice. Purposeful sampling was used to select and study the experience and perspective of novice fellows after they had completed simulation training and then performed ultrasound-guided central venous line in practice. Seven novice pediatric intensive care unit fellows and six supervising faculty in a university-affiliated academic center in a large urban city were recruited between September 2012 and January 2013. We conducted a qualitative study using semistructured interviews as our data source, employing a constructivist, grounded theory methodology. Both curricular and real-life factors influence the transfer of skills from simulation to practice and the overall performance of trainees. Clear instructions, the opportunity to practice to mastery, one-on-one observation with feedback, supervision, and further real-life experiences were perceived as factors that facilitated the transfer of skills. Concern for patient welfare, live trouble shooting, complexity of the intensive care unit environment, and the procedure itself were perceived as real-life factors that hindered the transfer of skills. Insights: As more studies confirm the superiority of simulation training versus apprenticeship training for initial student learning, the faculty should gain insight into factors that facilitate and hinder the transfer of skills from simulation to bedside settings and impact learners' performances. As simulation further augments clinical learning, efforts should be made to modify the curricular and bedside factors that facilitate transfer of skills from simulation to practice settings.

Predictors of poor adherence of U.S. gastroenterologists with colonoscopy screening and surveillance guidelines

PubMed Central

Iskandar, Heba; Yan, Yan; Elwing, Jill; Early, Dayna; Colditz, Graham A.; Wang, Jean S.

2014-01-01

Background The U.S. Multi-Society Task Force on Colorectal Cancer published guidelines for colonoscopy screening and surveillance in 2008 and affirmed them in 2012. Characteristics associated with guideline adherence among U.S. gastroenterologists have not been assessed. Aims Assess awareness and adherence of U.S. gastroenterologists with national guidelines for colonoscopy screening and surveillance and predictors of adherence to guidelines. Methods A web-based survey was administered to gastroenterologists in various practice settings across the United States. Results A total of 306 gastroenterologists completed the survey; 86% reported awareness of the guidelines. Low-volume colonoscopists (<20 /month) were less likely to be aware of the guidelines (OR 0.26, p=0.03) compared to high-volume colonoscopists (>100/month). Those completing training before 1990 were less likely to report following guidelines (OR 0.37, p=0.01). Adherence with guidelines was then assessed via clinical scenarios. Compared to physicians finishing training in 1991-2010, less adherence was seen in those finishing before 1990 (OR 0.75, p<0.001) or currently in training (OR 0.72, p=0.004). Compared to the Western U.S., less adherence was seen in the Midwest (OR 0.69, p=0.001), Northeast (OR 0.63, p<0.001), and South (OR 0.59, p<0.001). Lower adherence was seen among non-academic physicians (OR 0.72, p=0.001) and low-volume colonoscopists (OR 0.52, p<0.001). Conclusions There is poor adherence with colonoscopy screening and surveillance guidelines among U.S. gastroenterologists. Poor adherence was associated with being in training or finishing training before 1990, practicing in the South, non-academic settings, and low colonoscopy volume. These findings can target interventions for quality improvement in colorectal cancer screening and surveillance. PMID:25366146

Effects of barbell deadlift training on submaximal motor unit firing rates for the vastus lateralis and rectus femoris.

PubMed

Stock, Matt S; Thompson, Brennan J

2014-01-01

Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units.

Acceptability and feasibility of an interprofessional end-of-life/palliative care educational intervention in the intensive care unit: A mixed-methods study.

PubMed

Graham, Robyn; Lepage, Carolan; Boitor, Madalina; Petizian, Stephanie; Fillion, Lise; Gélinas, Céline

2018-06-21

This study aimed to describe a seven hour End-of-Life/Palliative Care educational intervention including online content related to symptom management, communication and decision-making capacity and an in-person group integration activity, from the perspective of the interprofessional team in terms of its acceptability and feasibility. A mixed-methods study design was used. The study was conducted in a medical-surgical Intensive Care Unit in Montreal, Canada. The sample consisted of 27 clinicians of the Intensive Care Unit interprofessional team who completed the End-of-Life/Palliative Care educational intervention, and participated in focus groups and completed a self-administered questionnaire. The main outcomes were the acceptability and feasibility of the educational intervention. The intervention was perceived to be appropriate and suitable in providing clinicians with knowledge and skills in symptom management and communication through self-reflection and self-evaluation, provision of assessment tools and promotion of interprofessional teamwork. The online format was more feasible, but the in-person group activity was key for the integration of knowledge and the promotion of interprofessional discussions. Findings suggest that an interprofessional educational intervention integrating on-line content with in-person training has the potential to support clinicians in providing quality End-of-Life/Palliative Care in the Intensive Care Unit. Copyright © 2018. Published by Elsevier Ltd.

A cross sectional study of surgical training among United Kingdom general practitioners with specialist interests in surgery.

PubMed

Ferguson, H J M; Fitzgerald, J E F; Reilly, J; Beamish, A J; Gokani, V J

2015-04-08

Increasing numbers of minor surgical procedures are being performed in the community. In the UK, general practitioners (family medicine physicians) with a specialist interest (GPwSI) in surgery frequently undertake them. This shift has caused decreases in available cases for junior surgeons to gain and consolidate operative skills. This study evaluated GPwSI's case-load, procedural training and perceptions of offering formalised operative training experience to surgical trainees. Prospective, questionnaire-based cross-sectional study. A novel, 13-item, self-administered questionnaire was distributed to members of the Association of Surgeons in Primary Care (ASPC). A total 113 of 120 ASPC members completed the questionnaire, representing a 94% response rate. Respondents were general practitioners practising or intending to practice surgery in the community. Respondents performed a mean of 38 (range 5-150) surgical procedures per month in primary care. 37% (42/113) of respondents had previously been awarded Membership or Fellowship of a Surgical Royal College; 22% (25/113) had completed a surgical certificate or diploma or undertaken a course of less than 1 year duration. 41% (46/113) had no formal British surgical qualifications. All respondents believed that surgical training in primary care could be valuable for surgical trainees, and the majority (71/113, 63%) felt that both general practice and surgical trainees could benefit equally from such training. There is a significant volume of surgical procedures being undertaken in the community by general practitioners, with the capacity and appetite for training of prospective surgeons in this setting, providing appropriate standards are achieved and maintained, commensurate with current standards in secondary care. Surgical experience and training of GPwSI's in surgery is highly varied, and does not yet benefit from the quality assurance secondary care surgical training in the UK undergoes. The Royal Colleges of Surgery and General Practice are well placed to invest in such infrastructure to provide long-term, high-quality service and training in the community. 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.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

ERIC Educational Resources Information Center

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

40 CFR 60.2905 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Operator Training... unit can be operated unless a fully trained and qualified OSWI unit operator is accessible, either at... operate the OSWI unit directly or be the direct supervisor of one or more other plant personnel who...

40 CFR 60.2905 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Operator Training... unit can be operated unless a fully trained and qualified OSWI unit operator is accessible, either at... operate the OSWI unit directly or be the direct supervisor of one or more other plant personnel who...

40 CFR 60.4810 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... the operator training and qualification requirements? (a) A SSI unit cannot be operated unless a fully... within 1 hour. The trained and qualified SSI unit operator may operate the SSI unit directly or be the...

40 CFR 60.4810 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... the operator training and qualification requirements? (a) A SSI unit cannot be operated unless a fully... within 1 hour. The trained and qualified SSI unit operator may operate the SSI unit directly or be the...

40 CFR 60.4810 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... the operator training and qualification requirements? (a) A SSI unit cannot be operated unless a fully... within 1 hour. The trained and qualified SSI unit operator may operate the SSI unit directly or be the...

40 CFR 60.2905 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Operator Training... unit can be operated unless a fully trained and qualified OSWI unit operator is accessible, either at... operate the OSWI unit directly or be the direct supervisor of one or more other plant personnel who...

PG medical training and accreditation: responsibility of the government for the adequate health service delivery.

PubMed

Bhattarai, M D

2012-09-01

On one hand there is obvious inadequate health coverage to the rural population and on the other hand the densely populated urban area is facing the triple burden of increasing non-communicable and communicable health problems and the rising health cost. The postgraduate medical training is closely interrelated with the adequate health service delivery and health economics. In relation to the prevailing situation, the modern medical education trend indicates the five vital issues. These are i). Opportunity needs to be given to all MBBS graduates for General Specialist and Sub-Specialist Training inside the country to complete their medical education, ii). Urgent need for review of PG residential training criteria including appropriate bed and teacher criteria as well as entry criteria and eligibility criteria, iii). Involvement of all available units of hospitals fulfilling the requirements of the residential PG training criteria, iv). PG residential trainings involve doing the required work in the hospitals entitling them full pay and continuation of the service without any training fee or tuition fee, and v). Planning of the proportions of General Specialty and Sub-Specialty Training fields, particularly General Practice (GP) including its career and female participation. With increased number of medical graduates, now it seems possible to plan for optimal health coverage to the populations with appropriate postgraduate medical training. The medical professionals and public health workers must make the Government aware of the vital responsibility and the holistic approach required.

Mammographic interpretation training in the UK: current difficulties and future outlook

NASA Astrophysics Data System (ADS)

Chen, Yan; Gale, Alastair G.; Scott, Hazel

2009-02-01

In the UK, most mammographic interpretation training needs to be undertaken where there is a mammo-alternator or other suitable light box; consequently limiting the time and places where training can take place. However, the gradual introduction of digital mammography is opening up new opportunities of providing such training without the restriction of current viewing devices. Whilst high-resolution monitors in appropriate viewing environments are de rigour for actual reporting; advantages of the digital image over film are in the flexibility of training opportunity afforded, e.g. training whenever, wherever suits the individual. A previous study indicated the possible potential for reporting mammographic cases utilising handheld devices with suitable interaction techniques. In a pilot study, a group of mammographers (n=4) were questioned in semi-structured interviews in order to help establish current UK film-readers' training profile. On the basis of the pilot study data, 109 Breast Screening Units (601 film readers) were approached to complete a structured questionnaire in order to establish the potential role of smaller computer devices in mammographic interpretation training (given the use of digital mammography). Subsequently, a study of radiologists' visual search behaviour in digital screening has begun. This has highlighted different image manipulations than found in structured experiments in this area and poses new challenges for visualising the inspection process. Overall the results indicate that using different display sizes for training is possible but is also a challenging task requiring novel interaction approaches.

Marksmanship Requirements From the Perspective of Combat Veterans - Volume I: Main Report

DTIC Science & Technology

2016-02-01

Research Report are not to be construed as an official Department of the Army position, unless so designated by other authorized documents. i REPORT... designated marksmanship (SDM) training was cited, but it was not always clear whether this course was given by the unit or by the United States Army...Appendix D. Some units designed specific marksmanship training programs. Collective training. Collective training was also cited (215 comments

The training of specialists in Family and Community Health Nursing according to the supervisors of the teaching units.

PubMed

Oltra-Rodríguez, Enrique; Martínez-Riera, José Ramón; Mármol-López, María Isabel; Pastor-Gallardo, Francisco Javier; Gras-Nieto, Elvira; Holgado-Fernández, Ana

To analyze the current situation of the training of specialists in family and community nursing from the perspective of nurses responsible for teaching units. Exploratory analysis using nominal group technique of the contributions made by representatives of 19 multidisciplinary teaching units in family and community care from 11 Spanish autonomous communities. They categorized and weighted those contributions. The emerging categories on the strengths and difficulties encountered related to the tutors, the environment where the training took place, the structure of the teaching unit, the organization of the teaching and the official programme of the speciality, the external supports and the theoretical training. Training in Family and Community Nursing is an opportunity to improve primary health care to train in news and necessary but complex skills. Support is required for training to be effective and the specialty and training should be made known. Tutors are a key part of this process. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Technical assistance offered to community health programs through a resource model.

PubMed

Merino, R; Fischer, E; Bosch, S J

1985-01-01

A multidisciplinary unit in the Department of Community Medicine, Mount Sinai School of Medicine, consists of a core group of specialists who plan, develop, and evaluate community health care programs. The primary tools used by the staff of the Services Coordination Unit, epidemiology and behavioral and management sciences, result in improved organization and coordination of health services and community resources. The small unit of specialists functions as a resource group, helping community groups address the complex problems of planning, organization, delivery, and financing of health services. By offering technical assistance rather than day-to-day health care services, the unit has established an education and training program in New York's East Harlem, which surrounds the medical school. Over the last 10 years, that approach has enhanced the administrative and financial viability of existing health programs in East Harlem. Since the unit's establishment, it has collaborated with a broad variety of community groups. More than 20 programs have resulted. The income generated by the unit completely covers the expenses and has done so since 1976; "seed money" was used for startup and the first 3 years of operation. The unit is paid for long-term services and for most consultations.

Effectiveness of a web-based child protection training programme designed for dental practitioners in Saudi Arabia: a pre- and post-test study.

PubMed

Al-Dabaan, R; Asimakopoulou, K; Newton, J T

2016-02-01

Safeguarding children is an integral part of dental training and practice. The purpose of this research was to evaluate a web-based training program in child protection on dental practitioners' knowledge and practice in Saudi Arabia. In addition, participants' views of the course were also assessed. Pre-, immediately post-training, and one month post-training knowledge and self reported behaviour were assessed following completion of an online training course in child protection by 82 dental practitioners working in Saudi Arabia. Eighty-two participants completed the whole training package and 62 completed the one month post-training survey. A significant increase in knowledge was found immediately after taking part in the child protection training program in comparison to baseline knowledge (P < 0.001). The course was highly rated by those who completed it. At one month following the training program, 21% have or intend to adopt a child protection policy in their practice, 29% identified a staff member to lead on child protection since completing the program, almost all participants have been aware of child abuse and neglect (CAN) signs in their daily practice and 27.4% have made a report of a suspected case of CAN in the last month since the training. The web-based training program in child protection was appraised positively and was effective in increasing knowledge and changing attitudes towards safeguarding children. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of self-recording on attendance and performance in a competitive swimming training environment

PubMed Central

McKenzie, Thomas L.; Rushall, Brent S.

1974-01-01

Swimmers' attendance at training and work rates were described by their coaches as being poor and irregular. Reinforcement contingencies were developed to remedy these unsatisfactory conditions. Two experiments were conducted. A multiple baseline design verified the effects of publicly marking attendance at practice as a sufficient solution for reducing absenteeism, tardiness, and leaving early. Follow-up analyses showed this contingency to have lasting effects. In the second experiment, a reversal design was used to assess the effects of employing program boards as a means of increasing work output during practice. Work rates in eight selected swimmers were elevated by an average of 27.1% when the boards were instituted. Follow-up evaluations showed that the use of the program boards had lasting effects. Publicly checking the completion of each training unit of work changed the nature of the swimming environment to produce a more productive use of time. The role of the coach was subsequently changed as less time was spent in directing and supervising behaviors. PMID:4436167

Effects of self-recording on attendance and performance in a competitive swimming training environment.

PubMed

McKenzie, T L; Rushall, B S

1974-01-01

Swimmers' attendance at training and work rates were described by their coaches as being poor and irregular. Reinforcement contingencies were developed to remedy these unsatisfactory conditions. Two experiments were conducted. A multiple baseline design verified the effects of publicly marking attendance at practice as a sufficient solution for reducing absenteeism, tardiness, and leaving early. Follow-up analyses showed this contingency to have lasting effects. In the second experiment, a reversal design was used to assess the effects of employing program boards as a means of increasing work output during practice. Work rates in eight selected swimmers were elevated by an average of 27.1% when the boards were instituted. Follow-up evaluations showed that the use of the program boards had lasting effects. Publicly checking the completion of each training unit of work changed the nature of the swimming environment to produce a more productive use of time. The role of the coach was subsequently changed as less time was spent in directing and supervising behaviors.

Case study: Nutrition and training periodization in three elite marathon runners.

PubMed

Stellingwerf, Trent

2012-10-01

Laboratory-based studies demonstrate that fueling (carbohydrate; CHO) and fluid strategies can enhance training adaptations and race-day performance in endurance athletes. Thus, the aim of this case study was to characterize several periodized training and nutrition approaches leading to individualized race-day fluid and fueling plans for 3 elite male marathoners. The athletes kept detailed training logs on training volume, pace, and subjective ratings of perceived exertion (RPE) for each training session over 16 wk before race day. Training impulse/load calculations (TRIMP; min × RPE = load [arbitrary units; AU]) and 2 central nutritional techniques were implemented: periodic low-CHO-availability training and individualized CHO- and fluid-intake assessments. Athletes averaged ~13 training sessions per week for a total average training volume of 182 km/wk and peak volume of 231 km/wk. Weekly TRIMP peaked at 4,437 AU (Wk 9), with a low of 1,887 AU (Wk 16) and an average of 3,082 ± 646 AU. Of the 606 total training sessions, ~74%, 11%, and 15% were completed at an intensity in Zone 1 (very easy to somewhat hard), Zone 2 (at lactate threshold) and Zone 3 (very hard to maximal), respectively. There were 2.5 ± 2.3 low-CHO-availability training bouts per week. On race day athletes consumed 61 ± 15 g CHO in 604 ± 156 ml/hr (10.1% ± 0.3% CHO solution) in the following format: ~15 g CHO in ~150 ml every ~15 min of racing. Their resultant marathon times were 2:11:23, 2:12:39 (both personal bests), and 2:16:17 (a marathon debut). Taken together, these periodized training and nutrition approaches were successfully applied to elite marathoners in training and competition.

Validation of an electronic program for pathologist training in the interpretation of a complex companion diagnostic immunohistochemical assay.

PubMed

Dennis, Eslie; Banks, Peter; Murata, Lauren B; Sanchez, Stephanie A; Pennington, Christie; Hockersmith, Linda; Miller, Rachel; Lambe, Jess; Feng, Janine; Kapadia, Monesh; Clements, June; Loftin, Isabell; Singh, Shalini; Das-Gupta, Ashis; Lloyd, William; Bloom, Kenneth

2016-10-01

Companion diagnostics assay interpretation can select patients with the greatest targeted therapy benefits. We present the results from a prospective study demonstrating that pathologists can effectively learn immunohistochemical assay-interpretation skills from digital image-based electronic training (e-training). In this study, e-training was used to train board-certified pathologists to evaluate non-small cell lung carcinoma for eligibility for treatment with onartuzumab, a MET-inhibiting agent. The training program mimicked the live training that was previously validated in clinical trials for onartuzumab. A digital interface was developed for pathologists to review high-resolution, static images of stained slides. Sixty-four pathologists practicing in the United States enrolled while blinded to the type of training. After training, both groups completed a mandatory final test using glass slides. The results indicated both training modalities to be effective. Overall, 80.6% of e-trainees and 72.7% of live trainees achieved passing scores (at least 85%) on the final test. All study participants reported that their training experience was "good" and that they had received sufficient information to determine the adequacy of case slide staining to score each case. This study established that an e-training program conducted under highly controlled conditions can provide pathologists with the skills necessary to interpret a complex assay and that these skills can be equivalent to those achieved with face-to-face training using conventional microscopy. Programs of this type are scalable for global distribution and offer pathologists the potential for readily accessible and robust training in new companion diagnostic assays linked to novel, targeted, adjuvant therapies for cancer patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Creating a sustainable, interprofessional-team training program: initial results.

PubMed

Riggall, Virginia K; Smith, Charlene M

2015-01-01

The purpose of this program evaluation was to explore whether incorporating deliberate learning concepts, through the use of simulated patient scenarios to teach interprofessional collaboration skills to a healthcare team on one acute-care hospital unit, would improve the resuscitation response in the first 5 minutes on that unit. This was a pilot program evaluation utilizing a unit-based, clinical nurse specialist in the deployment of an interprofessional educational program involving simulation on an acute medical floor in a large tertiary-care hospital. Eighty-four staff members participated in 17 simulations. The sample included first-year internal-medicine residents, registered nurses, respiratory therapists, and patient care technicians. This was a program evaluation that used the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) (Classroom slides: TeamSTEPPS essentials; http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/essentials/slessentials.html#s3) during the presimulation/postsimulation sessions to assess the participants' perceptions of teamwork. Expected intervention behaviors were collected through observations of participants in the simulations and compared with the American Heart Association guidelines (Circulation 2010;122:S685-S670, S235-S337). Common perceptions of participants regarding the experience were obtained through open-ended evaluation questions. Fifty-three participants completed the pre- and post-T-TPQ. Mean scores in the leadership category of T-TPQ decreased significantly (P = .003) from the pretest (median, 2.167) to the T-TPQ posttest (median, 2.566). Only 35% of the groups administered a defibrillation during the ventricular fibrillation simulation scenario, and only 1 group delivered this shock within the American Heart Association's recommended time frame of 2 minutes (Circulation 2010;122:S235-S337). A single resuscitation simulation was not enough interventional dosage for staff to improve the resuscitation process. A longitudinal study should be conducted to determine the effectiveness of the program after staff members have repeated the program multiple times. A unit-based quality-improvement simulation training program could help improve the first-5-minute response and resuscitation skills of staff by increasing the frequency of unit-based training overseen by the unit's clinical nurse specialist.

Nutrition Education for Pediatric Gastroenterology, Hepatology and Nutrition Fellows: A Survey of NASPGHAN Fellowship Training Programs

PubMed Central

Martinez, J. Andres; Koyama, Tatsuki; Acra, Sari; Mascarenhas, Maria R.; Shulman, Robert J.

2012-01-01

Objectives The aim of the study was to assess the methodology and content of nutrition education during gastroenterology fellowship training and the variability among the different programs. Methods A survey questionnaire was completed by 43 fellowship training directors of 62 active programs affiliated to NASPGHAN, including sites in the United States, Canada and Mexico. The data were examined for patterns in teaching methodology and coverage of specific nutrition topics based on Level 1 training in nutrition, which is the minimum requirement according to published NASPGHAN fellowship training guidelines. Results The majority of the teaching was conducted by MD degree faculty (61%), and most of the education was provided through clinical care experiences. Only 31% of Level 1 nutrition topics were consistently covered by more than 80% of programs, and coverage did not correlate with the size of the programs. Competency in nutrition training was primarily assessed through questions to individuals or groups of fellows (77 and 65%, respectively). Program directors cited a lack of faculty interested in nutrition and a high workload as common obstacles for teaching. Conclusions The methodology of nutrition education during gastroenterology fellowship training is for the most part unstructured and inconsistent among the different programs. The minimum Level 1 requirements are not consistently covered. The development of core curriculums and learning modules may be beneficial in improving nutrition education. PMID:22343911

Community-based pedestrian safety training in virtual reality: A pragmatic trial.

PubMed

Schwebel, David C; Combs, Tabitha; Rodriguez, Daniel; Severson, Joan; Sisiopiku, Virginia

2016-01-01

Child pedestrian injuries are a leading cause of mortality and morbidity across the United States and the world. Repeated practice at the cognitive-perceptual task of crossing a street may lead to safer pedestrian behavior. Virtual reality offers a unique opportunity for repeated practice without the risk of actual injury. This study conducted a pre-post within-subjects trial of training children in pedestrian safety using a semi-mobile, semi-immersive virtual pedestrian environment placed at schools and community centers. Pedestrian safety skills among a group of 44 seven- and eight-year-old children were assessed in a laboratory, and then children completed six 15-minute training sessions in the virtual pedestrian environment at their school or community center following pragmatic trial strategies over the course of three weeks. Following training, pedestrian safety skills were re-assessed. Results indicate improvement in delay entering traffic following training. Safe crossings did not demonstrate change. Attention to traffic and time to contact with oncoming vehicles both decreased somewhat, perhaps an indication that training was incomplete and children were in the process of actively learning to be safer pedestrians. The findings suggest virtual reality environments placed in community centers hold promise for teaching children to be safer pedestrians, but future research is needed to determine the optimal training dosage. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessing family medicine trainees--what can we learn from the European neighbours?

PubMed

Flum, Elisabeth; Maagaard, Roar; Godycki-Cwirko, Maciek; Scarborough, Nigel; Scherpbier, Nynke; Ledig, Thomas; Roos, Marco; Steinhäuser, Jost

2015-01-01

Although demands on family physicians (FP) are to a large extent similar in the European Union, uniform assessment standards for family medicine (FM) specialty training and assessment do not exist. Aim of this pilot study was to elicit and compare the different modalities and assessment methods of FM specialty training in five European countries. A semi structured survey was undertaken based on a convenient sample in five European countries (Denmark, Germany, Poland, the Netherlands and the United Kingdom). The respondents were asked to respond to ten items about aspects of FM specialty training and assessment methods in their respective countries. If available, this data was completed with information from official websites of the countries involved. FM specialty training is performed heterogeneously in the surveyed countries. Training time periods range from three to five years, in some countries requiring a foundation program of up to two years. Most countries perform longitudinal assessment during FM specialty training using a combination of competence-based approach with additional formative and summative assessment. There is some evidence on the assessments methods used, however the assessment method used and costs of assessment differs remarkably between the participating countries. Longitudinal and competence-based assessment is the presently preferred approach for FM specialty training. Countries which use less multifaceted methods for assessment could learn from best practice. Potential changes have significant cost implications.

Predicting Success of Preliminary Surgical Residents: A Multi-Institutional Study.

PubMed

Al Fayyadh, Mohammed J; Heller, Stephanie F; Rajab, Taufiek Konrad; Gardner, Aimee K; Bloom, Jordan P; Rawlings, Jeremy A; Mullen, John T; Smink, Douglas S; Farley, David R; Willis, Ross E; Dent, Daniel L

A nondesignated preliminary surgery (NDPS) position encompasses 1 year of training provided by many general surgery residencies. Our aim was to assess factors predicting success and provide evidence for program directors to support career guidance to preliminary residents. Retrospective cohort study of 221 NDPS residents who entered 5 university-based institutions were identified from 2009 to 2013. Records for trainees were reviewed. We defined primary success as obtaining a categorical position in the specialty of choice and secondary success as obtaining a categorical position in any specialty immediately after finishing their NDPS training. Statistical evaluation was performed using chi-square analysis, independent t-test and logistic regression using α <0.05. Of the 221 NDPS residents, 217 (98%) completed postgraduate year (PGY)-1 and 65 (29%) completed PGY-2. Totally, 90 (41%) obtained categorical general surgery positions, 89 (40%) obtained categorical positions in other specialties, and 42 (19%) failed to obtain a categorical position immediately after their NDPS years. Ultimately, 139 (63%) of residents achieved primary success and 40 (18%) additional residents obtained categorical positions in specialties other than their first choice, resulting in a total of 179 (81%) of residents obtaining categorical positions. Mean United States Medical Licensing Examination step 1 and step 2 scores for those who obtained secondary success were 227 and 234 vs. 214 and 219, respectively, for those who failed to secure a categorical position (p < 0.01). United States Medical Licensing Examination step 2 score was a significant predictor of primary (p < 0.03) and secondary success (p < 0.02). Of 65 PGY-2 NDPS residents, 32 (49%) achieved primary success, and 11 (17%) others achieved secondary success for a total of 43 (66%). For PGY-2 NDPS, American Board of Surgery In-Training Examination was the only significant predictor of primary and secondary success (p < 0.02 and p < 0.05). NDPS training provides a viable and successful opportunity for at least 81% of young physicians to pursue their career goals even after an unsuccessful first match. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A pilot study of pulmonary rehabilitation and chest physiotherapy versus chest physiotherapy alone in bronchiectasis.

PubMed

Mandal, P; Sidhu, M K; Kope, L; Pollock, W; Stevenson, L M; Pentland, J L; Turnbull, K; Mac Quarrie, S; Hill, A T

2012-12-01

The aim of our study was to assess the efficacy of pulmonary rehabilitation in addition to regular chest physiotherapy in non cystic fibrosis bronchiectasis. Thirty patients with clinically significant bronchiectasis and limited exercise tolerance were randomized into either the control group receiving chest physiotherapy (8 weeks) or into the intervention group, receiving pulmonary rehabilitation in addition to chest physiotherapy (8 weeks). Both groups were encouraged to maintain their exercise program and or chest physiotherapy, following completion of the study. End of training (8 weeks) No improvement in control group. In the intervention group, incremental shuttle walk test (ISWT) improved by 56.7 m (p = 0.03), endurance walk test (EWT) by 193.3 m (p = 0.01), Leicester Cough Questionnaire (LCQ) improved by 2.6 units (p < 0.001) and St. George's Respiratory Questionnaire (SGRQ) by 8 units (p < 0.001). At 20 weeks (12 weeks post end of training) No improvement in control group. In the intervention group, ISWT improved by 80 m (p = 0.04) and EWT by 247.5 m (p = 0.003). LCQ improved by 4.4 units (p < 0.001) and SGRQ by 4 units (p < 0.001). Pulmonary rehabilitation in addition to regular chest physiotherapy, improves exercise tolerance and health related quality of life in non cystic fibrosis bronchiectasis and the benefit was sustained at 12 weeks post end of pulmonary rehabilitation. Clinical trials regn no. NCT00868075. Copyright © 2012 Elsevier Ltd. All rights reserved.

75 FR 80832 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... trainings; Evaluative materials completed by participants of in- person SOAR trainings, including pre/post training evaluation forms and a customer satisfaction survey; Evaluative materials completed by users of... from community-based agencies. Respondents to the in-person training evaluative materials include an...

Reserve Force Training After the Gulf War

DTIC Science & Technology

1992-01-01

that problem, the critical variable for reserve units is time management : using the available training time better to improve unit readiness. This...article will offer proposals to improve reserve training through better time management .

Training product unit neural networks with genetic algorithms

NASA Technical Reports Server (NTRS)

Janson, D. J.; Frenzel, J. F.; Thelen, D. C.

1991-01-01

The training of product neural networks using genetic algorithms is discussed. Two unusual neural network techniques are combined; product units are employed instead of the traditional summing units and genetic algorithms train the network rather than backpropagation. As an example, a neural netork is trained to calculate the optimum width of transistors in a CMOS switch. It is shown how local minima affect the performance of a genetic algorithm, and one method of overcoming this is presented.

The Sundown of the United States Marine Corps Naval Flight Officer Military Occupational Specialties

DTIC Science & Technology

2010-04-20

EIA-6B Electronics Warfare Officer (EWO) will complete their training in FY2015 and FY2017, respectively, with the last Fl A-18D and El A-6B squadrons...Capability (IOC) of the F-4 Phantom, A-6 Intruder, and the OV -10 Bronco introduced the requirement for Naval Flight Officers and Aerial Observers (AO...Officer (ECMO) to target Surface to Air Radars during the Vietnam War and was subsequently replaced by the four-seat E/A-6B. The OV-10 Bronco , roc in

Perceptual Units Training for Improving Word Analysis Skills. Technical Report No. 1.

ERIC Educational Resources Information Center

Weaver, Phyllis A.; And Others

A training program was devised to develop automaticity of one subcomponent of reading--locating and disembedding multiletter units within words. The system involved the use of a training task that was implemented in a microcomputer-based game that required students to detect whether a target unit was presented within words that were shown in rapid…

42 CFR 62.9 - Under what circumstances can the period of obligated service be deferred to complete approved...

Code of Federal Regulations, 2013 CFR

2013-10-01

... obligated service be deferred to complete approved graduate training? 62.9 Section 62.9 Public Health PUBLIC... approved graduate training? (a) Requested deferment. Upon the request of any participant receiving a degree... complete an approved graduate training program. The period of this deferment may not exceed (1) three years...

42 CFR 62.9 - Under what circumstances can the period of obligated service be deferred to complete approved...

Code of Federal Regulations, 2012 CFR

2012-10-01

... obligated service be deferred to complete approved graduate training? 62.9 Section 62.9 Public Health PUBLIC... approved graduate training? (a) Requested deferment. Upon the request of any participant receiving a degree... complete an approved graduate training program. The period of this deferment may not exceed (1) three years...

42 CFR 62.9 - Under what circumstances can the period of obligated service be deferred to complete approved...

Code of Federal Regulations, 2014 CFR

2014-10-01

... obligated service be deferred to complete approved graduate training? 62.9 Section 62.9 Public Health PUBLIC... approved graduate training? (a) Requested deferment. Upon the request of any participant receiving a degree... complete an approved graduate training program. The period of this deferment may not exceed (1) three years...

Knowledge and attitudes of healthcare workers in Chinese intensive care units regarding 2009 H1N1 influenza pandemic.

PubMed

Ma, Xiaochun; He, Zhenyang; Wang, Yushan; Jiang, Li; Xu, Yuan; Qian, Chuanyun; Sun, Rongqing; Chen, Erzhen; Hu, Zhenjie; Zhou, Lihua; Zhou, Fachun; Qin, Tiehe; Cao, Xiangyuan; An, Youzhong; Sun, Renhua; Zhang, Xijing; Lin, Jiandong; Ai, Yuhang; Wu, Dawei; Du, Bin

2011-01-25

To describe the knowledge and attitudes of critical care clinicians during the 2009 H1N1 influenza pandemic. A survey conducted in 21 intensive care units in 17 provinces in China. Out of 733 questionnaires distributed, 695 were completed. Three hundred and fifty-six respondents (51.2%) reported their experience of caring for H1N1 patients. Despite the fact that 88.5% of all respondents ultimately finished an H1N1 training program, only 41.9% admitted that they had the knowledge of 2009 H1N1 influenza. A total of 572 respondents (82.3%) expressed willingness to care for H1N1 patients. Independent variables associated with increasing likelihood to care for patients in the logistic regression analysis were physicians or nurses rather than other professionals (odds ratio 4.056 and 3.235, p = 0.002 and 0.007, respectively), knowledge training prior to patient care (odds ratio 1.531, p = 0.044), and the confidence to know how to protect themselves and their patients (odds ratio 2.109, p = 0.001). Critical care clinicians reported poor knowledge of H1N1 influenza, even though most finished a relevant knowledge training program. Implementation of appropriate education program might improve compliance to infection control measures, and willingness to work in a pandemic.

75 FR 50764 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-17

... groups with participants of in-person SOAR trainings; Evaluative materials completed by participants of... survey; Evaluative materials completed by users of web-based SOAR trainings, including pre/post training... evaluative materials include an average of 15 individuals who participated in the first in-person training in...

14 CFR 135.337 - Qualifications: Check airmen (aircraft) and check airmen (simulator).

Code of Federal Regulations, 2010 CFR

2010-01-01

... satisfactorily completed the training phases for the aircraft, including recurrent training, that are required to... under this part; (2) Has satisfactorily completed the appropriate training phases for the aircraft... ON BOARD SUCH AIRCRAFT Training § 135.337 Qualifications: Check airmen (aircraft) and check airmen...

Factors Influencing Trainee Participation in Computer Software Applications Training.

ERIC Educational Resources Information Center

Alexander, Melody Webler

1993-01-01

Participants (n=130) who had completed training in WordPerfect, Lotus 1-2-3, and dBase III+ completed a questionnaire related to demographic characteristics and factors that influence training participation. Trainees are participating in computer training for personal reasons, seeking convenient time, location, and length. Child care or…

Fiscal Year 1970 Work Program for the Department of the Army; Research and Development in Training, Motivation, and Leadership.

ERIC Educational Resources Information Center

Human Resources Research Organization, Alexandria, VA.

Activities (28 Work Units and six other research efforts) performed by the Human Resources Research Organization for the Department of the Army for Fiscal Year 1970 have been grouped by six major areas: individual training and performance; unit training and performance; training for leadership, command, and control; language and area training;…

Effects of Barbell Deadlift Training on Submaximal Motor Unit Firing Rates for the Vastus Lateralis and Rectus Femoris

PubMed Central

Stock, Matt S.; Thompson, Brennan J.

2014-01-01

Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC) assessment. Twenty-four previously untrained men (mean age  = 24 years) were randomly assigned to training (n = 15) or control (n = 9) groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC) and y-intercepts (pps) of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70), but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units. PMID:25531294

Current practices in library/informatics instruction in academic libraries serving medical schools in the western United States: a three-phase action research study

PubMed Central

2013-01-01

Background To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Methods Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Results Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and teaching skills, and that they need to continually adapt to changes in curricula. Conclusions This study offers a long overdue, systematic view of current practices of library/informatics training at Western U.S. medical schools. Medical educators, particularly curricular leaders, will find opportunities in this study's results for more productive collaborations with the librarians responsible for library and informatics training at their medical schools. PMID:24007301

Mobile Simulation Unit: taking simulation to the surgical trainee.

PubMed

Pena, Guilherme; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy

2015-05-01

Simulation-based training has become an increasingly accepted part of surgical training. However, simulators are still not widely available to surgical trainees. Some factors that hinder the widespread implementation of simulation-based training are the lack of standardized methods and equipment, costs and time constraints. We have developed a Mobile Simulation Unit (MSU) that enables trainees to access modern simulation equipment tailored to the needs of the learner at the trainee's workplace. From July 2012 to December 2012, the MSU visited six hospitals in South Australia, four in metropolitan and two in rural areas. Resident Medical Officers, surgical trainees, Fellows and International Medical Graduates were invited to voluntarily utilize a variety of surgical simulators on offer. Participants were asked to complete a survey about the accessibility of simulation equipment at their workplace, environment of the MSU, equipment available and instruction received. Utilization data were collected. The MSU was available for a total of 303 h over 52 days. Fifty-five participants were enrolled in the project and each spent on average 118 min utilizing the simulators. The utilization of the total available time was 36%. Participants reported having a poor access to simulation at their workplace and overwhelmingly gave positive feedback regarding their experience in the MSU. The use of the MSU to provide simulation-based education in surgery is feasible and practical. The MSU provides consistent simulation training at the surgical trainee's workplace, regardless of geographic location, and it has the potential to increase participation in simulation programmes. © 2014 Royal Australasian College of Surgeons.

Selection criteria for the integrated model of plastic surgery residency.

PubMed

LaGrasso, Jeffrey R; Kennedy, Debbie A; Hoehn, James G; Ashruf, Salmon; Przybyla, Adrian M

2008-03-01

The purpose of this study was to identify those qualities and characteristics of fourth-year medical students applying for the Integrated Model of Plastic Surgery residency training that will make a successful plastic surgery resident. A three-part questionnaire was distributed to the training program directors of the 20 Integrated Model of Plastic Surgery programs accredited by the Residency Review Committee for Plastic Surgery by the Accreditation Council on Graduate Medical Education. The first section focused on 19 objective characteristics that directors use to evaluate applicants (e.g., Alpha Omega Alpha Honor Society membership, United States Medical Licensing Examination scores). The second section consisted of 20 subjective characteristics commonly used to evaluate applicants during the interview process. The third section consisted of reasons why, if any, residents failed to successfully complete the training program. Fifteen of the 20 program directors responded to the questionnaire. The results showed that they considered membership in the Alpha Omega Alpha Honor Society to be the most important objective criterion, followed by publications in peer-reviewed journals and letters of recommendation from plastic surgeons known to the director. Leadership capabilities were considered the most important subjective criterion, followed by maturity and interest in academics. Reasons residents failed to complete the training program included illness or death, academic inadequacies, and family demands. The authors conclude that applicants who have achieved high academic honors and demonstrate leadership ability with interest in academics were viewed most likely to succeed as plastic surgery residents by program directors of Integrated Model of Plastic Surgery residencies.

Improving Nurses' Peripheral Intravenous Catheter Insertion Knowledge, Confidence, and Skills Using a Simulation-Based Blended Learning Program: A Randomized Trial.

PubMed

Keleekai, Nowai L; Schuster, Catherine A; Murray, Connie L; King, Mary Anne; Stahl, Brian R; Labrozzi, Laura J; Gallucci, Susan; LeClair, Matthew W; Glover, Kevin R

2016-12-01

Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%. Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored.

10 CFR 35.690 - Training for use of remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Training for use of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.690 Section 35.690 Energy NUCLEAR REGULATORY...) Radiation physics and instrumentation; (B) Radiation protection; (C) Mathematics pertaining to the use and...

10 CFR 35.690 - Training for use of remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Training for use of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.690 Section 35.690 Energy NUCLEAR REGULATORY...) Radiation physics and instrumentation; (B) Radiation protection; (C) Mathematics pertaining to the use and...

10 CFR 35.690 - Training for use of remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Training for use of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.690 Section 35.690 Energy NUCLEAR REGULATORY...) Radiation physics and instrumentation; (B) Radiation protection; (C) Mathematics pertaining to the use and...

10 CFR 35.690 - Training for use of remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Training for use of remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.690 Section 35.690 Energy NUCLEAR REGULATORY...) Radiation physics and instrumentation; (B) Radiation protection; (C) Mathematics pertaining to the use and...

Familiarity with Long-acting Reversible Contraceptives among Obstetrics and Gynecology, Family Medicine, and Pediatrics Residents: Results of a 2015 National Survey and Implications for Contraceptive Provision for Adolescents.

PubMed

Davis, Susan A; Braykov, Nikolay P; Lathrop, Eva; Haddad, Lisa B

2018-02-01

To assess familiarity with long-acting reversible contraceptives (LARC) among current obstetrics and gynecology (OB/GYN), family medicine (FM), and pediatrics senior residents in the United States. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We selected 156 OB/GYN, FM, and pediatrics residency programs using the American Medical Association Freida database. Senior residents completed a survey addressing any training they had received on LARC, and rated their comfort level counseling about and inserting LARC. Residents rated their likelihood of recommending LARC to an adolescent, nulliparous patient, and indicated whether they would like additional training on LARC. Descriptive and analytic statistics were generated using R statistical software (The R Project for Statistical Computing; https://www.r-project.org). The survey was completed by 326 of 1,583 residents (20.6% response rate); at least 1 resident completed the survey at 105 (67.3%) of the residency programs contacted. Most programs (84.8%) provided some training on LARC. Residents in OB/GYN programs were comfortable counseling about and inserting contraceptive implants (97%, 83%), copper intrauterine devices (IUDs; 100%, 86%), and levonorgestrel (LNG) IUDs (100%, 86%). In FM programs, fewer residents were comfortable counseling about and inserting contraceptive implants (71%, 47%), copper IUDs (68%, 21%), and LNG IUDs (79%, 18%). Residents in pediatrics programs had low comfort levels counseling about contraceptive implants (14%), copper IUDs (14%), and LNG IUDs (25%); no pediatrics residents were comfortable inserting LARC. OB/GYN residents were significantly more likely to recommend a LARC to an adolescent, nulliparous patient (P = .019). Most pediatric and FM residents desired additional training on LARC (82.7% and 60.7%, respectively). This study shows that knowledge gaps exist regarding LARC among FM and pediatrics residents. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Sharing a Personal Trainer: Personal and Social Benefits of Individualized, Small-Group Training.

PubMed

Wayment, Heidi A; McDonald, Rachael L

2017-11-01

Wayment, HA and McDonald, RL. Sharing a personal trainer: personal and social benefits of individualized, small-group training. J Strength Cond Res 31(11): 3137-3145, 2017-We examined a novel personal fitness training program that combines personal training principles in a small-group training environment. In a typical training session, exercisers warm-up together but receive individualized training for 50 minutes with 1-5 other adults who range in age, exercise experience, and goals for participation. Study participants were 98 regularly exercising adult members of a fitness studio in the southwestern United States (64 women and 32 men), aged 19-78 years (mean, 46.52 years; SD = 14.15). Average membership time was 2 years (range, 1-75 months; mean, 23.54 months; SD = 20.10). In collaboration with the program directors, we developed a scale to assess satisfaction with key features of this unique training program. Participants completed an online survey in Fall 2015. Hypotheses were tested with a serial mediator model (model 6) using the SPSS PROCESS module. In support of the basic tenets of self-determination theory, satisfaction with small-group, individualized training supported basic psychological needs, which in turn were associated with greater autonomous exercise motivation and life satisfaction. Satisfaction with this unique training method was also associated with greater exercise self-efficacy. Autonomous exercise motivation was associated with both exercise self-efficacy and greater self-reported health and energy. Discussion focuses on why exercise programs that foster a sense of social belonging (in addition to motivation and efficacy) may be helpful for successful adherence to an exercise program.

Suicide-Related Knowledge and Confidence Among Behavioral Health Care Staff in Seven States.

PubMed

Silva, Caroline; Smith, April R; Dodd, Dorian R; Covington, David W; Joiner, Thomas E

2016-11-01

Death by suicide is a serious and growing public health concern in the United States. This noncontrolled, naturalistic study examined professionals' knowledge about suicide and confidence in working with suicidal individuals, comparing those who had received either of two gatekeeper trainings-Question, Persuade, and Refer (QPR) or Applied Suicide Intervention Skills Training (ASIST)-or other suicide-relevant training or no training. Participants (N=16,693) were individuals in various professional roles in the field of behavioral health care in Indiana, Kentucky, New York, Pennsylvania, Tennessee, Texas, and Utah. Participants completed a survey assessing suicide knowledge and skills confidence. Most participants (52.9%) reported no previous suicide prevention or assessment training. Individuals with suicide-relevant training demonstrated greater suicide knowledge and confidence than those with no such training. Among those who had received any training, no differences were found in suicide knowledge; however, individuals who had received ASIST reported greater confidence in working with suicidal individuals, compared with those who had received other training. Professional role and prior experience with a client who had died by suicide had significant positive relationships with suicide knowledge and confidence. Regional differences emerged between states and are examined within the context of statewide suicide prevention initiatives. Increasing access to and incentives for participating in suicide-relevant training among behavioral health care staff may foster a more knowledgeable and confident group of gatekeepers. Future research should examine whether increases in knowledge and confidence among staff translate into actual changes in practice that help protect and serve at-risk individuals.

Completion and Attrition Rates for Apprentices and Trainees, 2016. Australian Vocational Education and Training Statistics

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2017

2017-01-01

This publication presents completion and attrition rates for apprentices and trainees using three different methodologies: (1) contract completion and attrition rates: based on the outcomes of contracts of training; (2) individual completion rates: based on contract completion rates and adjusted for factors representing average recommencements by…

Completion and Attrition Rates for Apprentices and Trainees 2014. Australian Vocational Education and Training Statistics

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

This publication presents completion and attrition rates for apprentices and trainees using three different methodologies: (1) contract completion and attrition rates: based on the outcomes of contracts of training; (2) individual completion rates: based on contract completion rates and adjusted for factors representing average recommencements by…

Pacific Armies Management Seminar (5th) Held at Manila, Republic of the Philippines on 16-20 November 1981. Addendum.

DTIC Science & Technology

1981-01-01

8217 Malaysian Army 21 "Training Management in the Singapore COL Ha, MAJ Yong, and Armed Forces" MAJ Tan Singapore Armed Forces 27 "Army Unit Training" COL...nation. This will permit continued develop- ment of all sectors under conditions of stability and peace and will ensure our continued security from any...Military Occupational Specialty Training (MOS) in units. b. ASOPS exercises general staff supervision over: -a7T other individual training in units

Implementation of the integrated palliative care outcome scale in acute care settings - a feasibility study.

PubMed

Lind, Susanne; Sandberg, J; Brytting, T; Fürst, C J; Wallin, L

2018-01-21

Although hospitals have been described as inadequate place for end-of-life care, many deaths still occur in hospital settings. Although patient-reported outcome measures have shown positive effects for patients in need of palliative care, little is known about how to implement them. We aimed to explore the feasibility of a pilot version of an implementation strategy for the Integrated Palliative care Outcome Scale (IPOS) in acute care settings. A strategy, including information, training, and facilitation to support the use of IPOS, was developed and carried out at three acute care units. For an even broader understanding of the strategy, it was also tested at a palliative care unit. A process evaluation was conducted including collecting quantitative data and performing interviews with healthcare professionals. Result Factors related to the design and performance of the strategy and the context contributed to the results. The prevalence of completed IPOS in the patient's records varied from 6% to 44% in the acute care settings. At the palliative care unit, the prevalence in the inpatient unit was 53% and the specialized home care team 35%. The qualitative results showed opposing perspectives concerning the training provided: Related to everyday work at the acute care units and Nothing in it for us at the palliative care unit. In the acute care settings, A need for an improved culture regarding palliative care was identified. A context characterized by A constantly increasing workload, a feeling of Constantly on-going changes, and a feeling of Change fatigue were found at all units. Furthermore, the internal facilitators and the nurse managers' involvement in the implementation differed between the units. Significance of the results The feasibility of the strategy in our study is considered to be questionable and the components need to be further explored to enhance the impact of the strategy and thereby improve the use of IPOS.

Trial and evaluation of assertion training involving nursing students.

PubMed

Nishina, Yuko; Tanigaki, Shizuko

2013-09-01

The concept of assertion and conceptual/practical methods of assertion (assertiveness) training were originally developed in the United States and Europe. These principles were embraced and adapted in Japan in 1970's. However, only a few studies relating to assertion (assertiveness) have been undertaken thus far in Japan, especially so in the domain of nursing students in comparison with other countries. The purpose of this study was to design and implement assertion training with nursing students and to clarify its effects. The participants were all volunteers, invited from a class of 3rd year nursing students. Ten students (intervention group) participated in the assertion training comprised of five sessions in February 2006. Fifty-six students (control group) were participated only in the questionnaire. Both groups were asked to complete the same questionnaire twice, before and after the assertion training. The questionnaire measured levels of assertiveness, social skills, self-esteem, social support and satisfaction with university life. The results and variances, both before and after assertion training, between the intervention group and the control group were analyzed. The effectiveness of the assertion training was determined by changes in pre and post training questionnaire scores. The scores for social skills in the control group had a tendency to decline while the scores for social skills in the intervention group remained constant. Although there were no statistically significant results in the intervention group, the present study highlights areas appropriate for further study.

Trial and Evaluation of Assertion Training Involving Nursing Students

PubMed Central

Nishina, Yuko; Tanigaki, Shizuko

2013-01-01

Background The concept of assertion and conceptual/practical methods of assertion (assertiveness) training were originally developed in the United States and Europe. These principles were embraced and adapted in Japan in 1970’s. However, only a few studies relating to assertion (assertiveness) have been undertaken thus far in Japan, especially so in the domain of nursing students in comparison with other countries. The purpose of this study was to design and implement assertion training with nursing students and to clarify its effects. Methods The participants were all volunteers, invited from a class of 3rd year nursing students. Ten students (intervention group) participated in the assertion training comprised of five sessions in February 2006. Fifty-six students (control group) were participated only in the questionnaire. Both groups were asked to complete the same questionnaire twice, before and after the assertion training. The questionnaire measured levels of assertiveness, social skills, self-esteem, social support and satisfaction with university life. The results and variances, both before and after assertion training, between the intervention group and the control group were analyzed. The effectiveness of the assertion training was determined by changes in pre and post training questionnaire scores. Results The scores for social skills in the control group had a tendency to decline while the scores for social skills in the intervention group remained constant. Conclusion Although there were no statistically significant results in the intervention group, the present study highlights areas appropriate for further study. PMID:24174705

Effects of Selection and Training on Unit-Level Performance over Time: A Latent Growth Modeling Approach

ERIC Educational Resources Information Center

Van Iddekinge, Chad H.; Ferris, Gerald R.; Perrewe, Pamela L.; Perryman, Alexa A.; Blass, Fred R.; Heetderks, Thomas D.

2009-01-01

Surprisingly few data exist concerning whether and how utilization of job-related selection and training procedures affects different aspects of unit or organizational performance over time. The authors used longitudinal data from a large fast-food organization (N = 861 units) to examine how change in use of selection and training relates to…

Erasing Sex Bias Through Staff Training: Women in Employment. Unit I.

ERIC Educational Resources Information Center

Soldwedel, Bette J.

This document, one of four staff training units in a series designed to attack problems of sex bias in the counseling of women and girls, is intended to help counselors and counselor educators consider their knowledge of and attitudes toward the sex-limited status of women. In this unit, two staff training workshop strategies are provided. The…

A review of general cosmetic surgery training in fellowship programs offered by the American Academy of Cosmetic Surgery.

PubMed

Handler, Ethan; Tavassoli, Javad; Dhaliwal, Hardeep; Murray, Matthew; Haiavy, Jacob

2015-04-01

We sought, first, to evaluate the operative experience of surgeons who have completed postresidency fellowships offered by the American Academy of Cosmetic Surgery (AACS), and second, to compare this cosmetic surgery training to other surgical residency and fellowship programs in the United States. Finally, we suggest how new and existing oral and maxillofacial surgeons can use these programs. We reviewed the completed case logs from AACS-accredited fellowships. The logs were data mined for 7 of the most common cosmetic operations, including the median total number of operations. We then compared the cosmetic case requirements from the different residencies and fellowships. Thirty-nine case logs were reviewed from the 1-year general cosmetic surgery fellowships offered by the AACS from 2007 to 2012. The fellows completed a median of 687 total procedures. The median number of the most common cosmetic procedures performed was 14 rhinoplasties, 31 blepharoplasties, 21 facelifts, 24 abdominoplasties, 28 breast mastopexies, 103 breast augmentations, and 189 liposuctions. The data obtained were compared with the minimum cosmetic surgical requirements in residency and fellowship programs. The minimum residency requirements were as follows: no minimum listed for plastic surgery, 35 for otolaryngology, 20 for oral and maxillofacial surgery, 28 for ophthalmology, 0 for obstetrics and gynecology, and 20 for dermatology. The minimum fellowship requirements were as follows: 300 for the AACS cosmetic surgery fellowship, no minimum listed for facial plastic surgery and reconstruction, no minimum listed for aesthetic surgery, 133 for oculoplastic and reconstructive surgery, and 0 for Mohs dermatology. Dedicating one's practice exclusively to cosmetic surgery requires additional postresidency training owing to the breadth of the field. The AACS created comprehensive fellowship programs to fill an essential part in the continuum of cosmetic surgeons' education, training, and experience. This builds on the foundation of their primary board residency program. The AACS fellowships are a valuable option for additional training for qualified surgeons seeking proficiency and competency in cosmetic surgery. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

25 CFR 12.35 - Do Indian country law enforcement officers complete any special training?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Do Indian country law enforcement officers complete any special training? 12.35 Section 12.35 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Qualifications and Training Requirements § 12.35 Do Indian country law enforcement officers complete any...

Postgraduate Education in Quality Improvement Methods: Initial Results of the Fellows' Applied Quality Training (FAQT) Curriculum.

PubMed

Winchester, David E; Burkart, Thomas A; Choi, Calvin Y; McKillop, Matthew S; Beyth, Rebecca J; Dahm, Phillipp

2016-06-01

Training in quality improvement (QI) is a pillar of the next accreditation system of the Accreditation Committee on Graduate Medical Education and a growing expectation of physicians for maintenance of certification. Despite this, many postgraduate medical trainees are not receiving training in QI methods. We created the Fellows Applied Quality Training (FAQT) curriculum for cardiology fellows using both didactic and applied components with the goal of increasing confidence to participate in future QI projects. Fellows completed didactic training from the Institute for Healthcare Improvement's Open School and then designed and completed a project to improve quality of care or patient safety. Self-assessments were completed by the fellows before, during, and after the first year of the curriculum. The primary outcome for our curriculum was the median score reported by the fellows regarding their self-confidence to complete QI activities. Self-assessments were completed by 23 fellows. The majority of fellows (15 of 23, 65.2%) reported no prior formal QI training. Median score on baseline self-assessment was 3.0 (range, 1.85-4), which was significantly increased to 3.27 (range, 2.23-4; P = 0.004) on the final assessment. The distribution of scores reported by the fellows indicates that 30% were slightly confident at conducting QI activities on their own, which was reduced to 5% after completing the FAQT curriculum. An interim assessment was conducted after the fellows completed didactic training only; median scores were not different from the baseline (mean, 3.0; P = 0.51). After completion of the FAQT, cardiology fellows reported higher self-confidence to complete QI activities. The increase in self-confidence seemed to be limited to the applied component of the curriculum, with no significant change after the didactic component.

The CAM-ICU has now a French "official" version. The translation process of the 2014 updated Complete Training Manual of the Confusion Assessment Method for the Intensive Care Unit in French (CAM-ICU.fr).

PubMed

Chanques, Gérald; Garnier, Océane; Carr, Julie; Conseil, Matthieu; de Jong, Audrey; Rowan, Christine M; Ely, E Wesley; Jaber, Samir

2017-10-01

Delirium is common in Intensive-Care-Unit (ICU) patients but under-recognized by bed-side clinicians when not using validated delirium-screening tools. The Confusion-Assessment-Method for the ICU (CAM-ICU) has demonstrated very good psychometric properties, and has been translated into many different languages though not into French. We undertook this opportunity to describe the translation process. The translation was performed following recommended guidelines. The updated method published in 2014 including introduction letters, worksheet and flowsheet for bed-side use, the method itself, case-scenarios for training and Frequently-Asked-Questions (32 pages) was translated into French language by a neuropsychological researcher who was not familiar with the original method. Then, the whole method was back-translated by a native English-French bilingual speaker. The new English version was compared to the original one by the Vanderbilt University ICU-delirium-team. Discrepancies were discussed between the two teams before final approval of the French version. The entire process took one year. Among the 3692 words of the back-translated version of the method itself, 18 discrepancies occurred. Eight (44%) lead to changes in the final version. Details of the translation process are provided. The French version of CAM-ICU is now available for French-speaking ICUs. The CAM-ICU is provided with its complete training-manual that was challenging to translate following recommended process. While many such translations have been done for other clinical tools, few have published the details of the process itself. We hope that the availability of such teaching material will now facilitate a large implementation of delirium-screening in French-speaking ICUs. Copyright © 2017 Société française d'anesthésie et de réanimation (Sfar). All rights reserved.

ESA Press Event: See Mars Express before its departure to the Red Planet

NASA Astrophysics Data System (ADS)

2002-08-01

There will be ten participants: four ESA astronauts (Pedro Duque, Leopold Eyharts, Paolo Nespoli and Thomas Reiter), four Japanese astronauts from NASDA (Takao Doi, Koichi Wakata, Satoshi Furukawa and Aikihido Hoshide) and two NASA astronauts (Nicole Passonno Stott and Stephanie D. Wilson). The main objective of this training session is to prepare the astronauts for the tasks they will have to perform when the Japanese experiment module (JEM) and ESA's Columbus laboratory are docked with the core of the International Space Station over the years ahead. After completing their training and certification, the astronauts will be assigned to long-duration missions to the ISS. The advanced training at the EAC will focus on the Columbus systems and the Automated Transfer Vehicle (ATV). It will consist of 24 classroom lectures on the Columbus and ATV systems and 4 on payloads, and 2 sessions in the Columbus Trainer. Instructors are being provided by Astrium for the Columbus systems and Alenia Spazio for the ATV, with ESA/EAC staff as mentors for the Columbus payloads. The astronauts are scheduled to visit Astrium in Bremen on 30 August to get acquainted with the flight unit of the Columbus laboratory module currently undergoing integration. This group of astronauts started their advanced training in April 2001 at NASA's Johnson Space Center (JSC), Houston, where they attended a first course on the US segment of the International Space Station. This was followed by training on the JEM system at NASDA's Tsukuba Space Center, Japan, in December 2001 - January 2002 and additional training at the JSC in May 2002. At the beginning of next year the group will be returning to Tsukuba for training on Japanese payloads. Hands-on sessions on Columbus Payload Training Models are scheduled for the second half of 2003, again at ESA's European Astronaut Centre. On Thursday 5 September, between 16:30 and 18:30 hrs, the astronauts and other ESA specialists will be available for interviews. Media representatives interested in meeting them are requested to complete the attached reply form and to fax it by Tuesday 3 September to Maren Stock at ESA/EAC.

Qualifications, training, and perceptions of substance abuse counselors who work with victims of incest.

PubMed

Janikowski, Timothy P; Glover-Graf, Noreen M

2003-08-01

The study was an initial investigation into substance abuse counselors' qualifications and their training related to providing counseling for incest. Perceptions regarding the incidence of incest and insights into the difficulties of serving this subpopulation were also gathered. A total of 121 practicing substance abuse counselors, randomly sampled from treatment facilities across the United States, completed the "Substance Abuse Counselor Survey on Clients with Incest Histories" (SACSCIH). Participants estimated that, on average, about 24% of their clients were victims of incest. They also suspected that, on average, an additional 14% of their clients were victims of incest but did not report this information to the treatment staff. Participants revealed how they collected incest-related information and the various challenges they face in treating these clients. Data are analyzed descriptively and recommendations for future research are presented.

Overcoming nursing barriers to intensive care unit early mobilisation: A quality improvement project.

PubMed

Hunter, Oluwatobi O; George, Elisabeth L; Ren, Dianxu; Morgan, Douglas; Rosenzweig, Margaret; Klinefelter Tuite, Patricia

2017-06-01

To increase adherence with intensive care unit mobility by developing and implementing a mobility training program that addresses nursing barriers to early mobilisation. An intensive care unit mobility training program was developed, implemented and evaluated with a pre-test, immediate post-test and eight-week post-test. Patient mobility was tracked before and after training. A ten bed cardiac intensive care unit. The training program's efficacy was measured by comparing pre-test, immediate post-test and 8-week post-test scores. Patient mobilisation rates before and after training were compared. Protocol compliance was measured in the post training group. Nursing knowledge increased from pre-test to immediate post-test (p<0.0001) and pre-test to 8-week post-test (p<0.0001). Mean test scores decreased by seven points from immediate post-test (80±12) to 8-week post-test (73±14). Fear significantly decreased from pre-test to immediate post-test (p=0.03), but not from pre-test to 8-week post-test (p=0.06) or immediate post-test to 8-week post-test (p=0.46). Post training patient mobility rates increased although not significantly (p=0.07). Post training protocol compliance was 78%. The project successfully increased adherence with intensive care unit mobility and indicates that a training program could improve adoption of early mobility. Copyright © 2016 Elsevier Ltd. All rights reserved.

State of Simulation in Healthcare Education: An Initial Survey in Beijing

PubMed Central

Zhao, Zichen; Niu, Pengfei; Ji, Xiang

2017-01-01

Background and Objectives: In 2013, medical error was the third leading cause of death in the United States.1 In China, as in the case with the United States, training and assessment are developing as a strategy to reduce the occurrence of such errors. The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. Methods: This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program. The questionnaire was designed online and distributed to the SRT management departments by e-mail or instant message. Results: Thirty hospitals were invited to participate in this survey, and 15 responses were completed and met the inclusion criteria. Task trainers (15/15), full-scale mannequins (14/15), standardized patients (12/15), and virtual reality workstations (11/15) were the most common types of simulation modalities available for use. Among the given specialties for SRT, the availability of simulation courses was 2/2 for pediatric internal medicine, 1/1 for pediatric surgery, 10/11 for surgery, 11/14 for internal medicine, 7/9 for anesthesiology, 6/8 for emergency medicine, and 3/9 for obstetrics/gynecology. Of the 13 institutions with available simulation curricula, 12/13 had simulation focused on proficiency-based skill training, 11/13 had medical knowledge learning, 10/13 had skill competency assessment. The main targeted trainees in these hospitals were residents (or postgraduate residents) and medical students (or interns). The top 2 barriers were the shortage of sustainable financial resources (12/15) and advocacy from their institutional authorities (7/15). Conclusion: It is evident that there is a need for more development of training facilities, and for training the “trainers” and administrators. Financial funding, curricular design, and research seem to be crucial for building a long-term, sustainable, effective program. PMID:28144123

State of Simulation in Healthcare Education: An Initial Survey in Beijing.

PubMed

Zhao, Zichen; Niu, Pengfei; Ji, Xiang; Sweet, Robert M

2017-01-01

In 2013, medical error was the third leading cause of death in the United States. 1 In China, as in the case with the United States, training and assessment are developing as a strategy to reduce the occurrence of such errors. The objective of this study was to assess the current state of the use of simulation-based training in Beijing and to explore the barriers to further development. This study included hospitals in Beijing accredited by the Standardized Residency Training (SRT) program. The questionnaire was designed online and distributed to the SRT management departments by e-mail or instant message. Thirty hospitals were invited to participate in this survey, and 15 responses were completed and met the inclusion criteria. Task trainers (15/15), full-scale mannequins (14/15), standardized patients (12/15), and virtual reality workstations (11/15) were the most common types of simulation modalities available for use. Among the given specialties for SRT, the availability of simulation courses was 2/2 for pediatric internal medicine, 1/1 for pediatric surgery, 10/11 for surgery, 11/14 for internal medicine, 7/9 for anesthesiology, 6/8 for emergency medicine, and 3/9 for obstetrics/gynecology. Of the 13 institutions with available simulation curricula, 12/13 had simulation focused on proficiency-based skill training, 11/13 had medical knowledge learning, 10/13 had skill competency assessment. The main targeted trainees in these hospitals were residents (or postgraduate residents) and medical students (or interns). The top 2 barriers were the shortage of sustainable financial resources (12/15) and advocacy from their institutional authorities (7/15). It is evident that there is a need for more development of training facilities, and for training the "trainers" and administrators. Financial funding, curricular design, and research seem to be crucial for building a long-term, sustainable, effective program.

Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

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

Gondi, Vinai, E-mail: gondi@humonc.wisc.edu; Bernard, Johnny Ray; Jabbari, Siavash

2011-11-15

Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 tomore » 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties. Conclusions: Trends in clinical training and resident working conditions over 3 years are documented to allow residents and program directors to assess their residency training.« less

Expanded Use of Draftees

DTIC Science & Technology

1990-02-01

segregation of jobs - particularly in the CONUS support base - as "military" or "civilian" is inappropriate. Most positions should be coded so that...military training qualifying incumbent for deployment; Short - a 1-week orientation providing minimum information in preparation for on-the- job training or...support job using civilian experience; Unit - military training by unit (rather than training center) cadre, Refr - refresher training d FO - full

[Training program in endourological surgery. Future perspectives.

PubMed

Soria, Federico; Villacampa, Felipe; Serrano, Alvaro; Moreno, Jesús; Rioja, Jorge; Sánchez, Francisco Miguel

2018-01-01

Current training in urological endoscopy lacks a specific training program. However, there is a clear need for a specific and uniform program, which will ensure the training, regardless of the unit where it is carried out. So, the goal is to first evaluate the current model and then bring improvements for update. The hospital training accreditation programme are only the adjustment of the official program of the urology specialty to the specific circumstances of each center, which causes variability in training of residents. After reviewing 19 training programs belonging to 12 Spanish regions. The current outlook shows that scarcely 10% of hospitals quantify the number of procedures/ year, although the Spanish program emphasizes that the achievement of the residents should be quantified. Urology residents, sense their training as inadequate and therefore their level of satisfaction is moderate. The three main problems detected by residents as an obstacle on their training are: the lack of supervision, tutors completing their own learning. Finally, the lack of quantification in surgical activities is described as a threat. This has no easy solution, since the learning curve of the most common techniques in endourology is not correctly established. Regarding aspects that can improve the current model, they highlight the need to design a specific program. The need to customize the training, the ineludible accreditation of tutors and obviously dignify the tutor's teaching activity. Another basic aspect is the inclusion of new technologies as training tools, e-learning. As well as the implementation of an adequate competency assessment plan and the possibility of relying on simulation systems. Finally, they highlight the need to attend monographic meetings and external clinic rotations to promote critical training.

Training in intensive care medicine. A challenge within reach.

PubMed

Castellanos-Ortega, A; Rothen, H U; Franco, N; Rayo, L A; Martín-Loeches, I; Ramírez, P; Cuñat de la Hoz, J

2014-01-01

The medical training model is currently immersed in a process of change. The new paradigm is intended to be more effective, more integrated within the healthcare system, and strongly oriented towards the direct application of knowledge to clinical practice. Compared with the established training system based on certification of the completion of a series or rotations and stays in certain healthcare units, the new model proposes a more structured training process based on the gradual acquisition of specific competences, in which residents must play an active role in designing their own training program. Training based on competences guarantees more transparent, updated and homogeneous learning of objective quality, and which can be homologated internationally. The tutors play a key role as the main directors of the process, and institutional commitment to their work is crucial. In this context, tutors should receive time and specific formation to allow the evaluation of training as the cornerstone of the new model. New forms of objective summative and training evaluation should be introduced to guarantee that the predefined competences and skills are effectively acquired. The free movement of specialists within Europe is very desirable and implies that training quality must be high and amenable to homologation among the different countries. The Competency Based training in Intensive Care Medicine in Europe program is our main reference for achieving this goal. Scientific societies in turn must impulse and facilitate all those initiatives destined to improve healthcare quality and therefore specialist training. They have the mission of designing strategies and processes that favor training, accreditation and advisory activities with the government authorities. Copyright © 2013 Elsevier España, S.L. y SEMICYUC. All rights reserved.

International issues: Obtaining an adult neurology residency position in the United States: an overview.

PubMed

Jordan, Justin T; Sellner, Johann; Struhal, Walter; Schneider, Logan; Mayans, David

2014-04-08

Around the world, there are marked differences in neurology training, including training duration and degree of specialization. In the United States, adult neurology residency is composed of 1 year of internal medicine training (preliminary year) and 3 years of neurology-specific training. Child neurology, which is not the focus of this article, is 2 years of pediatrics and 3 years of neurology training. The route to adult neurology residency training in the United States is standardized and is similar to most other US specialties. Whereas US medical graduates often receive stepwise guidance from their medical school regarding application for residency training, international graduates often enter this complex process with little or no such assistance. Despite this discrepancy, about 10%-15% of residency positions in the United States are filled by international medical graduates.(1,2) In adult neurology specifically, 35% of matched positions were filled by international graduates in 2013, 75% of whom were not US citizens.(1) In an effort to provide a preliminary understanding of the application process and related terminology (table 1) and thereby encourage international residency applicants, we describe the steps necessary to apply for neurology residency in the United States.

Relationships between training load, injury, and fitness in sub-elite collision sport athletes.

PubMed

Gabbett, Tim J; Domrow, Nathan

2007-11-01

The purpose of this study was to develop statistical models that estimate the influence of training load on training injury and physical fitness in collision sport athletes. The incidence of training injuries was studied in 183 rugby league players over two competitive seasons. Participants were assessed for height, body mass, skinfold thickness, vertical jump, 10-m, 20-m and 40-m sprint time, agility, and estimated maximal aerobic power in the off-season, pre-season, mid-season, and end-season. Training load and injury data were summarised into pre-season, early-competition, and late-competition training phases. Individual training load, fitness, and injury data were modelled using a logistic regression model with a binomial distribution and logit link function, while team training load and injury data were modelled using a linear regression model. While physical fitness improved with training, there was no association (P=0.16-0.99) between training load and changes in physical fitness during any of the training phases. However, increases in training load during the early-competition training phase decreased (P= 0.04) agility performance. A relationship (P= 0.01-0.04) was observed between the log of training load and odds of injury during each training phase, resulting in a 1.50 - 2.85 increase in the odds of injury for each arbitrary unit increase in training load. Furthermore, during the pre-season training phase there was a relationship (P= 0.01) between training load and injury incidence within the training load range of 155 and 590 arbitrary units. During the early and late-competition training phases, increases in training load of 175-620 arbitrary units and 145-410 arbitrary units, respectively, resulted in no further increase in injury incidence. These findings demonstrate that increases in training load, particularly during the pre-season training phase, increase the odds of injury in collision sport athletes. However, while increases in training load from 175 to 620 arbitrary units during the early-competition training phase result in no further increase in injury incidence, marked reductions in agility performances can occur. These findings suggest that reductions in training load during the early-competition training phase can reduce the odds of injury without compromising agility performances in collision sport athletes.

Comparison of cardiothoracic surgery training in USA and Germany.

PubMed

Tchantchaleishvili, Vakhtang; Mokashi, Suyog A; Rajab, Taufiek K; Bolman, R Morton; Chen, Frederick Y; Schmitto, Jan D

2010-11-26

Training of cardiothoracic surgeons in Europe and the United States has expanded to incorporate new operative techniques and requirements. The purpose of this study was to compare the current structure of training programs in the United States and Germany. We thoroughly reviewed the existing literature with particular focus on the curriculum, salary, board certification and quality of life for cardiothoracic trainees. The United States of America and the Federal Republic of Germany each have different cardiothoracic surgery training programs with specific strengths and weaknesses which are compared and presented in this publication. The future of cardiothoracic surgery training will become affected by technological, demographic, economic and supply factors. Given current trends in training programs, creating an efficient training system would allow trainees to compete and grow in this constantly changing environment.

Outcomes of Fundamentals of Laparoscopic Surgery (FLS) mastery training standards applied to an ergonomically different, lower cost platform.

PubMed

Placek, Sarah B; Franklin, Brenton R; Haviland, Sarah M; Wagner, Mercy D; O'Donnell, Mary T; Cryer, Chad T; Trinca, Kristen D; Silverman, Elliott; Matthew Ritter, E

2017-06-01

Using previously established mastery learning standards, this study compares outcomes of training on standard FLS (FLS) equipment with training on an ergonomically different (ED-FLS), but more portable, lower cost platform. Subjects completed a pre-training FLS skills test on the standard platform and were then randomized to train on the FLS training platform (n = 20) or the ED-FLS platform (n = 19). A post-training FLS skills test was administered to both groups on the standard FLS platform. Group performance on the pretest was similar. Fifty percent of FLS and 32 % of ED-FLS subjects completed the entire curriculum. 100 % of subjects completing the curriculum achieved passing scores on the post-training test. There was no statistically discernible difference in scores on the final FLS exam (FLS 93.4, ED-FLS 93.3, p = 0.98) or training sessions required to complete the curriculum (FLS 7.4, ED-FLS 9.8, p = 0.13). These results show that when applying mastery learning theory to an ergonomically different platform, skill transfer occurs at a high level and prepares subjects to pass the standard FLS skills test.

Mobile Phone Training Platform for the Nursing Staff in the Emergency Department.

PubMed

Liu, Xueqing; Cheng, Jing; Huang, Sufang

2018-05-09

Continuous education is required for nursing staff, but continuous education can be complicated for nurses working shifts, such as those in the emergency department (ED). To explore the effectiveness of the ED Training Platform of Tongji Hospital for conventional continuing education of emergency nurses. The training completion rate and training outcomes were validated. This was a retrospective study of all in-service emergency nurses working at the Tongji Medical College of Huazhong University of Science and Technology between August 2016 and August 2017. The training results of the previous year of the same group were used as controls. The platform used was an online system called JikeXuetang ( www.jkxuetang.com/ ), using the WeChat application as a carrier. The training completion rate and pass rate were compared with the control data. Among 124 nurses, the training completion rate increased from <60% to 100%, and the passing rate was 100%. Among 121 nurses, 92.5% considered that the mobile phone platform was more convenient than conventional training course; 89.7% believed it as an effective tool of learning, and intended to join public courses after completion; and 63.4% nurses expressed the wish to receive push services once or twice weekly for training course. The outcome of emergency nurse training was improved using the mobile training platform. This approach was more feasible and easier for training.

Opioid Overdose Prevention Programs Providing Naloxone to Laypersons - United States, 2014.

PubMed

Wheeler, Eliza; Jones, T Stephen; Gilbert, Michael K; Davidson, Peter J

2015-06-19

Drug overdose deaths in the United States have more than doubled since 1999. During 2013, 43,982 drug overdose deaths (unintentional, intentional [suicide or homicide], or undetermined intent) were reported. Among these, 16,235 (37%) were associated with prescription opioid analgesics (e.g., oxycodone and hydrocodone) and 8,257 (19%) with heroin. For many years, community-based programs have offered opioid overdose prevention services to laypersons who might witness an overdose, including persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of programs provide laypersons with training and kits containing the opioid antagonist naloxone hydrochloride (naloxone) to reverse the potentially fatal respiratory depression caused by heroin and other opioids. In July 2014, the Harm Reduction Coalition (HRC), a national advocacy and capacity-building organization, surveyed 140 managers of organizations in the United States known to provide naloxone kits to laypersons. Managers at 136 organizations completed the survey, reporting on the amount of naloxone distributed, overdose reversals by bystanders, and other program data for 644 sites that were providing naloxone kits to laypersons as of June 2014. From 1996 through June 2014, surveyed organizations provided naloxone kits to 152,283 laypersons and received reports of 26,463 overdose reversals. Providing opioid overdose training and naloxone kits to laypersons who might witness an opioid overdose can help reduce opioid overdose mortality.

Skills acquired in research and public health in the specialty of family and community nursing in the Valencian Community.

PubMed

García-Martínez, Pedro; Lozano-Vidal, Ruth; Herraiz-Ortiz, María Del Carmen; Collado-Boira, Eladio

To evaluate the acquisition of skills in research and public health specialists in family and community nursing. Descriptive and analytical study on a population of specialist nurse members of with the Valencian Primary Nurse Society. Measured with anonymous self-administered questionnaire on activities implemented and turnaround time in the training period. The questionnaire was conducted and reviewed based on the training programme of the specialty. Sixteen of the 41 specialists responded. The four year groups of nurses who had finished their training were represented as well as seven national teaching units. The results show high heterogeneity in the activities developed in the training. The average rotation in public health is 7.07 weeks, with range of 0 to 16 weeks. The mean number of educational sessions is 2.69 in the two years. The average number of research projects is 1.19. The result shows a specialisation process with training gaps in the skills of research and public health that could be remedied. Some practitioners claim that they finish their specialisation without undertaking research activities or completing the minimum proposed shifts. There is no process of improvement in the four year groups studied. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Changes in information behavior in clinical teams after introduction of a clinical librarian service

PubMed Central

Urquhart, Christine; Turner, Janet; Durbin, Jane; Ryan, Jean

2007-01-01

Objectives: The eighteen-month evaluation of a clinical librarian project (October 2003–March 2005) conducted in North Wales, United Kingdom (UK) assessed the benefits of clinical librarian support to clinical teams, the impact of mediated searching services, and the effectiveness of information skills training, including journal club support. Methods: The evaluation assessed changes in teams' information-seeking behavior and their willingness to delegate searching to a clinical librarian. Baseline (n = 69 responses, 73% response rate) and final questionnaire (n = 57, 77% response rate) surveys were complemented by telephone and face-to-face interviews (n = 33) among 3 sites served. Those attending information skills training sessions (n = 130) completed evaluations at the session and were surveyed 1 month after training (n = 24 questionnaire responses, n = 12 interviews). Results: Health professionals in clinical teams reported that they were more willing to undertake their own searching, but also more willing to delegate some literature searching, than at the start of the project. The extent of change depended on the team and the type of information required. Information skills training was particularly effective when organized around journal clubs. Conclusions: Collaboration with a clinical librarian increased clinician willingness to seek information. Clinical librarian services should leverage structured training opportunities such as journal clubs. PMID:17252062

Superfund record of decision (EPA Region 10): Mountain Home Air Force Base, Site 8, Fire Training Area 8, Operable Unit 4, Elmore County, Mountain Home, ID. (First remedial action), June 1992. Final report

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

Not Available

1992-06-16

The 7-acre Mountain Home Air Force Base (AFB) site was a fire department training area located in Mountain Home, Elmore County, Idaho. From 1962 to 1975, the Mountain Home Air Force Base used the site for fire department training exercises. Each exercise began by saturating the bermed training area with water, followed directly by applying 250 to 500 gallons of fuel. The flames were extinguished with Aqueous Film Forming Foam (AFFF), or prior to 1972, with a water-based protein foam. The training session was completed with a post-exercise ignition of the residual fuel in a bermed area. The USAF investigationsmore » identified solvents and petroleum, oil, lubricant (POL) wastes in the soil. Under the Installation Restoration Program (IRP), the USAF conducted a record search, drilling, and sampling of soil borings to bedrock, the installation of monitoring wells, and hand auger samples. The ROD provided a final remedy for onsite soil as OU4. Because contaminants were found at such low concentrations, the soil was covered by crushed asphalt and has little potential to impact ecological receptors. The soil posed low risks for humans at the site and no remediation was necessary.« less

[Continuing training plan in a clinical management unit].

PubMed

Gamboa Antiñolo, Fernando Miguel; Bayol Serradilla, Elia; Gómez Camacho, Eduardo

2011-01-01

Continuing Care Unit (UCA) focused the attention of frail patients, polypathological patients and palliative care. UCA attend patients at home, consulting, day unit, telephone consulting and in two hospitals of the health area. From 2002 UCA began as a management unit, training has been a priority for development. Key elements include: providing education to the workplace, including key aspects of the most prevalent health care problems in daily work, directing training to all staff including organizational aspects of patient safety and the environment, improved working environment, development of new skills and knowledge supported by the evidence-based care for the development of different skills. The unit can be the ideal setting to undertake the reforms necessary conceptual training of professionals to improve the quality of care. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Are Enough Physicians of the Right Types Trained in the United States? Report to the Congress of the United States.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

The supply of physicians in the United States and the way in which physician graduate medical education programs are established are discussed. Too many physicians are being trained within certain specialties and too few are being trained as primary care physicians. No system exists for ensuring that the number and types of physicians being…

78 FR 18325 - Intent To Prepare an Environmental Impact Statement (EIS) for the Formal Training Unit (FTU) and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-26

... Statement (EIS) for the Formal Training Unit (FTU) and Main Operating Base 1 (MOB 1) for the Beddown of KC... Statement (EIS) for the Formal Training Unit (FTU) and Main Operating Base 1 (MOB 1) for the Beddown of KC...-46A tanker aircraft, associated infrastructure and manpower of the FTU and MOB 1 at existing active...

Crop Farm Employee. Agricultural Cooperative Training. Vocational Agriculture. Revised.

ERIC Educational Resources Information Center

Boyd, Chester; And Others

Designed for students enrolled in the Vocational Agricultural Cooperative Part-Time Training Program, this course of study contains 13 units for crop farm employees. Units include (examples of unit topics in parentheses): introduction (opportunities in farming, farming as a science, and farming in the United States), farm records (keeping farm…

Analysis of Practice Settings for Craniofacial Surgery Fellowship Graduates in North America.

PubMed

Silvestre, Jason; Runyan, Christopher; Taylor, Jesse A

In North America, the number of craniofacial surgery fellowship graduates is increasing, yet an analysis of practice settings upon graduation is lacking. We characterize the practice types of recent graduates of craniofacial fellowship programs in the United States and Canada. A 6-year cohort of craniofacial fellows in the United States and Canada (2010-2016) were obtained from craniofacial programs recognized by the American Society of Craniofacial Surgery. Practice setting was determined at 1 and 3 years of postgraduation, and predictors of practice setting were determined. A total of 175 craniofacial surgeons were trained at 35 fellowship programs. At 1 year of postgraduation, 33.6% had an academic craniofacial position and 27.1% were in private practice (p = 0.361). A minority of graduates pursued additional fellowships (16.4%), nonacademic craniofacial positions (10.0%), academic noncraniofacial positions (5.7%), and international practices (7.1%). At 3 years of postgraduation, the percentage of graduates in academic craniofacial positions was unchanged (34.5% vs 33.6%, p = 0.790). The strongest predictors of future academic craniofacial practice were completing plastic surgery residency at a program with a craniofacial fellowship program (odds ratio = 6.78, p < 0.001) and completing an academic craniofacial fellowship program (odds ratio = 4.48, p = 0.020). A minority of craniofacial fellowship graduates practice academic craniofacial surgery. A strong academic craniofacial surgery background during residency and fellowship is associated with a future career in academic craniofacial surgery. These data may assist trainees choose training programs that align with career goals and educators select future academic surgeons. Copyright © 2017. Published by Elsevier Inc.

Classification of deadlift biomechanics with wearable inertial measurement units.

PubMed

O'Reilly, Martin A; Whelan, Darragh F; Ward, Tomas E; Delahunt, Eamonn; Caulfield, Brian M

2017-06-14

The deadlift is a compound full-body exercise that is fundamental in resistance training, rehabilitation programs and powerlifting competitions. Accurate quantification of deadlift biomechanics is important to reduce the risk of injury and ensure training and rehabilitation goals are achieved. This study sought to develop and evaluate deadlift exercise technique classification systems utilising Inertial Measurement Units (IMUs), recording at 51.2Hz, worn on the lumbar spine, both thighs and both shanks. It also sought to compare classification quality when these IMUs are worn in combination and in isolation. Two datasets of IMU deadlift data were collected. Eighty participants first completed deadlifts with acceptable technique and 5 distinct, deliberately induced deviations from acceptable form. Fifty-five members of this group also completed a fatiguing protocol (3-Repition Maximum test) to enable the collection of natural deadlift deviations. For both datasets, universal and personalised random-forests classifiers were developed and evaluated. Personalised classifiers outperformed universal classifiers in accuracy, sensitivity and specificity in the binary classification of acceptable or aberrant technique and in the multi-label classification of specific deadlift deviations. Whilst recent research has favoured universal classifiers due to the reduced overhead in setting them up for new system users, this work demonstrates that such techniques may not be appropriate for classifying deadlift technique due to the poor accuracy achieved. However, personalised classifiers perform very well in assessing deadlift technique, even when using data derived from a single lumbar-worn IMU to detect specific naturally occurring technique mistakes. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of ergonomics training on the knowledge, attitudes, and practices of teleworkers.

PubMed

Harrington, Susan S; Walker, Bonnie L

2004-01-01

The rapid growth of teleworking has raised several social and legal issues regarding an employer's responsibility for the safety of an employee's home office. In this paper, researchers discuss the need for safety training for teleworkers and the effectiveness of a home office ergonomics training program. Study participants (N = 50) were randomly assigned into a treatment or control group. The treatment group completed the ergonomics training and a pre- and posttest. The control group completed the pre- and posttests without training. The study demonstrated the need for teleworker ergonomics training. More than 85% of participants had not received teleworker training before, and 44% had experienced pain or discomfort while teleworking. Participants who completed the training significantly improved their scores on knowledge, attitude, and practices subtests. In a follow-up survey, participants indicated that they had made ergonomic changes to their offices based on the training. Several participants indicated that the pain or discomfort that they had been experiencing was eliminated or reduced as a result of the training.

Enlist micros: Training science teachers to use microcomputers

NASA Astrophysics Data System (ADS)

Baird, William E.; Ellis, James D.; Kuerbis, Paul J.

A National Science Foundation grant to the Biological Sciences Curriculum Study (BSCS) at The Colorado College supported the design and production of training materials to encourage literacy of science teachers in the use of microcomputers. ENLIST Micros is based on results of a national needs assessment that identified 22 compentencies needed by K-12 science teachers to use microcomputers for instruction. A writing team developed the 16-hour training program in the summer of 1985, and field-test coordinators tested it with 18 preservice or in-service groups during the 1985-86 academic year at 15 sites within the United States. The training materials consist of video programs, interactive computer disks for the Apple II series microcomputer, a training manual for participants, and a guide for the group leader. The experimental materials address major areas of educational computing: awareness, applications, implementation, evaluation, and resources. Each chapter contains activities developed for this program, such as viewing video segments of science teachers who are using computers effectively and running commercial science and training courseware. Role playing and small-group interaction help the teachers overcome their reluctance to use computers and plan for effective implementation of microcomputers in the school. This study examines the implementation of educational computing among 47 science teachers who completed the ENLIST Micros training at a southern university. We present results of formative evaluation for that site. Results indicate that both elementary and secondary teachers benefit from the training program and demonstrate gains in attitudes toward computer use. Participating teachers said that the program met its stated objectives and helped them obtain needed skills. Only 33 percent of these teachers, however, reported using computers one year after the training. In June 1986, the BSCS initiated a follow up to the ENLIST Micros curriculum to develop, evaluate, and disseminate a complete model of teacher enhancement for educational computing in the sciences. In that project, we use the ENLIST Micros curriculum as the first step in a training process. The project includes seminars that introduce additional skills: It contains provisions for sharing among participants, monitors use of computers in participants' classrooms, provides structured coaching of participants' use of computers in their classrooms, and offers planned observations of peers using computers in their science teaching.

V-TIME: a treadmill training program augmented by virtual reality to decrease fall risk in older adults: study design of a randomized controlled trial.

PubMed

Mirelman, Anat; Rochester, Lynn; Reelick, Miriam; Nieuwhof, Freek; Pelosin, Elisa; Abbruzzese, Giovanni; Dockx, Kim; Nieuwboer, Alice; Hausdorff, Jeffrey M

2013-02-06

Recent work has demonstrated that fall risk can be attributed to cognitive as well as motor deficits. Indeed, everyday walking in complex environments utilizes executive function, dual tasking, planning and scanning, all while walking forward. Pilot studies suggest that a multi-modal intervention that combines treadmill training to target motor function and a virtual reality obstacle course to address the cognitive components of fall risk may be used to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. The proposed randomized controlled trial will evaluate the effects of treadmill training augmented with virtual reality on fall risk. Three hundred older adults with a history of falls will be recruited to participate in this study. This will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson's disease (n=100). These three sub-groups will be recruited in order to evaluate the effects of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to the intervention group (treadmill training with virtual reality) or to the active-control group (treadmill training without virtual reality). Each person will participate in a training program set in an outpatient setting 3 times per week for 6 weeks. Assessments will take place before, after, and 1 month and 6 months after the completion of the training. A falls calendar will be kept by each participant for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls and falls rate). In addition, we will measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function. This randomized controlled trial will demonstrate the extent to which an intervention that combines treadmill training augmented by virtual reality reduces fall risk, improves mobility and enhances cognitive function in a diverse group of older adults. In addition, the comparison to an active control group that undergoes treadmill training without virtual reality will provide evidence as to the added value of addressing motor cognitive interactions as an integrated unit. (NIH)-NCT01732653.

V-TIME: a treadmill training program augmented by virtual reality to decrease fall risk in older adults: study design of a randomized controlled trial

PubMed Central

2013-01-01

Background Recent work has demonstrated that fall risk can be attributed to cognitive as well as motor deficits. Indeed, everyday walking in complex environments utilizes executive function, dual tasking, planning and scanning, all while walking forward. Pilot studies suggest that a multi-modal intervention that combines treadmill training to target motor function and a virtual reality obstacle course to address the cognitive components of fall risk may be used to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. The proposed randomized controlled trial will evaluate the effects of treadmill training augmented with virtual reality on fall risk. Methods/Design Three hundred older adults with a history of falls will be recruited to participate in this study. This will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson’s disease (n=100). These three sub-groups will be recruited in order to evaluate the effects of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to the intervention group (treadmill training with virtual reality) or to the active-control group (treadmill training without virtual reality). Each person will participate in a training program set in an outpatient setting 3 times per week for 6 weeks. Assessments will take place before, after, and 1 month and 6 months after the completion of the training. A falls calendar will be kept by each participant for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls and falls rate). In addition, we will measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function. Discussion This randomized controlled trial will demonstrate the extent to which an intervention that combines treadmill training augmented by virtual reality reduces fall risk, improves mobility and enhances cognitive function in a diverse group of older adults. In addition, the comparison to an active control group that undergoes treadmill training without virtual reality will provide evidence as to the added value of addressing motor cognitive interactions as an integrated unit. Trial Registration (NIH)–NCT01732653 PMID:23388087

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

PubMed Central

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

2016-01-01

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

A Review of Extension Master Gardener Training Manuals from around the United States

ERIC Educational Resources Information Center

Moore, Kathleen; Bradley, Lucy K.

2015-01-01

Extension Master Gardener Volunteers (EMGVs) are recruited and trained to answer questions and diagnose gardening problems for the public. Most states have developed an EMGV Manual for use in the initial training. Thirty-two EMGV Training manuals from across the United States were reviewed for form and content. While many of the manuals have…

The American Influence in Indonesian Teacher Training, 1956-1964

ERIC Educational Resources Information Center

Suwignyo, Agus

2017-01-01

This paper examines United States-Indonesian cooperation in the training of Indonesian teachers during the early decades of the Cold War. Indonesia badly needed teachers but the government's efforts to train new teachers were hampered by the tremendous lack of teachers who could train new teachers. The aid provided by the United States enabled the…

Training in the Food and Beverages Sector in the United Kingdom. Report for the FORCE Programme. First Edition.

ERIC Educational Resources Information Center

Burns, Jim A.; King, Richard

An international team of researchers studied the following aspects of training in the United Kingdom's food and beverage sector: structure and characteristics, business and social context, training and recruitment, and future training requirements. Data were collected from an analysis of social and labor/employment statistics, literature review,…

Determining a core curriculum in surgical infections for fellowship training in acute care surgery using the Delphi technique.

PubMed

May, Addison K; Cuschieri, Joseph; Johnson, Jeffrey L; Duane, Therese M; Cherry-Bukowiec, Jill R; Rosengart, Matthew R

2013-12-01

Recent data highlight the educational, financial, and healthcare benefits of acute care surgery (ACS). These data serve as the impetus to create ACS fellowships, which now are accredited by the American Association for the Surgery of Trauma. However, the core components of a curriculum fundamental for ACS training and that yield competence and proficiency have yet to be determined. Experts in ACS from the United States (n=86) were asked to propose topics in surgical infectious diseases of potential importance in developing a core curriculum for ACS fellowship training. They were then required to rank these topics in order of importance to identify those considered most fundamental. Thirty-one filters ranking in the highest tertile are proposed as topics of surgical infectious diseases that are fundamental to any curriculum of ACS fellowship training. The majority pertains to aspects of thoracic infections (n=8), although topics of soft tissue infections (n=5) comprised four of the top 10 (40%) filters. Abdominal infections (n=6), the biology of sepsis (n=6), and risk, prevention, and prophylaxis (n=6) completed the list. This study identifies the most important topics of surgical infectious disease that merit consideration for incorporation into a core curriculum of ACS training. Hopefully, this information will assist in the development of ACS fellowships that optimize the training of future ACS surgeons.

Graduates' perceptions of their clinical competencies in allergy and immunology: results of a survey.

PubMed

Li, James T-C; Stoll, Doris A; Smith, June E; Lin, John J; Swing, Susan R

2003-09-01

The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) have identified six areas of general competency. This study surveyed graduates of allergy and immunology training programs about their perceived clinical competency and the adequacy of their subspecialty training. In August 2000 and May 2001, a questionnaire was mailed to 373 physicians who had completed a fellowship in allergy and immunology in the United States between 1995 and 2001. Physicians were asked to rate the perceived importance and adequacy of their training in, and their level of competency for, 57 general competencies and subspecialty-specific competencies and procedures. A total of 253 physicians responded (68%). All items in the six ACGME/ABMS general competencies had high ratings (>/= 90%) for perceived importance. One item in the practice-based learning area had low ratings for adequacy of training (57%) and intermediate for competency (75%). Two items in the system-based practice area had low ratings for training (65% and 67%) and intermediate for competency (86% and 88%). Generally, core specialty-specific items (allergic rhinitis, asthma, and urticaria) had high ratings (>/= 90%) for importance, training, and competency. Without exception, items with ratings of less than 70% for adequacy of training also had ratings of less than 90% for competency. The general competencies were considered important, but training in system-based practice and practice-based learning may be deficient. Although self-perceived competency in core areas of allergy and immunology was high, weaknesses in training and self-perceived competency in selected areas were identified.

Motivation Coaching Training for Instructional Coaches: A Pilot Study of Motivational Interviewing Skills Training

ERIC Educational Resources Information Center

Lyons, Michael D.; Jones, Sara J.; Smith, Bradley H.; McQuillin, Samuel D.; Richardson, Georgette; Reid, Erin; McClellan, Anne

2017-01-01

In our paper we describe a newly developed teacher coaching model that provides training on motivational interviewing (MI) to improve instructional coaches' effectiveness with classroom teachers. Participants were 38 coaches who completed a three-day coaching training. At pre- and post-test, the participants completed role plays with an actor who…

Consistency and reliability of judgements by assessors of case based discussions in general practice specialty training programmes in the United Kingdom.

PubMed

Bodgener, Susan; Denney, Meiling; Howard, John

2017-01-01

Case based discussions (CbDs) are a mandatory workplace assessment used throughout general practitioner (GP) specialty training; they contribute to the annual review of competence progression (ARCP) for each trainee. This study examined the judgements arising from CbDs made by different groups of assessors and whether or not these assessments supported ARCP decisions. The trainees selected were at the end of their first year of GP training and had been identified during their ARCPs to need extra training time. CbDs were specifically chosen as they are completed by both hospital and GP supervisors, enabling comparison between these two groups. The results raise concern with regard to the consistency of judgements made by different groups of assessors, with significant variance between assessors of different status and seniority. Further work needs to be done on whether the CbD in its current format is fit for purpose as one of the mandatory WPBAs for GP trainees, particularly during their hospital placements. There is a need to increase the inter-rater reliability of CbDs to ensure a consistent contribution to subsequent decisions about a trainee's overall progress.

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.

A Comparison of the Effects of Ethics Training on International and US Students.

PubMed

Steele, Logan M; Johnson, James F; Watts, Logan L; MacDougall, Alexandra E; Mumford, Michael D; Connelly, Shane; Lee Williams, T H

2016-08-01

As scientific and engineering efforts become increasingly global in nature, the need to understand differences in perceptions of research ethics issues across countries and cultures is imperative. However, investigations into the connection between nationality and ethical decision-making in the sciences have largely generated mixed results. In Study 1 of this paper, a measure of biases and compensatory strategies that could influence ethical decisions was administered. Results from this study indicated that graduate students from the United States and international graduate students studying in the US are prone to different biases. Based on these findings, recommendations are made for developing ethics education interventions to target these decision-making biases. In Study 2, we employed an ethics training intervention based on ethical sensemaking and used a well-established measure of ethical decision-making that more fully captures the content of ethical judgment. Similar to Study 1, the results obtained in this study suggest differences do exist between graduate students from the US and international graduate students in ethical decision-making prior to taking the research ethics training. However, similar effects were observed for both groups following the completion of the ethics training intervention.

Benefits of exercise training and the correlation between aerobic capacity and functional outcomes and quality of life in elderly patients with coronary artery disease.

PubMed

Chen, Chia-Hsin; Chen, Yi-Jen; Tu, Hung-Pin; Huang, Mao-Hsiung; Jhong, Jing-Hui; Lin, Ko-Long

2014-10-01

Cardiopulmonary exercise training is beneficial to people with coronary artery disease (CAD). Nevertheless, the correlation between aerobic capacity, and functional mobility and quality of life in elderly CAD patients is less addressed. The purpose of the current study is to investigate the beneficial effects of exercise training in elderly people with CAD, integrating exercise stress testing, functional mobility, handgrip strength, and health-related quality of life. Elderly people with CAD were enrolled from the outpatient clinic of a cardiac rehabilitation unit in a medical center. Participants were assigned to the exercise training group (N = 21) or the usual care group (N = 15). A total of 36 sessions of exercise training, completed in 12 weeks, was prescribed. Echocardiography, exercise stress testing, the 6-minute walking test, Timed Up and Go test, and handgrip strength testing were performed, and the Short-Form 36 questionnaire (SF-36) was administered at baseline and at 12-week follow-up. Peak oxygen consumption improved significantly after training. The heart rate recovery improved from 13.90/minute to 16.62/minute after exercise training. Functional mobility and handgrip strength also improved after training. Significant improvements were found in SF-36 physical function, social function, role limitation due to emotional problems, and mental health domains. A significant correlation between dynamic cardiopulmonary exercise testing parameters, the 6-minute walking test, Timed Up and Go test, handgrip strength, and SF-36 physical function and general health domains was also detected. Twelve-week, 36-session exercise training, including moderate-intensity cardiopulmonary exercise training, strengthening exercise, and balance training, is beneficial to elderly patients with CAD, and cardiopulmonary exercise testing parameters correlate well with balance and quality of life. Copyright © 2014. Published by Elsevier Taiwan.

Use of simulation-based education to reduce catheter-related bloodstream infections.

PubMed

Barsuk, Jeffrey H; Cohen, Elaine R; Feinglass, Joe; McGaghie, William C; Wayne, Diane B

2009-08-10

Simulation-based education improves procedural competence in central venous catheter (CVC) insertion. The effect of simulation-based education in CVC insertion on the incidence of catheter-related bloodstream infection (CRBSI) is unknown. The aim of this study was to determine if simulation-based training in CVC insertion reduces CRBSI. This was an observational education cohort study set in an adult intensive care unit (ICU) in an urban teaching hospital. Ninety-two internal medicine and emergency medicine residents completed a simulation-based mastery learning program in CVC insertion skills. Rates of CRBSI from CVCs inserted by residents in the ICU before and after the simulation-based educational intervention were compared over a 32-month period. There were fewer CRBSIs after the simulator-trained residents entered the intervention ICU (0.50 infections per 1000 catheter-days) compared with both the same unit prior to the intervention (3.20 per 1000 catheter-days) (P = .001) and with another ICU in the same hospital throughout the study period (5.03 per 1000 catheter-days) (P = .001). An educational intervention in CVC insertion significantly improved patient outcomes. Simulation-based education is a valuable adjunct in residency education.

An unusual case of an immersion hand presentation in a military signaller operating in the jungle in Belize.

PubMed

Forbes, Kirstie E; Foster, P

2017-12-01

Belize, hosting one of the British Army's overseas training areas, provides access to challenging terrain and austere environments, which allows the delivery of training to soldiers on survival and combat within the jungle environment. A 26-year-old infanteer on exercise in Belize presented with progressive bilateral dry, painful, oedematous hands, secondary to the harsh environmental conditions of the jungle and inadequate drying of his hands resulting in his inability to perform his combat duties. The symptoms completely resolved with drying, emollient application and analgesia. While there are no reported cases of immersion hand, comparisons can be made with the well-reported warm weather immersion foot. This case highlights the importance of force preparation and soldier education for units deploying to the jungle. Simple preventive measures, including adequate 'wet-dry' drills and use of emollients can reduce the prevalence of immersion hand, a preventable condition, which can have a significant impact on the overall combat effectiveness of the unit. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cost of Screening, Brief Intervention, and Referral to Treatment in Health Care Settings.

PubMed

Barbosa, Carolina; Cowell, Alexander J; Landwehr, Justin; Dowd, William; Bray, Jeremy W

2016-01-01

This study analyzed service unit and annual costs of substance abuse screening, brief intervention, and referral to treatment (SBIRT) programs implemented in emergency department (ED), inpatient, and outpatient medical settings in three U.S. states and one tribal organization. Unit costs and annual costs were estimated from the perspective of service providers. Data for unit costs came from 26 performance sites, and data for annual costs came from 10 programs. A bottom-up approach was used to derive unit costs and included labor, space, and materials used in each SBIRT activity. Activities included direct SBIRT services and activities that support direct service delivery. Labor time spent in each activity was collected by trained observers using a time-and-motion approach. A top-down approach used cost questionnaires completed by program administrators to calculate annual costs and included labor, space, contracted services, overhead, training, travel, equipment, and supplies and materials. Costs were estimated in 2012 U.S. dollars. Average unit costs for prescreening, screening, brief intervention, brief treatment, and referral to treatment were $0.61, $6.59, $10.48, $22.63, and $12.06 in ED; $0.86, $6.33, $9.07, $27.61, and $8.03 in inpatient; and $0.84, $3.98, $7.81, $27.94, and $9.23 in outpatient settings, respectively; over half of the costs were attributable to support activities. Across all settings, the average cost to provide SBIRT per positive screen, for 1year, was about $400. Support activities comprise a large proportion of costs. Health administrators can use the results to budget and compare how much sites are reimbursed for SBIRT to how much services actually cost. Copyright © 2015 Elsevier Inc. All rights reserved.

Tonometer disinfection practice in the United Kingdom: a national survey.

PubMed

Hillier, R J; Kumar, N

2008-08-01

To assess current tonometer disinfection practice in the UK, and compare with published recommendations. Every ophthalmology unit with training recognition in the UK was contacted (n=155). A senior nurse at each institution completed a telephone questionnaire regarding local tonometer disinfection practice. The response rate was 100%. Thirty-five units (23%) reported exclusive use of disposable tonometer heads and were excluded from further analysis. One hundred and twenty units (77%) used either reusable or a combination of reusable and disposable tonometer heads. Where reusable heads were used, 80 units (67%) immersed them in a chlorine-based solution such as sodium hypochlorite or sodium dichloroisocyanurate. Others used isopropyl alcohol (18 units), hydrogen peroxide (12 units), chloramine (5 units), chlorhexidine (4 units) and peracetic acid (1 unit). Where a chlorine-based agent was used, the concentration of available chlorine ranged from 125 to 30 000 p.p.m., with 50 units (63%) using a concentration of less than 5 000 p.p.m. (i.e., inadequate based on published recommendations). Where the tonometer head was immersed in disinfectant between patients (n=101), 29 units (29%) provided just one tonometer head per practitioner, making adequate soak time between patients unlikely. Every unit replenished the disinfectant at least daily, deemed sufficient for most agents. However, hydrogen peroxide solutions should be replenished twice daily, which did not take place in nine units. This survey reveals disparity between current tonometer disinfection practice and published international recommendations, with some institutions using practices that may render patients susceptible to transmissible infection.

Comparison of cardiothoracic surgery training in usa and germany

PubMed Central

2010-01-01

Background Training of cardiothoracic surgeons in Europe and the United States has expanded to incorporate new operative techniques and requirements. The purpose of this study was to compare the current structure of training programs in the United States and Germany. Methods We thoroughly reviewed the existing literature with particular focus on the curriculum, salary, board certification and quality of life for cardiothoracic trainees. Results The United States of America and the Federal Republic of Germany each have different cardiothoracic surgery training programs with specific strengths and weaknesses which are compared and presented in this publication. Conclusions The future of cardiothoracic surgery training will become affected by technological, demographic, economic and supply factors. Given current trends in training programs, creating an efficient training system would allow trainees to compete and grow in this constantly changing environment. PMID:21108853

9 CFR 161.5 - Specialization.

Code of Federal Regulations, 2010 CFR

2010-01-01

... completion of an orientation or training program approved by APHIS. For certain accredited specializations, the cost of orientation or training may be borne by the accredited veterinarian. An accredited... completion of an additional orientation or training program approved by APHIS that focuses on the specific...

Effect of postgraduate training on job and career satisfaction among health-system pharmacists.

PubMed

Padiyara, Rosalyn S; Komperda, Kathy E

2010-07-01

The effect of postgraduate training on job and career satisfaction among health-system pharmacists was evaluated. A mail-based questionnaire was sent to a random sample of pharmacist members of the American Society of Health-System Pharmacists. Previously validated questions for job and career satisfaction among pharmacists were utilized. The questionnaire was designed to obtain information regarding general employment, work environment, job satisfaction, career satisfaction, postgraduate training, and demographic characteristics. Pharmacists who had completed either a pharmacy residency or fellowship were classified as having postgraduate training. Questionnaires returned within two months of the original mailing date were included in the analysis. Responses from pharmacists who were retired, employed in a nonpharmacy career, or unemployed were excluded. Data were analyzed using SPSS software. Of the 2499 questionnaires mailed, 36 were undeliverable; 1058 were completed, yielding a response rate of 43%. Of these, 48 were excluded, resulting in 1010 questionnaires suitable for analysis. Approximately 37% of respondents indicated completion of postgraduate training. The most common practice setting was a community, not-for-profit hospital (40.9%). Overall, 90.7% of respondents indicated they were either satisfied or highly satisfied with their current employment. Approximately 45% of pharmacists with postgraduate training indicated they were highly satisfied with their employment, compared with 32.7% of pharmacists without postgraduate training (p < 0.001). Pharmacists who completed postgraduate training were more satisfied with their job than those who did not complete such training.

Managing Highway Maintenance: Instructor's Manual for Management by Objectives Review, Unit 11, All Levels.

ERIC Educational Resources Information Center

Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

Part of the series "Managing Highway Maintenance," the unit is designed for the training group leader and contains selected highlights and suggested discussion questions from six units of training: maintenance activities, work units, and classifying work; maintenance feature inventories; how to conduct a maintenance feature inventory;…

40 CFR 60.2070 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... requirements? (a) No CISWI unit can be operated unless a fully trained and qualified CISWI unit operator is... unit operator may operate the CISWI unit directly or be the direct supervisor of one or more other...

Nutrition education for pediatric gastroenterology, hepatology, and nutrition fellows: survey of NASPGHAN fellowship training programs.

PubMed

Martinez, J Andres; Koyama, Tatsuki; Acra, Sari; Mascarenhas, Maria R; Shulman, Robert J

2012-08-01

The aim of the study was to assess the methodology and content of nutrition education during gastroenterology fellowship training and the variability among the different programs. A survey questionnaire was completed by 43 fellowship training directors of 62 active programs affiliated to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, including sites in the United States, Canada, and Mexico. The data were examined for patterns in teaching methodology and coverage of specific nutrition topics based on level 1 training in nutrition, which is the minimum requirement according to the published North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition fellowship training guidelines. The majority of the teaching was conducted by MD-degree faculty (61%), and most of the education was provided through clinical care experiences. Only 31% of the level 1 nutrition topics were consistently covered by >80% of programs, and coverage did not correlate with the size of the programs. Competency in nutrition training was primarily assessed through questions to individuals or groups of fellows (77% and 65%, respectively). Program directors cited a lack of faculty interested in nutrition and a high workload as common obstacles for teaching. The methodology of nutrition education during gastroenterology fellowship training is, for the most part, unstructured and inconsistent among the different programs. The minimum level 1 requirements are not consistently covered. The development of core curriculums and learning modules may be beneficial in improving nutrition education.

Telemedicine in support of peacekeeping operations overseas: an audit.

PubMed

Navein, J; Hagmann, J; Ellis, J

1997-01-01

Since 1993, the Department of Defense has augmented the medical support for Army units on peacekeeping operations in Macedonia through the medium of telemedicine. This project, known as Operation Primetime 1, was the first satellite-based telemedicine system deployed in support of remote primary-care physician in the U.S. military. Its declared aims are: (1) to improve the standard of care; (2) to reduce evacuations; (3) to support junior physicians in the field; and (4) to improve the military effectiveness of the deployed units. This paper audits the success in attaining those goals for the period January 1994 to April 1995. A log was collated from the referring units and questionnaires completed by both referring and consulting physicians. The referring physicians were interviewed on their return from Macedonia, and a more detailed study was undertaken of cases in which a change in outcome was noted. Follow-up interview of consultants was not possible. A total of 53 consults were undertaken on 47 patients. The use of telemedicine affected the decision to evacuate 13 times (13/47), with a net reduction of 9 evacuations. Management of individual cases was changed in 30 of the 47 cases in which telemedicine was used. Physician confidence and military effectiveness were also improved. The level of utilization of the system was largely dependent on a training and sustainment program. Units and General Medical Officers who were trained in the clinical use of telemedicine and the technical sustainment of the equipment used the system; those who were not, did not. Most patients (45/47) were treated satisfactorily with a single consult. Telemedicine under these circumstances seems to be cost effective. The deployed sites chose the referral centers that provided the best service. Telemedicine is a valuable tool capable of augmenting medical support to deployed military units. A successful deployed telemedicine project requires an integrated support package that includes adequate provision for training and equipment sustainment at both ends of the link. Experience with telemedicine in Operation Primetime indicates the potential for substantial cost savings as well as cost-effective medical care. Further application of telemedicine should be encouraged. Successful deployment of telemedicine projects may hinge on an integrated support package.

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.

International Counseling Trainees' Experiences and Perceptions of Their Multicultural Counseling Training in the United States: A Mixed Method Inquiry

ERIC Educational Resources Information Center

Smith, Shannon D.; Ng, Kok-Mun

2009-01-01

This study examined international counseling students' (ICTs) experiences and perceptions of their multicultural counseling training (MCT) in the United States. The focus was on (a) relevance of the training, (b) effectiveness of the training methods, and (c) development of cross-cultural competence as trainees. Major findings indicated that ICTs…

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.

Construction of a Urologic Robotic Surgery Training Curriculum: How Many Simulator Sessions Are Required for Residents to Achieve Proficiency?

PubMed

Wiener, Scott; Haddock, Peter; Shichman, Steven; Dorin, Ryan

2015-11-01

To define the time needed by urology residents to attain proficiency in computer-aided robotic surgery to aid in the refinement of a robotic surgery simulation curriculum. We undertook a retrospective review of robotic skills training data acquired during January 2012 to December 2014 from junior (postgraduate year [PGY] 2-3) and senior (PGY4-5) urology residents using the da Vinci Skills Simulator. We determined the number of training sessions attended and the level of proficiency achieved by junior and senior residents in attempting 11 basic or 6 advanced tasks, respectively. Junior residents successfully completed 9.9 ± 1.8 tasks, with 62.5% completing all 11 basic tasks. The maximal cumulative success rate of junior residents completing basic tasks was 89.8%, which was achieved within 7.0 ± 1.5 hours of training. Of senior residents, 75% successfully completed all six advanced tasks. Senior residents attended 6.3 ± 3.5 hours of training during which 5.1 ± 1.6 tasks were completed. The maximal cumulative success rate of senior residents completing advanced tasks was 85.4%. When designing and implementing an effective robotic surgical training curriculum, an allocation of 10 hours of training may be optimal to allow junior and senior residents to achieve an acceptable level of surgical proficiency in basic and advanced robotic surgical skills, respectively. These data help guide the design and scheduling of a residents training curriculum within the time constraints of a resident's workload.

A Comparison of Procedural Variations in Teaching Behavior Chains: Manual Guidance, Trainer Completion, and No Completion of Untrained Steps

ERIC Educational Resources Information Center

Bancroft, Stacie L.; Weiss, Julie S.; Libby, Myrna E.; Ahearn, William H.

2011-01-01

We compared variations for teaching a sequence of responses through forward chaining. Seven children who had been diagnosed with autism participated in a comparison of teacher completion (TC) of steps beyond the training step and manually guiding the student (SC) to complete steps beyond the training step. A no-completion (NC) condition, in which…

A Survey of Graduates of Combined Emergency Medicine-Pediatrics Residency Programs: An Update.

PubMed

Strobel, Ashley M; Chasm, Rose M; Woolridge, Dale P

2016-10-01

In 1998, emergency medicine-pediatrics (EM-PEDS) graduates were no longer eligible for the pediatric emergency medicine (PEM) sub-board certification examination. There is a paucity of guidance regarding the various training options for medical students who are interested in PEM. We sought to to determine attitudes and personal satisfaction of graduates from EM-PEDS combined training programs. We surveyed 71 graduates from three EM-PEDS residences in the United States. All respondents consider their combined training to be an asset when seeking a job, 92% find it to be an asset to their career, and 88% think it provided added flexibility to job searches. The most commonly reported shortcoming was their ineligibility for the PEM sub-board certification. The lack of this designation was perceived to be a detriment to securing academic positions in dedicated children's hospitals. When surveyed regarding which training offers the better skill set for the practice of PEM, 90% (44/49) stated combined EM-PEDS training. When asked which training track gives them the better professional advancement in PEM, 52% (23/44) chose combined EM-PEDS residency, 27% (12/44) chose a pediatrics residency followed by a PEM fellowship, and 25% (11/44) chose an EM residency then a PEM fellowship. No EM-PEDS respondents considered PEM fellowship training after the completion of the dual training program. EM-PEDS graduates found combined training to be an asset in their career. They felt that it provided flexibility in job searches, and that it was ideal training for the skill set required for the practice of PEM. EM-PEDS graduates' practices varied, including mixed settings, free-standing children's hospitals, and community emergency departments. Copyright © 2016 Elsevier Inc. All rights reserved.

The cross education of strength and skill following unilateral strength training in the upper and lower limbs.

PubMed

Green, Lara A; Gabriel, David A

2018-04-18

Cross education is the strength gain or skill improvement transferred to the contralateral limb following unilateral training or practice. The present study examined the transfer of both strength and skill following a strength training program. Forty participants (20M, 20F) completed a 6-week unilateral training program of dominant wrist flexion or dorsiflexion. Strength, force variability, and muscle activity were assessed pre-training, post-training, and following 6-weeks of detraining (retention). Analyses of covariance compared the experimental limb (trained or untrained) to the control (dominant or non-dominant). There were no sex differences in the training response. Cross education of strength at post-training was 6% (p<0.01) in the untrained arm and 13% (p<0.01) in the untrained leg. Contralateral strength continued to increase following detraining to 15% in the arm (p<0.01) and 14% in the leg (p<0.01). There was no difference in strength gains between upper and lower limbs (p>0.05). Cross education of skill (force variability) demonstrated greater improvements in the untrained limbs compared to the control limbs during contractions performed without concurrent feedback. Significant increases in V-wave amplitude (p=0.02) and central activation (p<0.01) were highly correlated with contralateral strength gains. There was no change in agonist amplitude or motor unit firing rates in the untrained limbs (p>0.05). The neuromuscular mechanisms mirrored the force increases at post-training and retention supporting central drive adaptations of cross education. The continued strength increases at retention identified the presence of motor learning in cross education, as confirmed by force variability.

Robotic Surgical Training in an Academic Institution

PubMed Central

Chitwood, W. Randolph; Nifong, L. Wiley; Chapman, William H. H.; Felger, Jason E.; Bailey, B. Marcus; Ballint, Tara; Mendleson, Kim G.; Kim, Victor B.; Young, James A.; Albrecht, Robert A.

2001-01-01

Objective To detail robotic procedure development and clinical applications for mitral valve, biliary, and gastric reflux operations, and to implement a multispecialty robotic surgery training curriculum for both surgeons and surgical teams. Summary Background Data Remote, accurate telemanipulation of intracavitary instruments by general and cardiac surgeons is now possible. Complex technologic advancements in surgical robotics require well-designed training programs. Moreover, efficient robotic surgical procedures must be developed methodically and safely implemented clinically. Methods Advanced training on robotic systems provides surgeon confidence when operating in tiny intracavitary spaces. Three-dimensional vision and articulated instrument control are essential. The authors’ two da Vinci robotic systems have been dedicated to procedure development, clinical surgery, and training of surgical specialists. Their center has been the first United States site to train surgeons formally in clinical robotics. Results Established surgeons and residents have been trained using a defined robotic surgical educational curriculum. Also, 30 multispecialty teams have been trained in robotic mechanics and electronics. Initially, robotic procedures were developed experimentally and are described. In the past year the authors have performed 52 robotic-assisted clinical operations: 18 mitral valve repairs, 20 cholecystectomies, and 14 Nissen fundoplications. These respective operations required 108, 28, and 73 minutes of robotic telemanipulation to complete. Procedure times for the last half of the abdominal operations decreased significantly, as did the knot-tying time in mitral operations. There have been no deaths and few complications. One mitral patient had postoperative bleeding. Conclusion Robotic surgery can be performed safely with excellent results. The authors have developed an effective curriculum for training teams in robotic surgery. After training, surgeons have applied these methods effectively and safely. PMID:11573041

[Simulation-based intervention to improve anesthesiology residents communication with families of critically ill patients--preliminary prospective evaluation].

PubMed

Berkenstadt, Haim; Perlson, Daria; Shalomson, Orit; Tuval, Atalia; Haviv-Yadid, Yael; Ziv, Amitai

2013-08-01

Although effective communication with families of critically ill patients is a vital component of quality care, training in this field is neglected. The article aims to validate communication skills training program for anesthesiology residents in the intensive care set up. Ten anesthesia residents, following 3 months of Intensive Care Unit (ICU) rotation, had 4 hours of lectures and one day simulation-based communication skills training with families of critically ill patients. Participants completed an attitude questionnaire over 3 time periods--before training [t1], immediately following training (t2) and three months following training (t3). The participants' communication skills were assessed by two blinded independent observers using the SEGUE framework while performing a simulation-based scenario at t1 and t3. Seven participants finished the study protocol. Participants ndicated communication importance as 3.68 +/- 0.58 (t1), 4.05 +/- 0.59 (t2), 4.13 +/- 0.64 (t3); their communication ability as 3.09 +/- 0.90 (t1), 3.70 +/- 0.80 (t2), 3.57 +/- 0.64 (t3); the contribution of lecture to communication 3.04 +/- 0.43 (t1), 3.83 +/- 0.39 (t2), 3.87 +/- 0.51 (t3), and contribution of simulation training to communication 3.00 +/- 0.71 (t1), 4.04 +/- 0.52 (t2), 3.84 +/- 0.31 (t3). The differences did not reach statistical significance. Objective assessment of the communication skills using the SEGUE framework indicated that 6/7 participants improved their communication skills, with communication ability before training at 2.66 +/- 0.83 and 1 month following training it was 3.38 +/- 0.78 (p = 0.09). This preliminary study demonstrates the value of communication skills training in the intensive care environment.

Physical training, smoking, and injury during deployment: a comparison of men and women in the US Army.

PubMed

Anderson, Morgan K; Grier, Tyson; Canham-Chervak, Michelle; Bushman, Timothy T; Jones, Bruce H

2015-01-01

To investigate changes in physical training (PT), fitness, and injury during deployment and identify differences between men and women. Data were collected on male and female US Army Soldiers through self-reported surveys completed before and after deployment to Afghanistan. Changes in physical training activities, physical fitness, injury incidence, BMI, and smoking status were analyzed. Descriptive statistics were used to compare before deployment and deployment results and differences between men and women. Surveys were completed by 727 men and 43 women. The percentage of Soldiers engaging in unit PT running of 5 miles or more per week decreased by almost half for men and women. The percentage of Soldiers doing personal PT running of 5 miles or more per week and engaged in resistance training 3 or more days per week more than doubled for men and women during deployment. Cardiorespiratory endurance for women improved by 50 seconds (P=.06) and for men declined by 29 seconds (P<.01), while muscular endurance increased by 0.6 repetitions (P<.01) during deployment. Injury rates for men decreased, on average, 36.2 to 19.0 injuries per 1,000 Soldiers per month (P=.01). Injury rates for women decreased on average from 42.6 to 14.0 injuries per 1,000 Soldiers per month (P=.02). During deployment, BMI did not change for men or women and smoking increased 19% for men (P<.01), but did not increase for women. Comparisons of physical training activities and health behavior among men and women before and during deployment suggests that increased resistance training could be recommended for women and smoking cessation for men. Given the potentially important role of personal PT in maintaining physical fitness in the deployment environment, future work should support provision of the necessary environment and equipment for Soldiers to perform personal PT effectively and safely on their own. Further, the physical training gaps between men and women should be addressed, with suggestions regarding where improvements can be made, especially for women interested in seeking combat positions with high physical demands.

8 CFR 315.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Training Corps of the United States. Induction means compulsory entrance into military service of the...: EXEMPTION FROM MILITARY SERVICE § 315.1 Definitions. As used in this part: Exemption from military service... Training Corps of the United States for military training or military service; or (2) The release or...

8 CFR 315.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Training Corps of the United States. Induction means compulsory entrance into military service of the...: EXEMPTION FROM MILITARY SERVICE § 315.1 Definitions. As used in this part: Exemption from military service... Training Corps of the United States for military training or military service; or (2) The release or...

8 CFR 315.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Training Corps of the United States. Induction means compulsory entrance into military service of the...: EXEMPTION FROM MILITARY SERVICE § 315.1 Definitions. As used in this part: Exemption from military service... Training Corps of the United States for military training or military service; or (2) The release or...

8 CFR 315.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Training Corps of the United States. Induction means compulsory entrance into military service of the...: EXEMPTION FROM MILITARY SERVICE § 315.1 Definitions. As used in this part: Exemption from military service... Training Corps of the United States for military training or military service; or (2) The release or...

8 CFR 315.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Training Corps of the United States. Induction means compulsory entrance into military service of the...: EXEMPTION FROM MILITARY SERVICE § 315.1 Definitions. As used in this part: Exemption from military service... Training Corps of the United States for military training or military service; or (2) The release or...

Waste Encapsulation and Storage Facility (WESF) Dangerous Waste Training Plan (DWTP)

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

SIMMONS, F.M.

2000-03-29

This Waste Encapsulation Storage Facility (WESF) Dangerous Waste Training Plan (DWTP) applies to personnel who perform work at, or in support of WESF. The plan, along with the names of personnel, may be given to a regulatory agency inspector upon request. General workers, subcontractors, or visiting personnel who have not been trained in the management of dangerous wastes must be accompanied by an individual who meets the requirements of this training plan. Dangerous waste management includes handling, treatment, storage, and/or disposal of dangerous and/or mixed waste. Dangerous waste management units covered by this plan include: less-than-90-day accumulation area(s); pool cellsmore » 1-8 and 12 storage units; and process cells A-G storage units. This training plan describes general requirements, worker categories, and provides course descriptions for operation of the WESF permitted miscellaneous storage units and the Less-than-90-Day Accumulation Areas.« less

Primary care and addiction treatment: lessons learned from building bridges across traditions.

PubMed

Stanley, A H

1999-01-01

A primary care unit combined with residential addiction treatment allows patients with addictive disease and chronic medical or psychiatric problems to successfully complete the treatment. These are patients who would otherwise fail treatment or fail to be considered candidates for treatment. Health care providers should have a background in primary care and have the potential to respond professionally to clinical problems in behavioral medicine. Ongoing professional training and statistical quality management principles can maintain morale and productivity. Health education is an integral part of primary care. The costs of such concurrent care when viewed in the context of the high societal and economic costs of untreated addictive disease and untreated chronic medical problems are low. The principles used to develop this primary care unit can be used to develop health care units for other underserved populations. These principles include identification of specific health care priorities and continuity of rapport with the target population and with addiction treatment staff.

Sea Training at Maritime Academies Oversight. Hearings Before the Ad Hoc Select Subcommittee on Maritime Education and Training of the Committee on Merchant Marine and Fisheries, House of Representatives, Ninety-Sixth Congress, Second Session on Sea Training of United States Merchant Marine Officers and Different Ways of Satisfying This Requirement at the Various Maritime Academies.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Merchant Marine and Fisheries.

Recorded are minutes of hearings before the House Ad Hoc Select Subcommittee on Maritime Education and Training regarding the sea training of United States Merchant Marine officers. Examined are various approaches to meeting the sea training requirement, especially the options of maritime academy training vessels, sailing on U.S.-flag merchant…

United States Medical Licensing Examination and American Board of Pediatrics Certification Examination Results: Does the Residency Program Contribute to Trainee Achievement.

PubMed

Welch, Thomas R; Olson, Brad G; Nelsen, Elizabeth; Beck Dallaghan, Gary L; Kennedy, Gloria A; Botash, Ann

2017-09-01

To determine whether training site or prior examinee performance on the US Medical Licensing Examination (USMLE) step 1 and step 2 might predict pass rates on the American Board of Pediatrics (ABP) certifying examination. Data from graduates of pediatric residency programs completing the ABP certifying examination between 2009 and 2013 were obtained. For each, results of the initial ABP certifying examination were obtained, as well as results on National Board of Medical Examiners (NBME) step 1 and step 2 examinations. Hierarchical linear modeling was used to nest first-time ABP results within training programs to isolate program contribution to ABP results while controlling for USMLE step 1 and step 2 scores. Stepwise linear regression was then used to determine which of these examinations was a better predictor of ABP results. A total of 1110 graduates of 15 programs had complete testing results and were subject to analysis. Mean ABP scores for these programs ranged from 186.13 to 214.32. The hierarchical linear model suggested that the interaction of step 1 and 2 scores predicted ABP performance (F[1,1007.70] = 6.44, P = .011). By conducting a multilevel model by training program, both USMLE step examinations predicted first-time ABP results (b = .002, t = 2.54, P = .011). Linear regression analyses indicated that step 2 results were a better predictor of ABP performance than step 1 or a combination of the two USMLE scores. Performance on the USMLE examinations, especially step 2, predicts performance on the ABP certifying examination. The contribution of training site to ABP performance was statistically significant, though contributed modestly to the effect compared with prior USMLE scores. Copyright © 2017 Elsevier Inc. All rights reserved.

Education of gastroenterology trainees: first annual fellows' nutrition course.

PubMed

Scolapio, James S; Buchman, Alan L; Floch, Martin

2008-02-01

The degree of nutrition training in gastrointestinal (GI) fellowship programs has not been reported previously, but it is thought to be inadequate. The aim of this study was to determine GI fellows' exposure to nutrition and to assess nutrition knowledge and practice behaviors before and after completing a live nutrition course. This course was geared specifically for GI fellows. Nineteen faculty members from the United States and Canada participated. Electronic surveys were sent to each fellow before and after the course. The curriculum consisted of 20 hours of live education. Curriculum was revised when the precourse survey identified a gap in medical knowledge or practice behavior. Knowledge change was assessed by a 20-question survey before and after the course. Fifty-three fellows participated. Seventy percent reported no inpatient nutrition rotation. Seventy percent had never written a total parenteral nutrition or total enteral nutrition orders, and 12% had treated a home enteral or parenteral patient. Ninety percent had no outpatient nutrition or obesity rotation experience, and 59% had no core nutrition lecture series at their program. Eighty-seven percent had never been assessed for competency in nutrition, and 9% had completed a nutrition research project. Too few mentors, poor exposure, and a predominant focus on endoscopy were reasons cited for not pursing nutrition training. Knowledge change after the course was assessed; the mean correct response rates were 58% before and 88% postcourse. There is a considerable deficiency in nutrition training in GI programs. The established American Gastroenterological Association nutrition curriculum guidelines and core competencies are not being fulfilled in most programs. The curriculum of this course resulted in increased knowledge and improved nutrition practice behavior. There is a need for more nutrition training for our GI fellows.

Evacuation of Intensive Care Units During Disaster: Learning From the Hurricane Sandy Experience.

PubMed

King, Mary A; Dorfman, Molly V; Einav, Sharon; Niven, Alex S; Kissoon, Niranjan; Grissom, Colin K

2016-02-01

Data on best practices for evacuating an intensive care unit (ICU) during a disaster are limited. The impact of Hurricane Sandy on New York City area hospitals provided a unique opportunity to learn from the experience of ICU providers about their preparedness, perspective, roles, and activities. We conducted a cross-sectional survey of nurses, respiratory therapists, and physicians who played direct roles during the Hurricane Sandy ICU evacuations. Sixty-eight health care professionals from 4 evacuating hospitals completed surveys (35% ICU nurses, 21% respiratory therapists, 25% physicians-in-training, and 13% attending physicians). Only 21% had participated in an ICU evacuation drill in the past 2 years and 28% had prior training or real-life experience. Processes were inconsistent for patient prioritization, tracking, transport medications, and transport care. Respondents identified communication (43%) as the key barrier to effective evacuation. The equipment considered most helpful included flashlights (24%), transport sleds (21%), and oxygen tanks and respiratory therapy supplies (19%). An evacuation wish list included walkie-talkies/phones (26%), lighting/electricity (18%), flashlights (10%), and portable ventilators and suction (16%). ICU providers who evacuated critically ill patients during Hurricane Sandy had little prior knowledge of evacuation processes or vertical evacuation experience. The weakest links in the patient evacuation process were communication and the availability of practical tools. Incorporating ICU providers into hospital evacuation planning and training, developing standard evacuation communication processes and tools, and collecting a uniform dataset among all evacuating hospitals could better inform critical care evacuation in the future.

The Need for Social Ethics in Interdisciplinary Environmental Science Graduate Programs: Results from a Nation-Wide Survey in the United States.

PubMed

Hall, Troy E; Engebretson, Jesse; O'Rourke, Michael; Piso, Zach; Whyte, Kyle; Valles, Sean

2017-04-01

Professionals in environmental fields engage with complex problems that involve stakeholders with different values, different forms of knowledge, and contentious decisions. There is increasing recognition of the need to train graduate students in interdisciplinary environmental science programs (IESPs) in these issues, which we refer to as "social ethics." A literature review revealed topics and skills that should be included in such training, as well as potential challenges and barriers. From this review, we developed an online survey, which we administered to faculty from 81 United States colleges and universities offering IESPs (480 surveys were completed). Respondents overwhelmingly agreed that IESPs should address values in applying science to policy and management decisions. They also agreed that programs should engage students with issues related to norms of scientific practice. Agreement was slightly less strong that IESPs should train students in skills related to managing value conflicts among different stakeholders. The primary challenges to incorporating social ethics into the curriculum were related to the lack of materials and expertise for delivery, though challenges such as ethics being marginalized in relation to environmental science content were also prominent. Challenges related to students' interest in ethics were considered less problematic. Respondents believed that social ethics are most effectively delivered when incorporated into existing courses, and they preferred case studies or problem-based learning for delivery. Student competence is generally not assessed, and respondents recognized a need for both curricular materials and assessment tools.

Evaluation of Key Factors Impacting Feeding Safety in the Neonatal Intensive Care Unit: A Systematic Review.

PubMed

Matus, Bethany A; Bridges, Kayla M; Logomarsino, John V

2018-06-21

Individualized feeding care plans and safe handling of milk (human or formula) are critical in promoting growth, immune function, and neurodevelopment in the preterm infant. Feeding errors and disruptions or limitations to feeding processes in the neonatal intensive care unit (NICU) are associated with negative safety events. Feeding errors include contamination of milk and delivery of incorrect or expired milk and may result in adverse gastrointestinal illnesses. The purpose of this review was to evaluate the effect(s) of centralized milk preparation, use of trained technicians, use of bar code-scanning software, and collaboration between registered dietitians and registered nurses on feeding safety in the NICU. A systematic review of the literature was completed, and 12 articles were selected as relevant to search criteria. Study quality was evaluated using the Downs and Black scoring tool. An evaluation of human studies indicated that the use of centralized milk preparation, trained technicians, bar code-scanning software, and possible registered dietitian involvement decreased feeding-associated error in the NICU. A state-of-the-art NICU includes a centralized milk preparation area staffed by trained technicians, care supported by bar code-scanning software, and utilization of a registered dietitian to improve patient safety. These resources will provide nurses more time to focus on nursing-specific neonatal care. Further research is needed to evaluate the impact of factors related to feeding safety in the NICU as well as potential financial benefits of these quality improvement opportunities.

A national survey on the current status of informatics residency education in pharmacy.

PubMed

Blash, Anthony; Saltsman, Connie L; Steil, Condit

2017-11-01

Upon completion of their post-graduate training, pharmacy informatics residents need to be prepared to interact with clinical and technology experts in the new healthcare environment. This study describes pharmacy informatics residency programs within the United States. Preliminary information for all pharmacy informatics residency programs was accessed from program webpages. An email was sent out to programs asking them to respond to a six-item questionnaire. This questionnaire was designed to elicit information on attributes of the program, behaviors of the preceptors and residents, and attitudes of the residency directors. Of 22 pharmacy informatics residencies identified, nineteen (86%) participated. Twenty (91%) were second post-graduate year (PGY2) residencies. Ten (45%) were accredited by the American Society of Health-System Pharmacists (ASHP), while eight (36%) were candidates for accreditation. Hospital (17/22, 77%) and administrative offices (3/22, 14%) were the predominant training sites for pharmacy informatics residents. Large institutions were the predominant training environment for the pharmacy informatics resident, with 19 of 22 (86%) institutions reporting a licensed bed count of 500 or more. The median (range) number of informatics preceptors at a site was six to eight. Regarding barriers to pharmacy informatics residency education, residency directors reported that residents did not feel prepared based on the limited availability of curricular offerings. In the United States, relatively few residencies are explicitly focused on pharmacy informatics. Most of these are accredited and hospital affiliated, especially with large institutions (>500 beds). Copyright © 2017 Elsevier Inc. All rights reserved.

Development and Preliminary Evaluation of a Telephone-based Mindfulness Training Intervention for Survivors of Critical Illness

PubMed Central

Porter, Laura S.; Buck, Pamela J.; Hoffa, Mary; Jones, Derek; Walton, Brenda; Hough, Catherine L.; Greeson, Jeffrey M.

2014-01-01

Rationale: Persistent symptoms of psychological distress represent an unmet need among intensive care unit (ICU) survivors. Objectives: We aimed to develop and pilot test a simple telephone-based mindfulness training intervention to address this population’s unique needs. Methods: Open trial involving survivors of medical and surgical critical illness and their informal caregivers, using a pretest–posttest design. Measurements and Main Results: We developed a six-session, telephone-delivered, ICU survivor–specific mindfulness intervention based on past focus groups, the medical literature, and the precedent of the most effective components of existing mindfulness programs. A total of 11 survivors of mechanical ventilation were enrolled, together with 2 informal caregivers for exploratory purposes. Three patients dropped out before intervention initiation because of progressive illness or severe social stressors. Of the 10 remaining participants, 8 (80%) completed the program within 7 weeks. Among these eight patients and caregivers who completed all study procedures, six (75%) experienced improvement in symptoms of psychological distress (anxiety, depression, or post-traumatic stress disorder). Changes in distress symptoms were correlated with improvement in mindfulness qualities, adaptive coping, and emotion regulation. Participants reported high satisfaction with the program in postintervention interviews. Conclusions: A new ICU survivor–specific mindfulness training intervention delivered by telephone was acceptable and feasible. Changes in symptoms of distress were correlated with changes in skills that were targeted by the mindfulness program. Controlled trials are needed to further evaluate this promising intervention. PMID:24303911

The effect of video-assisted oral feedback versus oral feedback on surgical communicative competences in undergraduate training.

PubMed

Ruesseler, M; Sterz, J; Bender, B; Hoefer, S; Walcher, F

2017-08-01

Feedback can significantly improve future performance. Reviewing one's performance by video is discussed as useful adjunct to debriefing, particularly for non-technical skills. Communicative competencies are an essential part of daily clinical practice; thus should be taught and assessed during undergraduate training. The aim of this study was to compare the educational value of video-assisted feedback versus oral feedback in communicative competencies in the surgical context. Fourth-year medical students completed a 210-min training unit of 'taking patient's history and obtaining informed consents prior to surgery' using role plays. Oral feedback was received directly thereafter using agenda-led, outcome-based guidelines (ALOBA). In the study group, the role plays were video-taped and reviewed thereafter. Afterwards, students completed two OSCE stations, where they were assessed regarding their communicative competencies and the content of the clinical scenario. One-hundred students (49 receiving video-assisted feedback, 51 oral) participated in the study. Those receiving video-assisted feedback performed significantly better in overall score in both OSCE stations (p < 0.001), in all five assessed communicative competencies at taking patient history (p = 0.029 or better), and in 2 of 5 items at obtaining informed consent (p = 0.008, <0.001). The educational effect size for both tasks was large. Using our methodology, video-assisted feedback offered a significant educational benefit over oral feedback alone during a simulated patient encounter in a surgical context.

Complex clinical reasoning in the critical care unit - difficulties, pitfalls and adaptive strategies.

PubMed

Shaw, M; Singh, S

2015-04-01

Diagnostic error has implications for both clinical outcome and resource utilisation, and may often be traced to impaired data gathering, processing or synthesis because of the influence of cognitive bias. Factors inherent to the intensive/acute care environment afford multiple additional opportunities for such errors to occur. This article illustrates many of these with reference to a case encountered on our intensive care unit. Strategies to improve completeness of data gathering, processing and synthesis in the acute care environment are critically appraised in the context of early detection and amelioration of cognitive bias. These include reflection, targeted simulation training and the integration of social media and IT based aids in complex diagnostic processes. A framework which can be quickly and easily employed in a variety of clinical environments is then presented. © 2015 John Wiley & Sons Ltd.

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…

LAW ENFORCEMENT OFFICER TRAINING, BASIC COURSE, UNIT II, A UNIT OF THE OHIO LAW ENFORCEMENT OFFICERS' TRAINING PROGRAM, LEARNER'S MANUAL.

ERIC Educational Resources Information Center

REESE, ROBERT M.; AND OTHERS

STUDENTS MAY USE THIS MANUAL IN A LAW ENFORCEMENT TRAINING PROGRAM FOR INSERVICE LAW ENFORCEMENT OFFICERS AND RECRUITS. IT WAS DEVELOPED BY A STATEWIDE COMMITTEE OF LAW ENFORCEMENT TRAINING CONSULTANTS, SPECIALISTS, AND AN ADVISORY COMMITTEE AND WAS TESTED BY A SUBJECT MATTER SPECIALIST IN A PILOT-CLASS STUDY. THE PROGRAM IS DESIGNED TO PROVIDE…

Wearing a training version of the Extravehicular Mobility Unit (EMU) space suit, astronaut Mario

NASA Technical Reports Server (NTRS)

1995-01-01

STS-77 TRAINING VIEW --- Wearing a training version of the Extravehicular Mobility Unit (EMU) space suit, astronaut Mario Runco, mission specialist, prepares to participate in an underwater rehearsal of a contingency Extravehicular Activity (EVA). This type of training routinely takes place in the 25-feet deep pool of the Johnson Space Centers (JSC) Weightless Environment Training Center (WET-F). The training prepares at least two crew members on each flight for procedures to follow outside the spacecraft in event of failure of remote methods to perform various chores.

Meeting the Needs of Underserved Patients in Western Kenya by Creating the Next Generation of Global Health Pharmacists.

PubMed

Miller, Monica L; Karwa, Rakhi; Schellhase, Ellen M; Pastakia, Sonak D; Crowe, Susie; Manji, Imran; Jakait, Beatrice; Maina, Mercy

2016-03-25

Objective. To describe a novel training model used to create a sustainable public health-focused pharmacy residency based in Kenya and to describe the outcomes of this training program on underserved populations. Design. The postgraduate year 2 residency was designed to expose trainees to the unique public health facets of inpatient, outpatient, and community-based care delivery in low and middle-income countries. Public health areas of focus included supply chain management, reproductive health, pediatrics, HIV, chronic disease management, and teaching. Assessment. The outcomes of the residency were assessed based on the number of new clinical programs developed by residents, articles and abstracts written by residents, and resident participation in grant writing. To date, six residents from the United States and eight Kenyan residents have completed the residency. Eleven sustainable patient care services have been implemented as a result of the residency program. Conclusion. This pharmacy residency training model developed accomplished pharmacists in public health pharmacy, with each residency class expanding funding and clinical programming, contributing to curriculum development, and creating jobs.

Perceived social stigma and attitudes towards seeking therapy in training: a cross-national study.

PubMed

Digiuni, Malena; Jones, Fergal W; Camic, Paul M

2013-06-01

Given the potential value of undergoing psychological therapy when training as a therapist, it is important to understand what influences students' decisions regarding seeking therapy. The study examined the relationship between clinical psychology students' perception of the social stigma attached to receiving therapy and their attitudes toward seeking therapy. Students from Argentina (n = 121), England (n = 211), and the United States (n = 130) completed measures of demographic characteristics, perceived social stigma, attitudes, and other variables associated with therapy-seeking. The results revealed significant cross-national differences, with Argentinean students showing the lowest levels of perceived social stigma for receiving therapy, followed by English and Americans. English students showed relatively less positive attitudes toward seeking therapy than their Argentinean and American counterparts. Social stigma predicted students' attitudes toward seeking therapy among English and American but not Argentinean students. The relationship between perceived social stigma and attitudes was moderated by nationality. Implications for training are discussed, including English and American clinical psychology courses encouraging their students to reflect on the effect of perceived social stigma on their decision-making.

The need for time management training is universal: evidence from Turkey.

PubMed

Kisa, Adnan; Ersoy, Korkut

2005-01-01

In many developing countries, healthcare administrators are currently facing challenges that are representative of those in the United States. Most healthcare administrators here are physicians with no formal training in healthcare administration, and this is perhaps most apparent in their difficulties with time management. The authors' purpose in this study was to characterize the time management difficulties of administrators working in primary healthcare facilities of the Ministry of Healthcare. In the study, 67 healthcare administrators each completed a 31-item time management questionnaire. Of the participants, 79.1% reported that they have never attended time management courses or workshops. Although 76.1% said they were free to choose the priority of their daily tasks, only 44.8% felt they knew how much time they should allow for each activity in their daily life. These and other findings in the study suggest that the need for time management education is a well-defined target for intervention, both in university-based programs for future healthcare administrators and in workplace-based programs, such as in-service training for healthcare administrators who are already working.

Impact of rural training on physician work force: the role of postresidency education.

PubMed

Acosta, D A

2000-01-01

Many innovative strategies have been developed over the years to improve the recruitment and retention of physicians in the shortage areas of rural America. These strategies have met with varying success. Postresidency education, or fellowship training, for family physicians is yet another strategy that has been developed for the same purpose. Most applicants have been interested in obstetrical and rural health fellowship programs as a means for preparing for rural practice. This paper describes these programs (demographics, funding, applicant pool, curriculum) and reviews their graduate outcomes (practice location after matriculation, clinical privileges). Twenty-nine obstetrical and nine rural health fellowships are currently operational in the United States. Fellows who complete a rural health fellowship have a higher tendency to locate in rural settings. Almost all graduates from obstetrical and rural health programs attain general hospital privileges in family practice, including low-risk obstetrics. A significant number of graduates from both types of programs attain privileges in high-risk and operative obstetrics as well. Fellowship training can play an integral role in the preparation of family physicians for rural practice.

[Safety in intensive care medicine. Can we learn from aviation?].

PubMed

Graf, J; Pump, S; Maas, W; Stüben, U

2012-05-01

Safety is of extraordinary value in commercial aviation. Therefore, sophisticated and complex systems have been developed to ensure safe operation. Within this system, the pilots are of specific concern: they form the human-machine interface and have a special responsibility in controlling and monitoring all aircraft systems. In order to prepare pilots for their challenging task, specific selection of suitable candidates is crucial. In addition, for every commercial pilot regulatory requirements demand a certain number of simulator training sessions and check flights to be completed at prespecified intervals. In contrast, career choice for intensive care medicine most likely depends on personal reasons rather than eligibility or aptitude. In intensive care medicine, auditing, licensing, or mandatory training are largely nonexistent. Although knowledge of risk management and safety culture in aviation can be transferred to the intensive care unit, the diversity of corporate culture and tradition of leadership and training will represent a barrier for the direct transfer of standards or procedures. To accomplish this challenging task, the analysis of appropriate fields of action with regard to structural requirements and the process of change are essential.

Training Materials in Aging. An Annotated International Bibliography.

ERIC Educational Resources Information Center

Brookes, Toby, Comp.

This bibliography lists training programs and training materials, both print and audiovisual, related to aging irrespective of the source of language used. Materials emanate from Australia, Canada, Chile, Israel, New Zealand, Norway, the former Soviet Union, Thailand, the United Kingdom, and the United States as well as from several international…

Inclusion Inservice: Content and Training Procedures across the United States

ERIC Educational Resources Information Center

Harriott, Wendy A.

2004-01-01

Inservice training (locally or state provided) is the primary means used to improve teachers' instruction employed in public school districts throughout the United States. Individual states are increasing inclusion efforts in the local schools. Various states have established state-initiated training programs to improve instruction for students…

Engineering Industry Training Board (EITB) Foundation Training. Unit 1.

ERIC Educational Resources Information Center

Engineering Industry Training Board, London (England).

This instructional unit deals with broadly based appreciation training in a range of skills that are appropriate to a wide sector of occupations, including engineering drawing, engineering materials, bench fitting, sheet metal work, turning, milling, welding, and electricity/electronics. The materials presented are intended for instructors and…

Engineering Industry Training Board (EITB) Foundation Training. Unit 2.

ERIC Educational Resources Information Center

Engineering Industry Training Board, London (England).

This instructional unit deals with broadly based appreciation training in a range of skills that are appropriate to a wide sector of occupations, including safety, engineering drawing, engineering materials, bench fitting, sheet metal work, turning, milling, welding, and electricity/electronics. The materials presented are intended for instructors…

Requirement Specifications for a Design and Verification Unit.

ERIC Educational Resources Information Center

Pelton, Warren G.; And Others

A research and development activity to introduce new and improved education and training technology into Bureau of Medicine and Surgery training is recommended. The activity, called a design and verification unit, would be administered by the Education and Training Sciences Department. Initial research and development are centered on the…

Conflict Management Training for Peacekeepers: Assessment and Recommendations. Special Report 411

ERIC Educational Resources Information Center

Milofsky, Alison; Sany, Joseph; Lancaster, Illana; Krentel, Jeff

2017-01-01

This report examines the role of conflict management training in preparing peacekeepers for United Nations/African Union missions through an assessment of the United States Institute of Peace (USIP) Conflict Management Training for Peacekeepers program. The assessment relies on data collected through 137 semistructured interviews with returned…

Course Management System's Compatibility with Teaching Style Influences Willingness to Complete Training

ERIC Educational Resources Information Center

Pereira, Audrey Smith; Wahi, Monika Maya

2017-01-01

Although course management systems (CMSs) provide technology platforms that help faculty members adopt better techniques for teaching and learning, and training contributes to faculty information technology (IT) use, many higher education faculty members do not complete CMS training programs, resulting in underuse of CMSs. Therefore, the overall…

Meta-analysis of operative experiences of general surgery trainees during training.

PubMed

Elsey, E J; Griffiths, G; Humes, D J; West, J

2017-01-01

General surgical training curricula around the world set defined operative numbers to be achieved before completion of training. However, there are few studies reporting total operative experience in training. This systematic review aimed to quantify the published global operative experience at completion of training in general surgery. Electronic databases were searched systematically for articles in any language relating to operative experience in trainees completing postgraduate general surgical training. Two reviewers independently assessed citations for inclusion using agreed criteria. Studies were assessed for quantitative data in addition to study design and purpose. A meta-analysis was performed using a random-effects model of studies with appropriate data. The search resulted in 1979 titles for review. Of these, 24 studies were eligible for inclusion in the review and data from five studies were used in the meta-analysis. Studies with published data of operative experience at completion of surgical training originated from the USA (19), UK (2), the Netherlands (1), Spain (1) and Thailand (1). Mean total operative experience in training varied from 783 procedures in Thailand to 1915 in the UK. Meta-analysis produced a mean pooled estimate of 1366 (95 per cent c.i. 1026 to 1707) procedures per trainee at completion of training. There was marked heterogeneity between studies (I 2  = 99·6 per cent). There is a lack of robust data describing the operative experiences of general surgical trainees outside the USA. The number of surgical procedures performed by general surgeons in training varies considerably across the world. © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Lumbar muscle inflammation alters spinally mediated locomotor recovery induced by training in a mouse model of complete spinal cord injury.

PubMed

Jeffrey-Gauthier, Renaud; Piché, Mathieu; Leblond, Hugues

2017-09-17

Locomotor networks after spinal cord injury (SCI) are shaped by training-activated proprioceptive and cutaneous inputs. Nociception from injured tissues may alter these changes but has largely been overlooked. The objective of the present study was to ascertain whether lumbar muscle inflammation hinders locomotion recovery in a mouse model of complete SCI. Lower limb kinematics during treadmill training was assessed before and after complete SCI at T8 (2, 7, 14, 21 and 28days post-injury). Locomotor recovery was compared in 4 groups of CD1 mice: control spinal mice; spinal mice with daily locomotor training; spinal mice with lumbar muscle inflammation (Complete Freund's Adjuvant (CFA) injection); and spinal mice with locomotor training and CFA. On day 28, H-reflex excitability and its inhibition at high-frequency stimulation (frequency-dependent depression: FDD) were compared between groups, all of which showed locomotor recovery. Recovery was enhanced by training, whereas lumbar muscle inflammation hindered these effects (knee angular excursion and paw drag: p's<0.05). In addition, lumbar muscle inflammation impaired hind limb coupling during locomotion (p<0.05) throughout recovery. Also, H-reflex disinhibition was prevented by training, with or without CFA injection (p's<0.05). Altogether, these results indicate that back muscle inflammation modulates spinally mediated locomotor recovery in mice with complete SCI, in part, by reducing adaptive changes induced by training. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Quality improvement training for core medical and general practice trainees: a pilot study of project participation, completion and journal publication.

PubMed

McNab, Duncan; McKay, John; Bowie, Paul

2015-11-01

Small-scale quality improvement projects are expected to make a significant contribution towards improving the quality of healthcare. Enabling doctors-in-training to design and lead quality improvement projects is important preparation for independent practice. Participation is mandatory in speciality training curricula. However, provision of training and ongoing support in quality improvement methods and practice is variable. We aimed to design and deliver a quality improvement training package to core medical and general practice specialty trainees and evaluate impact in terms of project participation, completion and publication in a healthcare journal. A quality improvement training package was developed and delivered to core medical trainees and general practice specialty trainees in the west of Scotland encompassing a 1-day workshop and mentoring during completion of a quality improvement project over 3 months. A mixed methods evaluation was undertaken and data collected via questionnaire surveys, knowledge assessment, and formative assessment of project proposals, completed quality improvement projects and publication success. Twenty-three participants attended the training day with 20 submitting a project proposal (87%). Ten completed quality improvement projects (43%), eight were judged as satisfactory (35%), and four were submitted and accepted for journal publication (17%). Knowledge and confidence in aspects of quality improvement improved during the pilot, while early feedback on project proposals was valued (85.7%). This small study reports modest success in training core medical trainees and general practice specialty trainees in quality improvement. Many gained knowledge of, confidence in and experience of quality improvement, while journal publication was shown to be possible. The development of educational resources to aid quality improvement project completion and mentoring support is necessary if expectations for quality improvement are to be realised. © The Author(s) 2015.

Army National Guard Companies Have Not Developed Effective Training Programs to Attain or Sustain Mission Essential Task Proficiency (REDACTED)

DTIC Science & Technology

2016-12-05

consist of at least five company -level units: headquarters , two rifle, and two armored units. Reconnaissance squadrons generally consist of at...least four company - level units: headquarters and three reconnaissance units...Brief (U) Army National Guard Companies Have Not Developed Effective Training Programs to Attain or Sustain Mission Essential Task Proficiency

Retention of fundamental surgical skills learned in robot-assisted surgery.

PubMed

Suh, Irene H; Mukherjee, Mukul; Shah, Bhavin C; Oleynikov, Dmitry; Siu, Ka-Chun

2012-12-01

Evaluation of the learning curve for robotic surgery has shown reduced errors and decreased task completion and training times compared with regular laparoscopic surgery. However, most training evaluations of robotic surgery have only addressed short-term retention after the completion of training. Our goal was to investigate the amount of surgical skills retained after 3 months of training with the da Vinci™ Surgical System. Seven medical students without any surgical experience were recruited. Participants were trained with a 4-day training program of robotic surgical skills and underwent a series of retention tests at 1 day, 1 week, 1 month, and 3 months post-training. Data analysis included time to task completion, speed, distance traveled, and movement curvature by the instrument tip. Performance of the participants was graded using the modified Objective Structured Assessment of Technical Skills (OSATS) for robotic surgery. Participants filled out a survey after each training session by answering a set of questions. Time to task completion and the movement curvature was decreased from pre- to post-training and the performance was retained at all the corresponding retention periods: 1 day, 1 week, 1 month, and 3 months. The modified OSATS showed improvement from pre-test to post-test and this improvement was maintained during all the retention periods. Participants increased in self-confidence and mastery in performing robotic surgical tasks after training. Our novel comprehensive training program improved robot-assisted surgical performance and learning. All trainees retained their fundamental surgical skills for 3 months after receiving the training program.

Evaluation of a curriculum for intimate partner violence screening in a pediatric emergency department.

PubMed

Knapp, Jane F; Dowd, M Denise; Kennedy, Christopher S; Stallbaumer-Rouyer, Jennifer; Henderson, Deborah P

2006-01-01

We sought to describe the assessment of course participant changes in attitudes, self-efficacy, and behaviors after completion of the Its Time to Ask training curriculum for screening for intimate partner violence (IPV) in a pediatric emergency department (PED). A 22-item Likert scale questionnaire was administered at baseline (before training), after training, and at 6-month follow-up to PED employee participants in a 2-hour IPV education program. Mean participant responses were compared between baseline/posttraining and baseline/6-month follow-up. Participants also completed a course-satisfaction survey. A total of 79 PED staff completed the baseline questionnaire before the training. Eighty-seven participants completed the posttraining questionnaire, and 48 completed the 6-month follow-up questionnaire. Participants had consistent, positive changes in attitudes after training that persisted at the 6-month follow-up for 5 items on the questionnaire. Attitudes that did not change showed baseline means already in disagreement with questionnaire statements. Participants reported significant, positive changes for all 7 self-efficacy statements at 1 or both of the posttraining evaluations. The only changes in behavior were observed at 6 months. The majority of participants were satisfied with the training and would recommend it to colleagues. Significant, self-reported changes in attitudes, self-efficacy, and behaviors/clinical practice regarding screening for IPV in a PED can be achieved through participation in a brief training curriculum.

Relationship between Training Programs being Offered in State and Federal Penal Institutions and the Unfilled Job Openings in the Major Occupations in the United States.

ERIC Educational Resources Information Center

Torrence, John Thomas

Excluding military installations, training programs in state and federal penal institutions were surveyed, through a mailed checklist, to test the hypotheses that (1) training programs in penal institutions were not related to the unfilled job openings by major occupations in the United States, and (2) that training programs reported would have a…

Physical training risk factors for musculoskeletal injury in female soldiers.

PubMed

Roy, Tanja C; Songer, Thomas; Ye, Feifei; LaPorte, Ronald; Grier, Tyson; Anderson, Morgan; Chervak, Michelle

2014-12-01

Musculoskeletal injuries (MSIs) result in the most medical encounters, lost duty days, and permanent disability. Women are at greater risk of injury than men and physical training is the leading cause of injury. The purpose of this study was to investigate the demographic, body composition, fitness, and physical training risk factors for injuries in female Soldiers serving in garrison Army units over the past 12 months. Self-report survey was collected from 625 women. The ankle was the most frequently injured body region, 13%. Running was the activity most often associated with injury, 34%. In univariate analysis lower rank, older age, history of deployment, no unit runs, weekly frequency of personal resistance training, and history of injury were all associated with injury. In multivariate analysis rank, history of injury, weekly frequency of unit runs, and weekly frequency of personal resistance training were the best combination of predictors of injury. Running once or twice a week with the unit protected against MSIs, whereas participating in personal resistance training sessions once or twice a week increased the risk of MSIs. With more emphasis on running and resistance training, the U.S. Army could reduce injuries and save billions of dollars in training and health care costs. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

[Food hygiene training of members of corporate public catering committees].

PubMed

Quaranta, Gianluigi; Laurenti, Patrizia; Gerardo Cairo, Antonio; Ricciardi, Gualtiero

2007-01-01

A food hygiene training course was offered to 25 members of the public catering committees of seven corporate restaurants. In order to evaluate the effectiveness of the course and identify critical topics, participants were asked to complete a questionnaire before and after completing the training course. Results are presented in this article and underscore the importance of training members of public catering committees in addition to food handlers.

Methodological issues in the design and evaluation of supported communication for aphasia training: a cluster-controlled feasibility study

PubMed Central

Horton, Simon; Clark, Allan; Barton, Garry; Lane, Kathleen; Pomeroy, Valerie M

2016-01-01

Objective To assess the feasibility and acceptability of training stroke service staff to provide supported communication for people with moderate–severe aphasia in the acute phase; assess the suitability of outcome measures; collect data to inform sample size and Health Economic evaluation in a definitive trial. Design Phase II cluster-controlled, observer-blinded feasibility study. Settings In-patient stroke rehabilitation units in the UK matched for bed numbers and staffing were assigned to control and intervention conditions. Participants 70 stroke rehabilitation staff from all professional groups, excluding doctors, were recruited. 20 patients with moderate-severe aphasia were recruited. Intervention Supported communication for aphasia training, adapted to the stroke unit context versus usual care. Training was supplemented by a staff learning log, refresher sessions and provision of communication resources. Main outcome measures Feasibility of recruitment and acceptability of the intervention and of measures required to assess outcomes and Health Economic evaluation in a definitive trial. Staff outcomes: Measure of Support in Conversation; patient outcomes: Stroke and Aphasia Quality of Life Scale; Communicative Access Measure for Stroke; Therapy Outcome Measures for aphasia; EQ-5D-3L was used to assess health outcomes. Results Feasibility of staff recruitment was demonstrated. Training in the intervention was carried out with 28 staff and was found to be acceptable in qualitative reports. 20 patients consented to take part, 6 withdrew. 18 underwent all measures at baseline; 16 at discharge; and 14 at 6-month follow-up. Of 175 patients screened 71% were deemed to be ineligible, either lacking capacity or too unwell to participate. Poor completion rates impacted on assessment of patient outcomes. We were able to collect sufficient data at baseline, discharge and follow-up for economic evaluation. Conclusions The feasibility study informed components of the intervention and implementation in day-to-day practice. Modifications to the design are needed before a definitive cluster-randomised trial can be undertaken. Trial registration number ISRCTN37002304; Results. PMID:27091825

Perceptions of basic, advanced, and pediatric life support training in a United States medical school.

PubMed

Pillow, Malford Tyson; Stader, Donald; Nguyen, Matthew; Cao, Dazhe; McArthur, Robert; Hoxhaj, Shkelzen

2014-05-01

Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Pediatric Advanced Life Support (PALS) are integral parts of emergency resuscitative care. Although this training is usually reserved for residents, introducing the training in the medical student curriculum may enhance acquisition and retention of these skills. We developed a survey to characterize the perceptions and needs of graduating medical students regarding BLS, ACLS, and PALS training. This was a study of graduating 4th-year medical students at a U.S. medical school. The students were surveyed prior to participating in an ACLS course in March of their final year. Of 152 students, 109 (71.7%) completed the survey; 48.6% of students entered medical school without any prior training and 47.7% started clinics without training; 83.4% of students reported witnessing an average of 3.0 in-hospital cardiac arrests during training (range of 0-20). Overall, students rated their preparedness 2.0 (SD 1.0) for adult resuscitations and 1.7 (SD 0.9) for pediatric resuscitations on a 1-5 Likert scale, with 1 being unprepared. A total of 36.8% of students avoided participating in resuscitations due to lack of training; 98.2%, 91.7%, and 64.2% of students believe that BLS, ACLS, and PALS, respectively, should be included in the medical student curriculum. As per previous studies that have examined this topic, students feel unprepared to respond to cardiac arrests and resuscitations. They feel that training is needed in their curriculum and would possibly enhance perceived comfort levels and willingness to participate in resuscitations. Copyright © 2014 Elsevier Inc. All rights reserved.

A simultaneous examination of two forms of working memory training: Evidence for near transfer only.

PubMed

Minear, Meredith; Brasher, Faith; Guerrero, Claudia Brandt; Brasher, Mandy; Moore, Andrew; Sukeena, Joshua

2016-10-01

The efficacy of working-memory training is a topic of considerable debate, with some studies showing transfer to measures such as fluid intelligence while others have not. We report the results of a study designed to examine two forms of working-memory training, one using a spatial n-back and the other a verbal complex span. Thirty-one undergraduates completed 4 weeks of n-back training and 32 completed 4 weeks of verbal complex span training. We also included two active control groups. One group trained on a non-adaptive version of n-back and the other trained on a real-time strategy video game. All participants completed pre- and post-training measures of a large battery of transfer tasks used to create composite measures of short-term and working memory in both verbal and visuo-spatial domains as well as verbal reasoning and fluid intelligence. We only found clear evidence for near transfer from the spatial n-back training to new forms of n-back, and this was the case for both adaptive and non-adaptive n-back.

Protocol for a randomized controlled trial of piano training on cognitive and psychosocial outcomes.

PubMed

Bugos, Jennifer

2018-05-09

Age-related cognitive decline and cognitive impairment represent the fastest growing health epidemic worldwide among those over 60. There is a critical need to identify effective and novel complex cognitive interventions to promote successful aging. Since piano training engages cognitive and bimanual sensorimotor processing, we hypothesize that piano training may serve as an effective cognitive intervention, as it requires sustained attention and engages an executive network that supports generalized cognition and emotional control. Here, I describe the protocol of a randomized controlled trial (RCT) to evaluate the impact of piano training on cognitive performance in adulthood, a period associated with decreased neuroplasticity. In this cluster RCT, healthy older adults (age 60-80) were recruited and screened to control for confounding variables. Eligible participants completed an initial 3-h assessment of standardized cognitive and psychosocial measures. Participants were stratified by age, education, and estimate of intelligence and randomly assigned to one of three groups: piano training, computer brain training, or a no-treatment control group. Computer brain training consisted of progressively difficult auditory cognitive exercises (Brain HQ; Posit Science, 2010). Participants assigned to training groups completed a 16-week program that met twice a week for 90 minutes. Upon program completion and at a 3-month follow-up, training participants and no-treatment controls completed a posttest visit lasting 2.5 hours. © 2018 New York Academy of Sciences.

Agricultural Machinery - Equipment. Agricultural Cooperative Training. Vocational Agricluture. Revised.

ERIC Educational Resources Information Center

Sandlin, David, Comp.; And Others

Designed for students enrolled in the Agricultural Cooperative Part-Time Training Program, this course of study contains 12 units on agricultural machinery mechanics. Units include (examples of unit topics in parentheses): introduction (agricultural mechanics as an occupation; safety--shop and equipment; use of holding devices, jacks, lifts, and…

40 CFR 60.2635 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines... CISWI unit can be operated unless a fully trained and qualified CISWI unit operator is accessible... operator may operate the CISWI unit directly or be the direct supervisor of one or more other plant...

40 CFR 60.2635 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines... CISWI unit can be operated unless a fully trained and qualified CISWI unit operator is accessible... operator may operate the CISWI unit directly or be the direct supervisor of one or more other plant...

Evaluation of Team Development in a Corporate Adventure Training Program.

ERIC Educational Resources Information Center

Bronson, Jim; And Others

1992-01-01

An intact work unit of 17 corporate managers participated in a 3-day adventure training program to develop teamwork and group unity. The unit improved significantly on 8 of 10 items of the Team Development Inventory, administered before and 2 months after training, relative to an intact control group. (SV)

40 CFR 60.5130 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... operated unless a fully trained and qualified SSI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified SSI unit operator may operate the SSI...

40 CFR 60.2070 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... operated unless a fully trained and qualified CISWI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified CISWI unit operator may operate the...

40 CFR 60.2070 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of... operated unless a fully trained and qualified CISWI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified CISWI unit operator may operate the...

40 CFR 60.5130 - What are the operator training and qualification requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines... operated unless a fully trained and qualified SSI unit operator is accessible, either at the facility or can be at the facility within 1 hour. The trained and qualified SSI unit operator may operate the SSI...

"It Happened in Seconds" Firefighter Burn Prevention Program: Evaluation of a "Train the Trainer" Course.

PubMed

Kahn, Steven A; Held, Jenny M; Hollowed, Kathleen A; Woods, Jason; Holmes, James H

2016-01-01

Each year, there are approximately 100 firefighter fatalities and tens of thousands of injuries in the United States. 'It Happened in Seconds' is a firefighter burn injury awareness program offered to firefighters nationwide. The course focuses on situational awareness, personal protective equipment, and burn injury prevention. In order to create more instructors, a 'Train the Trainer' instructor course was developed to prepare experienced firefighters and healthcare providers from around the United States to teach firefighters in their respective communities. This study evaluates trainees' perception of the instructor course. Three instructor courses were held in a period between November 2013 and January 2015. Trainees were asked to complete both precourse/postcourse assessments and provide demographics. In both surveys, trainees rated their confidence to instruct firefighters about burn prevention and their awareness about firefighter-specific burn issues using a 5-point Likert Scale (1 = none and 5 = high). The postassessment asked if trainees thought the course should be mandatory for all firefighters. Pretest and post-test scores were compared using a Wilcoxon's signed-rank test. A total of 140 experienced firefighters and healthcare professionals completed the Train the Trainer course. The average age was 40 ± 9 years, and 41 were women and 99 men. The average trainee had 13.6 ± 9 years experience in his or her respective job and 11 ± 9 years experience in burn care. Trainees reported a significant increase in their confidence to instruct firefighters about burn prevention (2.9/5 precourse vs. 4.5/5 postcourse, P < .0001) and in their current awareness of firefighter-specific burn issues (3.2 precourse vs. 4.4 postcourse, P < .0001). In the postcourse assessment, 139 of 140 respondents agreed that the 'It Happened in Seconds' course should be mandatory for all firefighters. This study showed that experienced firefighters and healthcare professionals thought that the course significantly improved their awareness level of issues specific to firefighter burn injury as well as their confidence in teaching these concepts to firefighters. Based on this positive evaluation, additional instructors will be trained to provide the course to all firefighters nationwide. Additional research must be conducted to evaluate whether the 'It Happened in Seconds' course results in a decreased rate of firefighter burn injuries.

Comparing Online and In-Person Delivery Formats of the OSHA 10-Hour General Industry Health and Safety Training for Young Workers.

PubMed

Shendell, Derek G; Milich, Lindsey J; Apostolico, Alexsandra A; Patti, Alexa A; Kelly, Siobhan

2017-05-01

Seven school districts or comprehensive high schools were enrolled in online OSHA 10-hour General Industry or Construction health and safety training via CareerSafe to determine the feasibility of online training for students, given limited resources for in-person trainings. A two-campus school district was analyzed comparing OSHA 10 for General Industry across in-person, supervisor-level teachers as authorized trainers, and online course formats. The online training courses were completed by 86 of 91 students, while another 53 of 57 students completed in-person training. Both groups completed identical OSHA-approved quizzes for "Introduction to OSHA," the initial 2-h module consistently provided in OSHA 10 courses across topics and formats. Results indicated teacher supervision was critical, and girls had higher online course completion rates, overall quiz scores, and never failed. Though both cohorts passed, in-person had significantly higher scores than online; both struggled with two questions. Online OSHA 10 for General Industry can be an efficient learning tool for students when limited resources prevent widespread availability of in-person courses.

Management of children with type 1 diabetes during illness: a national survey.

PubMed

Soni, Astha; Agwu, Juliana Chizo; Wright, Neil Peter; Moudiotis, Christopher; Kershaw, Melanie; Edge, Julie; Drew, Josephine Helen; Ng, Sze May

2016-08-01

Adequate sick-day management at home can reduce the risk of progression to diabetic ketoacidosis and admission to hospital. The aim of this project was to review the management of diabetes during illness. The Association of Children's Diabetes Clinicians (ACDC) carried out a questionnaire survey of all paediatric diabetes units. In addition, parents of children with type 1 diabetes completed an online questionnaire. The survey of 127 units had a 73% response rate. Sick-day management guidelines were in place in 93%. All guidelines advised giving extra insulin during illness. In 67%, the extra dose was based on a fraction of total daily dose. 22% used units per kg body weight (U/kg). 21% used locally derived formulae to calculate extra dose of insulin. 3% of units advised only blood ketone monitoring. Although all units had an out-of-hours access policy for the families, 45% received advice from the general paediatric registrar. Only in 15%, the advice was directly from a member of the paediatric diabetes team. 680 parents completed the questionnaire. 86% reported receiving training on managing sick days. The majority (52.2%) receiving an informal session at diagnosis. 40% did not know what to do in the presence of raised blood glucose and high blood ketones. There was a wide variation in the practice of monitoring and advice given during illness. Both surveys highlight need for national guidance as well and to improve quality of sick-day rule education programmes for parents of children with type 1 diabetes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Quality control of colonoscopy procedures: a prospective validated method for the evaluation of professional practices applicable to all endoscopic units.

PubMed

Coriat, R; Pommaret, E; Chryssostalis, A; Viennot, S; Gaudric, M; Brezault, C; Lamarque, D; Roche, H; Verdier, D; Parlier, D; Prat, F; Chaussade, S

2009-02-01

To produce valid information, an evaluation of professional practices has to assess the quality of all practices before, during and after the procedure under study. Several auditing techniques have been proposed for colonoscopy. The purpose of this work is to describe a straightforward original validated method for the prospective evaluation of professional practices in the field of colonoscopy applicable in all endoscopy units without increasing the staff work load. Pertinent quality-control criteria (14 items) were identified by the endoscopists at the Cochin Hospital and were compatible with: findings in the available literature; guidelines proposed by the Superior Health Authority; and application in any endoscopy unit. Prospective routine data were collected and the methodology validated by evaluating 50 colonoscopies every quarter for one year. The relevance of the criteria was assessed using data collected during four separate periods. The standard checklist was complete for 57% of the colonoscopy procedures. The colonoscopy procedure was appropriate according to national guidelines in 94% of cases. These observations were particularly noteworthy: the quality of the colonic preparation was insufficient for 9% of the procedures; complete colonoscopy was achieved for 93% of patients; and 0.38 adenomas and 0.045 carcinomas were identified per colonoscopy. This simple and reproducible method can be used for valid quality-control audits in all endoscopy units. In France, unit-wide application of this method enables endoscopists to validate 100 of the 250 points required for continuous medical training. This is a quality-control tool that can be applied annually, using a random month to evaluate any changes in routine practices.

Structure, Process, and Culture of Intensive Care Units Treating Patients with Severe Traumatic Brain Injury: Survey of Centers Participating in the American College of Surgeons Trauma Quality Improvement Program.

PubMed

Alali, Aziz S; McCredie, Victoria A; Mainprize, Todd G; Gomez, David; Nathens, Avery B

2017-10-01

Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program (ACS TQIP) to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI. One hundred forty-two TMDs (76%) completed the survey. Severe TBI patients are admitted to dedicated neurocritical care units in 52 hospitals (37%), trauma ICUs in 44 hospitals (31%), general ICUs in 34 hospitals (24%), and surgical ICUs in 11 hospitals (8%). Fifty-seven percent are closed units. Board-certified intensivists directed 89% of ICUs, whereas 17% were led by neurointensivists. Sixty percent of ICU directors were general surgeons. Thirty-nine percent of hospitals had critical care fellowships and 11% had neurocritical care fellowships. Fifty-nine percent of ICUs had standard order sets and 61% had standard protocols specific for TBI, with the most common protocol relating to intracranial pressure management (53%). Only 43% of TMDs were satisfied with the current level of neurosurgeons' engagement in the ICU management of TBI; 46% believed that neurosurgeons should be more engaged; 11% believed they should be less engaged. In the largest survey of North American ICUs caring for TBI patients, there is substantial variation in the current approaches to ICU care for TBI, highlighting multiple opportunities for comparative effectiveness research.

Robotics training program: evaluation of the satisfaction and the factors that influence success of skills training in a resident robotics curriculum.

PubMed

Lucas, Steven M; Gilley, David A; Joshi, Shreyas S; Gardner, Thomas A; Sundaram, Chandru P

2011-10-01

We present our experience of training residents in a weekend robotic training program to assess its effectiveness and perceived usefulness. Bimonthly training sessions were arranged such that residents could sign up for hour-long, weekend training sessions. They are required to complete four training sessions. Five tasks were scored for time and accuracy: Peg-Board, checkerboard, string running, pattern cutting, and suturing. Participants completed surveys (5-point Likert scale) regarding program utility, ease of attendance, and interest in future weekend training sessions. Mean number of trials completed by 19 residents was >4, and 16 completed the trials within an average of 13.7±8.1 mos. Significant improvements (P<0.05) were seen in final trials for Peg-Board accuracy (95.8% vs 79.0%), checkerboard deviation (4.8% vs 18.2%), and time (293 s vs 404 s), pattern-cutting time (257 s vs 399 s), and suture time (203 s vs 305 s). Time to previous session correlated with relative improvement in Peg-Board and pattern-cutting time (r=0.300 and 0.277, P=0.021 and 0.041), but no specific training interval was predictive of improvement. Residents found the course easy to attend (3.6), noted skills improvement (4.1), and found it useful (4.0). Training in the weekend sessions improved performance of basic tasks on the robot. Training interval had a modest effect on some exercises and may be more important for difficult tasks. This training program is a useful supplement to resident training and would be easy to implement in most programs.

A longitudinal evaluation of the preservice training and retention of kinship and nonkinship foster/adoptive families one and a half years after training.

PubMed

Christenson, Brian L; McMurtry, Jerry

2009-01-01

A comprehensive evaluation of the Parent Resources for Information Development and Education (PRIDE) foster/adopt preservice training and resource family development program was conducted one and a half years after training. Results indicate PRIDE is an effective training, family development, and retention program whose lessons stay with the participants well after they have completed the program. Knowledge tests were administered to participants before PRIDE training, at graduation from training, and 18 months after the completion of training. This is the subsequent study to the Christenson and McMurtry (2007) publication titled "A Comparative Evaluation of Preservice Training of Kinship and Non-Kinship Foster/Adoptive Families."

Assessing the need for communication training for specialists in poison information.

PubMed

Planalp, Sally; Crouch, Barbara; Rothwell, Erin; Ellington, Lee

2009-07-01

Effective communication has been shown to be essential to physician-patient communication and may be even more critical for poison control center (PCC) calls because of the absence of visual cues, the need for quick and accurate information exchange, and possible suboptimal conditions such as call surges. Professionals who answer poison control calls typically receive extensive training in toxicology but very little formal training in communication. An instrument was developed to assess the perceived need for communication training for specialists in poison information (SPIs) with input from focus groups and a panel of experts. Requests to respond to an online questionnaire were made to PCCs throughout the United States and Canada. The 537 respondents were 70% SPIs or poison information providers (PIPs), primarily educated in nursing or pharmacy, working across the United States and Canada, and employed by their current centers an average of 10 years. SPIs rated communication skills as extremely important to securing positive outcomes for PCC calls even though they reported that their own training was not strongly focused on communication and existing training in communication was perceived as only moderately useful. Ratings of the usefulness of 21 specific training units were consistently high, especially for new SPIs but also for experienced SPIs. Directors rated the usefulness of training for experienced SPIs higher for 5 of the 21 challenges compared to the ratings of SPIs. Findings support the need for communication training for SPIs and provide an empirical basis for setting priorities in developing training units.

Injury prevention in male youth soccer: Current practices and perceptions of practitioners working at elite English academies.

PubMed

Read, Paul J; Jimenez, Pablo; Oliver, Jon L; Lloyd, Rhodri S

2018-06-01

Forty-one practitioners inclusive of physiotherapists, sports scientists and strength and conditioning coaches from the academies of elite soccer clubs in the United Kingdom completed an on-line questionnaire which examined their: (1) background information; (2) perceptions of injury occurrence and risk factors; (3) screening and return to play; and (4) approach to designing and delivering injury prevention programmes with a response rate of 55% (41/75). Contact injuries were the most common mechanism reported and players between 13-16 years of age were perceived to be at the greatest risk. Pertinent risk factors included: reduced lower limb and eccentric hamstring strength, proprioception, muscle imbalances, and under developed foundational movement skills. Joint range of motion, jump tests, the functional movement screen, overhead and single leg squats were the most utilised screening methods. Training modalities rated in order of importance included: resistance training, flexibility development, agility, plyometrics and balance training. Training frequency was most commonly once or twice per week, during warm-ups, independent sessions or a combination of both. Injury prevention strategies in this cohort appear to be logical; however, the classification of injury occurrence and application of screening tools to identify "at risk" players do not align with existing research. The frequency and type of training used may also be insufficient to elicit an appropriate stimulus to address pertinent risk factors based on current recommendations.

The first year: employment patterns and job perceptions of nursing assistants in a rural setting.

PubMed

Meyer, Deborah; Raffle, Holly; Ware, Lezlee J

2014-09-01

The aim of this study was to follow rural certified nursing assistants (CNAs) (n=123) in the United States for 1 year post-training to identify retention and turnover issues in the long-term care (LTC) setting by exploring the CNAs' perceptions of the LTC work experience.   Turnover among CNAs impacts the quality of care, imposes a financial burden on facilities and taxpayers, and creates increased stress and workloads on those who remain. A longitudinal survey design was used to track individuals completing CNA training for 1 year.   At 1 year post-training, 53.7% of respondents currently worked in LTC, 30.9% worked in LTC and left, and the remaining 15.4% never worked in LTC. While the training site does not appear to impact retention, the first 6 months of employment appear critical. The CNAs cited pay as a reason for leaving LTC, but better pay did not characterize the jobs taken by the CNAs who left. Implications for nursing management. This study highlights the importance of the first 6 months of employment to retention and provides practical information for nurse managers evaluating the resource-effectiveness of hosting training programmes. Additionally, the key issues influencing retention were identified and practical suggestions for nurse managers to improve retention are provided. © 2012 John Wiley & Sons Ltd.

Four years of training in family medicine: implications for residency redesign.

PubMed

Sigmon, J Lewis; McPherson, Vanessa; Little, John M

2012-09-01

In light of the ongoing consideration for extending the length of residency education in family medicine in the United States, this paper reports the findings from a retrospective, qualitative study of six family physicians that elected to extend their residency training from 3 to 4 years. Each participant completed a written questionnaire and a structured personal interview focusing on various aspects of career development resulting from the additional year of training. The authors independently evaluated these interviews to identify major themes. All the participants were found to have been involved in teaching medicine, valued a more flexible and expanded curriculum, and appreciated their individualized curricula-based on their respective career interests. Given the opportunity, each would opt again for a fourth year of training. There were mixed opinions as to whether the fourth year should be required of all family medicine residents. Other perceived benefits reported were: a better opportunity to find a personally satisfactory practice, additional time for gaining clarity about career plans, and a higher beginning salary as a result of the additional skills and experiences gained. This study of mid-career physicians supports that a fourth-year (PGY4) curriculum in family medicine may enhance subsequent career satisfaction. Further studies of residents in other PGY4 training programs are necessary to assess outcomes comparing our findings as well as guide the discipline's leaders in residency redesign.

Tribal Renewable Energy Report - Final Report: Bishop Paiute Tribe Residential Solar Program. Phase 1 (DOE Award # DE-EE0006949)

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

Adkins, Brian; Castilone, Lisa

The objective of the project was to provide affordable renewable energy to 22 low income reservation homeowners; provide job training to tribal members and reduce air pollution by equivalent carbon offsets. The project exceeded grant objectives installing 66kW of rooftop solar on 22 low income single family homes and providing hands-on PV rooftop solar installation training to 24 tribal individuals (four more than planned). The project was a phased installment of an on-going partnership between the Tribe and GRID that was initiated in 2013 whereby 62 rooftop solar units were installed prior to this funded effort. The reported work inmore » this report describes the funded effort where US Department of Energy provided partial funding through grant award IE0006949 and marks the first phase of an effort matching California Solar SASH Initiative funding with DOE Office of Indian Energy Funding and brings the total for the program to 84 installed systems (running total of 271 Kw installed) and the end of the project. Tribal workforce development was a key aspect of the project and trained 24tribal members for a total 1168 cumulative on-job training hours. The solar installations and training efforts were fully completed by September of 2016 with 66.6 kW installed - 8 kW more than the original estimate stated in the grant application.« less

The American Medical Association Older Driver Curriculum for health professionals: changes in trainee confidence, attitudes, and practice behavior.

PubMed

Meuser, Thomas M; Carr, David B; Irmiter, Cheryl; Schwartzberg, Joanne G; Ulfarsson, Gudmundur F

2010-01-01

Few gerontology and geriatrics professionals receive training in driver fitness evaluation, state reporting of unfit drivers, or transportation mobility planning yet are often asked to address these concerns in the provision of care to older adults. The American Medical Association (AMA) developed an evidence-based, multi-media Curriculum to promote basic competences. This study evaluated reported changes in practice behaviors 3 months posttraining in 693 professionals trained via the AMA approach. Eight Teaching Teams, designated and trained by AMA staff, offered 22 training sessions across the United States in 2006 to 2007. Trainees (67% female; mean age 46) completed a pretest questionnaire and a posttest administered by mail. Physicians were the largest professional group (32%). Although many trainees acknowledged having conversations with patients about driving at pretest, few endorsed utilizing specific techniques recommended by the AMA prior to this training. The posttest response rate was 34% (n = 235). Significant improvements in reported attitudes, confidence, and practices were found across measured items. In particular, posttest data indicated new adoption of in-office screening techniques, chart documentation of driver safety concerns, and transportation alternative planning strategies. Findings suggest that a well-designed, one-time continuing education intervention can enhance health professional confidence and clinical practice concerning driver fitness evaluation and mobility planning. Targeted dissemination of this Curriculum (in-person and online) will allow more to benefit in the future.

[Cognitive therapy for patients with refractory irritable bowel syndrome].

PubMed

Wang, Weian; Pan, Guozong; Qian, Jiaming

2002-03-01

To investigate the procedure and tactics used in the cognitive therapy for patients with irritable bowel syndrome (IBS), and to evaluate the efficacy of cognitive therapy in the treatment of refractory IBS. A self-control study on the cognitive therapy for 22 patients with refractory IBS symptoms (according to Rome II criteria) was performed. The procedure of cognitive therapy included five steps, namely health education, patients' questioning, relaxing training, dissensitization training, and patients' homework for enforcing the effect of former four steps. The effects of cognitive therapy for IBS were evaluated by improvement of symptom-related-anxiety, index of symptom, quality of life specific for IBS and coping. All 22 cases completed cognitive therapy and first follow-up unit (FFU), at the end of FFU, clinical symptoms in all patients improved (P < 0.05), of them, 81.8% improved significantly (P < 0.001); at 12-months-follow-up, complete remission of clinical symptoms occurred in 72.7% (8/11) patients. Comparison of the scores of symptom-related-anxiety, index of symptom, quality of life specific IBS and coping at the end of 1st follow-up unit with that at basal level, the scores of symptom-anxiety, indexes of severity and frequency of symptoms decreased significantly (P < 0.001, respectively); the scores of depression and anxiety in SCL-90 also decreased significantly (P < 0.001). The scores of active coping rose significantly (P = 0.000). IBS-QOL improved significantly (P < 0.05), of them, dysphoria, body image, food avoidence improved very significantly (P < 0.001, respectively). Cognitive therapy for patients with refractory IBS is rational and effective. During cognitive therapy, we should follow the therapeutic procedure and the principle of individuation.

Interest in and perceived barriers to flexible-track residencies in general surgery: a national survey of residents and program directors.

PubMed

Abbett, Sarah K; Hevelone, Nathanael D; Breen, Elizabeth M; Lipsitz, Stuart R; Peyre, Sarah E; Ashley, Stanley W; Smink, Douglas S

2011-01-01

The American Board of Surgery now permits general surgery residents to complete their clinical training over a 6-year period. Despite this new policy, the level of interest in flexible scheduling remains undefined. We sought to determine why residents and program directors (PDs) are interested in flexible tracks and to understand implementation barriers. National survey. All United States general surgery residency programs that participate in the Association of Program Directors in Surgery listserv. PDs and categorical general surgery residents in the United States. Attitudes about flexible tracks in surgery training. A flexible track was defined as a schedule that allows residents to pursue nonclinical time during residency with resulting delay in residency completion. Of the 748 residents and 81 PDs who responded, 505 residents and 45 PDs were supportive of flexible tracks (68% vs 56%, p = 0.03). Residents and PDs both were interested in flexible tracks to pursue research (86% vs 82%, p = 0.47) and child bearing (69% vs 58%, p = 0.13), but residents were more interested in pursuing international work (74% vs 53%, p = 0.004) and child rearing (63% vs 44%, p = 0.02). Although 71% of residents believe that flexible-track residents would not be respected as the equal of other residents, only 17% of PDs indicated they would not respect flexible-track residents (p < 0.001). Most residents and PDs support flexible tracks, although they differ in their motivation and perceived barriers. This finding lends support to the new policy of the American Board of Surgery. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Emergency Airway Response Team Simulation Training: A Nursing Perspective.

PubMed

Crimlisk, Janet T; Krisciunas, Gintas P; Grillone, Gregory A; Gonzalez, R Mauricio; Winter, Michael R; Griever, Susan C; Fernandes, Eduarda; Medzon, Ron; Blansfield, Joseph S; Blumenthal, Adam

Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants. Twenty-four simulation-based classes of 4-hour sessions were conducted during a 12-week period. Sixty-three nurses from the emergency department (ED) and the intensive care units (ICUs) completed the simulation. Participants were evaluated before and after the simulation program with a knowledge-based test and a team dynamics and confidence questionnaire. Additional comparisons were made between ED and ICU nurses and between nurses with previous EART experience and those without previous EART experience. Comparison of presimulation (presim) and postsimulation (postsim) results indicated a statistically significant gain in both team dynamics and confidence and Knowledge Test scores (P < .01). There were no differences in scores between ED and ICU groups in presim or postsim scores; nurses with previous EART experience demonstrated significantly higher presim scores than nurses without EART experience, but there were no differences between these nurse groups at postsim. This project supports the use of simulation training to increase nurses' knowledge, confidence, and team dynamics in an EART response. Importantly, nurses with no previous experience achieved outcome scores similar to nurses who had experience, suggesting that emergency airway simulation is an effective way to train both new and experienced nurses.

Nutrition in Medicine: Nutrition Education for Medical Students and Residents

PubMed Central

Adams, Kelly M.; Kohlmeier, Martin; Powell, Margo; Zeisel, Steven H.

2015-01-01

Proper nutrition plays a key role in disease prevention and treatment. Many patients understand this link and look to physicians for guidance diet and physical activity. Actual physician practice, however, is often inadequate in addressing the nutrition aspects of diseases such as cancer, obesity, and diabetes. Physicians do not feel comfortable, confident, or adequately prepared to provide nutrition counseling, which may be related to suboptimal knowledge of basic nutrition science facts and understanding of potential nutrition interventions. Historically, nutrition education has been underrepresented at many medical schools and residency programs. Our surveys over a decade show that most medical schools in the United States are still not ensuring adequate nutrition education, and they are not producing graduates with the nutrition competencies required in medical practice. Physicians, residents, and medical students clearly need more training in nutrition assessment and intervention. The Nutrition in Medicine (NIM) project, established to develop and distribute a core nutrition curriculum for medical students, offers a comprehensive online set of courses free of charge to medical schools. The NIM medical school curriculum is widely used in the United States and abroad. A new initiative, Nutrition Education for Practicing Physicians, offers an innovative online medical nutrition education program for residents and other physicians-in-training, but with targeted, practice-based educational units designed to be completed in 15 minutes or less. The NIM project is strengthening medical nutrition practice by providing a free, comprehensive, online nutrition curriculum with clinically relevant, evidence-based medical education for undergraduate and postgraduate learners. PMID:20962306

Mifepristone by prescription: a dream in the United States but reality in Australia.

PubMed

Grossman, Daniel; Goldstone, Philip

2015-09-01

The requirement that mifepristone be dispensed only by physicians in offices, clinics or hospitals - and not by prescription in pharmacies - has likely limited uptake by providers in the United States. However, in several other countries, provision by prescription in pharmacies is allowed, including in Australia. Mifepristone was first registered in Australia in 2012, and in 2015, a composite package including 200 mg mifepristone and four tablets of misoprostol 200 mcg was registered. Both were approved as Schedule 4 medications, which require prescribing by a physician and may be dispensed at pharmacies. As part of the registration for both products, a risk management plan was instituted that has several components. First, physicians must be certified to prescribe mifepristone. General practitioners wishing to become certified must complete online training that includes prescribing requirements and managing the medical abortion process; obstetrician-gynecologists are exempt from the online learning module. Pharmacists must also be certified in order to dispense the medication, although this does not require additional training. When a pharmacist receives a prescription for mifepristone, she or he must confirm through a secure website that the prescriber is certified. In every region of the country, there are more certified prescribers and dispensers of mifepristone than the number of facilities providing abortion care. The experience in Australia demonstrates the feasibility of mifepristone by prescription and should be a model for expanding access to early medical abortion in the United States. Copyright © 2015 Elsevier Inc. All rights reserved.

Research Experiences for Teachers: The Impacts on Their Students and the Economy

NASA Astrophysics Data System (ADS)

Dubner, J.

2006-12-01

In contrast to most other professions, schools require no real apprenticeship training of science teachers. Imagine the evolution of the career of a modern scientist who was required to undertake an independent research position immediately on completion of his/her Ph.D. Or imagine the quality of United States medical care if physicians began practicing medicine and surgery immediately upon graduation from medical school. This is the situation for teachers. Overall, only 38% of United States teachers have had any on-the-job training in their first teaching position, and in some cases this consisted of a few meetings over the course of a year between the beginning teacher and the assigned mentor or master teacher. Research shows that teacher expertise is one of the most important factors in raising student achievement. A review of 60 studies found that investing in support for teacher expertise was the most cost-effective way to increase student achievement. Seeking ways to address these matters, scientists and educators throughout the United States developed a variety of intensive professional development programs for science teachers. Data derived from Columbia University's Summer Research Program for Science Teachers will be presented showing strong evidence that Research Experiences for Teachers (RET) are one of the most effective forms of professional development yet identified for secondary school science teachers. The economic benefits to city, state and federal government of teacher participation in an RET are very large, both in absolute terms and in comparison to program costs.

Use of Entertainment Elements in an Online Video Mini-Series to Train Pharmacy Preceptors.

PubMed

Cox, Craig D; Cheon, Jongpil; Crooks, Steven M; Lee, Jaehoon; Curtis, Jacob D

2017-02-25

Objective. To create an entertaining approach to training pharmacy preceptors. Design. A training program was developed to provide an innovative, entertaining, and flexible continuing education program for pharmacy preceptors. Three instructional design principles - providing an authentic context, offering a diversity of content, and engaging and maintaining attention - were foundational to this concept. The mini-series consisted of 12 online video episodes. Participants completed three reflective questions and one evaluation after watching each episode. Three months following completion of the training, a survey was distributed to analyze the long-term impact of the mini-series on precepting skills. Assessment. Two hundred two participants completed all 12 episodes. After completing the training series, the participants' confidence level in their knowledge pertaining to the objectives was significantly greater than before they started. Among the 32% of participants who responded to the three-month follow-up survey, the mean score for precepting confidence was 6.8 on a scale of 1 to 10 on which 1=no increase to 10=big increase. Also, 99% of participants indicated they would complete a similar training program and recommend to others. Conclusions. Feedback from the mini-series provides evidence of the effectiveness of its delivery format and use as a preceptor learning tool.

Use of Entertainment Elements in an Online Video Mini-Series to Train Pharmacy Preceptors

PubMed Central

Cheon, Jongpil; Crooks, Steven M.; Lee, Jaehoon; Curtis, Jacob D.

2017-01-01

Objective. To create an entertaining approach to training pharmacy preceptors. Design. A training program was developed to provide an innovative, entertaining, and flexible continuing education program for pharmacy preceptors. Three instructional design principles – providing an authentic context, offering a diversity of content, and engaging and maintaining attention – were foundational to this concept. The mini-series consisted of 12 online video episodes. Participants completed three reflective questions and one evaluation after watching each episode. Three months following completion of the training, a survey was distributed to analyze the long-term impact of the mini-series on precepting skills. Assessment. Two hundred two participants completed all 12 episodes. After completing the training series, the participants’ confidence level in their knowledge pertaining to the objectives was significantly greater than before they started. Among the 32% of participants who responded to the three-month follow-up survey, the mean score for precepting confidence was 6.8 on a scale of 1 to 10 on which 1=no increase to 10=big increase. Also, 99% of participants indicated they would complete a similar training program and recommend to others. Conclusions. Feedback from the mini-series provides evidence of the effectiveness of its delivery format and use as a preceptor learning tool. PMID:28289302

Shoulder arthroscopy simulator training improves shoulder arthroscopy performance in a cadaveric model.

PubMed

Henn, R Frank; Shah, Neel; Warner, Jon J P; Gomoll, Andreas H

2013-06-01

The purpose of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaveric model of shoulder arthroscopy. Seventeen first-year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and 9 of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The 2 groups were compared by use of Student t tests, and change over time within groups was analyzed with paired t tests. There were no observed differences between the 2 groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (P < .05). Time to completion was significantly faster in the simulator group compared with controls at the final evaluation (P < .05). No difference was observed between the groups on the subjective scores at the final evaluation (P = .98). Shoulder arthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy time to task completion in this cadaveric model. This study provides important additional evidence of the benefit of simulators in orthopaedic surgical training. There may be a role for simulator training in shoulder arthroscopy education. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Shoulder Arthroscopy Simulator Training Improves Shoulder Arthroscopy Performance in a Cadaver Model

PubMed Central

Henn, R. Frank; Shah, Neel; Warner, Jon J.P.; Gomoll, Andreas H.

2013-01-01

Purpose The purpose of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaver model of shoulder arthroscopy. Methods Seventeen first year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and nine of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The two groups were compared with students t-tests, and change over time within groups was analyzed with paired t-tests. Results There were no observed differences between the two groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (p<0.05). Time to completion was significantly faster in the simulator group compared to controls at final evaluation (p<0.05). No difference was observed between the groups on the subjective scores at final evaluation (p=0.98). Conclusions Shoulder arthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy time to task completion in this cadaver model. This study provides important additional evidence of the benefit of simulators in orthopaedic surgical training. Clinical Relevance There may be a role for simulator training in shoulder arthroscopy education. PMID:23591380

The Feasibility and Potential Impact of Brain Training Games on Cognitive and Emotional Functioning in Middle-Aged Adults.

PubMed

McLaughlin, Paula M; Curtis, Ashley F; Branscombe-Caird, Laura M; Comrie, Janna K; Murtha, Susan J E

2018-02-01

To investigate whether a commercially available brain training program is feasible to use with a middle-aged population and has a potential impact on cognition and emotional well-being (proof of concept). Fourteen participants (ages 46-55) completed two 6-week training conditions using a crossover (counterbalanced) design: (1) experimental brain training condition and (2) active control "find answers to trivia questions online" condition. A comprehensive neurocognitive battery and a self-report measure of depression and anxiety were administered at baseline (first time point, before training) and after completing each training condition (second time point at 6 weeks, and third time point at 12 weeks). Cognitive composite scores were calculated for participants at each time point. Study completion and protocol adherence demonstrated good feasibility of this brain training protocol in healthy middle-aged adults. Exploratory analyses suggested that brain training was associated with neurocognitive improvements related to executive attention, as well as improvements in mood. Overall, our findings suggest that brain training programs are feasible in middle-aged cohorts. We propose that brain training games may be linked to improvements in executive attention and affect by promoting cognitive self-efficacy in middle-aged adults.

Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

PubMed

Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

2016-08-18

To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the course achieved its intended aims with realistic simulation scenarios. Participants believed patient care, patient safety and team working would all improve with further human factors training (4.4-4.6). and felt that NT skills learnt through simulation-based training should become an integral component of their training program. Participants demonstrated improved understanding of non-technical performance, recognised its relevance to patient safety and expressed a desire for its integration in training.