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Sample records for high competency residents

  1. Measuring the competence of residents as teachers.

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    Zabar, Sondra; Hanley, Kathleen; Stevens, David L; Kalet, Adina; Schwartz, Mark D; Pearlman, Ellen; Brenner, Judy; Kachur, Elizabeth K; Lipkin, Mack

    2004-05-01

    Medical residents, frontline clinical educators, must be competent teachers. Typically, resident teaching competence is not assessed through any other means than gleaning learner's comments. We developed, evaluated, and integrated into our annual objective structured clinical examination a resident teaching skills assessment using "standardized" students. Faculty observers rated residents using a customized 19-item rating instrument developed to assess teaching competencies that were identified and defined as part of our project. This was feasible, acceptable, and valuable to all 65 residents, 8 students, and 16 faculty who participated. Teaching scenarios have potential as reliable, valid, and practical measures of resident teaching skills.

  2. Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

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    Erik E. Langenau

    2011-09-01

    Full Text Available Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME and American Osteopathic Association (AOA, residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE, also assess competency in several clinical domains.The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009.The sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component were merged and analyzed for relationships.Biomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings.A few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA and ACGME core competencies.

  3. [Competency-based Neurosurgery Residency Programme].

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    Lobato, Ramiro D; Jiménez Roldan, Luis; Alen, José F; Castaño, Ana M; Munarriz, Pablo M; Cepeda, Santiago; Lagares, Alfonso

    2016-01-01

    A programme proposal for competency-based Neurosurgery training adapted to the specialization project is presented. This proposal has been developed by a group of neurosurgeons commissioned by the SENEC (Spanish Society of Neurosurgery) and could be modified to generate a final version that could come into force coinciding with the implementation of the specialization programme. This document aims to facilitate the test of the new programme included in the online version of our journal. Total training period is 6 years; initial 2 years belong to the surgery specialization and remaining 4 years belong to core specialty period. It is a competency-based programmed based on the map used by the US Accreditation Council for Graduate Medical Education (ACGME) including the following domains of clinical competency: Medical knowledge, patient care, communication skills, professionalism, practice-based learning and improvement, health systems, interprofessional collaboration and professional and personal development. Subcompetencies map in the domains of Knowledge and Patient care (including surgical competencies) was adapted to the one proposed by AANS and CNS (annex 1 of the programme). A subcompetency map was also used for the specialization rotations. Resident's training is based on personal study (self-learning) supported by efficient use of information sources and supervised clinical practice, including bioethical instruction, clinical management, research and learning techniques. Resident evaluation proposal includes, among other instruments, theoretical knowledge tests, objective and structured evaluation of the level of clinical competency with real or standardised patients, global competency scales, 360-degree evaluation, clinical record audits, milestones for residents progress and self-assessment (annex 2). Besides, residents periodically assess the teaching commitment of the department's neurosurgeons and other professors participating in rotations, and annually

  4. Time- versus Competency-Based Residency Training.

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    Nguyen, Vu T; Losee, Joseph E

    2016-08-01

    Graduate medical education is at the brink of a paradigm shift in educating the next generation of physicians. Over 100 years ago, the Flexner report helped usher in the Halstedian residency, based on timed exposure and knowledge assessment as the cornerstones of medical education. The addition of operative case logs and respective board examinations to the current model of surgical education has served to establish practice minimums; however, they do not provide any assessment of actual operative capability or clinical competence. Although these facets have been tempered over time, one could argue that they currently exist only as surrogates for the true goal of all graduate medical education: the development of competent, graduating physicians, capable of independent and ethical practice. There now exists a growing body of evidence that competency-based medical education is this century's Flexnerian revolution. By the objective, subjective, and global assessment of competence, it is thought that we can more effectively and efficiently educate our trainees, provide much needed accountability to our individual patients and to the public as a whole, and establish a lasting model of self-motivated, lifelong learning.

  5. Demonstration of portfolios to assess competency of residents.

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    O'Sullivan, Patricia S; Reckase, Mark D; McClain, Tina; Savidge, Mildred A; Clardy, James A

    2004-01-01

    Residency educators are identifying approaches to measure resident competence. Portfolios are well suited since they require work already completed as part of patient care where competency must be demonstrated. This paper describes assessment of the reliability and validity of portfolios in a psychiatry residency program. This was a cross-sectional study across 4years of residency education. Using guidelines, 18 residents assembled portfolios containing five entries chosen from 13 skills. Trained raters scored the portfolios. Residents and faculty were interviewed about their perceptions. Generalizability results indicated five entries and two raters were sufficient for relative decisions. Six entries or a third rater would be sufficient for absolute decisions. Portfolio scores tended to improve with years of training and correlated with psychiatric knowledge but not clinical performance. Residents and faculty identified benefits to assembling a portfolio. Portfolios incorporate tasks embedded in the residency to provide evidence of resident competency. The results support that the score is reliable and valid.

  6. Assessing Knowledge Base on Geriatric Competencies for Emergency Medicine Residents

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    Teresita M. Hogan

    2014-07-01

    Full Text Available Introduction: Emergency care of older adults requires specialized knowledge of their unique physiology, atypical presentations, and care transitions. Older adults often require distinctive assessment, treatment and disposition. Emergency medicine (EM residents should develop expertise and efficiency in geriatric care. Older adults represent over 25% of most emergency department (ED volumes. Yet many EM residencies lack curricula or assessment tools for competent geriatric care. Fully educating residents in emergency geriatric care can demand large amounts of limited conference time. The Geriatric Emergency Medicine Competencies (GEMC are high-impact geriatric topics developed to help residencies efficiently and effectively meet this training demand. This study examines if a 2-hour didactic intervention can significantly improve resident knowledge in 7 key domains as identified by the GEMC across multiple programs. Methods: A validated 29-question didactic test was administered at six EM residencies before and after a GEMC-focused lecture delivered in summer and fall of 2009. We analyzed scores as individual questions and in defined topic domains using a paired student t test. Results: A total of 301 exams were administered; 86 to PGY1, 88 to PGY2, 86 to PGY3, and 41 to PGY4 residents. The testing of didactic knowledge before and after the GEMC educational intervention had high internal reliability (87.9%. The intervention significantly improved scores in all 7 GEMC domains (improvement 13.5% to 34.6%; p<0.001. For all questions, the improvement was 23% (37.8% pre, 60.8% post; P<0.001 Graded increase in geriatric knowledge occurred by PGY year with the greatest improvement post intervention seen at the PGY 3 level (PGY1 19.1% versus PGY3 27.1%. Conclusion: A brief GEMC intervention had a significant impact on EM resident knowledge of critical geriatric topics. Lectures based on the GEMC can be a high-yield tool to enhance resident knowledge of

  7. Validation of core competencies during residency training in anaesthesiology

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    Spies, Claudia

    2011-01-01

    Full Text Available Background and goal: Curriculum development for residency training is increasingly challenging in times of financial restrictions and time limitations. Several countries have adopted the CanMEDS framework for medical education as a model into their curricula of specialty training. The purpose of the present study was to validate the competency goals, as derived from CanMEDS, of the Department of Anaesthesiology and Intensive Care Medicine of the Berlin Charité University Medical Centre, by conducting a staff survey. These goals for the qualification of specialists stipulate demonstrable competencies in seven areas: expert medical action, efficient collaboration in a team, communications with patients and family, management and organisation, lifelong learning, professional behaviour, and advocacy of good health. We had previously developed a catalogue of curriculum items based on these seven core competencies. In order to evaluate the validity of this catalogue, we surveyed anaesthetists at our department in regard to their perception of the importance of each of these items. In addition to the descriptive acquisition of data, it was intended to assess the results of the survey to ascertain whether there were differences in the evaluation of these objectives by specialists and registrars. Methods: The questionnaire with the seven adapted CanMEDS Roles included items describing each of their underlying competencies. Each anaesthetist (registrars and specialists working at our institution in May of 2007 was asked to participate in the survey. Individual perception of relevance was rated for each item on a scale similar to the Likert system, ranging from 1 (highly relevant to 5 (not at all relevant, from which ratings means were calculated. For determination of reliability, we calculated Cronbach’s alpha. To assess differences between subgroups, we performed analysis of variance.Results: All seven roles were rated as relevant. Three of the seven

  8. Portfolios: possibilities for addressing emergency medicine resident competencies.

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    O'Sullivan, Patricia; Greene, Constance

    2002-11-01

    Portfolios are an innovative approach to evaluate the competency of emergency medicine residents. Three key characteristics add to their attractiveness. First, portfolios draw from the resident's actual work. Second, they require self-reflection on the part of the resident. Third, they are inherently practice-based learning since residents must review and consider their practice in order to begin the portfolio. This paper illustrates five different applications of portfolios. First, portfolios are applied to evaluating specific competencies as part of the training of emergency physicians. While evaluating specific competencies, the portfolio captures aspects of the general competencies. Second, the article illustrates using portfolios as a way to address a specific residency review committee (RRC) requirement such as follow-ups. Third is a description of how portfolios can be used to evaluate resident conferences capturing the competency of practice-based learning and possibly other competencies such as medical knowledge and patient care. Fourth, the authors of the article designed a portfolio as a way to demonstrate clinical competence. Fifth, they elaborate as to how a continuous quality improvement project could be cast within the portfolio framework. They provide some guidance concerning issues to address when designing the portfolios. Portfolios are carefully structured and not haphazard collections of materials. Following criteria is important in maintaining the validity of the portfolio as well as contributing to reliability. The portfolios can enhance the relationship between faculty and residents since faculty will suggest cases, discuss anomalies, and interact with the residents around the portfolio. The authors believe that in general portfolios can cover many of the general competencies specified by the ACGME while still focusing on issues important to emergency medicine. The authors believe that portfolios provide an approach to evaluation commensurate

  9. Psychiatry Resident Training in Cultural Competence: An Educator's Toolkit.

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    Corral, Irma; Johnson, Toni L; Shelton, Pheston G; Glass, Oliver

    2017-06-01

    Resident physicians training in psychiatry in the U.S. are required to master a body of knowledge related to cultural psychiatry; are expected to adopt attitudes that endorse the principles of cultural competence; and finally are expected to acquire specific cultural competence skills that facilitate working effectively with diverse patients. This article first provides an overview of the Accreditation Council for Graduate Medical Education (ACGME) competencies related to cultural competence, as well as the American Academy of Child and Adolescent Psychiatry's (AACAP) recommendations for the cultural competence training of child/adolescent fellows. Next, numerous print and electronic resources that can be used in cultural competence education in psychiatry are reviewed and discussed. Finally, we conclude by providing recommendations for psychiatry residency programs that we culled from model cultural competence curricula.

  10. Evaluation of Professional Role Competency during Psychiatry Residency

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    Grujich, Nikola N.; Razmy, Ajmal; Zaretsky, Ari; Styra, Rima G.; Sockalingam, Sanjeev

    2012-01-01

    Objective: The authors sought to determine psychiatry residents' perceptions on the current method of evaluating professional role competency and the use of multi-source feedback (MSF) as an assessment tool. Method: Authors disseminated a structured, anonymous survey to 128 University of Toronto psychiatry residents, evaluating the current mode of…

  11. Electrocardiographic interpretation skills of cardiology residents: are they competent?

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    Sibbald, Matthew; Davies, Edward G; Dorian, Paul; Yu, Eric H C

    2014-12-01

    Achieving competency at electrocardiogram (ECG) interpretation among cardiology subspecialty residents has traditionally focused on interpreting a target number of ECGs during training. However, there is little evidence to support this approach. Further, there are no data documenting the competency of ECG interpretation skills among cardiology residents, who become de facto the gold standard in their practice communities. We tested 29 Cardiology residents from all 3 years in a large training program using a set of 20 ECGs collected from a community cardiology practice over a 1-month period. Residents interpreted half of the ECGs using a standard analytic framework, and half using their own approach. Residents were scored on the number of correct and incorrect diagnoses listed. Overall diagnostic accuracy was 58%. Of 6 potentially life-threatening diagnoses, residents missed 36% (123 of 348) including hyperkalemia (81%), long QT (52%), complete heart block (35%), and ventricular tachycardia (19%). Residents provided additional inappropriate diagnoses on 238 ECGs (41%). Diagnostic accuracy was similar between ECGs interpreted using an analytic framework vs ECGs interpreted without an analytic framework (59% vs 58%; F(1,1333) = 0.26; P = 0.61). Cardiology resident proficiency at ECG interpretation is suboptimal. Despite the use of an analytic framework, there remain significant deficiencies in ECG interpretation among Cardiology residents. A more systematic method of addressing these important learning gaps is urgently needed. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  12. The Computer Book of the Internal Medicine Resident: competence acquisition and achievement of learning objectives.

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    Oristrell, J; Oliva, J C; Casanovas, A; Comet, R; Jordana, R; Navarro, M

    2014-01-01

    The Computer Book of the Internal Medicine resident (CBIMR) is a computer program that was validated to analyze the acquisition of competences in teams of Internal Medicine residents. To analyze the characteristics of the rotations during the Internal Medicine residency and to identify the variables associated with the acquisition of clinical and communication skills, the achievement of learning objectives and resident satisfaction. All residents of our service (n=20) participated in the study during a period of 40 months. The CBIMR consisted of 22 self-assessment questionnaires specific for each rotation, with items on services (clinical workload, disease protocolization, resident responsibilities, learning environment, service organization and teamwork) and items on educational outcomes (acquisition of clinical and communication skills, achievement of learning objectives, overall satisfaction). Associations between services features and learning outcomes were analyzed using bivariate and multivariate analysis. An intense clinical workload, high resident responsibilities and disease protocolization were associated with the acquisition of clinical skills. High clinical competence and teamwork were both associated with better communication skills. Finally, an adequate learning environment was associated with increased clinical competence, the achievement of educational goals and resident satisfaction. Potentially modifiable variables related with the operation of clinical services had a significant impact on the acquisition of clinical and communication skills, the achievement of educational goals, and resident satisfaction during the specialized training in Internal Medicine. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  13. [The Computer Book of the Internal Medicine resident: validity and reliability of a questionnaire for self-assessment of competences in internal medicine residents].

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    Oristrell, J; Casanovas, A; Jordana, R; Comet, R; Gil, M; Oliva, J C

    2012-12-01

    There are no simple and validated instruments for evaluating the training of specialists. To analyze the reliability and validity of a computerized self-assessment method to quantify the acquisition of medical competences during the Internal Medicine residency program. All residents of our department participated in the study during a period of 28 months. Twenty-two questionnaires specific for each rotation (the Computer-Book of the Internal Medicine Resident) were constructed with items (questions) corresponding to three competence domains: clinical skills competence, communication skills and teamwork. Reliability was analyzed by measuring the internal consistency of items in each competence domain using Cronbach's alpha index. Validation was performed by comparing mean scores in each competence domain between senior and junior residents. Cut-off levels of competence scores were established in order to identify the strengths and weaknesses of our training program. Finally, self-assessment values were correlated with the evaluations of the medical staff. There was a high internal consistency of the items of clinical skills competences, communication skills and teamwork. Higher scores of clinical skills competence and communication skills, but not in those of teamwork were observed in senior residents than in junior residents. The Computer-Book of the Internal Medicine Resident identified the strengths and weaknesses of our training program. We did not observe any correlation between the results of the self- evaluations and the evaluations made by staff physicians. The items of Computer-Book of the Internal Medicine Resident showed high internal consistency and made it possible to measure the acquisition of medical competences in a team of Internal Medicine residents. This self-assessment method should be complemented with other evaluation methods in order to assess the acquisition of medical competences by an individual resident. Copyright © 2012 Elsevier Espa

  14. Meeting American Geriatrics Society Competencies: Are Residents Meeting Expectations for Quality Care of Older Adults?

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    Bynum, Debra L; Wilson, Lindsay A; Ong, Thuan; Callahan, Kathryn E; Dalton, Thomas; Ohuabunwa, Ugochi

    2015-09-01

    In order to determine how often internal medicine and family medicine residents performed specific actions related to the geriatric competencies established by the American Geriatrics Society (AGS) when caring for older hospitalized adults, a cross-sectional anonymous survey of residents at the University of North Carolina, University of Washington, Wake Forest University, Duke University, and Emory University was undertaken. Data on frequency of self-reported behaviors were analyzed, with comparisons made for different levels of training, institution, and program. A total of 375 residents responded for an overall response rate of 48%. Residents reported that they often do not demonstrate all of the AGS recommended core competencies when caring for older adults in the hospital setting. Residents report more frequently performing activities that are routinely integrated into hospital systems such as reviewing medication lists, working with an interdisciplinary team, evaluating for inappropriate bladder catheters, and evaluating for pressure ulcers. There were no consistent differences between institutions and only minor differences noted between Family Medicine and Internal Medicine residents. Operationalizing core competencies by integrating them into hospital systems' quality process indicators may prompt more consistent high-quality care and ensure systems support residents' competence. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  15. Competency-based medical education and scholarship: Creating an active academic culture during residency.

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    Bourgeois, James A; Hategan, Ana; Azzam, Amin

    2015-10-01

    The competency-based medical education movement has been adopted in several medical education systems across the world. This has the potential to result in a more active involvement of residents in the educational process, inasmuch as scholarship is regarded as a major area of competency. Substantial scholarly activities are well within the reach of motivated residents, especially when faculty members provide sufficient mentoring. These academically empowered residents have the advantage of early experience in the areas of scholarly discovery, integration, application, and teaching. Herein, the authors review the importance of instituting the germinal stages of scholarly productivity in the creation of an active scholarly culture during residency. Clear and consistent institutional and departmental strategies to promote scholarly development during residency are highly encouraged.

  16. Supervisors' and residents' patient-education competency in challenging outpatient consultations

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    Wouda, Jan C.; van de Wiel, Harry B. M.

    2015-01-01

    Objectives: We compared supervisors' and residents' patient-education competency in challenging consultations in order to establish whether supervisors demonstrate sufficient patient-education competency to act credibly as role models and coaches for residents. Methods: All consultations conducted a

  17. Family Skills for General Psychiatry Residents: Meeting ACGME Core Competency Requirements

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    Berman, Ellen M.; Heru, Alison M.; Grunebaum, Henry; Rolland, John; Wood, Beatrice; Bruty, Heidi

    2006-01-01

    Objective: The authors discuss the knowledge, attitudes, and skills needed for a resident to be competent in supporting and working with families, as mandated by the residency review committee (RRC) core competencies. Methods: The RRC core competencies, as they relate to patients and their families, are reviewed. The Group for Advancement of…

  18. How Dutch medical specialists perceive the competencies and training needs of medical residents in healthcare management.

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    Berkenbosch, L; Bax, M; Scherpbier, A; Heyligers, I; Muijtjens, A M M; Busari, J O

    2013-04-01

    The Dutch postgraduate medical training has been revised to focus on seven competencies. The role as manager is one of these competencies. Recent studies show that this competency receives little attention during the residency training. In an earlier study, we discovered that residents perceived their competency as managers to be moderate. In this study, we investigated how medical specialists perceived the managerial competencies of medical residents and their need for management education. In September 2010, a 46-item questionnaire was designed which examined medical specialists' perceptions of the competency and needs of residents in the field of medical management. Two hundred ninety-eight specialists were invited via email to participate. Hundred twenty-nine specialists (43.3%) responded to our survey. They rated the residents' competencies in contract negotiating skills, knowledge of the healthcare system, and specialist department poorly. They felt that residents were competent in updating their medical knowledge. Ninety-four percent reported a need for training in management among residents. Preferred topics were time management and healthcare organization. The preferred training method was a workshop given during residency by an extramural expert. Dutch medical specialists perceive the management competencies of residents in some areas to be inadequate. They feel that training in medical management during residency is necessary.

  19. Evaluation of resident attitudes and self-reported competencies in health advocacy

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    Fok Mark C

    2010-11-01

    Full Text Available Abstract Background The CanMEDS Health Advocate role, one of seven roles mandated by the Royal College of Physicians and Surgeons Canada, pertains to a physician's responsibility to use their expertise and influence to advance the wellbeing of patients, communities, and populations. We conducted our study to examine resident attitudes and self-reported competencies related to health advocacy, due to limited information in the literature on this topic. Methods We conducted a pilot experience with seven internal medicine residents participating in a community health promotion event. The residents provided narrative feedback after the event and the information was used to generate items for a health advocacy survey. Face validity was established by having the same residents review the survey. Content validity was established by inviting an expert physician panel to review the survey. The refined survey was then distributed to a cohort of core Internal Medicine residents electronically after attendance at an academic retreat teaching residents about advocacy through didactic sessions. Results The survey was completed by 76 residents with a response rate of 68%. The majority agreed to accept an advocacy role for societal health needs beyond caring for individual patients. Most confirmed their ability to identify health determinants and reaffirmed the inherent requirements for health advocacy. While involvement in health advocacy was common during high school and undergraduate studies, 76% of residents reported no current engagement in advocacy activity, and 36% were undecided if they would engage in advocacy during their remaining time as residents, fellows or staff. The common barriers reported were insufficient time, rest and stress. Conclusions Medical residents endorsed the role of health advocate and reported proficiency in determining the medical and bio-psychosocial determinants of individuals and communities. Few residents, however, were

  20. Development of RAD-Score: A Tool to Assess the Procedural Competence of Diagnostic Radiology Residents.

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    Isupov, Inga; McInnes, Matthew D F; Hamstra, Stan J; Doherty, Geoffrey; Gupta, Ashish; Peddle, Susan; Jibri, Zaid; Rakhra, Kawan; Hibbert, Rebecca M

    2017-04-01

    The purpose of this study is to develop a tool to assess the procedural competence of radiology trainees, with sources of evidence gathered from five categories to support the construct validity of tool: content, response process, internal structure, relations to other variables, and consequences. A pilot form for assessing procedural competence among radiology residents, known as the RAD-Score tool, was developed by evaluating published literature and using a modified Delphi procedure involving a group of local content experts. The pilot version of the tool was tested by seven radiology department faculty members who evaluated procedures performed by 25 residents at one institution between October 2014 and June 2015. Residents were evaluated while performing multiple procedures in both clinical and simulation settings. The main outcome measure was the percentage of residents who were considered ready to perform procedures independently, with testing conducted to determine differences between levels of training. A total of 105 forms (for 52 procedures performed in a clinical setting and 53 procedures performed in a simulation setting) were collected for a variety of procedures (eight vascular or interventional, 42 body, 12 musculoskeletal, 23 chest, and 20 breast procedures). A statistically significant difference was noted in the percentage of trainees who were rated as being ready to perform a procedure independently (in postgraduate year [PGY] 2, 12% of residents; in PGY3, 61%; in PGY4, 85%; and in PGY5, 88%; p radiology trainees with high levels of construct validity in multiple domains. Implementation of the tool in the radiology residency curriculum is planned and can play an instrumental role in the transition to competency-based radiology training.

  1. Competency-based Residency Training: The Next Advance in Graduate Medical Education.

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    Long, Donlin M.

    2000-01-01

    Proposes replacing the current approach to medical residents' education, which specifies a fixed time of training, with competency-based training. Reviews the basis of traditional residency training and its problems (both the fixed time and uncertainty of evaluation methods). Discusses the competency-based approach, probability that some residents…

  2. Psychiatric Residents' Views of Quality of Psychotherapy Training and Psychotherapy Competencies: A Multisite Survey

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    Calabrese, Christina; Sciolla, Andres; Zisook, Sidney; Bitner, Robin; Tuttle, Jeffrey; Dunn, Laura B.

    2010-01-01

    Objective: Few studies of residents' attitudes toward psychotherapy training exist. The authors examined residents' perceptions of the quality of their training, support for training, their own competence levels, and associations between self-perceived competence and perceptions of the training environment. Methods: An anonymous, web-based…

  3. A Theory of Competence in Anesthesiology: Faculty Perspectives on Resident Performance

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    Street, John P.

    2009-01-01

    This study was conducted to develop a theory of resident competence in anesthesiology and was guided by this research question: from the perspective of anesthesiology faculty members, "What are the attributes and indicators of clinical competence in residents?" The author used a grounded theory approach for this multi-case, multi-site…

  4. Assessment of Competence: The Accreditation Council for Graduate Medical Education/Residency Review Committee Perspective.

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    Potts, John R

    2016-02-01

    Competency is an individual trait. As an agency that accredits programs and institutions, the Accreditation Council for Graduate Medical Education (ACGME) does not define or access competency. However, in the past 15 years the ACGME has promulgated several initiatives to aid programs in the assessment of the competence of their residents and fellows. Those initiatives include the Outcomes Project (which codified the competencies), the Milestones, and the Clinical Learning Environment Review Program. In the near future, the ACGME will implement an initiative by which programs can develop and study the results of competency-based residency curricula.

  5. Effectiveness of a Core-Competency-based Program on Residents' Learning and Experience.

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    Charles, Lesley; Triscott, Jean; Dobbs, Bonnie; Tian, Peter George; Babenko, Oksana

    2016-06-01

    The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency-based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency-based program on residents' learning and their training experience as compared to residents trained using learning objectives. The data from the 2007-2013 COE residents were used in the study, with nine and eight residents trained in the LO and CC programs, respectively. Residents' learning was measured using preceptors' evaluations of residents' skills/abilities throughout the program (118 evaluations in total). Residents' rating of training experience was measured using the Graduate's Questionnaire which residents completed after graduation. For residents' learning, overall, there was no significant difference between the two programs. However, when examined as a function of the four CanMEDS roles, there were significant increases in the CC residents' scores for two of the CanMEDS roles: Communicator/Collaborator/Manager and Scholar compared to residents in the LO program. With respect to residents' training experience, seven out of ten program components were rated by the CC residents higher than by the LO residents. The implementation of a COE CC program appears to facilitate resident learning and training experience.

  6. Ratings of Residents' Clinical Competence and Performance on Certification Examination.

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    Norcinin, John J.; And Others

    1987-01-01

    A study of the correlation between certification test results and ratings of clinical competence for graduate medical students in internal medicine during a six-year period found strong correlations on both individual and general indicators of competence. (MSE)

  7. A core competency-based objective structured clinical examination (OSCE) can predict future resident performance.

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    Wallenstein, Joshua; Heron, Sheryl; Santen, Sally; Shayne, Philip; Ander, Douglas

    2010-10-01

    This study evaluated the ability of an objective structured clinical examination (OSCE) administered in the first month of residency to predict future resident performance in the Accreditation Council for Graduate Medical Education (ACGME) core competencies. Eighteen Postgraduate Year 1 (PGY-1) residents completed a five-station OSCE in the first month of postgraduate training. Performance was graded in each of the ACGME core competencies. At the end of 18 months of training, faculty evaluations of resident performance in the emergency department (ED) were used to calculate a cumulative clinical evaluation score for each core competency. The correlations between OSCE scores and clinical evaluation scores at 18 months were assessed on an overall level and in each core competency. There was a statistically significant correlation between overall OSCE scores and overall clinical evaluation scores (R = 0.48, p competencies of patient care (R = 0.49, p competencies. An early-residency OSCE has the ability to predict future postgraduate performance on a global level and in specific core competencies. Used appropriately, such information can be a valuable tool for program directors in monitoring residents' progress and providing more tailored guidance. © 2010 by the Society for Academic Emergency Medicine.

  8. The development and application of an instrument for assessing resident competence during preanesthesia consultation.

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    de Oliveira Filho, Getúlio Rodrigues; Schonhorst, Leonardo

    2004-07-01

    In this study, we aimed to construct, validate, and apply an instrument for assessing resident performance at outpatient preanesthesia consultation (PAC). A focus group and a Delphi panel of experts defined component items of a typical outpatient PAC, which could be used as indicators of competence. Items were incorporated in a checklist, which was further validated in a sample of consultations performed by board-certified anesthesiologists. The resulting instrument contained 37 items, grouped into five domains (physician-patient relationship, medical history, physical examination, patient education, and preanesthesia records), with high construct validity, high discriminant validity, moderate internal consistency, and high probability of inter-raters agreement. The instrument was applied to evaluate the performance of seven first-year residents at 317 consecutive PAC. Data were analyzed by constructing exponentially weighted moving average charts for domain and total scores. Statistically significant differing levels of performance could be consistently detected. Applying exponentially weighted moving average charts to the sequential analysis of the developed checklist scores can reliably assess resident performance at the devised criteria. The Preanesthesia Consultation Scoring Checklist is a potentially useful instrument for both formative and summative assessment of residents during their training in processes involved in outpatient preanesthesia evaluation.

  9. Teaching and Assessing Systems-based Competency in Ophthalmology Residency Training Programs

    NARCIS (Netherlands)

    Lee, Andrew G.; Beaver, Hilary A.; Greenlee, Emily; Oetting, Thomas A.; Boldt, H. Culver; Olson, Richard; Abramoff, Michael; Carter, Keith

    2007-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) has mandated that residency programs, including ophthalmology, teach and assess specific competencies, including systems-based learning. We review the pertinent literature on systems-based learning for ophthalmology and recommend speci

  10. Outcome-based residency education: teaching and evaluating the core competencies in plastic surgery.

    Science.gov (United States)

    Bancroft, Gregory N; Basu, C Bob; Leong, Mimi; Mateo, Carol; Hollier, Larry H; Stal, Samuel

    2008-06-01

    Through its oversight of residency education in the United States, the Accreditation Council for Graduate Medical Education has mandated new structural changes in resident education with its newly created core competencies and an emphasis on outcomes-based education. These core competencies represent the central areas in which the Accreditation Council for Graduate Medical Education believes a plastic surgery resident should receive adequate and appropriate education and training. In addition, as part of this outcomes-based education, residents are to be evaluated on their level of mastery in these core competencies. Increasingly, the Accreditation Council for Graduate Medical Education will assess the ability of residency programs to integrate the teaching and evaluating of the core competencies in their accreditation process of plastic surgery residency programs. This shift in residency evaluation initiated by the Outcomes Project by the Accreditation Council for Graduate Medical Education will have a significant impact in how plastic surgery residents are taught and, as importantly, evaluated in the coming years. The objectives of this work were as follows: (1) to outline the different methods available to foster a core competency-based plastic surgery training curriculum and (2) to serve as a primer to help both full-time academic and clinical faculty to further develop their curriculum to successfully teach and constructively evaluate their residents in the core competencies in accordance with the Accreditation Council for Graduate Medical Education guidelines. At the conclusion of this review, the reader should have a better understanding of what is necessary to formulate and help foster a plastic surgery core competency curriculum, particularly with an emphasis on the contemporary methods used for outcomes evaluations.

  11. Does operative experience during residency correlate with reported competency of recent general surgery graduates?

    Science.gov (United States)

    Safavi, Arash; Lai, Sarah; Butterworth, Sonia; Hameed, Morad; Schiller, Dan; Skarsgard, Erik

    2012-01-01

    Background Identification of attributes of residency training that predict competency would improve surgical education. We hypothesized that case experience during residency would correlate with self-reported competency of recent graduates. Methods Aggregate case log data of residents enrolled in 2 general surgery programs were collected over a 12-month period and stratified into Surgical Council on Resident Education (SCORE) categories. We surveyed recent (surgery (4, 0.04%), and the least common EU procedure was abdomen–spleen (1, 0.1%). The questionnaire response rate was 45%. For EC procedures, self-reported competency was highest in skin and soft tissue, thoracic and head and neck (each 100%) and lowest in vascular–venous (54%), whereas for EU procedures it was highest in abdomen–general (100%) and lowest in vascular–arterial (62%). The correlation between case volume and self-reported competency was poor (R = 0.2 for EC procedures). Conclusion Self-reported competency correlates poorly with operative case experience during residency. Other curriculum factors, including specific rotations and timing, balance between inpatient and outpatient surgical experience and competition for cases, may contribute to procedural competency acquisition during residency. PMID:22854144

  12. Assessing Residents' Confidence in the Context of Pharmacotherapy Competence.

    Science.gov (United States)

    Rakofsky, Jeffrey J; Garlow, Steven J; Haroon, Ebrahim; Hermida, Adriana P; Young, John Q; Dunlop, Boadie W

    2017-06-01

    We aimed to determine whether residents' confidence initiating medications increased with the number of times they prescribed individual medications and to quantify the relationship between prescription frequency and gains in confidence. From July 2011 to June 2014, PGY-3 residents completed a survey of confidence levels at their psychopharmacology clinic orientation and then again 12 months later. The Emory Healthcare electronic medical record was used to identify all medications prescribed by each resident during their 12-month rotation and the frequency of these prescriptions. Confidence in initiating treatment with all medicines/medication classes increased over the 12-month period. For three of the medication classes for which residents indicated they were least confident at orientation, the number of prescriptions written during the year was significantly associated with an increase in confidence. Measuring resident confidence is a relevant and achievable outcome and provides data for educators regarding the amount of experience needed to increase confidence.

  13. Development of a Tool to Assess Resident Physicians' Perceived Competence for Patient-Centered Obesity Counseling

    Science.gov (United States)

    Burton, Amy M.; Brezausek, Carl M.; Hendricks, Peter S.; Agne, April A.; Hankins, Shirley L.; Cherrington, Andrea L.

    2015-01-01

    Physicians report a number of barriers to obesity counseling, among them low perceived competence in the ability to counsel. While there is increasing recognition of the need for resident training on counseling, implementation requires residency programs to have the necessary curricula and tools to evaluate training effectiveness. This study's…

  14. International plastic surgery missions: a framework for resident education using the CanMEDS competencies.

    Science.gov (United States)

    White, Colin P; Lecours, Catherine; Bortoluzzi, Patricia; Caouette-Laberge, Louise; Ying, Yvonne

    2013-10-01

    Residency education has shifted over the past decade in an attempt to graduate well-rounded physicians. There is a recognition that a physician's abilities must extend beyond medical knowledge. The Royal College of Physicians and Surgeons of Canada introduced the CanMEDS physician competency framework in 2005. The framework provides 7 areas of competencies that are aimed at providing improved patient care. These competencies are medical expert, communicator, collaborator, manager, health advocate, scholar, and professional. Teaching and evaluating many of these competencies is often challenging for residency training programs. We believe that international surgical missions provide a prime opportunity to teach and evaluate all CanMEDS' roles.Plastic surgery is a field with many different organizations involved in international surgery. Many plastic surgery training programs offer opportunities for residents to become involved in these international surgical missions. Through these trips, residents gain surgical experience, see a variety and volume of clinical cases, and have the opportunity to travel to a foreign country and experience different cultures. We believe that international plastic surgery surgical missions also provide an exceptional micro environment for the teaching of CanMEDS roles. Using examples from residents' personal experiences on international plastic surgery missions to China, Mali, and Cambodia, we describe the benefits of these missions in transferring the CanMEDS competencies to resident training.

  15. Toward competency-based curricula in patient-centered spiritual care: recommended competencies for family medicine resident education.

    Science.gov (United States)

    Anandarajah, Gowri; Craigie, Frederic; Hatch, Robert; Kliewer, Stephen; Marchand, Lucille; King, Dana; Hobbs, Richard; Daaleman, Timothy P

    2010-12-01

    Spiritual care is increasingly recognized as an important component of medical care. Although many primary care residency programs incorporate spiritual care into their curricula, there are currently no consensus guidelines regarding core competencies necessary for primary care training. In 2006, the Society of Teachers of Family Medicine's Interest Group on Spirituality undertook a three-year initiative to address this need. The project leader assembled a diverse panel of eight educators with dual expertise in (1) spirituality and health and (2) family medicine. The multidisciplinary panel members represented different geographic regions and diverse faith traditions and were nationally recognized senior faculty. They underwent three rounds of a modified Delphi technique to achieve initial consensus regarding spiritual care competencies (SCCs) tailored for family medicine residency training, followed by an iterative process of external validation, feedback, and consensus modifications of the SCCs. Panel members identified six knowledge, nine skills, and four attitude core SCCs for use in training and linked these to competencies of the Accreditation Council for Graduate Medical Education. They identified three global competencies for use in promotion and graduation criteria. Defining core competencies in spiritual care clarifies training goals and provides the basis for robust curricula evaluation. Given the breadth of family medicine, these competencies may be adaptable to other primary care fields, to medical and surgical specialties, and to medical student education. Effective training in this area may enhance physicians' ability to attend to the physical, mental, and spiritual needs of patients and better maintain sustainable healing relationships.

  16. Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum

    Directory of Open Access Journals (Sweden)

    Shellenberger Sylvia

    2010-05-01

    Full Text Available Abstract Background This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008, presents a model curriculum for Family Medicine residency training in substance abuse. Methods The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME. The curriculum provides basic training in high risk substance use to all residents, while also addressing current training challenges presented by U.S. work hour regulations, increasing international diversity of Family Medicine resident trainees, and emerging new primary care practice models. Results This paper offers a core curriculum, focused on screening, brief intervention and referral to treatment, which can be adapted by residency programs to meet their individual needs. The curriculum encourages direct observation of residents to ensure that core skills are learned and trains residents with several "new skills" that will expand the basket of substance abuse services they will be equipped to provide as they enter practice. Conclusions Broad-based implementation of a comprehensive Family Medicine residency curriculum should increase the ability of family physicians to provide basic substance abuse services in a primary care context. Such efforts should be coupled with faculty development initiatives which ensure that sufficient trained faculty are available to teach these concepts and with efforts by major Family Medicine organizations to implement and enforce residency requirements for

  17. Spanish language immersion and reinforcement during residency: a model for rapid acquisition of competency.

    Science.gov (United States)

    Valdini, Anthony; Early, Scott; Augart, Carolyn; Cleghorn, G Dean; Miles, Helene C R

    2009-07-01

    Residencies serving non-English-speaking populations face the challenge of language training in addition to usual resident education issues. The clinic for the Lawrence Family Medicine residency is based in a 45,000-person Community Health Center serving a majority Spanish-language preference population. Although translators are available, they increase visit time for patients. Three successive intern classes and one faculty member (n = 24) participated in a preresidency, 10-day immersion program at a nearby language institute; thrice-monthly classroom instruction for a year; and personal instruction during continuity clinics by a teacher/translator during the R1 year. An independent examiner tested participants (average age = 29.5; 15 female) using a competency examination based on American Council of Teachers of Foreign Languages scoring. Prior Spanish preparation averaged 2 years in high school and 1 year of college, but was variable. Results were compared with Tukey's Honestly Significant Differences test of repeated measures. All individuals improved following immersion, 4.8 to 6.3, (p immersion, and continued improvement following 6 months of reinforcement.

  18. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    Science.gov (United States)

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  19. Welcome to cultural competency: surgery's efforts to acknowledge diversity in residency training.

    Science.gov (United States)

    Ly, Catherine L; Chun, Maria B J

    2013-01-01

    Although cultural competency is not a new concept in healthcare, it has only recently been formally embraced as important in the field of surgery. All physicians, including and especially surgeons, must acknowledge the potential influence of culture in order to provide effective and equitable care for patients of all backgrounds. The Accreditation Council for Graduate Medical Education (ACGME) recognizes cultural competency as a component of "patient care," "professionalism," and "interpersonal and communication skills." A systematic literature search was conducted using the MEDLINE, EBSCOhost, Web of Science, and Google Scholar databases. All publications focusing on surgical residents and the assessment of patient care, professionalism, interpersonal and communication skills, or specifically cultural competency and/or were considered. This initial search resulted in 12 articles. To further refine the review, publications discussing curricula in residencies other than surgery, the assessment of technical, or clinical skills and/or without any explicit focus on cultural competency were excluded. Based on the specified inclusion and exclusion criteria, 5 articles were selected. These studies utilized various methods to improve surgical residents' cultural competency, including lectures, Objective Structural Clinical Examinations (OSCE), and written exercises and evaluations. A number of surgical residency programs have made promising strides in training culturally competent surgeons. Ultimately, in order to maximize our collective efforts to improve the quality of health care, the development of cultural competency curricula must be made a priority and such training should be a requirement for all trainees in surgical residency programs. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. Electrodiagnostic medicine skills competency in physical medicine and rehabilitation residents: a method for development and assessment.

    Science.gov (United States)

    Brown, David; Cuccurullo, Sara; Lee, Joseph; Petagna, Ann; Strax, Thomas

    2008-08-01

    This project sought to create an educational module including evaluation methodology to instruct physical medicine and rehabilitation (PM&R) residents in electrodiagnostic evaluation of patients with neuromuscular problems, and to verify acquired competencies in those electrodiagnostic skills through objective evaluation methodology. Sixteen residents were trained by board-certified neuromuscular and electrodiagnostic medicine physicians through technical training, lectures, and review of self-assessment examination (SAE) concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill attainment were measured in (1) clinical skill in diagnostic procedures via a procedure checklist, (2) diagnosis and ability to design a patient-care management plan via chart simulated recall (CSR) exams, (3) physician/patient interaction via patient surveys, (4) physician/staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient-care report and to document a patient-care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME). To test the success of the standardized educational module, data were collected on an ongoing basis. Objective measures compared resident SAE scores in electrodiagnostics (EDX) before and after institution of the comprehensive EDX competency module in a PM&R residency program. Fifteen of 16 residents (94%) successfully demonstrated proficiency in every segment of the evaluation element of the educational module by the end of their PGY-4 electrodiagnostic rotation. The resident who did not initially pass underwent remedial coursework and passed on the second attempt. Furthermore, the

  1. A comprehensive collaborative patient safety residency curriculum to address the ACGME core competencies.

    Science.gov (United States)

    Singh, Ranjit; Naughton, Bruce; Taylor, John S; Koenigsberg, Marlon R; Anderson, Diana R; McCausland, Linda L; Wahler, Robert G; Robinson, Amanda; Singh, Gurdev

    2005-12-01

    Patient safety currently receives only scant attention in most residency curricula. Safety is a subject that transcends the US Accreditation Council for Graduate Medical Education's 6 core competencies. To design and implement a new patient safety curriculum in collaboration with the Schools of Nursing and Pharmacy, in such a way as to address all 6 competencies. The curriculum applies to a university-based family medicine residency programme with 45 residents at 5 sites, including urban, suburban and rural sites. CURRICULUM DESIGN: The curriculum includes introductory workshops for faculty and residents, a series of didactic courses, individual portfolios and a series of small group exercises including chart reviews, case presentations and a longitudinal quality improvement project. The activities are run by a multidisciplinary team. Main outcome measures include assessment of resident performance in curriculum activities and in an annual objective structured clinical examination (OSCE) that includes standardised patient interviews, simulations and a written examination. Programme evaluation will include comparison of OSCE performance with that at a neighbouring residency. Residents identified safety problems and system-based solutions using a safety journal. Cases of polypharmacy were identified using journals and chart reviews, and medication changes proposed and discussed. At resident practice sites, residents identified safety priorities based on a staff survey and proposed system-based solutions. Results of the OSCE will be presented elsewhere. A new patient safety curriculum was successfully introduced into a family medicine residency. The curriculum integrates patient safety into residents' daily activities and incorporates input from the disciplines of nursing and pharmacy so as to help build more effective clinical teams and inculcate a culture of safety.

  2. FEATURES OF VALUE ORIENTATIONS OF INTERCULTURAL COMPETENCE ON THE EXAMPLE OF IRKUTSK RESIDENTS

    Directory of Open Access Journals (Sweden)

    Alexandra Mikhailovna Zakharova

    2017-04-01

    Full Text Available The article is devoted to actual topic of intercultural competence. The subject of research is the impact of value orientations on the intercultural competence level. In this regard, the present research aims to: find the values that are valid for residents of the Irkutsk region and reveal the influence of value orientations on the intercultural competence level. Socio-psychological research was based on two methods measuring value orientations – Shalom Schwartz questionnaire, and author’s questionnaire by A. Zakharova and S. Gurieva, dedicated to intercultural competence. We used the Spearman correlation analysis and comparative analysis of average. Data was processed in IBM SPSS Statistics 21 program. The study revealed values, significant and insignificant for Irkutsk citizens. Correlation of intercultural competence level with value orientations, was also detected. The Conclusion of the research: safety is the most important for Irkutsk residents, the second in importance is kindness, the third is tradition; Insignificant value – is stimulation, then hedonism and the most insignificant - power; The higher the level of intercultural competence is, the more important traditions, conformity, universalism and safety are. The practical significance of the socio-psychological research is the method developed for studying the intercultural competence level, helping people to avoid ethnic conflicts and create a mutually beneficial relationship in spite of the cultural differences.

  3. Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians.

    Science.gov (United States)

    Neff, Joshua; Knight, Kelly R; Satterwhite, Shannon; Nelson, Nick; Matthews, Jenifer; Holmes, Seth M

    2017-04-01

    The influence of societal inequities on health has long been established, but such content has been incorporated unevenly into medical education and clinical training. Structural competency calls for medical education to highlight the important influence of social, political, and economic factors on health outcomes. This article describes the development, implementation, and evaluation of a structural competency training for medical residents. A California family medicine residency program serving a patient population predominantly (88 %) with income below 200 % of the federal poverty level. A cohort of 12 residents in the family residency program. The training was designed to help residents recognize and develop skills to respond to illness and health as the downstream effects of social, political, and economic structures. The training was evaluated via qualitative analysis of surveys gathered immediately post-training (response rate 100 %) and a focus group 1 month post-training (attended by all residents not on service). Residents reported that the training had a positive impact on their clinical practice and relationships with patients. They also reported feeling overwhelmed by increased recognition of structural influences on patient health, and indicated a need for further training and support to address these influences.

  4. A Practical Approach to Implementing the Core Competencies in a Child and Adolescent Psychiatry Residency Program

    Science.gov (United States)

    Dingle, Arden D.; Sexson, Sandra B.

    2007-01-01

    Objective: The authors describe the development and implementation of the Accreditation Council for Graduate Medical Education's core competencies in a child and adolescent psychiatry residency program. Method: The authors identify the program's organizational approach and participants and detail various strategies and methods of defining,…

  5. A Practical Approach to Implementing the Core Competencies in a Child and Adolescent Psychiatry Residency Program

    Science.gov (United States)

    Dingle, Arden D.; Sexson, Sandra B.

    2007-01-01

    Objective: The authors describe the development and implementation of the Accreditation Council for Graduate Medical Education's core competencies in a child and adolescent psychiatry residency program. Method: The authors identify the program's organizational approach and participants and detail various strategies and methods of defining,…

  6. Trends in the Medical Knowledge and Clinical Competence of Graduates of Internal Medicine Residency Training Programs.

    Science.gov (United States)

    Norcini, John J.; And Others

    1991-01-01

    A study assessed the effectiveness of medical resident training programs during 1983-88 by evaluating students' certification scores and comparing them to the program's evaluation of students' clinical competence. Results are reported and analyzed for top-rated, university-affiliated, and non-university-affiliated programs, focusing on trends over…

  7. An Apprenticeship Rotation Teaches Chief Residents Nontechnical Skills and ACGME Core Competencies.

    Science.gov (United States)

    Kwakye, Gifty; Chen, Xiaodong Phoenix; Havens, Joaquim M; Irani, Jennifer L; Yule, Steven; Smink, Douglas S

    2015-01-01

    Traditionally, surgical training has used an apprenticeship model but has more recently moved to a service-based model, with groups of residents working with groups of attending surgeons. We developed an apprenticeship rotation to enhance one-on-one interaction between chief residents and selected faculty. We hypothesized that the apprenticeship rotation would be effective for teaching nontechnical skills (NTS) and core competencies. An apprenticeship rotation was created at a university-based surgery residency in which each chief resident selected a single attending surgeon with whom to work exclusively with for a 4-week period. Emphasis was placed on teaching intraoperative NTS as well as the 4 difficult-to-teach Accreditation Council for Graduate Medical Education core competencies (DCC): Interpersonal and Communication Skills, Practice-Based Learning and Improvement, Professionalism, and Systems-Based Practice. Participants were surveyed afterwards about their rotation using a 5-point Likert scale. A Wilcoxon signed rank test was used to compare differences depending on data distribution. All (13/13) the chief residents and 67% (8/12) faculty completed the survey. Overall, 85% of residents and 87.5% of faculty would recommend the rotation to other residents/faculty members. Both residents and faculty reported improvement in trainees' technical skills and NTS. Residents reported improvement in all 4 DCC, particularly, Practice-Based Learning and Improvement, Professionalism, and Interpersonal and Communication Skills. The apprenticeship rotation is an effective means of teaching residents both NTS and DCC essential for independent practice. Consideration should be given to introducing this program into surgical curricula nationally. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. Identifying and Eliminating Deficiencies in the General Surgery Resident Core Competency Curriculum.

    Science.gov (United States)

    Tapia, Nicole M; Milewicz, Allen; Whitney, Stephen E; Liang, Michael K; Braxton, Carla C

    2014-06-01

    Although the Accreditation Council for Graduate Medical Education has defined 6 core competencies required of resident education, no consensus exists on best practices for reaching resident proficiency. Surgery programs must develop resourceful methods to incorporate learning. While patient care and medical knowledge are approached with formal didactics and traditional Halstedian educational formats, other core competencies are presumed to be learned on the job or emphasized in conferences. To test the hypothesis that our residents lack a foundation in several of the nonclinical core competencies and to seek to develop a formal curriculum that can be integrated into our current didactic time, with minimal effect on resident work hours and rest hours. Anonymous Likert-type scale needs assessment survey requesting residents within a large single general surgery residency program to rate their understanding, working knowledge, or level of comfort on the following 10 topics: negotiation and conflict resolution; leadership styles; health care legislation; principles of quality delivery of care, patient safety, and performance improvement; business of medicine; clinical practice models; role of advocacy in health care policy and government; personal finance management; team building; and roles of innovation and technology in health care delivery. Proportions of resident responses scored as positive (agree or strongly agree) or negative (disagree or strongly disagree). In total, 48 surgery residents (70%) responded to the survey. Only 3 topics (leadership styles, team building, and roles of innovation and technology in health care delivery) had greater than 70% positive responses, while 2 topics (negotiation and conflict resolution and principles of quality delivery of care, patient safety, and performance improvement) had greater than 60% positive responses. The remaining topics had less than 40% positive responses, with the least positive responses on the topics

  9. The effects of self-assessment and supervisor feedback on residents' patient-education competency using videoed outpatient consultations

    NARCIS (Netherlands)

    Wouda, Jan C.; van de Wiel, Harry B. M.

    2014-01-01

    Objectives: To determine the effects of residents' communication self-assessment and supervisor feedback on residents' communication-competency awareness, on their patient-education competency, and on their patients' opinion. Methods: The program consisted of the implementation of a communication se

  10. A collaborative national model to assess competencies for medical students, residents, and other healthcare practitioners in gait and falls risk evaluation.

    Science.gov (United States)

    Atkinson, Hal H; Tan, Zaldy S; Brennan, Maura; Granville, Lisa

    2014-06-01

    To ensure that the healthcare workforce is adequately prepared to care for the growing population of older adults, minimum competencies in geriatrics have been published for medical students and primary care residents. Approaches to teaching and assessing these competencies are needed to guide medical schools, residencies, and continuing medical education programs. With sponsorship by the Education Committee and Teachers Section of the American Geriatrics Society (AGS), geriatrics educators from multiple institutions collaborated to develop a model to teach and assess a major domain of student and resident competency: Gait and Falls Risk Evaluation. The model was introduced as a workshop at annual meetings of the AGS and the American College of Physicians in 2011 and 2012. Participants included medical students, residents, geriatrics fellows, practicing physicians, and midlevel practitioners. At both national meetings, participants rated the experience highly and reported statistically significant gains in overall competence in gait and falls risk evaluation. The largest gains were observed for medical students, residents, and practicing physicians (P competence and therefore had a lower magnitude of improvement, albeit still significant (P = .02). Finally, the majority of participants reported intent to disseminate the model in their institutions. This article describes the design, implementation, and evaluation of this collaborative national model. A number of institutions have used the model, and the goal of this article is to aid in further dissemination of this successful approach to teaching and assessing geriatrics competencies.

  11. Competency Assessment in Senior Emergency Medicine Residents for Core Ultrasound Skills.

    Science.gov (United States)

    Schmidt, Jessica N; Kendall, John; Smalley, Courtney

    2015-11-01

    Quality resident education in point-of-care ultrasound (POC US) is becoming increasingly important in emergency medicine (EM); however, the best methods to evaluate competency in graduating residents has not been established. We sought to design and implement a rigorous assessment of image acquisition and interpretation in POC US in a cohort of graduating residents at our institution. We evaluated nine senior residents in both image acquisition and image interpretation for five core US skills (focused assessment with sonography for trauma (FAST), aorta, echocardiogram (ECHO), pelvic, central line placement). Image acquisition, using an observed clinical skills exam (OSCE) directed assessment with a standardized patient model. Image interpretation was measured with a multiple-choice exam including normal and pathologic images. Residents performed well on image acquisition for core skills with an average score of 85.7% for core skills and 74% including advanced skills (ovaries, advanced ECHO, advanced aorta). Residents scored well but slightly lower on image interpretation with an average score of 76%. Senior residents performed well on core POC US skills as evaluated with a rigorous assessment tool. This tool may be developed further for other EM programs to use for graduating resident evaluation.

  12. Resident dashboards: helping your clinical competency committee visualize trainees’ key performance indicators

    Directory of Open Access Journals (Sweden)

    Karen A. Friedman

    2016-03-01

    Full Text Available Introduction: Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC through the creation of a resident dashboard. Methods: Program leadership at a large university-based program developed four new end of rotation evaluations based on the American Board of Internal Medicine (ABIM and Accreditation Council of Graduated Medical Education's (ACGME 22 reportable milestones. A resident dashboard was then created to pull together both milestone- and non-milestone-based quantitative data and qualitative data compiled from faculty, nurses, peers, staff, and patients. Results: Dashboards were distributed to the members of the CCC in preparation for the semiannual CCC meeting. CCC members adjudicated quantitative and qualitative data to present their cohort of residents at the CCC meeting. Based on the committee's response, evaluation scores remained the same or were adjusted. Final milestone scores were then entered into the accreditation data system (ADS on the ACGME website. Conclusions: The process of resident assessment is complex and should comprise both quantitative and qualitative data. The dashboard is a valuable tool for program leadership to use both when evaluating house staff on a semiannual basis at the CCC and to the resident in person.

  13. Impact of a competency based curriculum on quality improvement among internal medicine residents.

    Science.gov (United States)

    Fok, Mark C; Wong, Roger Y

    2014-11-28

    Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency

  14. Development of Veteran-Centric Competency Domains for Psychiatric-Mental Health Nurse Practitioner Residents.

    Science.gov (United States)

    York, Janet; Sternke, Lisa Marie; Myrick, Donald Hugh; Lauerer, Joy; Hair, Carole

    2016-11-01

    The mental health needs of military service members, Veterans, and their families are a designated national priority; however, there has been little emphasis on the inclusion of Veteran-centric domains in competency-based nursing education for psychiatric-mental health nurse practitioners (PMHNPs). The current article describes the identification and application of Veteran-centric domains in an innovative pilot residency program for PMHNPs, funded by the Veterans Health Administration Office of Academic Affiliations. Fourteen Veteran-centric competency domains were developed from literature review, including knowledge, attitudes, and skill behaviors. Adoption and application of these domains in curricular components included the resident competency evaluation, baseline assessment of military experience, and evidence-based practice seminars and training. Methods of competency domain evaluation are presented, along with gaps related to the evaluation of competency skills. The delivery of mental health services reflecting these domains is consistent with the VA core values and goal of developing a positive service culture. [Journal of Psychosocial Nursing and Mental Health Services, 54(11), 31-36.]. Copyright 2016, SLACK Incorporated.

  15. Program director and resident perspectives of a competency-based medical education anesthesia residency program in Canada: a needs assessment

    Directory of Open Access Journals (Sweden)

    Sylvain Boet

    2016-06-01

    Full Text Available Purpose: In July 2015, the University of Ottawa introduced a competency-based medical education (CBME postgraduate program for anesthesia. Prior to program implementation, this study aimed to identify Canadian anesthesiology program directors perceptions of CBME and residents’ opinion on how the program should be designed and perceived consequences of CBME. Methods: This two-phase, qualitative study included semi-structured interviews with Canadian anesthesia program directors (Phase I and a focus group interview with residents enrolled in the University of Ottawa time-based anesthesia program (Phase II. Both phases sought to gauge participant’s perceptions of CBME. Interviews were recorded, transcribed verbatim and thematically analyzed. Results: Data was combined to protect anonymity of the six participants (three program directors and three residents. Participants spoke about the perceived advantages of CBME, the need to establish definitions, and challenges to a CBME program highlighting logistical factors, implications for trainees and the role assessment plays in CBME. Conclusion: These findings will inform CBME implementation strategies in anesthesia programs across the country, and may assist other residency programs in the design of their programs. Furthermore, our findings may help identify potential challenges and issues that other postgraduate specialties may face as they transition to a CBME model.

  16. Effects of mobile and digital support for a structured, competency-based curriculum in neurosurgery residency education.

    Science.gov (United States)

    Gonzalez, Nestor R; Dusick, Joshua R; Martin, Neil A

    2012-07-01

    Changes in neurosurgical practice and graduate medical education impose new challenges for training programs. We present our experience providing neurosurgical residents with digital and mobile educational resources in support of the departmental academic activities. A weekly mandatory conference program for all clinical residents based on the Accreditation Council for Graduate Medical Education competencies, held in protected time, was introduced. Topics were taught through didactic sessions and case discussions. Faculty and residents prepare high-quality presentations, equivalent to peer-review leading papers or case reports. Presentations are videorecorded, stored in a digital library, and broadcasted through our Website and iTunes U. Residents received mobile tablet devices with remote access to the digital library, applications for document/video management, and interactive teaching tools. Residents responded to an anonymous survey, and performances on the Self-Assessment in Neurological Surgery examination before and after the intervention were compared. Ninety-two percent reported increased time used to study outside the hospital and attributed the habit change to the introduction of mobile devices; 67% used the electronic tablets as the primary tool to access the digital library, followed by 17% hospital computers, 8% home computers, and 8% personal laptops. Forty-two percent have submitted operative videos, cases, and documents to the library. One year after introducing the program, results of the Congress of Neurological Surgeons-Self-Assessment in Neurological Surgery examination showed a statistically significant improvement in global scoring and improvement in 16 of the 18 individual areas evaluated, 6 of which reached statistical significance. A structured, competency-based neurosurgical education program supported with digital and mobile resources improved reading habits among residents and performance on the Congress of Neurological Surgeons

  17. Development of a Quality and Safety Competency Curriculum for Radiation Oncology Residency: An International Delphi Study.

    Science.gov (United States)

    Adleman, Jenna; Gillan, Caitlin; Caissie, Amanda; Davis, Carol-Anne; Liszewski, Brian; McNiven, Andrea; Giuliani, Meredith

    2017-06-01

    To develop an entry-to-practice quality and safety competency profile for radiation oncology residency. A comprehensive list of potential quality and safety competency items was generated from public and professional resources and interprofessional focus groups. Redundant or out-of-scope items were eliminated through investigator consensus. Remaining items were subjected to an international 2-round modified Delphi process involving experts in radiation oncology, radiation therapy, and medical physics. During Round 1, each item was scored independently on a 9-point Likert scale indicating appropriateness for inclusion in the competency profile. Items indistinctly ranked for inclusion or exclusion were re-evaluated through web conference discussion and reranked in Round 2. An initial 1211 items were compiled from 32 international sources and distilled to 105 unique potential quality and safety competency items. Fifteen of the 50 invited experts participated in round 1: 10 radiation oncologists, 4 radiation therapists, and 1 medical physicist from 13 centers in 5 countries. Round 1 rankings resulted in 80 items included, 1 item excluded, and 24 items indeterminate. Two areas emerged more prominently within the latter group: change management and human factors. Web conference with 5 participants resulted in 9 of these 24 items edited for content or clarity. In Round 2, 12 participants rescored all indeterminate items resulting in 10 items ranked for inclusion. The final 90 enabling competency items were organized into thematic groups consisting of 18 key competencies under headings adapted from Deming's System of Profound Knowledge. This quality and safety competency profile may inform minimum training standards for radiation oncology residency programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Initial experiences in embedding core competency education in entry-level surgery residents through a nonclinical rotation.

    Science.gov (United States)

    Kahol, Kanav; Huston, Carrie; Hamann, Jessica; Ferrara, John J

    2011-03-01

    Health care continues to expand in scope and in complexity. In this changing environment, residents are challenged with understanding its intricacies and the impact it will have on their professional activities and careers. Embedding each of the competency elements in residents in a meaningful way remains a challenge for many surgery residency program directors. We established a nonclinical rotation to provide surgery postgraduate year-1 (PGY-1) residents with a structured, multifaceted, largely self-directed curriculum into which each of the 6 core competencies are woven. Posttesting strategies were established for most curricular experiences to ensure to the greatest possible extent that each resident will have achieved an acceptable level of understanding of each of the competency areas before being given credit for the rotation. By uniformly exceeding satisfactory scores on respective objective analyses, residents demonstrated an increased (at least short-term) understanding of each of the assessed competency areas. Our project sought to address a prior lack of opportunity for our residents to develop a sound foundation for our residents in systems-based practice. Our new rotation addresses systems-based practice in several different learning environments, including emergency medical service ride-along, sentinel event participation, and hospice visits. Several research projects have enhanced the overall learning program. Our experience shows that a rotation dedicated to competency training can provide an innovative and engaging means of teaching residents the value of each element.

  19. Understanding the current anatomical competence landscape: Comparing perceptions of program directors, residents, and fourth-year medical students.

    Science.gov (United States)

    Fillmore, Erin P; Brokaw, James J; Kochhar, Komal; Nalin, Peter M

    2016-07-08

    A mixed methods survey of fourth-year medical students, resident physicians, and residency program directors at the Indiana University School of Medicine gathered perceptions of anatomical competence-defined as the anatomical education necessary for effective clinical practice. The survey items explored numerous aspects of anatomical competence, including the most effective modes of instruction, perceptions of readiness for clinical practice, and specific suggestions for improving anatomical education during medical school and residency. The response rate was 46% for fourth-year medical students, 47% for residents (as graduates from 137 medical schools), and 71% for program directors. A majority of students and residents reported that their course in Gross Anatomy prepared them well for clinical practice; that cadaveric dissection was important in the early development of their anatomical competence; and that placing a greater emphasis on clinical relevance in medical school would have improved their anatomical competence even further. However, in terms of anatomical preparedness upon entering residency, the program directors rated their residents less prepared than the residents rated themselves. All three groups agreed that there is need for additional opportunities for anatomical educational during medical school and residency. Suggestions for improving anatomical education included the following: providing more opportunities for cadaveric dissection during medical school and residency; more consistent teaching of anatomy for clinical practice; more workshops that review anatomy; and better integration of anatomy with the teaching of other subjects during medical school. Anat Sci Educ 9: 307-318. © 2015 American Association of Anatomists.

  20. Competency-based residency training and the web log: modeling practice-based learning and enhancing medical knowledge

    Directory of Open Access Journals (Sweden)

    Matthew F. Hollon

    2015-12-01

    Full Text Available Background: By using web-based tools in medical education, there are opportunities to innovatively teach important principles from the general competencies of graduate medical education. Objectives: Postulating that faculty transparency in learning from uncertainties in clinical work could help residents to incorporate the principles of practice-based learning and improvement (PBLI in their professional development, faculty in this community-based residency program modeled the steps of PBLI on a weekly basis through the use of a web log. Method: The program confidentially surveyed residents before and after this project about actions consistent with PBLI and knowledge acquired through reading the web log. Results: The frequency that residents encountered clinical situations where they felt uncertain declined over the course of the 24 weeks of the project from a mean frequency of uncertainty of 36% to 28% (Wilcoxon signed rank test, p=0.008; however, the frequency with which residents sought answers when faced with uncertainty did not change (Wilcoxon signed rank test, p=0.39, remaining high at approximately 80%. Residents answered a mean of 52% of knowledge questions correct when tested prior to faculty posts to the blog, rising to a mean of 65% of questions correct when tested at the end of the project (paired t-test, p=0.001. Conclusions: Faculty role modeling of PBLI behaviors and posting clinical questions and answers to a web log led to modest improvements in medical knowledge but did not alter behavior that was already taking place frequently among residents.

  1. Encouraging Reflexivity in a Residency Leadership Development Program: Expanding Outside the Competency Approach.

    Science.gov (United States)

    Clapp, Justin T; Gordon, Emily K B; Baranov, Dimitry J; Trey, Beulah; Tilin, Felice Y; Fleisher, Lee A

    2017-09-14

    While leadership development is increasingly a goal of academic medicine, it is typically framed as competency acquisition, which can limit its focus to a circumscribed set of social behaviors. This orientation may also reinforce the cultural characteristics of academic medicine that can make effective leadership difficult, rather than training leaders capable of examining and changing this culture. Expanding leadership development so it promotes social reflexivity presents a way to bolster some of the weaknesses of the competency paradigm. In 2013-2016, the University of Penns-ylvania's Department of Anesthesiology and Critical Care (DACC) carried out a leadership development program for residents, which included seminars focused on developing particular leadership skills and annual capstone sessions facilitating discussion between residents and attending physicians about topics chosen by residents. The capstone sessions proved to be most impactful, serving as forums for open conversation about how these groups interact when engaged in social behaviors such as giving/receiving feedback, offering support after an adverse event, and teaching/learning in the clinic. The success of the capstone sessions led to a 2016 DACC-wide initiative to facilitate transparency among all professional roles (faculty, residents, nurse anesthetists, administrative staff) and encourage widespread reflexive examination about how the manner in which these groups interact encourages or impedes leadership and teamwork. Further work is necessary to describe how leadership program formats can be diversified to better encourage reflexivity. There is also a need to develop mechanisms for assessing outcomes of leadership programs that expand outside the competency-based system.

  2. Competency-based evaluation tools for integrative medicine training in family medicine residency: a pilot study

    Directory of Open Access Journals (Sweden)

    Schneider Craig

    2007-04-01

    Full Text Available Abstract Background As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning. This paper presents the results from the implementation of direct observation and treatment plan evaluation tools, as well as the results of two Objective Structured Clinical Examinations (OSCEs developed for the program. Methods The direct observation (DO and treatment plan (TP evaluation tools developed for the IFM program were implemented by faculty at each of the six sites during the PGY-4 year (n = 11 on DO and n = 8 on TP. The OSCE I was implemented first in 2005 (n = 6, revised and then implemented with a second class of IFM participants in 2006 (n = 7. OSCE II was implemented in fall 2005 with only one class of IFM participants (n = 6. Data from the initial implementation of these tools are described using descriptive statistics. Results Results from the implementation of these tools at the IFM sites suggest that we need more emphasis in our curriculum on incorporating spirituality into history-taking and treatment planning, and more training for IFM residents on effective assessment of readiness for change and strategies for delivering integrative medicine treatment recommendations. Focusing our OSCE assessment more narrowly on integrative medicine history-taking skills was much more effective in delineating strengths and weaknesses in our residents' performance than using the OSCE for both integrative and more basic communication competencies. Conclusion As these tools are refined further they will be of value both in improving

  3. Primary care resident, faculty, and patient views of barriers to cultural competence, and the skills needed to overcome them.

    Science.gov (United States)

    Shapiro, Johanna; Hollingshead, Judy; Morrison, Elizabeth H

    2002-08-01

    Primary care residencies are expected to provide training in cultural competence. However, we have insufficient information about the perceptions of stakeholders actually involved in healthcare (i.e. residents, faculty and patients) regarding commonly encountered cross-cultural barriers and the skills required to overcome them. This study used a total of 10 focus groups to explore resident, faculty and patient attitudes and beliefs about what culturally competent doctor-patient communication means, what obstacles impede or prevent culturally competent communication, and what kinds of skills are helpful in achieving cultural competence. A content analysis was performed to identify major themes. Residents and faculty defined culturally competent communication in terms of both generic and culture-specific elements, however, patients tended to emphasize only generic attitudes and skills. Residents and patients were liable to blame each other in explaining barriers; faculty were more likely to consider systemic influences contributing to resident-patient difficulties. All groups emphasized appropriate skill and attitude development in learners as the key to successful communication. However, residents were sceptical of sensitivity and communication skills training, and worried that didactic presentations would result in cultural stereotyping. All stakeholders recognized the importance of effective doctor-patient communication. Of concern was the tendency of various stakeholders to engage in person-blame models.

  4. Designing and Implementing a Competency-Based Training Program for Anesthesiology Residents at the University of Ottawa

    Directory of Open Access Journals (Sweden)

    Emma J. Stodel

    2015-01-01

    Full Text Available Competency-based medical education is gaining traction as a solution to address the challenges associated with the current time-based models of physician training. Competency-based medical education is an outcomes-based approach that involves identifying the abilities required of physicians and then designing the curriculum to support the achievement and assessment of these competencies. This paradigm defies the assumption that competence is achieved based on time spent on rotations and instead requires residents to demonstrate competence. The Royal College of Physicians and Surgeons of Canada (RCPSC has launched Competence by Design (CBD, a competency-based approach for residency training and specialty practice. The first residents to be trained within this model will be those in medical oncology and otolaryngology-head and neck surgery in July, 2016. However, with approval from the RCPSC, the Department of Anesthesiology, University of Ottawa, launched an innovative competency-based residency training program July 1, 2015. The purpose of this paper is to provide an overview of the program and offer a blueprint for other programs planning similar curricular reform. The program is structured according to the RCPSC CBD stages and addresses all CanMEDS roles. While our program retains some aspects of the traditional design, we have made many transformational changes.

  5. Internal Medicine Residency Program Directors' Views of the Core Entrustable Professional Activities for Entering Residency: An Opportunity to Enhance Communication of Competency Along the Continuum.

    Science.gov (United States)

    Angus, Steven V; Vu, T Robert; Willett, Lisa L; Call, Stephanie; Halvorsen, Andrew J; Chaudhry, Saima

    2017-06-01

    To examine internal medicine (IM) residency program directors' (PDs') perspectives on the Core Entrustable Professional Activities for Entering Residency (Core EPAs)-introduced into undergraduate medical education to further competency-based assessment-and on communicating competency-based information during transitions. A spring 2015 Association of Program Directors in Internal Medicine survey asked PDs of U.S. IM residency programs for their perspectives on which Core EPAs new interns must or should possess on day 1, which are most essential, and which have the largest gap between expected and observed performance. Their views and preferences were also requested regarding communicating competency-based information at transitions from medical school to residency and residency to fellowship/employment. The response rate was 57% (204/361 programs). The majority of PDs felt new interns must/should possess 12 of the 13 Core EPAs. PDs' rankings of Core EPAs by relative importance were more varied than their rankings by the largest gaps in performance. Although preferred timing varied, most PDs (82%) considered it important for medical schools to communicate Core EPA-based information to PDs; nearly three-quarters (71%) would prefer a checklist format. Many (60%) would be willing to provide competency-based evaluations to fellowship directors/employers. Most (> 80%) agreed that there should be a bidirectional communication mechanism for programs/employers to provide feedback on competency assessments. The gaps identified in Core EPA performance may help guide medical schools' curricular and assessment tool design. Sharing competency-based information at transitions along the medical education continuum could help ensure production of competent, practice-ready physicians.

  6. Teaching Cultural Competence to Psychiatry Residents: Seven Core Concepts and Their Implications for Therapeutic Technique.

    Science.gov (United States)

    Pena, Jose M; Manguno-Mire, Gina; Kinzie, Erik; Johnson, Janet E

    2016-04-01

    The authors describe the Tulane Model for teaching cultural competence to psychiatry residents in order to outline an innovative approach to curricula development in academic psychiatry. The authors focus on the didactic experience that takes place during the first and second postgraduate years and present seven core concepts that should inform the emerging clinician's thinking in the formulation of every clinical case. The authors discuss the correspondence between each core concept and the Outline for Cultural Formulation, introduced in Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and updated in DSM-5. The authors illustrate how each of the core concepts is utilized as a guideline for teaching residents a process for eliciting culturally relevant information from their patients and their personal histories and how to apply that knowledge in the assessment and treatment of patients in clinical settings.

  7. [Competence perception survey among residents of orthopedics and trauma in a hospital of Yucatán México].

    Science.gov (United States)

    Martínez-Hernández, G; Escalante-Magaña, J R; Vargas-Mena, R

    2014-01-01

    The competence model states that what is most important is to have the elements to solve problems since abstract training does not provide enough tools to solve them. Therefore, it uses key and auxiliary competences that are linked to values such as attitudes. This study was performed to explore these competences. This is a cross sectional, observational and descriptive trial. An anonymous survey with profile data of Orthopedics and Trauma residents was given, it contained 14 questions for residents of different academic levels. 24 residents participated out of the 35 registered in the course. 100% agreed to answer the survey, 54% was in the second year, 29% in the first year and 17% in the fourth year. 75% expressed auxiliary competences, 13% did not respond, 8% developed key competences and 4% don't know. Three main factors that are a negative influence to improve the knowledge of orthopedics were expressed. The most relevant is that residents describe a bad attitude from attending physicians, lack of willingness to teach and, poor interpersonal relationships. Awareness should be raised among orthopedics specialists so they understand that having the knowledge and skills is not enough to approach health issues in a comprehensive manner for each patient and the development of better competences should be fostered, especially key competences.

  8. The research rotation: competency-based structured and novel approach to research training of internal medicine residents

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    Dimitrov Vihren

    2006-10-01

    Full Text Available Abstract Background In the United States, the Accreditation Council of graduate medical education (ACGME requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

  9. Resident education in orthopaedic trauma: the future role of competency-based medical education.

    Science.gov (United States)

    Nousiainen, M T; McQueen, S A; Hall, J; Kraemer, W; Ferguson, P; Marsh, J L; Reznick, R R; Reed, M R; Sonnadara, R

    2016-10-01

    As residency training programmes around the globe move towards competency-based medical education (CBME), there is a need to review current teaching and assessment practices as they relate to education in orthopaedic trauma. Assessment is the cornerstone of CBME, as it not only helps to determine when a trainee is fit to practice independently, but it also provides feedback on performance and guides the development of competence. Although a standardised core knowledge base for trauma care has been developed by the leading national accreditation bodies and international agencies that teach and perform research in orthopaedic trauma, educators have not yet established optimal methods for assessing trainees' performance in managing orthopaedic trauma patients. This review describes the existing knowledge from the literature on assessment in orthopaedic trauma and highlights initiatives that have recently been undertaken towards CBME in the United Kingdom, Canada and the United States. In order to support a CBME approach, programmes need to improve the frequency and quality of assessments and improve on current formative and summative feedback techniques in order to enhance resident education in orthopaedic trauma. Cite this article: Bone Joint J 2016;98-B:1320-5. ©2016 The British Editorial Society of Bone & Joint Surgery.

  10. Digital slides and ACGME resident competencies in anatomic pathology: An altered paradigm for acquisition and assessment.

    Science.gov (United States)

    Hassell, Lewis A; Fung, Kar-Ming; Chaser, Brad

    2011-01-01

    Whole slide digital imaging technology has matured considerably over the past decade. Applications in pathology education are widespread and are rapidly transforming the manner in which medical students learn pathology and histology, and they have a novel and significant impact on postgraduate continuing medical education. Whole slide digital images for use in pathology graduate education have been slower in adoption and remain much less widespread. Emphasis on professional competency by the Accreditation Council on Graduate Medical Education (ACGME) and credentialing organizations, however, appear poised to significantly increase. The convergence of these two forces is propitious for pathology training. This article examines the opportunities for the use of whole slide images (WSI) in pathology residency training along with the developing potential uses in each of the areas of competency, as categorized by the ACGME. Barriers to WSI adoption in the pathology community are identified along with potentially significant promoters for adoption in training and practice. Current literature and recent presentations are reviewed. Digital pathology coupled with emphasis on competency is a shift of tremendous magnitude that can dramatically improve our abilities to help trainees acquire, demonstrate, and maintain the skills to practice pathology in the generation ahead.

  11. Digital slides and ACGME resident competencies in anatomic pathology: An altered paradigm for acquisition and assessment

    Directory of Open Access Journals (Sweden)

    Lewis A Hassell

    2011-01-01

    Full Text Available Whole slide digital imaging technology has matured considerably over the past decade. Applications in pathology education are widespread and are rapidly transforming the manner in which medical students learn pathology and histology, and they have a novel and significant impact on postgraduate continuing medical education. Whole slide digital images for use in pathology graduate education have been slower in adoption and remain much less widespread. Emphasis on professional competency by the Accreditation Council on Graduate Medical Education (ACGME and credentialing organizations, however, appear poised to significantly increase. The convergence of these two forces is propitious for pathology training. This article examines the opportunities for the use of whole slide images (WSI in pathology residency training along with the developing potential uses in each of the areas of competency, as categorized by the ACGME. Barriers to WSI adoption in the pathology community are identified along with potentially significant promoters for adoption in training and practice. Current literature and recent presentations are reviewed. Digital pathology coupled with emphasis on competency is a shift of tremendous magnitude that can dramatically improve our abilities to help trainees acquire, demonstrate, and maintain the skills to practice pathology in the generation ahead.

  12. Surgery and Medicine Residents' Perspectives of Morbidity and Mortality Conference: An Interdisciplinary Approach to Improve ACGME Core Competency Compliance.

    Science.gov (United States)

    Flynn-O'Brien, Katherine T; Mandell, Samuel P; Eaton, Erik Van; Schleyer, Anneliese M; McIntyre, Lisa K

    2015-01-01

    Morbidity and mortality conferences (MMCs) are often used to fulfill the Accreditation Council for Graduate Medical Education practice-based learning and improvement (PBLI) competency, but there is variation among institutions and disciplines in their approach to MMCs. The objective of this study is to examine the trainees' perspective and experience with MMCs and adverse patient event (APE) reporting across disciplines to help guide the future implementation of an institution-wide, workflow-embedded, quality improvement (QI) program for PBLI. Between April 1, 2013, and May 8, 2013, surgical and medical residents were given a confidential survey about APE reporting practices and experience with and attitudes toward MMCs and other QI/patient safety initiatives. Descriptive statistics and univariate analyses using the chi-square test for independence were calculated for all variables. Logistic regression and ordered logistic regression were used for nominal and ordinal categorical dependent variables, respectively, to calculate odds of reporting APEs. Qualitative content analysis was used to code free-text responses. A large, multihospital, tertiary academic training program in the Pacific Northwest. Residents in all years of training from the Accreditation Council for Graduate Medical Education-accredited programs in surgery and internal medicine. Survey response rate was 46.2% (126/273). Although most respondents agreed or strongly agreed that knowledge of and involvement in QI/patient safety activities was important to their training (88.1%) and future career (91.3%), only 10.3% regularly or frequently reported APEs to the institution's established electronic incident reporting system. Senior-level residents in both surgery and medicine were more likely to report APEs than more junior-level residents were (odds ratio = 4.8, 95% CI: 3.1-7.5). Surgery residents had a 4.9 (95% CI: 2.3-10.5) times higher odds than medicine residents had to have reported an APE to

  13. Training on the DSM-5 Cultural Formulation Interview Improves Cultural Competence in General Psychiatry Residents: A Multi-site Study.

    Science.gov (United States)

    Mills, Stacia; Wolitzky-Taylor, Kate; Xiao, Anna Q; Bourque, Marie Claire; Rojas, Sandra M Peynado; Bhattacharya, Debanjana; Simpson, Annabelle K; Maye, Aleea; Lo, Pachida; Clark, Aaron; Lim, Russell; Lu, Francis G

    2016-10-01

    The authors assessed whether a 1-h didactic session on the DSM-5 Cultural Formulation Interview (CFI) improves cultural competence of general psychiatry residents. Psychiatry residents at six residency programs completed demographics and pre-intervention questionnaires, were exposed to a 1-h session on the CFI, and completed a post-intervention questionnaire. Repeated measures ANCOVA compared pre- to post-intervention change. Linear regression assessed whether previous cultural experience predicted post-intervention scores. Mean scores on the questionnaire significantly changed from pre- to post-intervention (p cultural experience did not predict post-intervention scores. Psychiatry residents' cultural competence scores improved with a 1-h session on the CFI but with notable limitations.

  14. Training on the DSM-5 Cultural Formulation Interview improves cultural competence in general psychiatry residents: A pilot study.

    Science.gov (United States)

    Mills, Stacia; Xiao, Anna Q; Wolitzky-Taylor, Kate; Lim, Russell; Lu, Francis G

    2017-04-01

    The objective of this study was to assess whether a 1-hour didactic session on the DSM-5 Cultural Formulation Interview (CFI) improves the cultural competence of general psychiatry residents. The main hypothesis was that teaching adult psychiatry residents a 1-hour session on the CFI would improve cultural competence. The exploratory hypothesis was that trainees with more experience in cultural diversity would have a greater increase in cultural competency scores. Psychiatry residents at a metropolitan, county hospital completed demographics and preintervention questionnaires, were exposed to a 1-hour session on the CFI, and were given a postintervention questionnaire. The questionnaire was an adapted version of the validated Cultural Competence Assessment Tool . Paired samples t tests compared pre- to posttest change. Hierarchical linear regression assessed whether pretraining characteristics predicted posttest scores. The mean change of total pre- and posttest scores was significant ( p = .002), as was the mean change in subscales Nonverbal Communications ( p < .001) and Cultural Knowledge ( p = .002). Demographic characteristics did not predict higher posttest scores (when covarying for pretest scores). Psychiatry residents' cultural competence scores improved irrespective of previous experience in cultural diversity. More research is needed to further explore the implications of the improved scores in clinical practice.

  15. Learners' perspective: where and when pre-residency trainees learn more to achieve their core clinical competencies.

    Science.gov (United States)

    Ahn, Eusang; Ahn, Ducksun; Lee, Young-Mee

    2016-12-01

    While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies. The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery, and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse. The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence.

  16. Learners’ perspective: where and when pre-residency trainees learn more to achieve their core clinical competencies

    Science.gov (United States)

    2016-01-01

    Purpose While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. Methods A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies. Results The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery, and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse. Conclusion The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence. PMID:27907982

  17. Tissue-resident macrophages can contain replication-competent virus in antiretroviral-naive, SIV-infected Asian macaques

    Science.gov (United States)

    DiNapoli, Sarah R.; Ortiz, Alexandra M.; Wu, Fan; Matsuda, Kenta; Hirsch, Vanessa M.; Knox, Kenneth

    2017-01-01

    SIV DNA can be detected in lymphoid tissue–resident macrophages of chronically SIV-infected Asian macaques. These macrophages also contain evidence of recently phagocytosed SIV-infected CD4+ T cells. Here, we examine whether these macrophages contain replication-competent virus, whether viral DNA can be detected in tissue-resident macrophages from antiretroviral (ARV) therapy–treated animals and humans, and how the viral sequences amplified from macrophages and contemporaneous CD4+ T cells compare. In ARV-naive animals, we find that lymphoid tissue–resident macrophages contain replication-competent virus if they also contain viral DNA in ARV-naive Asian macaques. The genetic sequence of the virus within these macrophages is similar to those within CD4+ T cells from the same anatomic sites. In ARV-treated animals, we find that viral DNA can be amplified from lymphoid tissue–resident macrophages of SIV-infected Asian macaques that were treated with ARVs for at least 5 months, but we could not detect replication-competent virus from macrophages of animals treated with ARVs. Finally, we could not detect viral DNA in alveolar macrophages from HIV-infected individuals who received ARVs for 3 years and had undetectable viral loads. These data demonstrate that macrophages can contain replication-competent virus, but may not represent a significant reservoir for HIV in vivo.

  18. 住院医师规范化培训基地学员胜任力的调查研究%The study on core competence of the resident doctors in the resident standardization training bases

    Institute of Scientific and Technical Information of China (English)

    周勣

    2015-01-01

    Objective:The study aims to investigate the competence and the influencing factors of the resident doctors in the standardized bases for training residents in the two general hospitals in Minhang District. Methods:The questionnaire survey for the resident doctors in the standardized base for training residents are conducted. Results:The core competency are in high level. There was statistically significant difference on competency among the investigated with different education experience and gender(P<0.05,P<0.01). Conclusion:It was suggested that resident standardization training bases or institutions should strengthen the training to the trainee physician to improve core competence of the resident doctors in the resident standardization training bases.%目的:调查上海市闵行区2家二级以上综合性医院住院规范化培训基地学员的核心胜任力状况及其影响因素。方法:采用问卷调查方式,对闵行区2家二级以上综合性医院规范化培训基地学员进行胜任力问卷调查。结果:本次调查对象核心胜任力大多处于高水平状态,不同学历、性别在不同胜任力条目中有统计学意义(P<0.05,P<0.01)。结论:住院医师规范化培训基地或机构应加强对基地住院医师的个性化培训,使其更有针对性,促进基地住院医师核心胜任力的提高。

  19. Otolaryngology residency education: a scoping review on the shift towards competency-based medical education.

    Science.gov (United States)

    Wagner, N; Fahim, C; Dunn, K; Reid, D; Sonnadara, R R

    2017-06-01

    Residency training programmes worldwide are experiencing a shift from the traditional time-based curriculum to competency-based medical education (CBME), due to changes in the healthcare system that have impacted clinical learning opportunities. Otolaryngology-Head and Neck Surgery (OTL-HNS) programmes are one of the first North American surgical specialties to adopt the new CBME curriculum. The purpose of this scoping review is to examine the literature pertaining to CBME in OTL-HNS programmes worldwide, to identify the tools that have been developed and identify potential barriers to the implementation of CBME. Four online databases, OVID MEDLINE (R) from 1946 to 5 August 2015, EMBASE 1974 to 5 August 2015, Cochrane and CINAHL databases up to 5 August 2015, were searched using key words related to OTL-HNS and CBME. Two researchers independently reviewed the literature in a systematic manner and met to discuss and address any discrepancies at each step of the review process. Of the 207 publications identified in the initial search, 31 were included in this scoping review. Two key themes emerged from the literature: first, OTL-HNS programmes reported a need for new assessment tools that assess competency and also provide the learner with formative feedback. Second, although varieties of tools assessing both technical and non-technical skills have been developed, implementation of such tools has been met with some challenges. These challenges include a lack of faculty support, inadequate administrative support and a lack of knowledge on how to start the transition to CBME. This scoping review suggests that task-specific checklists, entrustment scales, evaluation portfolios from multiple assessments and faculty training sessions are key aspects to incorporate as OTL-HNS training programmes shift towards a CBME curriculum. © 2016 John Wiley & Sons Ltd.

  20. Determinants of resident competence in mastoidectomy: role of interest and deliberate practice.

    Science.gov (United States)

    Malik, Mohammad U; Varela, David A Diaz Voss; Park, EunMi; Masood, Hamid; Laeeq, Kulsoom; Bhatti, Nasir I; Francis, Howard W

    2013-12-01

    This study explores the influence of selected factors on achievement of competency in mastoid surgery. A prospective study of surgical performance and a retrospective survey of learner and training factors. The longitudinal performance of 15 residents was evaluated using the mastoidectomy task-based checklist (TBC). The influence of surgical experience, resident interest, and training factors (course attendance, voluntary use of simulation laboratory) was also examined and compared for the acquisition of distinct levels of technical skill difficulty (cortical mastoidectomy vs. facial recess). Ninety-six observations made during the first otology rotation were analyzed. Cortical mastoidectomy tasks showed positive associations with cumulated case numbers (OR 1.13, CI 1.04-1.23, P = .003) and interest in otology (OR 3.86, CI 1.21-12.27, P = .022). Facial recess tasks showed a larger positive association with interest in otology (OR 10.38, CI 2.25-47.94, P = .003), and negative association with extra time spent in laboratory practice (OR .05, CI 0.011-0.23, P = .000). Learning trajectory for cortical mastoidectomy and facial recess may be influenced by different factors. Interest in otology, in particular, may have a moderating effect on the acquisition of more complex skills in mastoid surgery. A negative association between self-directed laboratory simulation and performance may reflect the impact of assessment-guided feedback in promoting deliberate practice. Further investigations are suggested to explore the interactions between individual trainee differences, educational models, and learning outcomes. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Content analysis of resident evaluations of faculty anesthesiologists: supervision encompasses some attributes of the professionalism core competency.

    Science.gov (United States)

    Dexter, Franklin; Szeluga, Debra; Hindman, Bradley J

    2017-05-01

    Anesthesiology departments need an instrument with which to assess practicing anesthesiologists' professionalism. The purpose of this retrospective analysis of the content of a cohort of resident evaluations of faculty anesthesiologists was to investigate the relationship between a clinical supervision scale and the multiple attributes of professionalism. From July 1, 2013 to the present, our department has utilized the de Oliveira Filho unidimensional nine-item supervision scale to assess the quality of clinical supervision of residents provided by our anesthesiologists. The "cohort" we examined included all 13,664 resident evaluations of all faculty anesthesiologists from July 1, 2013 through December 31, 2015, including 1,387 accompanying comments. Words and phrases associated with the core competency of professionalism were obtained from previous studies, and the supervision scale was analyzed for the presence of these words and phrases. The supervision scale assesses some attributes of anesthesiologists' professionalism as well as patient care and procedural skills and interpersonal and communication skills. The comments that residents provided with the below-average supervision scores included attributes of professionalism, although numerous words and phrases related to professionalism were not present in any of the residents' comments. The de Oliveira Filho clinical supervision scale includes some attributes of anesthesiologists' professionalism. The core competency of professionalism, however, is multidimensional, and the supervision scale and/or residents' comments did not address many of the other established attributes of professionalism.

  2. Perspective: Competencies, outcomes, and controversy--linking professional activities to competencies to improve resident education and practice.

    Science.gov (United States)

    Jones, M Douglas; Rosenberg, Adam A; Gilhooly, Joseph T; Carraccio, Carol L

    2011-02-01

    Regulatory organizations have recently emphasized the importance of structuring graduate medical education around mastery of core competencies. The difficulty is that core competencies attempt to distill a range of professional behaviors into arguable abstractions. As such, competencies can be difficult to grasp for trainees and faculty, who see them as unrelated to the intricacies of daily patient care. In this article, the authors describe how two initiatives are converging in a way that should make competencies tangible and relevant. One initiative is based on the idea that competencies will be more meaningful if trainees understand specifically how they relate to important professional activities in their own specialty. The authors suggest that there is a dyadic relationship between competencies and major professional activities in pediatric medicine. They also suggest that these relationships should be discussed as part of the process by which trainees are entrusted to perform clinical activities without direct supervision. The other initiative proposes to construct narrative milestones that provide a picture of what progression toward mastery of core competencies might look like. Together, the authors argue, these two initiatives should illuminate the core competencies by providing relevant clinical context and valuable educational substance.

  3. Analysis of dermatology resident self-reported successful learning styles and implications for core competency curriculum development.

    Science.gov (United States)

    Stratman, Erik J; Vogel, Curt A; Reck, Samuel J; Mukesh, Bickol N

    2008-01-01

    There are different teaching styles for delivering competency-based curricula. The education literature suggests that learning is maximized when teaching is delivered in a style preferred by learners. To determine if dermatology residents report learning style preferences aligned with adult learning. Dermatology residents attending an introductory cutaneous biology course completed a learning styles inventory assessing self-reported success in 35 active and passive learning activities. The 35 learning activities were ranked in order of preference by learners. Mean overall ratings for active learning activities were significantly higher than for passive learning activities (P = 0.002). Trends in dermatology resident learning style preferences should be considered during program curriculum development. Programs should integrate a variety of curriculum delivery methods to accommodate various learning styles, with an emphasis on the active learning styles preferred by residents.

  4. Integrative Medicine in Preventive Medicine Education: Competency and Curriculum Development for Preventive Medicine and Other Specialty Residency Programs.

    Science.gov (United States)

    Jani, Asim A; Trask, Jennifer; Ali, Ather

    2015-11-01

    During 2012, the USDHHS's Health Resources and Services Administration funded 12 accredited preventive medicine residencies to incorporate an evidence-based integrative medicine curriculum into their training programs. It also funded a national coordinating center at the American College of Preventive Medicine, known as the Integrative Medicine in Preventive Medicine Education (IMPriME) Center, to provide technical assistance to the 12 grantees. To help with this task, the IMPriME Center established a multidisciplinary steering committee, versed in integrative medicine, whose primary aim was to develop integrative medicine core competencies for incorporation into preventive medicine graduate medical education training. The competency development process was informed by central integrative medicine definitions and principles, preventive medicine's dual role in clinical and population-based prevention, and the burgeoning evidence base of integrative medicine. The steering committee considered an interdisciplinary integrative medicine contextual framework guided by several themes related to workforce development and population health. A list of nine competencies, mapped to the six general domains of competence approved by the Accreditation Council of Graduate Medical Education, was operationalized through an iterative exercise with the 12 grantees in a process that included mapping each site's competency and curriculum products to the core competencies. The competencies, along with central curricular components informed by grantees' work presented elsewhere in this supplement, are outlined as a roadmap for residency programs aiming to incorporate integrative medicine content into their curricula. This set of competencies adds to the larger efforts of the IMPriME initiative to facilitate and enhance further curriculum development and implementation by not only the current grantees but other stakeholders in graduate medical education around integrative medicine training.

  5. Competency-based (CanMEDS) residency training programme in radiology: systematic design procedure, curriculum and success factors

    Energy Technology Data Exchange (ETDEWEB)

    Jippes, Erik [University Medical Centre Groningen, University of Groningen, Postgraduate School of Medicine, Wenckebach Institute, Hanzeplein 1, Postbus 30.001, Groningen (Netherlands); Engelen, Jo M.L. van [University of Groningen, Product Development and Strategy, Faculty Economics and Business, Groningen (Netherlands); Brand, Paul L.P. [University Medical Centre Groningen, UMCG Postgraduate School of Medicine, Hanzeplein 1, Postbus 30.001, Groningen (Netherlands); Amalia Children' s Clinic, Isala Klinieken Zwolle, Zwolle (Netherlands); Oudkerk, Matthijs [University Medical Centre Groningen, University of Groningen, Department of Radiology, Hanzeplein 1, Postbus 30.001, Groningen (Netherlands)

    2010-04-15

    Based on the CanMEDS framework and the European Training Charter for Clinical Radiology a new radiology curriculum was designed in the Netherlands. Both the development process and the resulting new curriculum are presented in this paper. The new curriculum was developed according to four systematic design principles: discursiveness, hierarchical decomposition, systematic variation and satisficing (satisficing is different from satisfying; in this context, satisficing means searching for an acceptable solution instead of searching for an optimal solution). The new curriculum is organ based with integration of radiological diagnostic techniques, comprises a uniform national common trunk followed by a 2-year subspecialisation, is competency outcome based with appropriate assessment tools and techniques, and is based on regional collaboration among radiology departments. The application of the systematic design principles proved successful in producing a new curriculum approved by all authorities. The principles led to a structured, yet flexible, development process in which creative solutions could be generated and adopters (programme directors, supervisors and residents) were highly involved. Further research is needed to empirically test the components of the new curriculum. (orig.)

  6. Competence and competency of high school teacher as the components of his innovative development

    Directory of Open Access Journals (Sweden)

    I. K. Yarmola

    2013-10-01

    Full Text Available Priority direction of state policy concerning the development of higher education inUkraineis to prepare qualified and competitive staff in the labor market. The high level of competence and scientific competence along with pedagogical craftsmanship and psychological culture of teachers is condition for improving the efficiency of the educational process in higher education. Aim of research was theoretical justification importance of competence and competency of high school teacher for the establishment his innovation potential. In the article the analysis of interpretation of the terms competence and competency in various scientific sources and scientific works of individual authors were presented. Moreover important are ability to creativity, solving of problem’s tasks, ingenuity, flexibility and criticality mind, intuition, originality and self-confidence; ability to formulate and solve non-standard tasks; ability to analyse, synthesis and combination, to share experiences, predictions, etc.. Emotionally-shaped quality represented by the following components as spirituality, the emotional upsurge in creative situations; associativity, imagination, sense of novelty, sensitivity to contradictions, empathy; insight, ability to see the familiar in an unfamiliar; overcome the stereotypes; risk appetite, desire for freedom. The general regularities of formation of research competence have been detected. In particular, the formation carried out through the development of competencies invariant character and increasing of specialized skills. It is proved that scientific and research competence is determined primarily by the system of teacher's professional education and self-education. The most important objective characteristics that reflect the competence of teachers in the field R & D is the total number of publications, number of scientific articles, monographs, and also won grants, competitions, etc. Moreover the level of competence in the

  7. Ensuring Resident Competence: A Narrative Review of the Literature on Group Decision Making to Inform the Work of Clinical Competency Committees.

    Science.gov (United States)

    Hauer, Karen E; Cate, Olle Ten; Boscardin, Christy K; Iobst, William; Holmboe, Eric S; Chesluk, Benjamin; Baron, Robert B; O'Sullivan, Patricia S

    2016-05-01

    Background The expectation for graduate medical education programs to ensure that trainees are progressing toward competence for unsupervised practice prompted requirements for a committee to make decisions regarding residents' progress, termed a clinical competency committee (CCC). The literature on the composition of these committees and how they share information and render decisions can inform the work of CCCs by highlighting vulnerabilities and best practices. Objective We conducted a narrative review of the literature on group decision making that can help characterize the work of CCCs, including how they are populated and how they use information. Methods English language studies of group decision making in medical education, psychology, and organizational behavior were used. Results The results highlighted 2 major themes. Group member composition showcased the value placed on the complementarity of members' experience and lessons they had learned about performance review through their teaching and committee work. Group processes revealed strengths and limitations in groups' understanding of their work, leader role, and information-sharing procedures. Time pressure was a threat to the quality of group work. Conclusions Implications of the findings include the risks for committees that arise with homogeneous membership, limitations to available resident performance information, and processes that arise through experience rather than deriving from a well-articulated purpose of their work. Recommendations are presented to maximize the effectiveness of CCC processes, including their membership and access to, and interpretation of, information to yield evidence-based, well-reasoned judgments.

  8. Medical residents' perceptions of their competencies and training needs in health care management

    DEFF Research Database (Denmark)

    Berkenbosch, Lizanne; Schoenmaker, Suzanne Gerdien; Ahern, Susannah

    2013-01-01

    Previous research has shown that Dutch medical residents feel inadequate in certain management areas: 85% had a need for management training and reported preferences on the format of such training. Our objective was to explore if the perceived deficiencies and needs among Dutch residents were...

  9. Simulation-based assessment of anesthesiology residents' competence: development and implementation of the Canadian National Anesthesiology Simulation Curriculum (CanNASC).

    Science.gov (United States)

    Chiu, Michelle; Tarshis, Jordan; Antoniou, Andreas; Bosma, T Laine; Burjorjee, Jessica E; Cowie, Neil; Crooks, Simone; Doyle, Kate; Dubois, David; Everett, Tobias; Fisher, Rachel; Hayter, Megan; McKinnon, Genevieve; Noseworthy, Diana; O'Regan, Noel; Peachey, Greg; Robitaille, Arnaud; Sullivan, Michael; Tenenbein, Marshall; Tremblay, Marie-Helene

    2016-12-01

    The specialty of anesthesiology will soon adopt the Competence By Design (CBD) approach to residency education developed by the Royal College of Physicians and Surgeons of Canada (RCPSC). A foundational component of CBD is frequent and contextualized assessment of trainees. In 2013, the RCPSC Anesthesiology Specialty Committee assembled a group of simulation educators, representing each of the 17 Canadian anesthesiology residency programs, to form the Canadian National Anesthesiology Simulation Curriculum (CanNASC) Task Force. The goals were to develop, implement, and evaluate a set of consensus-driven standardized mannequin-based simulation scenarios that every trainee must complete satisfactorily prior to completion of anesthesiology residency and certification. Curriculum development followed Kern's principles and was accomplished via monthly teleconferences and annual face-to-face meetings. The development and implementation processes included the following key elements: 1) Curriculum needs assessment: 368 of 958 invitees (38.4%) responded to a national survey resulting in 64 suggested scenario topics. Use of a modified Delphi technique resulted in seven important and technically feasible scenarios. 2) Scenario development: All scenarios have learning objectives from the National Curriculum for Canadian Anesthesiology Residency. Standardized scenario templates were created, and the content was refined and piloted. 3) Assessment: A validated Global Rating Scale (GRS) is the primary assessment tool, informed by using scenario-specific checklists (created via a modified Delphi technique) and the Anesthesia Non-Technical Skills GRS. 4) Implementation: Standardized implementation guidelines, pre-brief/debrief documents, and rater training videos, guide, and commentary were generated. National implementation of the scenarios and program evaluation is currently underway. It is highly feasible to achieve specialty-based consensus on the elements of a national

  10. Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians

    OpenAIRE

    Neff, J; Knight, KR; Satterwhite, S.; Nelson, N; Matthews, J.; Holmes, SM

    2017-01-01

    © 2016, Society of General Internal Medicine. Background: The influence of societal inequities on health has long been established, but such content has been incorporated unevenly into medical education and clinical training. Structural competency calls for medical education to highlight the important influence of social, political, and economic factors on health outcomes. Aim: This article describes the development, implementation, and evaluation of a structural competency training for medic...

  11. Developing and successfully implementing a competency-based portfolio assessment system in a postgraduate family medicine residency program.

    Science.gov (United States)

    McEwen, Laura A; Griffiths, Jane; Schultz, Karen

    2015-11-01

    The use of portfolios in postgraduate medical residency education to support competency development is increasing; however, the processes by which these assessment systems are designed, implemented, and maintained are emergent. The authors describe the needs assessment, development, implementation, and continuing quality improvement processes that have shaped the Portfolio Assessment Support System (PASS) used by the postgraduate family medicine program at Queen's University since 2009. Their description includes the impetus for change and contextual realities that guided the effort, plus the processes used for selecting assessment components and developing strategic supports. The authors discuss the identification of impact measures at the individual, programmatic, and institutional levels and the ways the department uses these to monitor how PASS supports competency development, scaffolds residents' self-regulated learning skills, and promotes professional identity formation. They describe the "academic advisor" role and provide an appendix covering the portfolio elements. Reflection elements include learning plans, clinical question logs, confidence surveys, and reflections about continuity of care and significant incidents. Learning module elements cover the required, online bioethics, global health, and consult-request modules. Assessment elements cover each resident's research project, clinical audits, presentations, objective structured clinical exam and simulated office oral exam results, field notes, entrustable professional activities, multisource feedback, and in-training evaluation reports. Document elements are the resident's continuing medical education activities including procedures log, attendance log, and patient demographic summaries.The authors wish to support others who are engaged in the systematic portfolio-design process or who may adapt aspects of PASS for their local programs.

  12. IT Professionals' Competences: High School Students' Views

    Science.gov (United States)

    Garcia-Crespo, Angel; Colomo-Palacios, Ricardo; Gomez-Berbis, Juan Miguel; Tovar-Caro, Edmundo

    2009-01-01

    During last few years, the competential paradigm has become a standard for modern Human Resources Management. The importance and the impact of this concept have led higher education institutions to adopt this concept in the definition of educational resources. In this scenario, knowing which competencies and characteristics define professionals in…

  13. Professional Competency Differences among High School Teachers in Indonesia

    Science.gov (United States)

    Mustafa, M. Nur

    2013-01-01

    This study aims to evaluate the levels of professional competency among high school teachers as well as to identify the differnces based on gender and work experience, as the teachers' professional competency level is of paramount importance in quality of teaching and learning and students' achievements. The study sample involved 327 teachers from…

  14. Potential impact of a bedside procedure service on training procedurally competent hospitalists in a community-based residency program

    Science.gov (United States)

    Montuno, Anthony; Hunt, Bijou R.; Lee, May M.

    2016-01-01

    Background The Society of Hospital Medicine has delineated procedures as one of the core competencies for hospitalists. Little is known about whether exposure to a medical procedure service (MPS) impacts the procedural certification rate in internal medicine trainees in a community hospital training program. Objective To determine whether or not exposure to an MPS would impact both the number of procedures performed and the rate of resultant certifications in a community hospital internal medicine training program. Design Retrospective review. Methods Five cohorts of resident physicians and their procedure data were analyzed comparing months where residents were unexposed to the intervention (pre-MPS) to months where residents were exposed to the intervention (post-MPS). We calculated the average number of procedures performed per month for pre- versus post-MPS periods. For procedural certification, we compared two proportions: the number of certifications over the number of 6-month pre-MPS periods and the number of certifications over the number of 6-month post-MPS periods. Setting/subjects The study was conducted at a community-based academic medical center. Subjects included all internal medicine residents. Results We found a statistically significant difference between the groups, with pre-MPS groups performing 4.3 procedures per month compared with post-MPS groups performing 6.7 procedures per month (p=0.0010). For certification rates, we found statistically significant differences in several categories – overall, paracentesis, femoral central lines, and jugular central lines. Conclusions This study demonstrated that resident exposure to an MPS statistically significantly increased the total number of procedures performed. This study also showed that overall certification rates were statistically significantly different between the pre- and post-MPS groups for several procedures. PMID:27406445

  15. Psychotherapy Training for Residents: Reconciling Requirements with Evidence-Based, Competency-Focused Practice

    Science.gov (United States)

    Weerasekera, Priyanthy; Manring, John; Lynn, David John

    2010-01-01

    Objective: The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies…

  16. Using Motivational Interviewing to Meet Core Competencies in Psychiatric Resident Training

    Science.gov (United States)

    Kaplan, Sebastian; Elliott, Harold

    2011-01-01

    Objective: The authors propose that motivational interviewing (MI), a brief intervention designed to manage ambivalence regarding complex behavior change, is well suited for integration into psychiatric residency training programs. Methods: The authors provide a brief description of MI. In addition, based on a review of the literature the authors…

  17. Using Motivational Interviewing to Meet Core Competencies in Psychiatric Resident Training

    Science.gov (United States)

    Kaplan, Sebastian; Elliott, Harold

    2011-01-01

    Objective: The authors propose that motivational interviewing (MI), a brief intervention designed to manage ambivalence regarding complex behavior change, is well suited for integration into psychiatric residency training programs. Methods: The authors provide a brief description of MI. In addition, based on a review of the literature the authors…

  18. The Competency Crisis and the High School Diploma.

    Science.gov (United States)

    Spady, William G.

    1978-01-01

    The high school diploma is attacked as providing inadequate evidence of student development, socialization, and achievement. Discussed are major potential consequences of the movement towards "competency-based education" affecting college admissions, curricula, graduation requirements, and student learning. (AF)

  19. Currículo baseado em competências na residência médica

    Directory of Open Access Journals (Sweden)

    Cláudia Regina Fernandes

    Full Text Available Competência foi definida como uma síntese de conhecimentos, habilidades e atitudes, que, integrados, propiciam ao indivíduo a utilização integrada dos recursos cognitivos e técnicos para diagnosticar, tratar e proporcionar benefício, menor morbidade ao doente e menor custo às instituições. Posteriormente, ampliou-se a definição, que passou a incorporar a dependência do contexto, necessidade de experiência, capacidade de reflexão e de continuar aprendendo. O objetivo deste estudo é descrever o currículo proposto e em implantação na Residência de Anestesiologia do Hospital Universitário Walter Cantídio (HUWC da Universidade Federal do Ceará, que foi embasado em seis competências principais: comunicação, documentação, cuidados pré-operatórios, cuidados intraoperatórios, cuidados pós-operatórios e gestão de qualidade e segurança no perioperatório. São também demonstrados os instrumentos que compõem o sistema de avaliação neste currículo: teste cognitivo, instrumento de avaliação de habilidades procedurais por observação direta (Dops, logbook, feedback de múltiplas fontes (MSF e avaliação dos preceptores pelos residentes. A implantação do currículo e dos processos de avaliação visou ampliar a qualificação do egresso do programa de residência médica em Anestesiologia do HUWC, assim como dos preceptores que participam do processo de formação desses especialistas.

  20. Developing leadership competencies among medical trainees: five-year experience at the Cleveland Clinic with a chief residents' training course.

    Science.gov (United States)

    Farver, Carol F; Smalling, Susan; Stoller, James K

    2016-10-01

    Challenges in healthcare demand great leadership. In response, leadership training programs have been developed within academic medical centers, business schools, and healthcare organizations; however, we are unaware of any well-developed programs for physicians-in-training. To address this gap, we developed a two-day leadership development course for chief residents (CRs) at the Cleveland Clinic, framed around the concept of emotional intelligence. This paper describes our five-year experience with the CRs leadership program. Since inception, 105 CRs took the course; 81 (77%) completed before-and-after evaluations. Participants indicated that they had relatively little prior knowledge of the concepts that were presented and that the workshop greatly enhanced their familiarity with leadership competencies. Qualitative analysis of open-ended responses indicated that attendees valued the training, especially in conflict resolution and teamwork, and indicated specific action plans for applying these skills. Furthermore, the workshop spurred some participants to express plans to learn more about leadership competencies. This study extends prior experience in offering an emotional intelligence-based leadership workshop for CRs. Though the program is novel, further research is needed to more fully understand the impact of leadership training for CRs and for the institutions and patients they serve. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  1. "Here for the residents": a case study of cultural competence of personal support workers in a long-term care home.

    Science.gov (United States)

    Tayab, Aysha; Narushima, Miya

    2015-03-01

    This study explores the perception of cultural competence of personal support workers (PSWs) in a long-term care (LTC) home in Ontario. As Canada's demography becomes older and more diverse, LTC homes will increasingly accommodate residents from various cultural backgrounds. However, few studies have examined cultural competence among PSWs in the LTC home setting. The study employed a qualitative case study approach. Data collection and analysis were conducted in three phases: document analysis of organizational policies, a key informant interview with the Director of Care, and two focus groups with PSWs. Our findings illuminated the PSWs' broad definition of culture, the process of developing cultural competence and its strong connections to person-centered care, and the organizational factors that facilitate or hinder PSWs' cultural competence. The ambiguous perception of cultural competence reported by PSWs suggests the need for more education and further research on this topic. © The Author(s) 2014.

  2. Development of a new valid, reliable, and internationally applicable assessment tool of residents' competence in ophthalmic surgery (an American Ophthalmological Society thesis).

    Science.gov (United States)

    Golnik, C; Beaver, Hilary; Gauba, Vinod; Lee, Andrew G; Mayorga, Eduardo; Palis, Gabriela; Saleh, George M

    2013-09-01

    To test the validity and reliability of a new tool for assessing residents' competence in ophthalmic surgery. Changing paradigms of ophthalmic education in the United States have influenced worldwide ophthalmic education and necessitated new methods of assessing resident competence. Accordingly, a new tool for assessing residents' competence in ophthalmic surgery (phacoemulsification) that could be applicable internationally was developed. We hypothesize that this instrument is valid and reliable. A panel of six international content experts adapted a previously published tool for assessing phacoemulsification. The tool (called the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric, or ICO-OSCAR:phaco) was reviewed by 12 international content experts for their constructive comments, which were incorporated to ensure content validity. Ten expert cataract surgery teachers then graded six recorded phacoemulsification surgeries with the ICO-OSCAR:phaco to investigate inter-rater reliability. The coefficient alpha statistic (a measure of reliability/internal consistency) for the ICO-OSCAR:phaco as a whole was 0.92, and 17 of its 20 dimensions had alpha coefficients greater than 0.70. The ICO-OSCAR:phaco is a valid and reliable assessment tool that could be applied internationally to satisfy the global need of new instruments to comply with emerging trends in ophthalmic education. A toolbox of similar surgical competency assessment tools is being developed.

  3. SOCIAL COMPETENCE DEVELOPMENT IN HIGH SCHOOL STUDENTS› SOCIALIZATION PROCESS

    Directory of Open Access Journals (Sweden)

    Anzhelika Ahmetovna Novikova

    2016-01-01

    The article presents the social competence structure and diagnostic methods; described author matrix of diagnosis and determination of students’ social competence formed level in high school educational space.

  4. Incorporation of core competency questions into an annual national self-assessment examination for residents in physical medicine and rehabilitation: results and implications.

    Science.gov (United States)

    Webster, Joseph B

    2009-03-01

    To determine the performance and change over time when incorporating questions in the core competency domains of practice-based learning and improvement (PBLI), systems-based practice (SBP), and professionalism (PROF) into the national PM&R Self-Assessment Examination for Residents (SAER). Prospective, longitudinal analysis. The national Self-Assessment Examination for Residents (SAER) in Physical Medicine and Rehabilitation, which is administered annually. Approximately 1100 PM&R residents who take the examination annually. Inclusion of progressively more challenging questions in the core competency domains of PBLI, SBP, and PROF. Individual test item level of difficulty (P value) and discrimination (point biserial index). Compared with the overall test, questions in the subtopic areas of PBLI, SBP, and PROF were relatively easier and less discriminating (correlation of resident performance on these domains compared with that on the total test). These differences became smaller during the 3-year time period. The difficulty level of the questions in each of the subtopic domains was raised during the 3 year period to a level close to the overall exam. Discrimination of the test items improved or remained stable. This study demonstrates that, with careful item writing and review, multiple-choice items in the PBLI, SBP, and PROF domains can be successfully incorporated into an annual, national self-assessment examination for residents. The addition of these questions had value in assessing competency while not compromising the overall validity and reliability of the exam. It is yet to be determined if resident performance on these questions corresponds to performance on other measures of competency in the areas of PBLI, SBP, and PROF.

  5. Recursive Model of a Methodical Competency Formation of a High School Teacher in the Context of Competency-Based Education

    Science.gov (United States)

    ??lekhina, ??rina Borisovna

    2015-01-01

    The present study examines the professional development problems of a high school teacher. A high school teacher is both a scientist and a teacher. Teaching and research activities are integrated by using methodical activity. Methodical competency of a teacher is defined as a basis in the context of Competence-based Education. The methodical…

  6. Clinical instructors' perception of a faculty development programme promoting postgraduate year-1 (PGY1) residents' ACGME six core competencies: a 2-year study.

    Science.gov (United States)

    Lee, Fa-Yauh; Yang, Ying-Ying; Hsu, Hui-Chi; Chuang, Chiao-Lin; Lee, Wei-Shin; Chang, Ching-Chih; Huang, Chia-Chang; Chen, Jaw-Wen; Cheng, Hao-Min; Jap, Tjin-Shing

    2011-01-01

    Objective The six core competencies designated by Accreditation Council for Graduate Medical Education (ACGME) are essential for establishing a patient centre holistic medical system. The authors developed a faculty programme to promote the postgraduate year 1 (PGY(1)) resident, ACGME six core competencies. The study aims to assess the clinical instructors' perception, attitudes and subjective impression towards the various sessions of the 'faculty development programme for teaching ACGME competencies.' Methods During 2009 and 2010, 134 clinical instructors participated in the programme to establish their ability to teach and assess PGY(1) residents about ACGME competencies. Results The participants in the faculty development programme reported that the skills most often used while teaching were learnt during circuit and itinerant bedside, physical examination teaching, mini-clinical evaluation exercise (mini-CEX) evaluation demonstration, training workshop and videotapes of 'how to teach ACGME competencies.' Participants reported that circuit bedside teaching and mini-CEX evaluation demonstrations helped them in the interpersonal and communication skills domain, and that the itinerant teaching demonstrations helped them in the professionalism domain, while physical examination teaching and mini-CEX evaluation demonstrations helped them in the patients' care domain. Both the training workshop and videotape session increase familiarity with teaching and assessing skills. Participants who applied the skills learnt from the faculty development programme the most in their teaching and assessment came from internal medicine departments, were young attending physician and had experience as PGY(1) clinical instructors. Conclusions According to the clinical instructors' response, our faculty development programme effectively increased their familiarity with various teaching and assessment skills needed to teach PGY(1) residents and ACGME competencies, and these clinical

  7. Cultivation of Intercultural Communicative Competence of Senior High School Students

    Institute of Scientific and Technical Information of China (English)

    苏丹

    2014-01-01

    With the trend of globalization in education and the strengthened position of English as a foreign language in China, the need to understand the cultural differences between Chinese and Western culture is becoming increasingly urgent, especially for the students in senior high schools in China. This paper is aimed to arouse the awareness of the urgency to improve the inter-cultural communication competence of the students in senior high school in China. It proposes four feasible and conducive sug-gestions for senior high schools in China to set up curriculum about Western culture to meet the needs of their students.

  8. A novel approach to assessing technical competence of colorectal surgery residents: the development and evaluation of the Colorectal Objective Structured Assessment of Technical Skill (COSATS).

    Science.gov (United States)

    de Montbrun, Sandra L; Roberts, Patricia L; Lowry, Ann C; Ault, Glenn T; Burnstein, Marcus J; Cataldo, Peter A; Dozois, Eric J; Dunn, Gary D; Fleshman, James; Isenberg, Gerald A; Mahmoud, Najjia N; Reznick, Richard K; Satterthwaite, Lisa; Schoetz, David; Trudel, Judith L; Weiss, Eric G; Wexner, Steven D; MacRae, Helen

    2013-12-01

    To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.

  9. Distributed Mentoring: Preparing Preservice Resident Teachers for High Needs Urban High Schools

    Science.gov (United States)

    Leon, Marjorie Roth

    2014-01-01

    A distributed mentoring model was implemented to scaffold preservice teachers completing a residency in high needs urban turnaround high schools. In this situated learning context, expert faculty and peer mentors contributed confirmatory insights for promoting engaged evidence-based pedagogy, instructional differentiation, homework completion,…

  10. Lack of Association between Blood Pressure Management by Anesthesia Residents and Competence Committee Evaluations or In-training Exam Performance: A Cohort Analysis.

    Science.gov (United States)

    Sessler, Daniel I; Makarova, Natalya; Riveros-Perez, Ricardo; Brown, David L; Kimatian, Stephen

    2016-02-01

    Prompt treatment of severe blood pressure instability requires both cognitive and technical skill. The ability to anticipate and respond to episodes of hemodynamic instability should improve with training. The authors tested the hypothesis that the duration of severe hypotension during anesthesia administered by residents correlates with concurrent adjusted overall performance evaluations by the Clinical Competence Committee and subsequent in-training exam scores. The authors obtained data on 70 first- and second-year anesthesia residents at the Cleveland Clinic. Analysis was restricted to adults having noncardiac surgery with general anesthesia. Outcome variables were in-training exam scores and subjective evaluations of resident performance ranked in quintiles. The primary predictor was cumulative systolic arterial pressure less than 70 mmHg. Secondary predictors were administration of vasopressors, frequency of hypotension, average duration of hypotensive episodes, and blood pressure variability. The primary statistical approach was mixed-effects modeling, adjusted for potential confounders. The authors considered 15,216 anesthesia care episodes. A total of 1,807 hypotensive episodes were observed, lasting an average of 32 ± 20 min (SD) per 100 h of anesthesia, with 68% being followed by vasopressor administration. The duration of severe hypotension (systolic pressure less than 70 mmHg) was associated with neither Competence Committee evaluations nor in-training exam scores. There was also no association between secondary blood pressure predictors and either Competence Committee evaluations or in-training exam results. There was no association between any of the five blood pressure management characteristics and either in-training exam scores or clinical competence evaluations. However, it remains possible that the measures of physiologic control, as assessed from electronic anesthesia records, evaluate useful but different aspects of anesthesiologist

  11. Context as Mediator: Teaching Residents' Opportunity and Learning in High-Need Urban Schools

    Science.gov (United States)

    Kolman, Joni S.; Roegman, Rachel; Goodwin, A. Lin

    2016-01-01

    This article presents findings from an exploratory empirical study of teaching residents' opportunities and learning within the overlapping contexts of English as a Second Language (ESL)/special education classrooms and high-need urban schools. Utilizing documentation from the first year of a teacher residency program, our findings illustrate the…

  12. The Medical Mission and Modern Core Competency Training: A 10-Year Follow-Up of Resident Experiences in Global Plastic Surgery.

    Science.gov (United States)

    Yao, Caroline A; Swanson, Jordan; McCullough, Meghan; Taro, Trisa B; Gutierrez, Ricardo; Bradshaw, Allison; Campbell, Alex; Magee, William P; Magee, William P

    2016-09-01

    The emphasis on cultural competency for physicians and surgeons is increasingly important, as communication with both patients and other providers significantly affects individual and system-wide outcomes. International surgical training has been shown to improve leadership skills, cultural competency, and technical proficiency of participants in short-term follow-up. This study explores the long-term impact of international surgical mission experiences on developing participants' core competencies, professional outcomes, and commitment to global health. All 208 plastic and reconstructive surgeons who completed the Operation Smile Regan/Stryker fellowship programs between 2006 and 2015 were surveyed electronically. One hundred sixty-five surveys were returned, for an overall response rate of 79.3 percent. The majority of participants reported that the fellowship positively impacted all six Accreditation Council for Graduate Medical Education core competencies. Most participants who were attending physicians at the time of the survey were practicing general plastic surgery, with 42 percent in an academic/teaching environment, 32 percent in assistant/associate professor positions, and 6 percent in either a program director or department chairman position. The majority currently volunteer on local or international missions, and all respondents would consider volunteering again. Carefully structured and rigorously proctored programs such as the Regan/Stryker Fellowship offer plastic surgery residents the opportunity to gain valuable professional and personal experiences that benefit them long after their service experience. Programs of this nature can not only effectively improve cultural competency of physicians, but also positively influence their attitudes toward leadership and direct that potential to meet the growing need for surgical care in low- and middle-income countries.

  13. Are Orthopaedic Residents Competent at Performing Basic Nonoperative Procedures in an Unsupervised Setting? A "Pop Quiz" of Casting, Knee Arthrocentesis, and Pressure Checks for Compartment Syndrome.

    Science.gov (United States)

    Abzug, Joshua M; O'Toole, Robert V; Paryavi, Ebrahim; Sterling, Robert

    2016-01-01

    Many patient care procedures are routinely performed by orthopaedic residents while not directly supervised by attending physicians. However, resident competence to perform these procedures is often presumed and not confirmed by objective measures. The purpose of this study was to formally evaluate 3 basic pediatric orthopaedic procedures commonly performed without attending supervision. All orthopaedic residents (n=20) were asked to complete 3 procedures (placement and removal of a short arm cast, aspiration of a knee joint, and compartment pressure checks of a leg) under direct attending supervision. Attending faculty developed a checklist for each procedure, listing the appropriate steps required and criteria with which to assess the final results. Scores were calculated, including means and SDs. Change in score by postgraduate year level was determined by simple linear regression. The mean score for short arm cast application and removal was 6.2 of a total possible score of 8, with an average 1.1 increase in score per year of training (Ppressures had an average score of 9.7 of 12, with an average increase in score of 0.5 per increase in year of training (P=0.087). Injecting an inappropriate amount of fluid and not recording measurements were the most common reasons for losing points. The ability of a resident to appropriately perform certain procedures without direct supervision improves with advancing level of training. The most junior residents might not appropriately be placing short arm casts, aspirating knee joints, or checking compartment pressures of the leg. Level II—Diagnostic.

  14. Impact of Residents on Surgical Outcomes in High-Complexity Procedures.

    Science.gov (United States)

    Ferraris, Victor A; Harris, Jennifer W; Martin, Jeremiah T; Saha, Sibu P; Endean, Eric D

    2016-04-01

    There are different views on the effects of resident involvement on surgical outcomes. We hypothesized that resident participation in surgical care does not appreciably alter outcomes. We analyzed an American College of Surgeons NSQIP subset of inpatients having procedures with high complexity, including 4 surgical specialties (general surgery, cardiothoracic surgery, neurosurgery, and vascular surgery) with the highest mean work relative value units. We evaluated surgical outcomes in patients having procedures performed by the attending surgeon alone, or by the attending surgeon with assistance from at least one surgical resident (PGY1 to PGY≥6). Outcomes measures included operative mortality, composite morbidity, and failure to rescue (FTR). Propensity-score matching minimized the effects of nonrandom assignment of residents to procedures. In 266,411 patients, unmatched comparisons showed significantly higher operative mortality and composite morbidity rates, but decreased FTR, in operations performed with resident involvement. After propensity-score matching, there were small but significant resident-related increases in composite morbidity, but significant improvement in FTR. Senior-level resident involvement translated into improved outcomes, especially in cardiothoracic surgery procedures where >63.6% of procedures had PGY≥6 resident involvement. Resident involvement attenuated the significant worsening of operative mortality and FTR associated with multiple serious complications in individual patients. Measures of resource use increased modestly with resident involvement. We found substantial improvement in FTR with resident involvement, both in unmatched and propensity-matched comparisons. Senior-level resident participation seemed to attenuate, and even improve, surgical outcomes, despite slightly increased resource use. These results provide some reassurance about teaching paradigms. Copyright © 2016 American College of Surgeons. Published by

  15. Investigating Social Competence in Students with High Intelligence

    Science.gov (United States)

    Schirvar, Wendi Margaret

    2013-01-01

    Social competence is vital for healthy development (Canto-Sperber & Dupuy, 2001; Spence, Barrett & Tuner, 2003). Beginning in childhood and heavily influenced by culture, social competence develops as we combine personal and environmental resources for positive social outcomes and includes the absence of negative behaviors alongside the…

  16. Implementation of a competency-based residency curriculum : experiences from a resource-limited environment in the Caribbean

    NARCIS (Netherlands)

    Busari, Jamiu O.; Verhagen, Eduard A. A.; Muskiet, Fred D.; Duits, Ashley J.

    2008-01-01

    Background: The introduction of competency-based curricula in institutions situated in resource-limited environments is likely to pose new challenges for the implementation process. The St. Elisabeth Hospital (SEHOS) in Curacao, Dutch Caribbean, is affiliated to university teaching hospitals in the

  17. Implementation of a competency-based residency curriculum : experiences from a resource-limited environment in the Caribbean

    NARCIS (Netherlands)

    Busari, Jamiu O.; Verhagen, Eduard A. A.; Muskiet, Fred D.; Duits, Ashley J.

    2008-01-01

    Background: The introduction of competency-based curricula in institutions situated in resource-limited environments is likely to pose new challenges for the implementation process. The St. Elisabeth Hospital (SEHOS) in Curacao, Dutch Caribbean, is affiliated to university teaching hospitals in the

  18. Multicultural Psychiatric Education: Using the DSM-IV-TR Outline for Cultural Formulation to Improve Resident Cultural Competence

    Science.gov (United States)

    Harris, Treniece Lewis; McQuery, Joy; Raab, Barbara; Elmore, Shekinah

    2008-01-01

    Objective: The authors present a 9-week multicultural competence course organized around the DSM-IV-TR Outline for Cultural Formulation. Method: The course alternated large group lectures with experiential small group discussions to acquire knowledge, develop skills, and explore attitudes. The authors evaluated the effectiveness of the course on…

  19. Increased self-efficacy: the experience of high-intensity exercise of nursing home residents with dementia - a qualitative study.

    Science.gov (United States)

    Olsen, Cecilie Fromholt; Telenius, Elisabeth Wiken; Engedal, Knut; Bergland, Astrid

    2015-09-14

    There has been increasing interest in the use of non-pharmacological interventions, such as physical exercise, to improve the well-being of nursing home residents with dementia. For reasons regarding disease symptoms, persons with dementia might find it difficult to participate in exercise programs. Therefore, it is important to find ways to successfully promote regular exercise for patients in residential care. Several quantitative studies have established the positive effects of exercise on biopsychosocial factors, such as self-efficacy in older people; however, little is known regarding the qualitative aspects of participating in an exercise program among older people with dementia. From the perspective of residents, we explored the experiences of participating in a high-intensity functional exercise program among nursing home residents with dementia. The participants were eight elderly people with mild-to-moderate dementia. We conducted semi-structured interviews one week after they had finished a 10-week supervised high-intensity exercise program. We analyzed the data using an inductive content analysis. Five overreaching and interrelated themes emerged from the interviews: "Pushing the limits," "Being invested in," "Relationships facilitate exercise participation," "Exercise revives the body, increases independence and improves self-esteem" and "Physical activity is a basic human necessity--use it or lose it!" The results were interpreted in light of Bandura's self-efficacy theory. The exercise program seemed to improve self-efficacy through several mechanisms. By being involved, "being invested in" and having something expected of them, the participants gained a sense of empowerment in their everyday lives. The importance of social influences related to the exercise instructor and the exercise group was accentuated by the participants. The nursing home residents had, for the most part, positive experiences with regard to participating in the exercise program

  20. Physical fitness and health indices in children, adolescents and adults with high or low motor competence.

    Science.gov (United States)

    Cantell, Marja; Crawford, Susan G; Tish Doyle-Baker, P K

    2008-04-01

    The overall purpose of the study was to examine if individuals with low motor competence achieve age-adequate fitness and health. A group of 149 children, adolescents, and adults with low or high motor competence participated in motor, fitness, and health assessments. Individuals with low motor competence did not differ on their basic physiological health parameters, but they had less optimal levels of overall health and fitness indices than those with high motor competence. As a function of age, musculoskeletal fitness was significantly compromised for the low motor competence group. The metabolic indices suggested that the low motor competence group had significantly higher BMI's compared to the high motor competence group. Motor skills and static balance were significant predictors of the BMI. Exercise intensity differed between children in the low and high motor competence group. The findings suggest that individuals with low motor competence have compromised health-related fitness. In order to discriminate between individuals with high and low motor competence, fitness assessment should include at least back extension, curl ups, and sit and reach. In addition, health-related fitness measurements such as BMI, waist circumference, blood lipid profile and bone mineral density are also recommended.

  1. Summary of ACOP (American College of Osteopathic Pediatricians) Program Directors' Annual Reports for First-Year Residents and Relationships between Resident Competency Performance Ratings and COMLEX-USA Test Scores

    Science.gov (United States)

    Langenau, Erik E.; Pugliano, Gina; Roberts, William L.; Hostoffer, Robert

    2010-01-01

    Context: The Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA) endorsed the use of competency-based assessment, with the intention to improve health care administration [1, 2]. High-stakes licensing exams, such as the Comprehensive Osteopathic Medical Licensing Examination -- USA (COMLEX-USA),…

  2. Current state of professional and core competency in pediatric residency program at Shiraz University of Medical Sciences: A local survey.

    Science.gov (United States)

    Ebrahimi, Sedigheh; Rezaee, Rita

    2015-10-01

    Accreditation assesses performance, or capacity to perform, against predetermined standards. It typically combines external quality assurance, through a process of peers review, with elements of self-regulation through internal and self-directed assessment. This study is an attempt to identify the quality of pediatrics residency educational programs regarding predetermined standards. This descriptive-analytical evaluation study of applied type was conducted during 2010 and 2011 in the pediatrics department of Shiraz Medical School, Iran. The assessment process occurred in several phases; at first an assessment model for a residency educational development and a series of educational criteria and indices were created based on WFME Standards. Multiple methods including a self-assessment questionnaire and several checklists were used to collect data, whereas systematic site visit, peer review and document reviewing were conducted with survey team. Due to limitation of the statistical society, all faculty members (n=34) and residents (n=41) of the pediatric department were asked to complete the survey. At last, descriptive and deductive statistics data analysis was performed using SPSS version 14. According to the records available in assessing program quality, it seems that the input criteria were desirable for the program based on the residents' viewpoints (86.6 %).There were proper physical facilities for them to meet the residency program goals.  The study indicated that the learning environment needed to be revised for the educational needs (Likert scale: 2.96±1.05). The peer evaluation team demonstrated achievement of mission fulfillment in the context of the objectives and indicators by meeting the desired themes.  In spite of some weaknesses in the process criteria, the criteria for output indicators were good according to the report (more than desired level of 75-80%). Accreditation is an important step towards strengthening the quality of educational

  3. High-fidelity simulation in anesthesiology training: a survey of Canadian anesthesiology residents' simulator experience.

    Science.gov (United States)

    Price, James W; Price, John R; Pratt, Dan D; Collins, John B; McDonald, Julie

    2010-02-01

    The objective of this survey was to explore Canadian anesthesiology residents' educational experience with high-fidelity simulation and to improve understanding of the factors perceived to have either a positive or a negative effect on residents' learning. In 2008, all Canadian anesthesiology residents (n = 599) were invited to complete a ten-minute anonymous online survey. Survey questions were derived from two sources, a literature search of MEDLINE (1966 to present), EMBASE (1980 to present), and the Cochrane and Campbell collaboration libraries and the experience of 25 pilot residents and the lead author. The survey response rate was 27.9% (n = 167). Junior residents (PGY1-3) responded that it would be helpful to have an introductory simulation course dealing with common intraoperative emergencies. The introduction of multidisciplinary scenarios (where nurses and colleagues from different specialties were involved in scenarios) was strongly supported. With respect to gender, male anesthesia residents indicated their comfort in making mistakes and asking for help in the simulator more frequently than female residents. In accordance with the ten Best Evidence Medical Education (BEME) principles of successful simulator education, Canadian centres could improve residents' opportunities for repetitive practice (with feedback), individualization of scenarios, and defined learning outcomes for scenarios. Anesthesiology residents indicate that simulation-based education is an anxiety provoking experience, but value its role in promoting safe practice and enhancing one's ability to deal with emergency situations. Suggestions to improve simulation training include increasing residents' access, adopting a more student-centred approach to learning, and creating a safer learning environment.

  4. Head-camera video recordings of trauma core competency procedures can evaluate surgical resident's technical performance as well as colocated evaluators.

    Science.gov (United States)

    Mackenzie, Colin F; Pasley, Jason; Garofalo, Evan; Shackelford, Stacy; Chen, Hegang; Longinaker, Nyaradzo; Granite, Guinevere; Pugh, Kristy; Hagegeorge, George; Tisherman, Samuel A

    2017-07-01

    Unbiased evaluation of trauma core competency procedures is necessary to determine if residency and predeployment training courses are useful. We tested whether a previously validated individual procedure score (IPS) for individual procedure vascular exposure and fasciotomy (FAS) performance skills could discriminate training status by comparing IPS of evaluators colocated with surgeons to blind video evaluations. Performance of axillary artery (AA), brachial artery (BA), and femoral artery (FA) vascular exposures and lower extremity FAS on fresh cadavers by 40 PGY-2 to PGY-6 residents was video-recorded from head-mounted cameras. Two colocated trained evaluators assessed IPS before and after training. One surgeon in each pretraining tertile of IPS for each procedure was randomly identified for blind video review. The same 12 surgeons were video-recorded repeating the procedures less than 4 weeks after training. Five evaluators independently reviewed all 96 randomly arranged deidentified videos. Inter-rater reliability/consistency, intraclass correlation coefficients were compared by colocated versus video review of IPS, and errors. Study methodology and bias were judged by Medical Education Research Study Quality Instrument and the Quality Assessment of Diagnostic Accuracy Studies criteria. There were no differences (p ≥ 0.5) in IPS for AA, FA, FAS, whether evaluators were colocated or reviewed video recordings. Evaluator consistency was 0.29 (BA) - 0.77 (FA). Video and colocated evaluators were in total agreement (p = 1.0) for error recognition. Intraclass correlation coefficient was 0.73 to 0.92, dependent on procedure. Correlations video versus colocated evaluations were 0.5 to 0.9. Except for BA, blinded video evaluators discriminated (p competency. Prognostic study, level II.

  5. High School Students Residing in Educational Public Institutions: Health-Risk Behaviors

    Science.gov (United States)

    Silveira, Nusa de Almeida; Noll, Matias; Barros, Patrícia de Sá

    2016-01-01

    Although several health-risk behaviors of adolescents have been described in the literature, data of high school students who reside at educational institutions in developing countries are scarce. This study aimed to describe behaviors associated with health risks among high school students who reside at an educational public institution and to associate these variables with the length of stay at the institution. This cross-sectional study was conducted during the year 2015 and included 122 students aged 14–19 years at a federal educational institution in the Midwest of Brazil; students were divided into residents of 20 months. Information concerning the family socioeconomic status and anthropometric, dietary and behavioral profiles was investigated. Despite being physically active, students exhibited risk-associated behaviors such as cigarette and alcohol use and risky sexual behaviors that were exacerbated by fragile socioeconomic conditions and distance from family. A longer time in residence at the institution was associated with an older age (p ≤ 0.001), adequate body mass index (BMI; p = 0.02), nutritional knowledge (p = 0.01), and less doses of alcohol consumption (p ≤ 0.01) compared with those with shorter times in residence. In conclusion, the students exhibited different health-risk behaviors, and a longer institutional residence time, compared with a shorter time, was found to associate with the reduction of health-risk behaviors. PMID:27560808

  6. High School Students Residing in Educational Public Institutions: Health-Risk Behaviors.

    Science.gov (United States)

    Noll, Priscilla Rayanne E Silva; Silveira, Nusa de Almeida; Noll, Matias; Barros, Patrícia de Sá

    2016-01-01

    Although several health-risk behaviors of adolescents have been described in the literature, data of high school students who reside at educational institutions in developing countries are scarce. This study aimed to describe behaviors associated with health risks among high school students who reside at an educational public institution and to associate these variables with the length of stay at the institution. This cross-sectional study was conducted during the year 2015 and included 122 students aged 14-19 years at a federal educational institution in the Midwest of Brazil; students were divided into residents of 20 months. Information concerning the family socioeconomic status and anthropometric, dietary and behavioral profiles was investigated. Despite being physically active, students exhibited risk-associated behaviors such as cigarette and alcohol use and risky sexual behaviors that were exacerbated by fragile socioeconomic conditions and distance from family. A longer time in residence at the institution was associated with an older age (p ≤ 0.001), adequate body mass index (BMI; p = 0.02), nutritional knowledge (p = 0.01), and less doses of alcohol consumption (p ≤ 0.01) compared with those with shorter times in residence. In conclusion, the students exhibited different health-risk behaviors, and a longer institutional residence time, compared with a shorter time, was found to associate with the reduction of health-risk behaviors.

  7. The Influence of Competence, Motivation, and Organisational Culture to High School Teacher Job Satisfaction and Performance

    Science.gov (United States)

    Arifin, H. Muhammad

    2015-01-01

    The study aims to find out and analyze the influence of competence, motivation, and organizational competence to high school teacher job satisfaction and performance in Jayapura City, Papua, Indonesia. The study was conducted on 117 respondents of 346 teachers by means of questionnaire. Data is analyzed by SEM analysis method in AMOS program.…

  8. 基于住院医师临床胜任力的医学模拟教学体系构建%Construction of medical simulation teaching system based on the clinical competence of resident doctors

    Institute of Scientific and Technical Information of China (English)

    罗茜; 康宝丽; 孙晓靓; 朱亚琴; 谭军; 徐增光; 陈义汉; 陈迟

    2015-01-01

    By introducing the international general simulation course and developing the series of simulation courses independently, Shanghai East Hospital has established series of objective indicators to evaluate the clinical competence of the residents.In the meantime, Shanghai East Hospital has also adopted the Kirkpatrick Model to do the self-evaluation of the teaching system, and to train the professional simulated medical teaching faculty.By doing so, we can set up a standardized implementation platform of medical simulation teaching system to provide an important guarantee for achieving and improving continuously the high-quality standardized training of the residents.%上海市东方医院引进了国际通用模拟课程及自主开发系列模拟课程,建立起客观系列指标评价住院医师临床胜任力,同时采用"柯氏评估法"对教学体系进行自我评价,并培养专业化模拟医学教学师资团队.从而构建起标准化的医学模拟教学体系实施平台,为实现和持续改进高质量的住院医师规范化培训提供了重要保证.

  9. Developing a high-performance team training framework for internal medicine residents: the ABC'S of teamwork.

    Science.gov (United States)

    Carbo, Alexander R; Tess, Anjala V; Roy, Christopher; Weingart, Saul N

    2011-06-01

    Effective teamwork and communication can prevent error and mitigate harm. High-performance team training was developed in the aviation industry for flight crews and is being incorporated in health care settings, such as emergency departments, operating rooms, and labor and delivery suites. We translated and adapted high-performance teamwork and communication principles from other industries and other disciplines to an inpatient internal medicine environment. We selected key principles from aviation and anesthesia crew training programs in 2004 and organized them into the ABC'S of teamwork. These included appropriate Assertiveness, effective Briefings, Callback and verification, Situational awareness, and Shared mental models. Based on this content, we developed a training session for internal medicine residents and faculty, and evaluated learners' patient safety attitudes and knowledge before and after training with a written survey. More than 50 residents participated in the module. The percentage of correct answers on a question related to key teamwork principles increased from 35% before training to 67% after training (P = 0.03). Before training, 65% of the residents reported that they "would feel comfortable telling a senior clinician his/her plan was unsafe"; this increased to 94% after training (P = 0.005). After the training session, residents were able to provide examples from their clinical practice that emphasized all of the ABC'S of teamwork. Teamwork principles can be adapted from other disciplines and applied to internal medicine. After a single session, residents displayed greater knowledge of teamwork principles and reported changed attitudes toward key teamwork behaviors.

  10. Are Simulation Stethoscopes a Useful Adjunct for Emergency Residents' Training on High-Fidelity Mannequins?

    Directory of Open Access Journals (Sweden)

    Steven J Warrington

    2013-05-01

    Full Text Available Introduction: Emergency medicine residents use simulation training for many reasons, such as gaining experience with critically ill patients and becoming familiar with disease processes. Residents frequently criticize simulation training using current high-fidelity mannequins due to the poor quality of physical exam findings present, such as auscultatory findings, as it may lead them down an alternate diagnostic or therapeutic pathway. Recently wireless remote programmed stethoscopes (simulation stethoscopes have been developed that allow wireless transmission of any sound to a stethoscope receiver, which improves the fidelity of a physical examination and the simulation case. Methods: Following institutional review committee approval, 14 PGY1-3 emergency medicine residents were assessed during 2 simulation-based cases using pre-defined scoring anchors on multiple actions, such as communication skills and treatment decisions (Appendix 1. Each case involved a patient presenting with dyspnea requiring management based off physical examination findings. One case was a patient with exacerbation of heart failure, while the other was a patient with a tension pneumothorax. Each resident was randomized into a case associated with the simulation stethoscope. Following the cases residents were asked to fill out an evaluation questionnaire. Results: Residents perceived the most realistic physical exam findings on those associated with the case using the simulation stethoscope (13/14, 93%. Residents also preferred the simulation stethoscope as an adjunct to the case (13/14, 93%, and they rated the simulation stethoscope case to have significantly more realistic auscultatory findings (4.4/5 vs. 3.0/5 difference of means 1.4, P = 0.0007. Average scores of residents were significantly better in the simulation stethoscope-associated case (2.5/3 vs. 2.3/3 difference of means 0.2, P = 0.04. There was no considerable difference in the total time taken per case

  11. High School 21+: A Competency-Based Diploma for Adults. Washington's Community and Technical Colleges

    Science.gov (United States)

    Washington State Board for Community and Technical Colleges, 2013

    2013-01-01

    Adults who lack a high school diploma now have a new way to get a second chance. It's called "High School 21+," a competency-based high school diploma offered at Washington's community and technical colleges. Adults 21 years old and older can go to participating colleges to earn a high school diploma. An advisor will look at transcripts…

  12. Initial performance of a modified milestones global evaluation tool for semiannual evaluation of residents by faculty.

    Science.gov (United States)

    Borman, Karen R; Augustine, Rebecca; Leibrandt, Thomas; Pezzi, Christopher M; Kukora, John S

    2013-01-01

    To determine whether faculty could successfully evaluate residents using a competency-based modified Milestones global evaluation tool. A program's leadership team modified a draft Surgery Milestones Working Group summative global assessment instrument into a modified Milestones tool (MMT) for local use during faculty meetings devoted to semiannual resident review. Residents were scored on 15 items spanning all competencies using an 8-point graphic response scale; unstructured comments also were solicited. Arithmetic means were computed at the resident and postgraduate year cohort levels for items and competency item sets. Score ranges (highest minus lowest score) were calculated; variability was termed "low" (range 2.0). A subset of "low" was designated "small" (1.0-1.9). Trends were sought among item, competency, and total Milestones scores. MMT correlations with examination scores and multisource (360°) assessments were explored. The success of implementing MMT was judged using published criteria for educational assessment methods. Fully accredited, independently sponsored residency. Program leaders and 22 faculty members (71% voluntary, mean 12y of experience). Twenty-six residents were assessed, yielding 7 to 13 evaluations for MMT per categorical resident and 3 to 6 per preliminary trainee. Scores spanned the entire response scale. All MMT evaluations included narrative comments. Individual resident score variability was low (96% within competencies and 92% across competencies). Subset analysis showed that small variations were common (35% within competencies and 54% across competencies). Postgraduate year cohort variability was higher (61% moderate or high within competencies and 50% across competencies). Cohort scores at the item, competency, and total score levels exhibited rising trajectories, suggesting MMT construct validity. MMT scores did not demonstrate concurrent validity, correlating poorly with other metrics. The MMT met multiple criteria for

  13. Early resident-to-resident physics education in diagnostic radiology.

    Science.gov (United States)

    Kansagra, Akash P

    2014-01-01

    The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula.

  14. ASYNCHRONICAL MEANS OF FORMING CROSS CULTURAL COMPETENCE OF HIGH SCHOOL STUDENTS (IN THE CASE OF ENGLISH LANGUAGE TEACHING

    Directory of Open Access Journals (Sweden)

    Valeriy G. Apalkov

    2014-01-01

    Full Text Available The article covers the key problems of forming cross cultural competence by means of asynchronic Internet-communication techniques. A concise overview of main studies in using e-mail group in forming cross cultural competence. An algorithm of forming cross cultural competence of high school students is described. 

  15. Interaction with a high-versus low-competence influence source in inductive reasoning.

    Science.gov (United States)

    Butera, Fabrizio; Caverni, Jean-Paul; Rossi, Sandrine

    2005-04-01

    Literature on inductive reasoning shows that when testing hypotheses, people are biased toward the use of confirmatory strategies (P. C. Wason, 1960). In the present article, the authors presented 2 studies showing how people use confirmation and disconfirmation strategies during actual interaction in problem solving. Study 1 showed that participants were able to learn to use disconfirmation when confronted with a low-competence, nonthreatening partner. When the partner was high in competence (thereby threatening the participant's competence), participants used confirmation, even when the partner used disconfirmation. In Study 2, the authors aimed at generalizing the aforementioned results by exploring the hypothesis that disconfirmation stems from the possibility of diverging from norms. Participants who were confronted with the violation of a conversational norm used a high proportion of disconfirmation, whatever the source of influence. When there was no violation but there was a low-competence partner, the proportion of disconfirmation was high; when there was no violation but there was a high-competence partner, the proportion of disconfirmation was low. The authors discussed the interpersonal functions of confirmation and disconfirmation.

  16. Supporting the Development of Emotional Intelligence Competencies to Ease the Transition from Primary to High School

    Science.gov (United States)

    Qualter, P.; Whiteley, H. E.; Hutchinson, J. M.; Pope, D. J.

    2007-01-01

    This study aims to explore (1) whether pupils with high emotional intelligence (EI) cope better with the transition to high school; and (2) whether the introduction of an intervention programme to support the development of EI competencies can increase EI and self-worth, and so ease the negative effects of transition. Results suggest that pupils…

  17. Teachers' and Administrators' Perceptions of Knowledge Management Competence of High School Administrators

    Science.gov (United States)

    Memisoglu, Salih Pasa

    2016-01-01

    This study aims to determine the teachers' and administrators' perceptions of knowledge management competence in high school administration. The study was conducted using the screening model and the study group consisted of 162 teachers and 35 administrators working at eight high schools in Turkey. Administrators' knowledge management competence…

  18. Spanish-speaking patients perceive high quality care in resident continuity practices: a CORNET study.

    Science.gov (United States)

    Krugman, Scott D; Parra-Roide, Lilia; Hobson, Wendy L; Garfunkel, Lynn C; Serwint, Janet R

    2009-04-01

    Prior research has demonstrated that limited English proficiency in Hispanic patients is associated with adverse health outcomes. The authors sought to compare the perception of primary care in resident practices between Spanish-speaking and English-speaking parents using a previously validated tool, the Parents' Perception of Primary Care. Using survey results from 19 CORNET sites nationwide, they compared mean scores for each primary care domain and the full scale between the groups using Student's t test. Multiple linear regression models compared outcomes controlling for demographic variables. Of the 2122 analyzable surveys, 490 (23%) were completed in Spanish and 1632 (77%) in English. The mean scores for each domain and the total scale were not statistically different between the 2 groups. After adjustment, Spanish-speaking parents rated communication significantly higher. Resident clinics may use systems to provide high quality care to Spanish-speaking patients, which may help other sites improve care.

  19. Cerebrovascular reactivity among native-raised high altitude residents: an fMRI study

    Directory of Open Access Journals (Sweden)

    Zhang Jiaxing

    2011-09-01

    Full Text Available Abstract Background The impact of long term residence on high altitude (HA on human brain has raised concern among researchers in recent years. This study investigated the cerebrovascular reactivity among native-born high altitude (HA residents as compared to native sea level (SL residents. The two groups were matched on the ancestral line, ages, gender ratios, and education levels. A visual cue guided maximum inspiration task with brief breath holding was performed by all the subjects while Blood-Oxygenation-Level-Dependent (BOLD functional Magnetic Resonance Imaging (fMRI data were acquired from them. Results Compared to SL controls, the HA group showed generally decreased cerebrovascular reactivity and longer delay in hemodynamic response. Clusters showing significant differences in the former aspect were located at the bilateral primary motor cortex, the right somatosensory association cortex, the right thalamus and the right caudate, the bilateral precuneus, the right cingulate gyrus and the right posterior cingulate cortex, as well as the left fusiform gyrus and the right lingual cortex; clusters showing significant differences in the latter aspect were located at the precuneus, the insula, the superior frontal and temporal gyrus, the somatosensory cortex (the postcentral gyrus and the cerebellar tonsil. Inspiratory reserve volume (IRV, which is an important aspect of pulmonary function, demonstrated significant correlation with the amount of BOLD signal change in multiple brain regions, particularly at the bilateral insula among the HA group. Conclusions Native-born HA residents generally showed reduced cerebrovascular reactivity as demonstrated in the hemodynamic response during a visual cue guided maximum inspiration task conducted with BOLD-fMRI. This effect was particularly manifested among brain regions that are typically involved in cerebral modulation of respiration.

  20. High prevalence of Clostridium difficile colonization among nursing home residents in Hesse, Germany.

    Directory of Open Access Journals (Sweden)

    Mardjan Arvand

    Full Text Available Clostridium difficile is the most common cause of antibiotic-associated diarrhoea in hospitals and other healthcare facilities. The elderly are particularly susceptible and at increased risk for adverse outcome as a result of C. difficile infection. The aim of this study was to determine the prevalence of C. difficile colonization among residents of nursing homes in Hesse and to compare it with the prevalence in the general population living outside long-term care facilities (LTCF. We assessed possible risk factors for C. difficile colonization and determined the genotype of circulating strains. C. difficile was isolated from 11/240 (4.6% nursing home residents and 2/249 (0.8% individuals living outside LTCF (p = 0.02. Ten of 11 (90.9% isolates from nursing homes and one of two isolates from the population outside LTCF were toxigenic. The prevalence of C. difficile colonization varied from 0% to 10% between different nursing homes. Facilities with known actual or recent CDI cases were more likely to have colonized residents than facilities without known CDI cases. C. difficile PCR-ribotypes 014 and 001 were the most prevalent genotypes and accounted for 30% and 20% of toxigenic isolates in nursing homes, respectively. Interestingly, no individuals carried the epidemic strain PCR-ribotype 027. Our results suggest that residents of nursing homes in Germany are at high risk for colonization by virulent C. difficile strains. The high prevalence of C. difficile colonization in nursing homes underscores the importance of good adherence to standard infection control precautions even in the absence of a diagnosed infection. They also emphasize the need for specific programs to increase the awareness of healthcare professionals in LTCF for CDI.

  1. The Social Competence of Highly Gifted Math and Science Adolescents

    Science.gov (United States)

    Lee, Seon-Young; Olszewski-Kubilius, Paula; Thomson, Dana

    2012-01-01

    Involving 740 highly gifted math and science students from two different countries, Korea and the United States, this study examined how these gifted adolescents perceived their interpersonal ability and peer relationships and whether there were differences between these two groups by demographic variables. Based on the survey data, results showed…

  2. High Hydrostatic Pressure Treatment of Porcine Oocytes before Handmade Cloning Improves Developmental Competence and Cryosurvival

    DEFF Research Database (Denmark)

    Du, Yutao; Lin, Lin; Schmidt, Mette

    2008-01-01

    An innovative technique, called the high hydrostatic pressure (HHP) treatment, has been recently reported to improve the cryosurvival of gametes or embryos in certain mammalian species. The aim of the present study was to investigate the in vitro and in vivo developmental competence and cryotoler......An innovative technique, called the high hydrostatic pressure (HHP) treatment, has been recently reported to improve the cryosurvival of gametes or embryos in certain mammalian species. The aim of the present study was to investigate the in vitro and in vivo developmental competence...... on day 5 of the estrous cycle. One recipient was diagnosed pregnant and gave birth to two healthy piglets by naturally delivery on day 122 of gestation. This pilot study proved that the sublethal HHP treatment of porcine oocytes before HMC results in improved in vitro developmental competence...

  3. Role of the altitude level on cerebral autoregulation in residents at high altitude.

    Science.gov (United States)

    Jansen, Gerard F A; Krins, Anne; Basnyat, Buddha; Odoom, Joseph A; Ince, Can

    2007-08-01

    Cerebral autoregulation is impaired in Himalayan high-altitude residents who live above 4,200 m. This study was undertaken to determine the altitude at which this impairment of autoregulation occurs. A second aim of the study was to test the hypothesis that administration of oxygen can reverse this impairment in autoregulation at high altitudes. In four groups of 10 Himalayan high-altitude dwellers residing at 1,330, 2,650, 3,440, and 4,243 m, arterial oxygen saturation (Sa(O(2))), blood pressure, and middle cerebral artery blood velocity were monitored during infusion of phenylephrine to determine static cerebral autoregulation. On the basis of these measurements, the cerebral autoregulation index (AI) was calculated. Normally, AI is between zero and 1. AI of 0 implies absent autoregulation, and AI of 1 implies intact autoregulation. At 1,330 m (Sa(O(2)) = 97%), 2,650 m (Sa(O(2)) = 96%), and 3,440 m (Sa(O(2)) = 93%), AI values (mean +/- SD) were, respectively, 0.63 +/- 0.27, 0.57 +/- 0.22, and 0.57 +/- 0.15. At 4,243 m (Sa(O(2)) = 88%), AI was 0.22 +/- 0.18 (P < 0.0005, compared with AI at the lower altitudes) and increased to 0.49 +/- 0.23 (P = 0.008, paired t-test) when oxygen was administered (Sa(O(2)) = 98%). In conclusion, high-altitude residents living at 4,243 m have almost total loss of cerebral autoregulation, which improved during oxygen administration. Those people living at 3,440 m and lower have still functioning cerebral autoregulation. This study showed that the altitude region between 3,440 and 4,243 m, marked by Sa(O(2)) in the high-altitude dwellers of 93% and 88%, is a transitional zone, above which cerebral autoregulation becomes critically impaired.

  4. Anxiety and stress among anaesthesiology and critical care residents during high-fidelity simulation sessions.

    Science.gov (United States)

    Bauer, Christian; Rimmelé, Thomas; Duclos, Antoine; Prieto, Nathalie; Cejka, Jean-Christophe; Carry, Pierre-Yves; Grousson, Sébastien; Friggeri, Arnaud; Secco, Julien; Bui-Xuan, Bernard; Lilot, Marc; Lehot, Jean-Jacques

    2016-12-01

    High-fidelity simulation (HFS) calls heavily upon cognitive capacities and generates stress and anxiety. The objectives of this prospective, observational study were to assess trait anxiety and fear of negative evaluation (FNE) in anaesthesiology and critical care residents and appraise their state anxiety levels and cardiovascular responses during HFS training sessions. First-year anaesthesiology and critical care residents completed the French-Canadian adaptation of the State-Trait Anxiety Inventory (IASTA Y-1: state anxiety, IASTA Y-2: trait anxiety) and the French adaptation of the Fear of Negative Evaluation Scale (FNE). Their heart rate (HR) and blood pressure (BP) were assessed before and after the training session. Twenty-three residents (8 women, 15 men) were included in the study. IASTA Y-1 and Y-2 scores were low (respectively 40.2±9.9 and 39.7±8) and FNE scores were moderate (16.7±5.5). HR measurements before and after the training sessions were significantly higher than at rest (respectively 78±19, 80±17 and 63±9b/min; Panxiety and FNE. HFS training increased their HR but not their BP. Their state anxiety also remained low. Several differences between individuals were noted, particularly between men and women. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  5. High-fidelity nursing simulation: impact on student self-confidence and clinical competence.

    Science.gov (United States)

    Blum, Cynthia A; Borglund, Susan; Parcells, Dax

    2010-01-01

    Development of safe nursing practice in entry-level nursing students requires special consideration from nurse educators. The paucity of data supporting high-fidelity patient simulation effectiveness in this population informed the development of a quasi-experimental, quantitative study of the relationship between simulation and student self-confidence and clinical competence. Moreover, the study reports a novel approach to measuring self-confidence and competence of entry-level nursing students. Fifty-three baccalaureate students, enrolled in either a traditional or simulation-enhanced laboratory, participated during their first clinical rotation. Student self-confidence and faculty perception of student clinical competence were measured using selected scale items of the Lasater Clinical Judgment Rubric. The results indicated an overall improvement in self-confidence and competence across the semester, however, simulation did not significantly enhance these caring attributes. The study highlights the need for further examination of teaching strategies developed to promote the transfer of self-confidence and competence from the laboratory to the clinical setting.

  6. High Disparity Between Orthopedic Resident Interest and Participation in International Health Electives.

    Science.gov (United States)

    Zhang, Steven; Shultz, Paul; Daniels, Alan; Ackelman, Edward; Kamal, Robin N

    2016-07-01

    Few orthopedic surgical residency programs offer international health electives (IHEs). Efforts to expand these programs have been increasing across medical disciplines. Whether orthopedic residents will participate remains unknown. This study quantified and characterized orthopedic resident interest and barriers to IHEs in US residency programs. A web-based survey was administered to residents from 154 US orthopedic residency programs accredited by the Accreditation Council for Graduate Medical Education 2014 to 2015. Questions assessed demographics and program background, previous medical experience abroad, barriers to participation, and level of interest in participating in an international health elective during their training and beyond. Twenty-seven (17.5%) residency programs responded. Chi-square analysis showed that residents who expressed interest in participating were significantly more likely to have experience abroad compared with those who expressed no interest (Porthopedic residencies (POrthopedics. 2016; 39(4):e680-e686.].

  7. The Preparation of Highly Motivated and Professionally Competent Teachers in Initial Teacher Education

    Science.gov (United States)

    Tang, Sylvia Y. F.; Wong, Angel K. Y.; Cheng, May M. H.

    2015-01-01

    Education systems around the world need to recruit highly motivated individuals to become teachers and prepare professionally competent teacher education graduates to take up these broadened and deepened roles and responsibilities with a deep and lasting engagement to the profession. This article reports on a mixed-methods study that examines…

  8. Core Competencies and the Prevention of High-Risk Sexual Behavior

    Science.gov (United States)

    Charles, Vignetta Eugenia; Blum, Robert Wm.

    2008-01-01

    Adolescent sexual risk-taking behavior has numerous individual, family, community, and societal consequences. In an effort to contribute to the research and propose new directions, this chapter applies the core competencies framework to the prevention of high-risk sexual behavior. It describes the magnitude of the problem, summarizes explanatory…

  9. Developing the Principal Technology Leadership Competency Indicators for Technical High Schools in K-12 in Taiwan

    Science.gov (United States)

    Shyr, Wen-Jye

    2017-01-01

    The purpose of this study was to develop principal technology leadership competency indicators for technical high schools in K-12 in Taiwan in order to improve the effectiveness of school administration and teaching. In the first part of the study, five experts in the technology leadership field are interviewed to explore the technology leadership…

  10. Students' Evaluation of Professional Personality Competencies of Physical Education Teachers Working in High Schools

    Science.gov (United States)

    Demir, Erdal

    2015-01-01

    The purpose of the study is to examine the relationship between professional personality competencies of physical education teachers working in high schools and gender, school type, and class variables of students. The study was organised according to the screening model. The study was carried out in a total of 17 schools, 16 state and one…

  11. Strengthening High School Teaching and Learning in New Hampshire's Competency-Based System

    Science.gov (United States)

    Haynes, Mariana

    2013-01-01

    For a century, most students have advanced from grade to grade based on the number of days they spend in class, but in New Hampshire, schools have moved away from "seat time" and toward "competency-based learning," which advances students when they have mastered course content. This report profiles how two high schools in New…

  12. Competencies That Count: Strategies for Assessing High-Performance Skills. LAB Working Paper No. 2.

    Science.gov (United States)

    Allen, Lili

    This guide provides a "road map" to the various ways that schools and employers assess high-performance competencies, such as problem solving, information management, and communication and negotiation skills. The guide begins with a brief analysis of why it is important to assess these skills in light of the current standards environment…

  13. Effectiveness of a Simulated Clinical Examination in the Assessment of the Clinical Competencies of Entry-Level Trainees in a Family Medicine Residency Programme

    Science.gov (United States)

    Curran, Vernon R.; Butler, Roger; Duke, Pauline; Eaton, William H.; Moffatt, Scott M.; Sherman, Greg P.; Pottle, Madge

    2012-01-01

    Clinical competence is a multidimensional concept and encompasses a variety of skills including procedural, problem-solving and clinical judgement. The initial stages of postgraduate medical training are believed to be a particularly important time for the development of clinical skill competencies. This study reports on an evaluation of a…

  14. 以能力为本全科医学住院医师培训方案的初步评价研究%Preliminary Evaluation of the General Medicine Residency Training Program Based on Competency

    Institute of Scientific and Technical Information of China (English)

    杜改燕; 王爽; 苏婷婷; 许龙龙; 齐殿君; 于晓松

    2012-01-01

    目的 以能力为本的全科医学住院医师培训方案实施过程中开展了形成性评价研究,以进一步完善培训方案,提高培训质量.方法 采用问卷调查、个别访谈、理论考试、客观结构化临床考试、360°评估等方法对全科医学住院医师培训实施方案进行中期评价研究.结果 本研究对由9个培训模块构成的、以能力为本的全科医学住院医师培训方案进行了中期评价研究,结果表明,该方案实施后,住院医师的道德素质、人际交往与沟通能力、医疗、教学能力均有不同程度的提高,同时强化了全科医师的核心能力.结论 以能力为本的全科医学住院医师培训方案有助于更好地为社区培养适宜的高素质全科医师.%Objective A formative evaluation study was conducted in the implementation process of the competency -based general medicine residency training program, in order to further improve training programs and increase effectiveness of training. Methods The questionnaire surveys, interviews, theoretical examinations, objective structured clinical tests, andgram. Results The study contained nine training modules, dealing with mid - term evaluation of competency - based general medicine residency training program. The results showed that, after the implementation of the program, the general practitioners' moral integrity, interpersonal and communication skills, and medical service and teaching competencies had to different degrees improved. Meanwhile, the core competencies of general practitioners were also enhanced. Conclusion The competency - based general medicine residency training program is conducive to training appropriate and qualified general practitioners for community.

  15. Affective variables, parental involvement and competence among South Korean high school learners of English

    Directory of Open Access Journals (Sweden)

    Annie Morris

    2013-10-01

    Full Text Available This study investigated the relationships between various affective variables and two measures of competence in English, for 190 South Korean high school students. A 55-item questionnaire was used to measure attitudes (Attitudes toward English Speakers and their Communities and Attitudes toward the English-speaking Culture, motivation (Motivational Intensity, Desire to Learn and Attitudes toward the Learning of English, amotivation, parental involvement (Active Parental Encouragement, Passive Parental Encouragement and Parental Pressure, parental disinterest and students’ competence in L2 (English- EXAM and English-SELF. Pearson product-moment coefficients indicate that active and passive forms of parental encouragement correlate with motivationto learn, as conceptualized by Gardner (1985, 2010, as well as with parental pressure, which suggests that South Korean students report undergoing forms of pressure when their parents actively or passively encourage them. Furthermore, the obtained correlations of the active and passive forms of encouragement with different variables suggest that the two forms represent two distinct concepts. While parental disinterest correlated negatively with motivational variables, parental pressure correlated only with motivational intensity, and only weakly. Therefore, parental pressure seems not to interact significantly with participants’ attitudes, motivation and competence. Multiple linear regression analyses confirm the importance of motivation to learn for students' L2 competence.

  16. The Theoretical Connotation and Systematic Essence of Core Competence of Agricultural High-tech Enterprises

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Six representative interpretations about the core competence of the corporate proposed by the researchers both at home and abroad from different perspectives are introduced,which includes "Resource theory","Capacity theory","Integration theory of assets and mechanism","Theory of consumer surplus","Theory of institutions and systems" and "Theory of innovation". It is pointed out that although these interpretations play an active role in enriching the theory of core competence,it still faces the problems to further deepen these interpretations:the first problem is how to give a precise definition;the second is about its extension;the third is on the logical and practical relationship between the production mechanism and its sustainable competitive advantages;the fourth is the problems in the production process and the corresponding management. Both the systematic essence and features of core competence are introduced:the first is the system self-organization process produced within the corporate;the second is the interaction between corporate system and environment;it needs a growing and evolution process. This paper briefly describes the essence of core competence of agricultural high-tech corporate,introduces its five features including systematicness,integration,non-imitation,ductility and non-equilibrium,and finally explains its component parts,mainly including corporate culture system,technological innovation system,human resource system,management capability system,corporate production and marketing system,financial capability system and adaptability system.

  17. Microbes residing in young organic rich Alaskan soils contain older carbon than those residing in old mineral high Arctic soils

    Science.gov (United States)

    Ziolkowski, L. A.; Slater, G. F.; Onstott, T. C.; Whyte, L.; Townsend-Small, A.

    2013-12-01

    Arctic soils range from very organic rich to low carbon and mineral-dominated soils. At present, we do not yet fully understand if all carbon in the Arctic is equally vulnerable to mineralization in a warmer climate. Many studies have demonstrated that ancient carbon is respired when permafrost has thawed, yet our understanding of the active layer and permafrost carbon dynamics is still emerging. In an effort to remedy this disconnect between our knowledge of surface fluxes and below ground processes, we used radiocarbon to examine the microbial carbon dynamics in soil cores from organic rich soils near Barrow, Alaska and mineral soils from the Canadian high Arctic. Specifically, we compared the microbial community using lipid biomarkers, the inputs of carbon using n-alkanes and measured the 14C of both the bulk organic carbon and of the microbial lipids. In theory, the microbial lipids (phospholipid fatty acids, PLFA) represent the viable microbial community, as these lipids are hydrolyzed quickly after cell death. Variations in the PLFA distributions suggested that different microbial communities inhabit organic rich Alaskan soils and those of the Canadian high Arctic. When the PLFA concentrations were converted to cellular concentration, they were within the same order of magnitude (1 to 5 x 108 cells/g dry soil) with slightly higher cell concentrations in the organic rich Alaskan soils. When these cellular concentrations were normalized to the organic carbon content, the Canadian high Arctic soils contained a greater proportion of microbes. Although bulk organic carbon 14C of Alaskan soils indicated more recent carbon inputs into the soil than the Canadian high Arctic soils, the 14C of the PLFA revealed the opposite. For corresponding depth horizons, microbes in Alaskan soils were consuming carbon 1000 to 1500 years older than those in the Canadian high Arctic. Differences between the 14C content of bulk organic carbon and the microbial lipids were much smaller

  18. Enhancing resident training in abortion and contraception through hospital-community partnership.

    Science.gov (United States)

    Sankey, Heather Z; Lewis, Rebekah S; O'shea, Donna; Paul, Maureen

    2003-09-01

    The study was undertaken to assess the efficacy of a hospital-community rotation in abortion and contraception. The program was developed and implemented by the Planned Parenthood League of Massachusetts (PPLM) and the Department of Obstetrics and Gynecology at Baystate Medical Center in November 2000. Abortion and contraceptive training is integrated into postgraduate year 3 and includes didactic presentations and 10 mandatory clinical sessions in first trimester abortion care. Five residents complete the program annually. Before rotation, residents report their competence in first-trimester abortion procedure as 2 on a scale of 1 to 5 (1=not at all comfortable, 5=very comfortable). After rotation, the reported competency rating is 4.5 on the same scale. Residents, trainers, and staff report high satisfaction with the program. A collaborative hospital-community rotation in abortion and contraception increases residents' clinical competence in these areas and is highly acceptable to residents, faculty, and staff.

  19. The construction and exploration of competency-based personalized resident training system%以能力为导向的个体化住院医师培训体系的建立与探索

    Institute of Scientific and Technical Information of China (English)

    倪诚; 李民; 韩彬; 张祺; 徐懋; 王军; 郭向阳

    2015-01-01

    我国的住院医师培训存在着发展不平衡、培训体系复杂、培训方式相对落后等问题.依托北京大学20年的住院医师培训经验和国内外的相关经验,北京大学第三医院以住院医师临床能力培训为核心,调动系统资源,注重医患沟通和医教研综合能力的培养;在此基础上,建立考核和反馈系统,根据住院医师的考核结果开展有针对性的培训,同时注意临床教师的培训并建立导师制,为住院医师的发展提供个体化指导;培训方法采用临床病例讨论、以问题为基础学习、模拟医学教学等多种形式:从而形成了以能力培养为导向、注重住院医师个体化特点和发展的住院医师规范化培训体系——个体化职业培训体系,为我国住院医师培训体系的改革、临床医师综合能力的提高和医疗资源的优化配置提供了切实可行的系统平台.%The resident training in China has a series of problems including imbalanced development,complicated training system,under-developed training methods and etc.Based on 20 years resident training experience in Peking University,and related domestic and foreign experience,Peking University Third Hospital has constructed competency-based resident training,which focuses on clinical competency training,as well as competencies of physician-patient communication,systems-based practice and teaching-research integration.Furthermore,assessment and feedback systems are constructed,and targeted training based on assessment results is developed.Clinical instructor training and tutorial system are also established,which provide personalized resident guidance.Training methods include clinical case discussion,problem based learning,medical simulation and etc.Thus,competency-based,personalized character and development focused standardized resident training ——personalized professional training system is formed,which provides possible system platformfor resident

  20. The Effect of School Supervisors Competence and School Principals Competence on Work Motivation and Performance of Junior High School Teachers in Maros Regency, Indonesia

    Science.gov (United States)

    Arman; Thalib, Syamsul Bachri; Manda, Darman

    2016-01-01

    This study aims at analyzing the effect of the competence of school supervisors and school principals on work motivation and performance of Junior High School teachers in Maros Regency. This research was a quantitative research by using survey approach. This approach was used because it is adjusted to the nature and assumptions of the study in…

  1. Affective variables, parental involvement and competence among South Korean high school learners of English

    OpenAIRE

    Annie Morris; Marc Lafontaine; François Pichette; Linda de Serres

    2013-01-01

    This study investigated the relationships between various affective variables and two measures of competence in English, for 190 South Korean high school students. A 55-item questionnaire was used to measure attitudes (Attitudes toward English Speakers and their Communities and Attitudes toward the English- speaking Culture), motivation (Motivational Intensity, Desire to Learn and Attitudes toward the Learning of English), amotivation, parental involvement (Active Parental E...

  2. COMPET: High resolution high sensitivity MRI compatible pre-clinical PET scanner

    CERN Document Server

    Hines, Kim-Eigard; Skretting, Arne; Rohne, Ole; Bjaalie, Jan G; Volgyes, David; Rissi, Michael; Dorholt, Ole; Stapnes, Steinar

    2013-01-01

    COMPET is a pre-clinical MRI compatible PET scanner which decouples sensitivity and resolution by the use of a novel detector design. The detector has been built using 8 x 8 cm(2) square layers consisting of 30 LYSO crystals (2 x 3 x 80 mm(2)) interleaved with 24 Wavelength Shifting Fibers (WLS) (3 x 1 x 80 mm(3)). By stacking several layers into a module, the point-of-interaction (POI) can be measured in 3D. Four layers form a PET ring where the sensitivity can be increased by stacking several layers. The layers can be stacked so that no inter-crystal or inter-module gap is formed. COMPET has used four assembled layers for module and scanner characterization. The modules are connected to the COMPET data-acquisition chain and the reconstructed images are produced with the novel geometry-independent COMPET image reconstruction algorithm. Time and energy resolution have been resolved and found to be around 4 as and 14% respectively. Tests for MRI interference and count rate performance have been carried out The...

  3. On-site storage of high level nuclear waste: attitudes and perceptions of local residents.

    Science.gov (United States)

    Bassett, G W; Jenkins-Smith, H C; Silva, C

    1996-06-01

    No public policy issue has been as difficult as high-level nuclear waste. Debates continue regarding Yucca Mountain as a disposal site, and-more generally-the appropriateness of geologic disposal and the need to act quickly. Previous research has focused on possible social, political, and economic consequences of a facility in Nevada. Impacts have been predicted to be potentially large and to emanate mainly from stigmatization of the region due to increased perceptions of risk. Analogous impacts from leaving waste at power plants have been either ignored or assumed to be negligible. This paper presents survey results on attitudes of residents in three counties where nuclear waste is currently stored. Topics include perceived risk, knowledge of nuclear waste and radiation, and impacts on jobs, tourism, and housing values from leaving waste on site. Results are similar to what has been reported for Nevada; the public is concerned about possible adverse effects from on-site storage of waste.

  4. Intellectual Ability, Self-Perceived Social Competence, and Depressive Symptomatology in Children with High-Functioning Autistic Spectrum Disorders

    Science.gov (United States)

    Vickerstaff, Sandy; Heriot, Sandra; Wong, Michelle; Lopes, Ana; Dossetor, David

    2007-01-01

    Although social competence deficits in children with high-functioning autistic spectrum disorders (HFASD) are well documented, there is little research investigating self-perceptions of social limitations. This study replicated research showing a negative association between self-perceived social competence and intellectual ability and…

  5. The body weight loss during acute exposure to high-altitude hypoxia in sea level residents.

    Science.gov (United States)

    Ge, Ri-Li; Wood, Helen; Yang, Hui-Huang; Liu, Yi-Ning; Wang, Xiu-Juan; Babb, Tony

    2010-12-25

    Weight loss is frequently observed after acute exposure to high altitude. However, the magnitude and rate of weight loss during acute exposure to high altitude has not been clarified in a controlled prospective study. The present study was performed to evaluate weight loss at high altitude. A group of 120 male subjects [aged (32±6) years] who worked on the construction of the Golmud-Lhasa Railway at Kunlun Mountain (altitude of 4 678 m) served as volunteer subjects for this study. Eighty-five workers normally resided at sea level (sea level group) and 35 normally resided at an altitude of 2 200 m (moderate altitude group). Body weight, body mass index (BMI), and waist circumference were measured in all subjects after a 7-day stay at Golmud (altitude of 2 800 m, baseline measurements). Measurements were repeated after 33-day working on Kunlun Mountain. In order to examine the daily rate of weight loss at high altitude, body weight was measured in 20 subjects from the sea level group (sea level subset group) each morning before breakfast for 33 d at Kunlun Mountain. According to guidelines established by the Lake Louise acute mountain sickness (AMS) consensus report, each subject completed an AMS self-report questionnaire two days after arriving at Kunlun Mountain. After 33-day stay at an altitude of 4 678 m, the average weight loss for the sea level group was 10.4% (range 6.5% to 29%), while the average for the moderate altitude group was 2.2% (-2% to 9.1%). The degree of weight loss (Δ weight loss) after a 33-day stay at an altitude of 4 678 m was significantly correlated with baseline body weight in the sea level group (r=0.677, P0.05). In the sea level subset group, a significant weight loss was observed within 20 d, but the weight remained stable thereafter. AMS-score at high altitude was significantly higher in the sea level group (4.69±2.48) than that in the moderate altitude group (2.97±1.38), and was significantly correlated with baseline body weight

  6. Using Reflections of Recent Resident Graduates and their Pediatric Colleagues to Evaluate a Residency Program

    Directory of Open Access Journals (Sweden)

    Robert K. Kamei, M.D.

    2003-01-01

    Full Text Available Background and Purposes: In response to the new Accreditation Council for Graduate Medical Education (ACGME mandate for residency programs to use feedback to improve its educational program, we piloted a novel evaluation strategy of a residency program using structured interviews of resident graduates working in a primary care practice and their physician associates. Methods: A research assistant performed a structured telephone interview. Quantitative data assessing the graduate’s self-assessment and the graduate’s clinical practice by the associate were analyzed. In addition, we performed a qualitative analysis of the interviews. Results: Thirteen resident graduates in primary care practice and seven physician practice associates participated in the study. Graduate self-assessment revealed high satisfaction with their residency training and competency. The associates judged our graduates as highly competent and mentioned independent decision-making and strong interpersonal skills (such as teamwork and communication as important. They specifically cited the graduate’s skills in intensive care medicine and adolescent medicine as well as communication and teamwork skills as important contributions to their practice. Conclusions: The ACGME Outcomes Project, which increases the emphasis on educational outcomes in the accreditation of residency education programs, requires programs to provide evidence of its effectiveness in preparing residents for practice. Direct assessment of the competency of our physician graduates in practice using structured interviews of graduates and their practice associates provide useful feedback information to a residency program as part of a comprehensive evaluation plan of our program’s curriculum and can be used to direct future educational initiatives of our training program

  7. Relating emotional intelligence to social competence and academic achievement in high school students.

    Science.gov (United States)

    Gil-Olarte Márquez, Paloma; Palomera Martín, Raquel; Brackett, Marc A

    2006-01-01

    This study investigated the discriminant, criterion and incremental validity of an ability measure of Emotional Intelligence (EI). High school students (N = 77) took the Mayer-Salovey-Caruso Emotional Intelligence Test - Spanish Version (MSCEIT V. 2.0, 2002), a measure of Big Five personality traits (BFQ; Caprara, Barbanelli, & Borgogni , 1993), an General Intelligence test (IGF-r 5; Yuste, 2002), and a social competence inventory (AECS; Moraleda, González, & García-Gallo, 1998). Students' academic grades also were obtained from official school records at the end of the school year. As predicted, the MSCEIT was discriminable from well-established measures of personality and intelligence. The test was also moderately related to social competence and predicted students' final grades. Most of the findings remained significant after personality and academic intelligence were statistically controlled. The potential utility of EI in the context of academic institutions is discussed.

  8. Assessing cataract surgical competency

    NARCIS (Netherlands)

    Lee, Andrew G.; Greenlee, Emily; Oetting, Thomas A.; Beaver, Hilary A.; Johnson, A. Tim; Boldt, H. Culver; Abramoff, Michael; Olson, Richard; Carter, Keith

    2007-01-01

    The Accreditation Council for Graduate Medical Education has mandated that all residency training programs teach and assess 6 general competencies.1 A.G. Lee and K.D. Carter, Managing the new mandate in resident education: A blueprint for translating a national mandate into local compliance, Ophthal

  9. Assessing cataract surgical competency

    NARCIS (Netherlands)

    Lee, Andrew G.; Greenlee, Emily; Oetting, Thomas A.; Beaver, Hilary A.; Johnson, A. Tim; Boldt, H. Culver; Abramoff, Michael; Olson, Richard; Carter, Keith

    2007-01-01

    The Accreditation Council for Graduate Medical Education has mandated that all residency training programs teach and assess 6 general competencies.1 A.G. Lee and K.D. Carter, Managing the new mandate in resident education: A blueprint for translating a national mandate into local compliance,

  10. Assessing cataract surgical competency

    NARCIS (Netherlands)

    Lee, Andrew G.; Greenlee, Emily; Oetting, Thomas A.; Beaver, Hilary A.; Johnson, A. Tim; Boldt, H. Culver; Abramoff, Michael; Olson, Richard; Carter, Keith

    2007-01-01

    The Accreditation Council for Graduate Medical Education has mandated that all residency training programs teach and assess 6 general competencies.1 A.G. Lee and K.D. Carter, Managing the new mandate in resident education: A blueprint for translating a national mandate into local compliance, Ophthal

  11. [What are the competencies that public health physician should have today? A proposal for a shared training program at three Hygiene and Preventive Medicine residency training schools in Rome (Italy)].

    Science.gov (United States)

    D'Andrea, Elvira; Lucaroni, Francesca; Parente, Paolo; Damiani, Gianfranco; La Torre, Giuseppe; Mancinelli, Sandro; Bucci, Roberto; De Vito, Corrado; Maurici, Massimo; De Vito, Elisabetta; Franco, Elisabetta; Villari, Paolo; Ricciardi, Walter

    2016-01-01

    To acquire essential knowledge and skills for Public Health practice, residents in Hygiene and Preventive Medicine programs should be provided with excellent training. On behalf of the Roman Public Health Academy (ARSP), the authors, representing the three Hygiene and Preventive Medicine residency training programs in Rome (Italy) aimed to propose a training program to be shared by the above three schools. Firstly, they performed a scientific literature review to identify the core competencies that a public health specialist should have acquired at the end of training. Ten areas (macro-areas or domains) relevant to Public Health practice were defined. The authors then identified the main characteristics that the proposed training program should have, which include: enhancement of community healthcare services and optimization of local resources to create/strengthen exchange and cooperation networks; possibility to adapt the training proposal to an international setting; adoption of a training approach that can respond effectively to a changing health system; customization of training on the basis of residents' individual abilities and motivations, so that their individual strengths can be enhanced; achievement of educational excellence, in compliance with ethical requirements.

  12. Sleep and the endogenous melatonin rhythm of high arctic residents during the summer and winter.

    Science.gov (United States)

    Paul, Michel A; Love, Ryan J; Hawton, Andrea; Arendt, Josephine

    2015-03-15

    The seasonal extremes of photoperiod in high latitudes place particular strain on the human circadian system. Arctic residence has been associated with poor sleep in both summer and winter. The goal of the work reported here was to study the circadian rhythms of individuals living in the high Arctic by measuring sleep variables and the timing of melatonin production. Two research trials were conducted in the built environment of CFS Alert (82° 29' 58″ N). Participants wore motion logging devices (actigraphs), which measure ambient light as well as motion, for 1week to provide data on sleep quantity, quality and light exposure. On the penultimate day of each trial, the participants were maintained together in a gymnasium with lounge chairs and saliva was collected at regular intervals to measure melatonin and assess the dim light melatonin onset (DLMO), offset (MelOFF), 50% rise and fall times of the whole profile and total production. In general, sleep duration was found to be significantly different between the January and June data collections at CFS Alert, with participants in June sleeping 50min on average less each day compared to their January counterparts. In June sleep was mistimed in many subjects relative to circadian phase as evidenced by the melatonin rhythm. Exposure to bright evening light was the most likely causal factor and should be avoided in the Arctic summer. The Arctic summer represents a particularly challenging environment for obtaining sufficient sleep. This has implications for the cognitive performance of staff during work hours.

  13. Prospective randomized comparison of standard didactic lecture versus high-fidelity simulation for radiology resident contrast reaction management training.

    Science.gov (United States)

    Wang, Carolyn L; Schopp, Jennifer G; Petscavage, Jonelle M; Paladin, Angelisa M; Richardson, Michael L; Bush, William H

    2011-06-01

    The objective of our study was to assess whether high-fidelity simulation-based training is more effective than traditional didactic lecture to train radiology residents in the management of contrast reactions. This was a prospective study of 44 radiology residents randomized into a simulation group versus a lecture group. All residents attended a contrast reaction didactic lecture. Four months later, baseline knowledge was assessed with a written test, which we refer to as the "pretest." After the pretest, the 21 residents in the lecture group attended a repeat didactic lecture and the 23 residents in the simulation group underwent high-fidelity simulation-based training with five contrast reaction scenarios. Next, all residents took a second written test, which we refer to as the "posttest." Two months after the posttest, both groups took a third written test, which we refer to as the "delayed posttest," and underwent performance testing with a high-fidelity severe contrast reaction scenario graded on predefined critical actions. There was no statistically significant difference between the simulation and lecture group pretest, immediate posttest, or delayed posttest scores. The simulation group performed better than the lecture group on the severe contrast reaction simulation scenario (p = 0.001). The simulation group reported improved comfort in identifying and managing contrast reactions and administering medications after the simulation training (p ≤ 0.04) and was more comfortable than the control group (p = 0.03), which reported no change in comfort level after the repeat didactic lecture. When compared with didactic lecture, high-fidelity simulation-based training of contrast reaction management shows equal results on written test scores but improved performance during a high-fidelity severe contrast reaction simulation scenario.

  14. Differences in food environment perceptions and spatial attributes of food shopping between residents of low and high food access areas.

    Science.gov (United States)

    Sohi, Inderbir; Bell, Bethany A; Liu, Jihong; Battersby, Sarah E; Liese, Angela D

    2014-01-01

    To explore potential differences in food shopping behaviors and healthy food availability perceptions between residents living in areas with low and high food access. A cross-sectional telephone survey to assess food shopping behaviors and perceptions. Data from an 8-county food environment field census used to define the Centers for Disease Control and Prevention (CDC) healthier food retail tract and US Department of Agriculture Economic Research Service food desert measure. A total of 968 residents in 8 South Carolina counties. Residents' food shopping behaviors and healthy food availability perceptions. Linear and logistic regression. Compared with residents in high food access areas, residents in low food access areas traveled farther to their primary food store (US Department of Agriculture Economic Research Service: 8.8 vs 7.1 miles, P = .03; CDC: 9.2 vs 6.1 miles, P shopping miles per week (CDC: 28.0 vs 15.4 miles; P shopping access (P < .001). These findings lend support to ongoing community and policy interventions aimed at reducing food access disparities. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  15. Development and implementation of a mini-Clinical Evaluation Exercise (mini-CEX) program to assess the clinical competencies of internal medicine residents: from faculty development to curriculum evaluation.

    Science.gov (United States)

    Liao, Kuo-Chen; Pu, Shou-Jin; Liu, Maw-Sen; Yang, Chih-Wei; Kuo, Han-Pin

    2013-02-26

    The mini-CEX is a valid and reliable method to assess the clinical competencies of trainees. Its data could be useful for educators to redesign curriculum as a process of quality improvement. The aim of this study was to evaluate a mini-CEX assessment program in our internal medicine residency training. We investigated the impact of mini-CEX workshops as a faculty development program on the acquisition of cognitive knowledge and the difference of practice behaviors among faculty members used the mini-CEX to assess residents' performance at work. We designed an observational, two-phase study. In the faculty development program, we started a mini-CEX workshop for trainers in 2010, and the short-term outcome of the program was evaluated by comparing the pretest and posttest results to demonstrate the improvement in cognitive knowledge on mini-CEX. From September 2010 to August 2011, we implemented a monthly mini-CEX assessment program in our internal medicine residency training. The data of these mini-CEX assessment forms were collected and analyzed. In the group of 49 mini-CEX workshop attendees, there was a statistically significant improvement in cognitive knowledge by comparing the pretest and posttest results (67.35 ± 15.25 versus 81.22 ± 10.34, p principles of mini-CEX as a formative assessment in regard to provision of feedback. However, a deficiency in engaging residents' reflection was found. Faculty development is a prerequisite to train evaluators in order to implement a successful mini-CEX assessment program. We demonstrated the effectiveness of our mini-CEX workshops in terms of knowledge acquisition and enhancement of giving feedback when the faculty members used the tool. Further programs on providing effective feedback should be conducted to increase the impact of the mini-CEX as a formative assessment.

  16. High-Dose Flu Shot May Help Nursing Home Residents Avoid Hospital

    Science.gov (United States)

    ... Flu Shot May Help Nursing Home Residents Avoid Hospital Rates of all-cause admission were significantly lower ... moved out of their comfortable environment to a hospital," noted Dr. Theodore Strange. "This [new vaccine] is ...

  17. Critical perspectives on cultural competence as a strategic opportunity for achieving high performance in healthcare organizations.

    Science.gov (United States)

    Strelitz, Philippa; Watson, Kerry

    2008-01-01

    * Cultural proficiency is a critical component of diversity competence. Diversity competency attends to issues of cultural proficiency and links cultural competence to issues of diverse representation and organizational inclusivity. * Developing and applying cultural competencies in diagnostic and invasive imaging services provides strategic opportunities to experience better patient cooperation, increase patient satisfaction, reduce medical errors, reduce patient complaints, and improve service recovery. * New Jersey recently passed legislation that requires 16 hours of cultural competency education as a condition of licensure to practice medicine. Four other states have similar legislation pending. The state of Washington passed legislation requiring all state accredited programs to include cultural competency education.

  18. 持续质量改进应用于住院医师临床能力考评%Application of Continuous Quality Improvement for Clinical Competence Assessment of Resident Physician

    Institute of Scientific and Technical Information of China (English)

    边琪; 薛芊; 宋彬; 郭志勇

    2013-01-01

    目的:探讨持续质量改进对提高住院医师临床能力考评效能的具体应用与收效。方法采用计划-实施-检查-处理( PDCA)循环应用的持续质量改进方法,改进住院医师临床能力考评效能。结果通过调查问卷、教学联席会等发现影响临床能力考评的主要问题包括临床实践机会少、考核形式较单一、评分标准不一致、人文观念欠缺等;通过开放临床技能中心、细化考评标准、多元化考评模式的应用、强化人文医学等方法,提高临床能力考评的效度与信度;一系列改进措施实施后再通过问卷调查评估质量改进效果,总结并提出质量改进方案。结论持续质量改进能有效提高住院医师临床能力考评效能,是一种实用、有效的方法,值得推广应用。%Objective To study the application of CQI in clinical competence assessment of resident physi-cians, and its effects.Methods Circulation of PDCA (plan-do-study-act) was implemented to improve the efficiency of clinical competence assessment .Results Questionnaire was implemented to evaluate the effect of CQI.The primary problems included less chance of clinical practice , single form of examination , scoring criteria inconsistency , deficiency of humanistic concept , etc.Many approaches were carried out to enhance the validity and reliability of examination of clinical competence , such as detailing assessment criteria , applying diversity assess-ments, strengthening humanistic concept .Conclusions CQI is an effective and practical way to improve the effi-ciency of clinical competence assessment in resident physicians .

  19. A novel program for clinical pathology training for residents emphasizing high-impact and attending-level learning opportunities.

    Science.gov (United States)

    Ranheim, Erik A

    2014-02-01

    Clinical pathology (CP) rotations in our residency program consistently received lower evaluations and lower scores on the Resident In-Service Exam (RISE) in comparison to anatomic pathology rotations. In 2010 to 2011, we instituted a new model for CP training, wherein the separate rotations for chemistry, transfusion medicine, molecular diagnostics, microbiology, and coagulation/immunology were combined into a 3-month "Superblock" in an effort to maximize and repeat high-impact learning opportunities in a team-based model. Resident and faculty satisfaction with the new curriculum and RISE scores were assessed in the 3 years before and after implementation of the curriculum. Large majorities of residents and faculty expressed increased satisfaction with the curriculum. Average RISE scores increased 8.3% in CP in the 3 years following introduction of the curriculum compared to the 3 years prior to introduction, while anatomic pathology average scores decreased by 1.5%. The CP Superblock provides a model of CP education which may address some of the difficulties in teaching CP topics and recruiting residents to CP specialization. The pros and cons of its implementation are discussed.

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

    NARCIS (Netherlands)

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

    2016-01-01

    Introduction: Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed w

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

    NARCIS (Netherlands)

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

    Introduction: Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed

  2. Attitudes of psychiatry residents toward mental illness

    Directory of Open Access Journals (Sweden)

    Pejović-Milovančević Milica

    2007-01-01

    Full Text Available Introduction. Attitudes of lay people and physicians towards mentally ill patients are frequently highly biased. The aim of this study was to investigate differences in attitudes of psychiatry and internal medicine residents toward mental illness and to establish the relationship between their attitudes and their personal characteristics. Material and methods. The sample consisted of 45 psychiatry and 36 internal medicine residents. The attitudes toward mental illness were assessed using Opinions about Mental Illness Questionnaire (OMI and personality traits were examined using the Eysenck Personality Questionnaire (EPQ. Results. Our findings showed that in regard to internal medicine residents, psychiatry residents do not consider mentally ill patients to be inferior and dangerous. Psychiatry residents have a benevolent attitude toward the mentally ill. Personality traits of psychiatry residents were not related to their opinions about mental illness. Discussion. The results suggest that there is a need to develop strategies that would bring about changes in the curriculum of training programs for medical residents, including proper training in mental health issues. Such strategies should help in destigmatization of persons with mental disorders and increase the competence of physicians to deal with mentally ill. .

  3. High-fidelity simulation enhances pediatric residents' retention, knowledge, procedural proficiency, group resuscitation performance, and experience in pediatric resuscitation.

    Science.gov (United States)

    Mills, David M; Wu, Chang L; Williams, Daniel C; King, Lydia; Dobson, Joseph V

    2013-07-01

    The goal of this study was to assess the effect of high-fidelity simulation (HFS) pediatric resuscitation training on resident performance and self-reported experience compared with historical controls. In this case-control study, pediatric residents at a tertiary academic children's hospital participated in a 16-hour HFS resuscitation curriculum. Primary outcome measures included cognitive knowledge, procedural proficiency, retention, and self-reported comfort and procedural experience. The intervention group was compared with matched-pair historical controls. Forty-one residents participated in HFS training with 32 matched controls. The HFS group displayed significant initial and overall improvement in knowledge (P historical controls but also reported increased real-life resuscitation experiences and related procedures.

  4. Competence is Competence

    DEFF Research Database (Denmark)

    Bramming, Pia

    2004-01-01

    The article will address competence, its' diffusion, application, and the consequence of this application within the field of Human Resource Management (HRM). The concept competence-in-practice will be presented and in conclusion the article will consider implications and possibilities of compete...

  5. Application of diversity assessment on clinical competence in standardized training of residents%多元化临床能力评估在住院医师规范化培训中的实践

    Institute of Scientific and Technical Information of China (English)

    宋彬; 边琪; 徐晓璐

    2011-01-01

    为了进一步提高住院医师规范化培训的质量,探索建立一套实用、有效的住院医师临床能力考评体系.通过在住院医师规范化培训的不同阶段联合应用迷你临床演练评估、病例答辩、临床步骤的直接观察和客观结构化临床考试等多种方法,对住院医师的临床能力进行全方位的评估.结果 表明,多元化评估方法的应用具有知识与技能并重、考核与培训互促、强化人文素质培养的优势,值得进一步推广.%To establish a practical and effective evaluation system for residents' clinical competence in the standardized residents training program, multiple means of Mini-CEX, Cbd, DOPS and OSCE were implemented in different stages of training. Results demonstrated that multi-directional and diverse evaluation strategies valued both knowledge and skills, mutually promoted training and evaluation, and intensified humane quality culture, which are worth popularizing.

  6. Physical Fitness Measures Among Adolescents With High and Low Motor Competence

    Directory of Open Access Journals (Sweden)

    Þórdís Gísladóttir

    2013-08-01

    Full Text Available Physical fitness level is considered to yield substantial health benefits. Earlier studies have demonstrated poor physical fitness outcomes and reduced level of physical activity among adolescents. There have been very few studies on adolescents concerning motor competence and its possible relationship with physical fitness. This study’s aim was to compare physical fitness in adolescents aged 15 to 16 years with high (HMC and low motor competence (LMC. From an initial sample of 94 adolescents, a group of 18 were identified as having HMC or LMC on the Movement Assessment Battery for Children-2. Eight adolescents (3 girls and 5 boys comprised the LMC group, and 10 children (5 girls and 5 boys made up the HMC group. To measure physical fitness, four tasks were used: one endurance test, one power test, one speed test (Test of Physical Fitness and one flexibility test (EUROFIT. A one-way ANOVA revealed significant differences between the group with LMC and the HMC group in all tasks except the endurance task (Reduced Cooper Test. The findings suggest that physical fitness components are negatively associated with LMC. However, no significant difference between the two groups in the Reduced Cooper Test might indicate that adolescents with LMC can enhance their cardiovascular fitness despite their poor motor coordination.

  7. Competing Risks Data Analysis with High-dimensional Covariates:An Application in Bladder Cancer

    Institute of Scientific and Technical Information of China (English)

    Leili Tapak; Massoud Saidijam; Majid Sadeghifar; Jalal Poorolajal; Hossein Mahjub

    2015-01-01

    Analysis of microarray data is associated with the methodological problems of high dimension and small sample size. Various methods have been used for variable selection in high-dimension and small sample size cases with a single survival endpoint. However, little effort has been directed toward addressing competing risks where there is more than one failure risks. This study compared three typical variable selection techniques including Lasso, elastic net, and likelihood-based boosting for high-dimensional time-to-event data with competing risks. The per-formance of these methods was evaluated via a simulation study by analyzing a real dataset related to bladder cancer patients using time-dependent receiver operator characteristic (ROC) curve and bootstrap .632+prediction error curves. The elastic net penalization method was shown to outper-form Lasso and boosting. Based on the elastic net, 33 genes out of 1381 genes related to bladder cancer were selected. By fitting to the Fine and Gray model, eight genes were highly significant (P< 0.001). Among them, expression of RTN4, SON, IGF1R, SNRPE, PTGR1, PLEK, and ETFDH was associated with a decrease in survival time, whereas SMARCAD1 expression was associated with an increase in survival time. This study indicates that the elastic net has a higher capacity than the Lasso and boosting for the prediction of survival time in bladder cancer patients. Moreover, genes selected by all methods improved the predictive power of the model based on only clinical variables, indicating the value of information contained in the microarray features.

  8. Factors related to the high fall rate in long-term care residents with dementia

    NARCIS (Netherlands)

    Kosse, Nienke M.; de Groot, Maartje H.; Vuillerme, Nicolas; Hortobagyi, Tibor; Lamoth, Claudine J. C.

    2015-01-01

    Background: Falls in long-term care residents with dementia represent a costly but unresolved safety issue. The aim of the present study was to (1) determine the incidence of falls, fall-related injuries and fall circumstances, and (2) identify the relationship between patient characteristics and fa

  9. Factors related to the high fall rate in long-term care residents with dementia

    NARCIS (Netherlands)

    Kosse, Nienke M.; de Groot, Maartje H.; Vuillerme, Nicolas; Hortobagyi, Tibor; Lamoth, Claudine J. C.

    Background: Falls in long-term care residents with dementia represent a costly but unresolved safety issue. The aim of the present study was to (1) determine the incidence of falls, fall-related injuries and fall circumstances, and (2) identify the relationship between patient characteristics and

  10. The Importance of Military Cultural Competence.

    Science.gov (United States)

    Meyer, Eric G; Writer, Brian W; Brim, William

    2016-03-01

    Military cultural competence has recently gained national attention. Experts have posited that limited outcomes in the treatment of posttraumatic stress disorder and depression in the military may be related to limited familiarity with the military. National surveys have indicated low military cultural competence among providers and limited educational efforts on military culture or pertinent military pathology in medical schools and residency training programs. Military families, with their own unique military cultural identity, have been identified as a population with increased risks associated with deployment. In response to these findings, several curricula regarding military culture have been established and widely distributed. Assessments of military cultural competence have also been developed. The clinical impact of enhanced cultural competence in general has thus far been limited. The military, however, with its highly prescribed cultural identity, may be a model culture for further study.

  11. The Development Of Career Competence Instrument Based On Computer Assisted Testing For Students Of Junior High Schools In Jakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Dr. Gantina Komalasari, M.Psi

    2015-12-01

    Full Text Available This research is motivated by results of theoretical studies and empirical facts about the importance of student’s career competence achievement, as well as the study of government policies on the mandate for the assessment in the specialization program/career counseling of Junior High School students. The research was aimed at developing student’s career competence standardized instrument based on Computer Assisted Testing (CAT which is effective as a support system of specialization program/career counseling in junior high schools. The study employed the standardized instrument development procedure (Anwar, 2010. The study population was all Grade IX students of Junior High School of Jakarta in the academic year of 2015/2016. The research sample was gained by using multistage cluster random sampling technique. Members of the research sample were 466 junior high school students representing the five regions of Jakarta. The data collection was performed by using Junior High School Student’s Career Competence Scale. The data were then analyzed by using validity and reliability tests. Operational data analysis was performed by using IBM SPSS version 20.0 for Windows. The results show that: first, all statements of Junior High School Student’s Career Competence Scale are valid because the Sig. (2-tailed < α (0.05; second, the reliability of Junior High School Student’s Career Competence Scale is in the high category because the reliability index reached r = 0.880. The final version of Junior High School Student’s Career Competence Scale consists of 43 items.

  12. Developing high-level change and innovation agents: competencies and challenges for executive leadership.

    Science.gov (United States)

    Malloch, Kathy; Melnyk, Bernadette Mazurek

    2013-01-01

    The work of health care reform and revolution requires leadership competencies that integrate the digital realities of time, space, and media. Leadership skills and behaviors of command, control, and directing from predigital times are no longer effective, given the impacts of the digital changes. Developing leadership competence in evidence-driven processes, facilitation, collaborative teamwork, and instilling a sense of urgency is the work of today's executive leaders. Ten competencies necessary for contemporary executive leadership are presented in this article.

  13. How we developed an emergency psychiatry training course for new residents using principles of high-fidelity simulation.

    Science.gov (United States)

    Thomson, Alex B; Cross, Sean; Key, Suzie; Jaye, Peter; Iversen, Amy C

    2013-10-01

    New psychiatry residents must rapidly acquire new clinical skills and learn to work effectively with new colleagues. In medical and surgical specialties, high-fidelity simulation with structured debriefing is widely used, but so far this has not been applied to psychiatry. We have developed a one-day simulation-based training course for emergency psychiatry which incorporates clinical and team-working skills training. Five scenarios covering key psychiatric emergencies are delivered in a purpose-built simulation facility. Patients are played by an actor or a high-fidelity manikin. Each scenario is followed by a 45-minute group debrief. Evaluation of a pilot group found that the course was well received and improved participants' workplace confidence. We are now planning to expand the course, provide it to all new residents and conduct further evaluation.

  14. Cultural competence and simulated patients.

    Science.gov (United States)

    Paroz, Sophie; Daele, Amaury; Viret, Francine; Vadot, Sara; Bonvin, Raphaël; Bodenmann, Patrick

    2016-10-01

    Cultural competence education is central in addressing the socio-cultural factors that affect health care; however, there is little agreement over the best teaching approach. Although simulated patients are widely used in medical education, little is known about their application to cultural competence education. At the Department of Ambulatory Care and Community Medicine, University of Lausanne, the content of a cultural competence education module for resident doctors was recently restructured, with a final session emphasising previous principles through a simulated patient-doctor encounter. We tested the feasibility of cultural competence training with simulated patients. We created two complementary case scenarios based on real clinical practice and focused on specific clinical skills. An interdisciplinary team trained two simulated patients, and a 90-minute pilot session took place. General satisfaction was high and the increased opportunity for interaction was greatly appreciated. According to the learners, the simulated case setting was relevant for improving self-reflection and cultural sensitivity: applying skills in the session enhanced perceived impact for 'real-world' practice. We tested the feasibility of cultural competence training with simulated patients The use of patient-centred simulated clinical practice as a teaching approach seems to be advantageous in increasing providers' self-reflection about cultural competence and intensifying the impact of cultural competence education in clinical practice, and hopefully will improve the quality of care for every patient. Case scenarios based on a diversity of socio-cultural factors and oriented towards a broad skills set would seem preferable to avoid cultural drift and to enhance the learning of cultural approaches that are adaptable to every patient. © 2016 John Wiley & Sons Ltd.

  15. A Framework for Assessing High School Students' Intercultural Communicative Competence in a Computer-Mediated Language Learning Project

    Science.gov (United States)

    Peng, Hsinyi; Lu, Wei-Hsin; Wang, Chao-I

    2009-01-01

    The purposes of this study were to identify the essential dimensions of intercultural communicative competence (ICC) and to establish a framework for assessing the ICC level of high school students that included a self-report inventory and scoring rubrics for online interaction in intercultural contexts. A total of 472 high school students from…

  16. Competencias transversales en la formación de especialistas en pediatría, Universidad de Chile Transversal competencies for specialists training in the Pediatrics Residency Program, University of Chile

    Directory of Open Access Journals (Sweden)

    L. Schonhaut-Berman

    2009-03-01

    specialties training programs (CT, that are important for the Pediatrics Residency Program (PFEP at the Chile University. Subjects and methods. Qualitative and interpretive study, performed between November 2006 and January 2007. Key persons were interviewed (6 residents, 6 graduates and 8 opinion leaders about the relevance and achievement of six CT. Results. The interviewed highlighted the necessity of trained pediatricians in ambulatory settings and continuity clinics, the acquisition of competencies in emergency units and basic skills in hospital training. They considered that the current training is lacking of important CT such as bioethics, physician-patient and family communication, public health, team work and evidence based medicine. Teaching skills and practice management are part of the medical profession; they could be introduced as an elective activity. Conclusion. The acquisition of CT during the PFEP transcend beyond the traditional clinical competencies, it is a challenge to introduce them in the PFEP.

  17. DEVELOPMENT PERSONALITY/SOCIAL COMPETENCY OF SECONDARY HIGH SCHOOL STUDENTS TROUGH A COMPREHENSIVE GUIDANCE AND COUNSELING PROGRAM

    Directory of Open Access Journals (Sweden)

    Anwar Sutoyo

    2015-10-01

    Full Text Available Abstract The goal this research is to find the effectiveness of model guidance and counseling comprehensive program to develop the personality/ social competency of secondary high school students.This research uses method one group pretest and posttest design. In data collecting technique, this research was directly done through interview, documentation and assessment scale.The conclusions of the research are, The model of guidance and counseling comprehensive program that developed is effective to evolving the personality/ social competency of secondary high school students. Therefore it, counselor need to have leadership ability, create an collaboration atmospherebetweenstakeholders, and tecnology information mastered. Keywords: Comprehensive Program; Personality/ Social Competency 

  18. Radioactivity levels in the mostly local foodstuff consumed by residents of the high level natural radiation areas of Ramsar, Iran.

    Science.gov (United States)

    Fathabadi, Nasrin; Salehi, Ali Akbar; Naddafi, Kazem; Kardan, Mohammad Reza; Yunesian, Masud; Nodehi, Ramin Nabizadeh; Deevband, Mohammad Reza; Shooshtari, Molood Gooniband; Hosseini, Saeedeh Sadat; Karimi, Mahtab

    2017-04-01

    Among High Level Natural Radiation Areas (HLNRAs) all over the world, the northern coastal city of Ramsar has been considered enormously important. Many studies have measured environmental radioactivity in Ramsar, however, no survey has been undertaken to measure concentrations in the diets of residents. This study determined the (226)Ra activity concentration in the daily diet of people of Ramsar. The samples were chosen from both normal and high level natural radiation areas and based on the daily consumption patterns of residents. About 150 different samples, which all are local and have the highest consumption, were collected during the four seasons. In these samples, after washing and drying and pretreatment, the radionuclide was determined by α-spectrometry. The mean radioactivity concentration of (226)Ra ranged between 5 ± 1 mBq kg(-1) wet weight (chino and meat) to 725 ± 480 mBq kg(-1) for tea dry leaves. The (226)Ra activity concentrations compared with the reference values of UNSCEAR appear to be higher in leafy vegetables, milk and meat product. Of the total daily dietary (226)Ra exposure for adults in Ramsar, the largest percentage was from eggs. The residents consuming eggs from household chickens may receive an elevated dose in the diet.

  19. Mature seed-derived callus of the model indica rice variety Kasalath is highly competent in Agrobacterium-mediated transformation.

    Science.gov (United States)

    Saika, Hiroaki; Toki, Seiichi

    2010-12-01

    We previously established an efficient Agrobacterium-mediated transformation system using primary calli derived from mature seeds of the model japonica rice variety Nipponbare. We expected that the shortened tissue culture period would reduce callus browning--a common problem with the indica transformation system during prolonged tissue culture in the undifferentiated state. In this study, we successfully applied our efficient transformation system to Kasalath--a model variety of indica rice. The Luc reporter system is sensitive enough to allow quantitative analysis of the competency of rice callus for Agrobacterium-mediated transformation. We unexpectedly discovered that primary callus of Kasalath exhibits a remarkably high competency for Agrobacterium-mediated transformation compared to Nipponbare. Southern blot analysis and Luc luminescence showed that independent transformation events in primary callus of Kasalath occurred successfully at ca. tenfold higher frequency than in Nipponbare, and single copy T-DNA integration was observed in ~40% of these events. We also compared the competency of secondary callus of Nipponbare and Kasalath and again found superior competency in Kasalath, although the identification and subsequent observation of independent transformation events in secondary callus is difficult due to the vigorous growth of both transformed and non-transformed cells. An efficient transformation system in Kasalath could facilitate the identification of QTL genes, since many QTL genes are analyzed in a Nipponbare × Kasalath genetic background. The higher transformation competency of Kasalath could be a useful trait in the establishment of highly efficient systems involving new transformation technologies such as gene targeting.

  20. The development of a TED-Ed online resident research training program.

    Science.gov (United States)

    Moreau, Katherine A; Pound, Catherine M; Peddle, Beth; Tokarewicz, Jaclyn; Eady, Kaylee

    2014-01-01

    Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians' research competencies, it is vital to integrate practical and context-specific research training into residency programs. To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1) critically evaluating research literature, 2) writing a research proposal, 3) submitting an application for research funding, and 4) writing a manuscript. This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents' scholarly roles. A formal evaluation of the research training program is now underway.

  1. Resident resistance.

    Science.gov (United States)

    Price, J L; Cleary, B

    1999-01-01

    Clearly, faculty must work hard with residents to explore the nature of their resistance to a program's learning and growth opportunities. Initial steps to a deeper, more effective, and longer-lasting change process must be pursued. If resident resistance is mishandled or misunderstood, then learning and professional growth may be sidetracked and the purposes of residency training defeated. Listening to the whole person of the resident and avoiding the trap of getting caught up in merely responding to select resident behaviors that irritate us is critical. Every faculty member in the family practice residency program must recognize resistance as a form of defense that cannot immediately be torn down or taken away. Resident defenses have important purposes to play in stress reduction even if they are not always healthy. Residents, especially interns, use resistance to avoid a deeper and more truthful look at themselves as physicians. A family practice residency program that sees whole persons in their residents and that respects resident defenses will effectively manage the stress and disharmony inherent to the resistant resident.

  2. Global Women's Health Education in Canadian Obstetrics and Gynaecology Residency Programs: A Survey of Program Directors and Senior Residents.

    Science.gov (United States)

    Millar, Heather C; Randle, Elizabeth A; Scott, Heather M; Shaw, Dorothy; Kent, Nancy; Nakajima, Amy K; Spitzer, Rachel F

    2015-10-01

    To become culturally competent practitioners with the ability to care and advocate for vulnerable populations, residents must be educated in global health priorities. In the field of obstetrics and gynaecology, there is minimal information about global women's health (GWH) education and interest within residency programs. We wished to determine within obstetrics and gynaecology residency programs across Canada: (1) current GWH teaching and support, (2) the importance of GWH to residents and program directors, and (3) the level of interest in a national postgraduate GWH curriculum. We conducted an online survey across Canada of obstetrics and gynaecology residency program directors and senior obstetrics and gynaecology residents. Of 297 residents, 101 (34.0%) responded to the survey and 76 (26%) completed the full survey. Eleven of 16 program directors (68.8%) responded and 10/16 (62.5%) provided complete responses. Four of 11 programs (36.4%) had a GWH curriculum, 2/11 (18.2%) had a GWH budget, and 4/11 (36.4%) had a GWH chairperson. Nine of 10 program directors (90%) and 68/79 residents (86.1%) felt that an understanding of GWH issues is important for all Canadian obstetrics and gynaecology trainees. Only 1/10 program directors (10%) and 11/79 residents (13.9%) felt that their program offered sufficient education in these issues. Of residents in programs with a GWH curriculum, 12/19 (63.2%) felt that residents in their program who did not undertake an international elective would still learn about GWH, versus only 9/50 residents (18.0%) in programs without a curriculum (P < 0.001). Obstetrics and gynaecology residents and program directors feel that GWH education is important for all trainees and is currently insufficient. There is a high level of interest in a national postgraduate GWH educational module.

  3. Service-Based Learning for Residents: A Success for Communities and Medical Education.

    Science.gov (United States)

    Gefter, Liana; Merrell, Sylvia Bereknyei; Rosas, Lisa G; Morioka-Douglas, Nancy; Rodriguez, Eunice

    2015-01-01

    Community-based service-learning opportunities could support residents' acquisition of Accreditation Council for Graduate Medical Education (ACGME) competencies, but this concept has not been tested, and such programs are difficult to find. The objective of this work was to assess the value and the ACGME competency relevance of a service-learning program for residents that could be easily replicated nationally. Forty-one family medicine residents from three training programs participated in the Stanford Youth Diabetes Coaches Program at six high schools in California and Georgia serving minority students of low socioeconomic status. Residents completed online surveys to provide qualitative feedback and assess the program's impact on their acquisition of residency program competencies and self-management support proficiencies, including prior use and planned use of action plans-a key self-management support strategy. Ninety-five percent of residents indicated that the program was a valuable experience that contributed to acquisition of residency program competencies, including interpersonal and communication skills and communication with teens. Compared with baseline, significantly more residents reported intention to use action plans with patients following participation. Themes from qualitative feedback included: valuing the overall experience, increasing opportunities to practice teaching, enhancing their ability to communicate with adolescents, contributing to the health of the community, recognizing the potential of action plans, and increasing intent to use action plans. This pilot demonstrated that a brief service-learning program can enhance standard residency curriculum by encouraging acquisition of ACGME competencies and promoting utilization of self-management support in clinical practice.

  4. Leadership development study :success profile competencies and high-performing leaders at Sandia National Laboratories.

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Katherine M.; Mulligan, Deborah Rae; Szenasi, Gail L.; Crowder, Stephen Vernon

    2005-04-01

    Sandia is undergoing tremendous change. Sandia's executive management recognized the need for leadership development. About ten years ago the Business, Leadership, and Management Development department in partnership with executive management developed and implemented the organizational leadership Success Profile Competencies to help address some of the changes on the horizon such as workforce losses and lack of a skill set in the area of interpersonal skills. This study addresses the need for the Business, Leadership, and Management Development department to provide statistically sound data in two areas. One is to demonstrate that the organizational 360-degree success profile assessment tool has made a difference for leaders. A second area is to demonstrate the presence of high performing leaders at the Labs. The study utilized two tools to address these two areas. Study participants were made up of individuals who have solid data on Sandia's 360-degree success profile assessment tool. The second assessment tool was comprised of those leaders who participated in the Lockheed Martin Corporation Employee Preferences Survey. Statistical data supports the connection between leader indicators and the 360-degree assessment tool. The study also indicates the presence of high performing leaders at Sandia.

  5. Relationships between Health-Related Fitness Knowledge, Perceived Competence, Self- Determination, and Physical Activity Behaviors of High School Students

    Science.gov (United States)

    Haslem, Liz; Wilkinson, Carol; Prusak, Keven A.; Christensen, William F.; Pennington, Todd

    2016-01-01

    The purpose of this study was (a) to test a hypothesized model of motivation within the context of conceptual physical education (CPE), and (b) to explore the strength and directionality of perceived competence for physical activity as a possible mediator for health-related fitness knowledge (HRFK) and physical activity behaviors. High school…

  6. Dome-shaped magnetic order competing with high-temperature superconductivity at high pressures in FeSe.

    Science.gov (United States)

    Sun, J P; Matsuura, K; Ye, G Z; Mizukami, Y; Shimozawa, M; Matsubayashi, K; Yamashita, M; Watashige, T; Kasahara, S; Matsuda, Y; Yan, J-Q; Sales, B C; Uwatoko, Y; Cheng, J-G; Shibauchi, T

    2016-07-19

    The coexistence and competition between superconductivity and electronic orders, such as spin or charge density waves, have been a central issue in high transition-temperature (Tc) superconductors. Unlike other iron-based superconductors, FeSe exhibits nematic ordering without magnetism whose relationship with its superconductivity remains unclear. Moreover, a pressure-induced fourfold increase of Tc has been reported, which poses a profound mystery. Here we report high-pressure magnetotransport measurements in FeSe up to ∼15 GPa, which uncover the dome shape of magnetic phase superseding the nematic order. Above ∼6 GPa the sudden enhancement of superconductivity (Tc≤38.3 K) accompanies a suppression of magnetic order, demonstrating their competing nature with very similar energy scales. Above the magnetic dome, we find anomalous transport properties suggesting a possible pseudogap formation, whereas linear-in-temperature resistivity is observed in the normal states of the high-Tc phase above 6 GPa. The obtained phase diagram highlights unique features of FeSe among iron-based superconductors, but bears some resemblance to that of high-Tc cuprates.

  7. A pilot study examining activity participation, sensory responsiveness, and competence in children with high functioning Autism Spectrum Disorder.

    Science.gov (United States)

    Reynolds, Stacey; Bendixen, Roxanna M; Lawrence, Tami; Lane, Shelly J

    2011-11-01

    This pilot study explored activity patterns in children with and without ASD and examined the role of sensory responsiveness in determining children's level of competence in activity performance. Twenty-six children with high functioning ASD and twenty-six typically-developing children 6-12 years old were assessed using the Sensory Profile and the Child Behavior Checklist. Results reflect differences in the types of activities and jobs/chores engaged in by children with ASD compared to children without ASD. Significant differences were seen in overall level of competence in activities, social, and school performance. Children demonstrating more frequent Sensory Sensitivity and Sensory Avoiding had significantly lower competence scores than children with fewer behaviors in these domains, suggesting that sensory responsiveness may impact the ability to participate successfully.

  8. Resident training in pathology: From resident's point of view

    Directory of Open Access Journals (Sweden)

    Kemal KÖSEMEHMETOĞLU

    2008-01-01

    Full Text Available In many recent studies in the literature have described and commented on “competency based resident training” in pathology. According to this model, competencies are subclassified in 6 main categories: Patient care, medical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism, and systems based practice. Assessment of competency forms the main component of this model.Under the framework of Ankara Society of Pathology, a working group, composed of 11 residents, 6 of which representing the Training and Research Hospitals of Ministry of Health and the rest representing the university hospitals in Ankara, was established in order to participate in the think-tank about resident training in pathology. A questionnaire, composed of 12 questions, was prepared. According to this questionnaire, the number of trainers in the university hospitals is much higher than in the commercial hospitals. While the total number of cases and cases per resident do not differ between the university and commercial hospitals, microscopes used for the educational purposes are significantly less in the commercial hospitals, that is due to less number of binocular microscopes. The amount of resident training program, which consists of intra and intersectional meetings, are similar in the university and commercial hospitals, however, theoretic lectures are given only in 3 departments. Residents working in the university hospitals have obviously heavier burden than in the commercial hospitals. Lastly, residents generally exclaimed that the time dedicated to the macroscopy training is less sufficient than time used for the microscopy training.The factors affecting the training of resident in pathology are divided into two main groups: 1 Factors directly affecting training (quality of trainer, time dedicated for education, feed back, eg. and 2 Conditions which waste residents' time. For instant, workload which does need

  9. THE DEVELOPMENT OF ENGLISH LANGUAGE TEACHING (ELT COMPETENCY-BASED SYLLABUS IN SENIOR HIGH SCHOOL

    Directory of Open Access Journals (Sweden)

    Besral Besral

    2012-07-01

    Full Text Available Although competency has long been the major concern in ELT either in the EFL or ESL contexts, the rise of competency-based syllabus launched by the Ministry of National Education (2006 brought about significant issue among the English teachers in the country. One of the crucial issues is that how to transfer the concepts of competences into the syllabus design.  Since a syllabus does not only contain a list of subject content, but also how curriculum planners (teachers reflect their understanding and belief about nature of language and of language teaching and learning, the ELT must be carried out to achieve communicative competence. Current investigation on the practices of ELT, however, indicates that English teachers are still walking in place, leaving the CC as a big slogan in their jobs.

  10. THE DEVELOPMENT OF ENGLISH LANGUAGE TEACHING (ELT COMPETENCY-BASED SYLLABUS IN SENIOR HIGH SCHOOL

    Directory of Open Access Journals (Sweden)

    Besral Besral

    2012-07-01

    Full Text Available Although competency has long been the major concern in ELT either in the EFL or ESL contexts, the rise of competency-based syllabus launched by the Ministry of National Education (2006 brought about significant issue among the English teachers in the country. One of the crucial issues is that how to transfer the concepts of competences into the syllabus design.  Since a syllabus does not only contain a list of subject content, but also how curriculum planners (teachers reflect their understanding and belief about nature of language and of language teaching and learning, the ELT must be carried out to achieve communicative competence. Current investigation on the practices of ELT, however, indicates that English teachers are still walking in place, leaving the CC as a big slogan in their jobs.

  11. Establishment of assessment system for comprehensive clinical competency of general practice residents%全科住院医师临床综合能力评价指标体系的研究

    Institute of Scientific and Technical Information of China (English)

    寿涓; 祝墡珠; 张向杰; 杨华

    2013-01-01

    Objective To establish a assessment system for comprehensive clinical competency of general practice residents.Methods An assessment system for comprehensive clinical competency of general practice residents was developed with modified Delphi expert consultation during November 2010 to October 2011.Thirty three experts in clinical practice,education and administration of general practice were invited for two-round Delphi questionnaire consultation.Results In two-round consultation,the expert activity coefficient was 100%,the authority coefficient was 0.852 and 0.855,and the coordination coefficient for the importance of the indicators was 0.228 and 0.245 respectively (P =0.000).The opinions among the experts became consistent from round 1 to round 2.An assessment system was established,which consisted of 5 first-level (professionalism,communicate skills,clinical competency and professional development ability) and 36 second-level indicators.Conclusion The index system established in this study may be used as references for evaluating comprehensive clinical abilities of general practitioners systematically and objectively.%目的 建立全科住院医师临床综合能力评价指标体系,有效地衡量全科医师的临床能力.方法 在2010年11月至2011年10月间,采用改进的Delphi专家咨询法,在上海市全科医师规范化培训临床基地和社区基地,遴选33名相关专业(全科医疗、教学、行政管理)的专家进行了两轮函询.结果 两轮函询中专家的积极系数均为100%;权威程度分别为0.852和0.855;评价指标重要性的专家协调系数分别为0.228和0.245(P=0.000),专家意见渐趋一致.最终建立了一套由5个一级指标(职业态度、沟通技能、临床能力、社区实践能力、职业发展能力)和36个二级指标组成的指标体系,用于上海市全科住院医师临床综合能力的评价.结论 建立的指标体系设置合理,能全面、客观地衡量全科住院医师的临床综合能力.

  12. The development of a TED-Ed online resident research training program

    Directory of Open Access Journals (Sweden)

    Katherine A. Moreau

    2014-12-01

    Full Text Available Background: Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians’ research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose: To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods: We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results: Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1 critically evaluating research literature, 2 writing a research proposal, 3 submitting an application for research funding, and 4 writing a manuscript. Discussion: This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents’ scholarly roles. A formal evaluation of the research training program is now underway.

  13. Social Competence with an Unfamiliar Peer in Children and Adolescents with High Functioning Autism: Measurement and Individual Differences.

    Science.gov (United States)

    Usher, Lauren V; Burrows, Catherine A; Schwartz, Caley B; Henderson, Heather A

    2015-09-01

    Children and adolescents with high functioning autism (HFA) display heterogeneity in social competence, which may be particularly evident during interactions with unfamiliar peers. The goal of this study was to examine predictors of social competence variability during an unfamiliar peer interaction. Thirty-nine participants with HFA and 39 age-, gender- and IQ-matched comparison participants were observed during dyadic laboratory interactions and detailed behavioral coding revealed three social competence dimensions: social initiative, social reciprocity, and social self-monitoring. Participants with HFA displayed higher social initiative but lower reciprocity than comparison participants. For participants with HFA, theory of mind was positively associated with observed initiative. For COM participants, social anxiety was negatively associated with reciprocity. However, for HFA participants, there was a quadratic relation between parent-reported social anxiety and observed reciprocity, demonstrating that low and high levels of anxiety were associated with low reciprocity. Results demonstrated the utility of our behavioral coding scheme as a valid assessment of social competence for children and adolescents with and without HFA. The curvilinear association between social anxiety and reciprocity highlights the importance of examining nonlinear relations in individuals with HFA, and emphasizes that discrete profiles of social anxiety in individuals with HFA may necessitate different treatment options.

  14. [Burnout in nursing residents].

    Science.gov (United States)

    Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum

    2011-03-01

    Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

  15. Residential Satisfaction and Friendship Formation in High- and Low-Rise Student Housing: An Interactional Analysis

    Science.gov (United States)

    Holahan, Charles J.; Wilcox, Brian L.

    1978-01-01

    An analysis of the interaction between social competence and type of environment showed that residents of low-rise dormitories were significantly more satisfied and established more dormitory-based friendships than residents of a high-rise mega-dorm setting. A number of interactions were found between social competence, type of environment, and…

  16. Preparing residents for family practice: role of an integrated “Triple C” curriculum

    Directory of Open Access Journals (Sweden)

    Joseph Lee

    2013-03-01

    Full Text Available Background: There is limited understanding of the impact of Triple C competency-based curriculums on the preparation of residents for family practice. This paper describes a competency-based curriculum within an integrated longitudinal block design and presents preliminary evaluation data on the impact of this curriculum on preparedness for family practice. Methods: First and second year family medicine residents were surveyed as a component of a year-end program evaluation to assess the extent to which the residency program is preparing them to engage in a variety of practice domains, the likelihood that they would engage in these domains, and the extent to which this residency program is comprehensive, relevant to their development as a family physician, and promotes interprofessional practice. Results: Residents perceived themselves as prepared to engage in most practice areas and their intentions to engage in various practice domains were positively correlated to their ratings of preparedness. Ratings reflected that residents perceived this program as comprehensive and relevant to their development as a family physician and they perceived a high degree of encouragement for interprofessional practice. Conclusions: This study provides some preliminary evidence that an integrated competency-based curriculum, with an emphasis on interprofessional practice has the potential to effectively prepare residents for practice in family medicine.

  17. Are residents of high-walkable areas satisfied with their neighbourhood?

    Science.gov (United States)

    Grasser, Gerlinde; Titze, Sylvia; Stronegger, Willibald J

    2016-01-01

    While the association between walkability and walking for transport has been well established, less is known about the association between walkability and neighbourhood satisfaction. This study aims to examine the direction and strength of the association between objective measures of residential walkability and neighbourhood satisfaction, as well as the differences by sex. Using a cross-sectional study design, outcome data were derived from the representative cross-sectional survey (n = 843) 'Bicycle-friendly City' of adults in the city of Graz (Austria). Walkability was measured as gross population density, household unit density, entropy index, proportion of mixed land use, three-way intersection density, four-way intersection density and walkability indices. The outcomes were measured as general neighbourhood satisfaction and neighbourhood satisfaction with the general socio-environmental quality, social cohesion and local infrastructure. Logistic regression analyses were conducted, including age, socio-economic status and place of residence. Walkability was negatively associated with general neighbourhood satisfaction, neighbourhood satisfaction with general socio-environmental quality and social cohesion. It was positively associated with neighbourhood satisfaction with local infrastructure. Connectivity and the entropy index showed the weakest or no association with the outcomes. The strongest association was between walkability and neighbourhood satisfaction with socio-environmental quality. There were no differences by sex. These results contribute to the current limited understanding of the association between walkability and neighbourhood satisfaction, especially in a European context. More comparable, longitudinal research would be helpful to determine what impact walkability has on neighbourhood satisfaction and to identify the important mediating factors.

  18. The graduate nurse experience: qualitative residency program outcomes.

    Science.gov (United States)

    Fink, Regina; Krugman, Mary; Casey, Kathy; Goode, Colleen

    2008-01-01

    Graduate nurses experience role conflict and stress as they begin practice in work environments of high complexity, nurse shortages, and expectations to become competent rapidly. The authors report outcomes from a study that evaluated qualitative responses to the Casey-Fink Graduate Nurse Experience Survey administered to graduate nurse residents in the University HealthSystem Consortium/American Association of Colleges of Nursing postbaccalaureate nurse residency program at 12 academic hospital sites. Qualitative analysis provided sufficient evidence to convert specific open-ended questions on the Casey-Fink Graduate Nurse Experience Survey instrument to a quantitative format for ease of administration and analysis.

  19. ACGME core competencies: where are we?

    Science.gov (United States)

    Yaszay, Burt; Kubiak, Erik; Agel, Julie; Hanel, Douglas P

    2009-03-01

    Beginning in July 2002, the Accreditation Council for Graduate Medical Education (ACGME) instructed all residency programs to require their residents to demonstrate competency in 6 core areas: patient care, interpersonal and communication skills, medical knowledge, professionalism, practice-based learning, and systems-based practice. The goal was to have objective markers of performance that would serve as a gauge to determine a program's accreditation. To determine the experiences of orthopedic residency programs with regard to the ACGME's core competencies, a national survey was administered to orthopedic program directors and selected orthopedic residents. Of those orthopedic programs that responded, most appeared to be complying with the ACGME requirements. Both directors and residents thought patient care and medical knowledge ranked most important, while practice-based learning and systems-based practice were assigned the lowest ranks. Barriers to implementation of the core competencies included low priority compared with clinical duties, lack of faculty or resident education, and lack of formal orthopedic core competencies. Residents and program directors agreed that their programs would benefit from a definition of each of the core competencies, including a greater commitment to the processes involved in surgical procedures. This study demonstrated a commitment to the core competencies by the programs that responded. The survey also suggested this commitment would be aided by improved definitions of some of the competencies for the orthopedic resident.

  20. Adaptive response of blood lymphocytes of inhabitants residing in high background radiation areas of ramsar- micronuclei, apoptosis and comet assays.

    Science.gov (United States)

    Mohammadi, Shahla; Taghavi-Dehaghani, Mahnaz; Gharaati, Mohammad R; Masoomi, Reza; Ghiassi-Nejad, Mehdi

    2006-11-01

    The hot springs in certain areas of Ramsar contain (226)Ra and (222)Rn. The effects of natural radiation on the inhabitants of these areas and the inhabitant's radiosensitivity or adaptive responses were studied. One group of volunteers from areas with high natural background radiation and another group from areas with normal background radiation were chosen as the case and control group respectively. The frequency of micronuclei, apoptosis, and DNA damage in peripheral blood mononuclear cells were measured following gamma irradiation (4 Gy). The incidence of micronuclei in the case group was significantly lower than that in the control group while their frequency of apoptosis was higher (P sites, the individuals in the case group are more sensitive and susceptible to DNA damage. The results of micronuclei, apoptosis and repair studies suggest that an adaptive response might be induced in people residing in areas with high background radiation.

  1. An examination of the perceived teaching competencies of novice alternatively licensed and traditionally licensed high school science teachers

    Science.gov (United States)

    Shea, Kathleen A.

    In most states, there are two routes to teacher licensure; traditional and alternative. The alternative route provides an accelerated entry into the classroom, often without the individual engaging in education coursework or a practicum. No matter the route, teaching skills continue to be learned by novice teachers while in the classroom with the guidance of a school-based mentor. In this study, the perceptions of mentor teachers of traditionally and alternatively licensed high school science teachers were compared with respect to mentees' science teaching competency. Further, the study explored the novice teachers' self-perception of their teaching competency. A survey, consisting of 56 Likert-type questions, was completed by mentors (N = 79) and novice high school science teachers (N = 83) in six northeastern states. The results revealed a statistically significant difference in the perceptions of the mentors of traditionally and alternatively licensed novice high school science teachers in the areas of general pedagogical knowledge, pedagogical content knowledge and professional growth, with more favorable perceptions recorded by mentors of traditionally licensed science teachers. There were no differences in the perceptions of the mentors with respect to novice high school teachers' content knowledge. There was no statistical difference in the self-perceptions of competency of the novice teachers. While alternative routes to licensure in science may be a necessity, the results of this study indicate that the lack of professional preparation may need to be addressed at the school level through the agency of the mentor. This study indicates that mentors must be prepared to provide alternatively licensed novice teachers with different assistance to that given to traditionally licensed novice teachers. School districts are urged to develop mentoring programs designed to develop the teaching competency of all novice teachers regardless of the route that led them

  2. Development of a Comprehensive Communication Skills Curriculum for Pediatrics Residents.

    Science.gov (United States)

    Peterson, Eleanor B; Boland, Kimberly A; Bryant, Kristina A; McKinley, Tara F; Porter, Melissa B; Potter, Katherine E; Calhoun, Aaron W

    2016-12-01

    Effective communication is an essential element of medical care and a priority of medical education. Specific interventions to teach communication skills are at the discretion of individual residency programs. We developed the Resident Communication Skills Curriculum (RCSC), a formal curriculum designed to teach trainees the communication skills essential for high-quality practice. A multidisciplinary working group contributed to the development of the RCSC, guided by an institutional needs assessment, literature review, and the Accreditation Council for Graduate Medical Education core competencies. The result was a cohesive curriculum that incorporates didactic, role play, and real-life experiences over the course of the entire training period. Methods to assess curricular outcomes included self-reporting, surveys, and periodic faculty evaluations of the residents. Curricular components have been highly rated by residents (3.95-3.97 based on a 4-point Likert scale), and residents' self-reported communication skills demonstrated an improvement over the course of residency in the domains of requesting a consultation, providing effective handoffs, handling conflict, and having difficult conversations (intern median 3.0, graduate median 4.0 based on a 5-point Likert scale, P ≤ .002). Faculty evaluations of residents have also demonstrated improvement over time (intern median 3.0, graduate median 4.5 based on a 5-point Likert scale, P communication skills curriculum for pediatrics residents was implemented, with a multistep evaluative process showing improvement in skills over the course of the residency program. Positive resident evaluations and informal comments from faculty support its general acceptance. The use of existing resources makes this curriculum feasible.

  3. High prevalence of type 2 diabetes in Iraqi and Swedish residents in a deprived Swedish neighbourhood - a population based study

    Directory of Open Access Journals (Sweden)

    Sundquist Jan

    2011-05-01

    Full Text Available Abstract Background Immigrants from the Middle-East are at high risk of developing type 2 diabetes (T2D. The aim of the present survey was to measure, in a single deprived neighbourhood, the prevalence rates of impaired fasting glucose (IFG, impaired glucose tolerance (IGT and T2D in residents originating from Iraq and to compare them to those in residents born in Sweden. An additional aim was to identify metabolic, lifestyle and socioeconomic risk factors associated with IFG/IGT and T2D in these residents. Methods The study was conducted February 1'st to March 31'st 2010. Men and women aged 45 to 65 years of Swedish or Iraqi origin, living in the neighbourhood of Rosengård, Malmö, Sweden, were randomly selected from the census register. Each participant signed a written informed consent form, underwent a physical examination and an oral glucose tolerance test (OGTT, provided blood samples and filled in a questionnaire. A total of 175 subjects participated (Swedish origin n = 79, Iraqi origin n = 96, reflecting an overall response rate of almost 60%. Results In total, 21.9% and 19.0% of the Iraqi and Swedish participants, respectively, suffered from T2D, while 24.0% of the Iraqi participants and 25.3% of the Swedish participants had IFG/IGT. There were no significant differences in prevalence rates relating to country of origin. Obesity (BMI ≥30 kg/m2 and sedentary leisure time physical activity were highly prevalent in both groups, while a family history of diabetes was more prevalent in participants from Iraq (49.2% than in those from Sweden (22.8% (p = 0.001. Being obese or having a sedentary leisure time were, independently associated with T2D (OR 5.43 (95% CI 2.10-14.02 and 2.89 (95% CI 1.03-8.10 respectively, while economic difficulties were independently associated with IFG/IGT (OR 2.55 (95% CI 1.06-6.15 after adjustment for the confounding effects of other common risk factors for T2D. Conclusions This study reveals a high prevalence

  4. High-Rise Refurbishment: The Energy-Efficient Upgrade of Multi-Story Residences in the European Union

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    Some 36 million European households are in high-rise residences, one in six of all households, and yet many of the buildings are in urgent need of refurbishment. This study, which is one in a series being conducted on behalf of the International Energy Agency addressing the energy performance of the existing IEA-wide building stock, identifies a Europe-wide cost-effective energy saving potential of 28% from energy-efficient refurbishment of the high-rise residential building stock. Attainment of this potential would imply a 1.5% reduction of Europe's total final energy demand and annual CO2 emissions savings of 35 Mt. In practice only the less efficient buildings need to be refurbished to realise these stockaverage savings and for these buildings typical savings in heating energy from refurbishment of between 70 and 80% are identified. Buildings in general suffer from a variety of barriers that tend to prevent their occupants from maintaining and refurbishing them to levels of comfort and energy performance that would be justified over the longer term, but collective housing in general is particularly susceptible to market failures. Many occupants do not own the property while their landlords usually have little motivation to finance improvements. Refurbishment requires collective agreement on a capital investment, which is difficult to establish especially when some occupants expect to live in the building over the longer-term but others only for the short-term. Furthermore, in most cases the occupants of high-rise residences are not among the wealthier members of society and they find it difficult to raise capital for longer-term investments. It is not surprising, then, to find that this section of the building stock is the most neglected and that there remain significant cost-effective opportunities for it to be refurbished in a way that improves comfort, saves energy, reduces CO2 emissions and significantly improves the urban environment.

  5. Indoor Air Quality in 24 California Residences Designed as High-Performance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Less, Brennan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mullen, Nasim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-07-01

    Today’s high performance green homes are reaching previously unheard of levels of airtightness and are using new materials, technologies and strategies, whose impacts on Indoor Air Quality (IAQ) cannot be fully anticipated from prior studies. This research study used pollutant measurements, home inspections, diagnostic testing and occupant surveys to assess IAQ in 24 new or deeply retrofitted homes designed to be high performance green buildings in California.

  6. Reducing oral and maxillofacial surgery resident risk exposure: lessons from graduate medical education reform.

    Science.gov (United States)

    Buhrow, Suzanne Morse; Buhrow, Jack A

    2013-12-01

    It is estimated that, in the United States, more than 40,000 patients are injured each day because of preventable medical errors. Although numerous studies examine the causes of medical trainee errors and efforts to mitigate patient injuries in this population, little research exists on adverse events experienced by oral and maxillofacial surgery (OMFS) residents or strategies to improve patient safety awareness in OMFS residency programs. The authors conducted a retrospective literature review of contemporary studies on medical trainees' reported risk exposure and the impact of integrating evidence-based patient safety training into residency curricula. A review of the literature suggests that OMFS residents face similar risks as medical trainees in medical, surgical, and anesthesia residency programs and may benefit from integrating competency-based safety training in the OMFS residency curriculum. OMFS trainees face particular challenges when transitioning from dental student to surgical resident, particularly related to their limited clinical exposure to high-reliability organizations, which may place them at higher risk than other medical trainees. OMFS educators should establish resident competence in patient safety principles and system improvement strategies throughout the training period.

  7. FORMATION OF TEACHER’S SOCIO-ECONOMIC COMPETENCE THROUGH HIGH SCHOOL’S PUBLIC MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Inna G . Ryabova

    2016-03-01

    Full Text Available Introduction: the article explores one of topical issues in modernisation of contemporary education – enhancement of socio-economic competence of a teacher. Social and economic functions, such as goal-setting, planning, organisation, analysis, control and correction act as integral components in its structure. Materials and Мethods: scholarly works on the formation of social and economic competence of teacher and public school management are a basis for the article. Methods of pedagogical research with emphasis on theoretical and practical methods were used in this study. Results: the pedagogical analysis examines the ways of shaping socio-economic competence of a teacher capable of comprehending a social situation, able to effectively operate educational institution in market conditions, to think economically, to find social consent, to shape open educational environment, to quickly solve problems of specific goal realisation. The article substantiates that the problem of formation of social and economic competence can be solved if a teacher acquires skills of public intraschool management. Further, the authors present the analysis of results of a long-term experimental work on the organisation of public management environment at the educational institution, lyceum no. 26 in Saransk (Republic of Mordovia. Discussion and Сonclusion: the article highlights the importance of professional development of educators specialising in “State and public management: public expert review” as a factor in broadening social and economic competence of a teacher. Criteria of participation in public management of education are discussed. It is proved that democratisation of management and its public character allow to involve the personality (administrator, teacher, pupil, parents in the processes of a goal-setting, joint administrative activity, improvement of the interpersonal relations. All these factors make educational system open and take it to a

  8. Suicide Intervention Skills among Japanese Medical Residents

    Science.gov (United States)

    Fujisawa, Daisuke; Suzuki, Yuriko; Kato, Takahiro A.; Hashimoto, Naoki; Sato, Ryoko; Aoyama-Uehara, Kumi; Fukasawa, Maiko; Tomita, Masayuki; Watanabe, Koichiro; Kashima, Haruo; Otsuka, Kotaro

    2013-01-01

    Objectives: Patient suicide is a tragic occurrence, and it can be a demoralizing experience for medical residents. Few studies, however, have assessed suicide management skills among these front-line healthcare professionals. This study evaluated the self-assessed competence and confidence of medical residents with regard to the management of…

  9. Putting "Rural" into Psychiatry Residency Training Programs

    Science.gov (United States)

    Nelson, William A.; Pomerantz, Andrew; Schwartz, Jonathan

    2007-01-01

    Objective: Evidence indicates disparities in the number of psychiatrists practicing in rural America compared to urban areas suggesting the need for a greater emphasis on rural psychiatry in residency training programs. The authors offer suggestions for integrating a rural focus in psychiatry residency training to foster greater competency and…

  10. Hair and toenail arsenic concentrations of residents living in areas with high environmental arsenic concentrations.

    OpenAIRE

    Hinwood, Andrea L; Sim, Malcolm R; Jolley, Damien; de Klerk, Nick; Bastone, Elisa B; Gerostamoulos, Jim; Drummer, Olaf H

    2003-01-01

    Surface soil and groundwater in Australia have been found to contain high concentrations of arsenic. The relative importance of long-term human exposure to these sources has not been established. Several studies have investigated long-term exposure to environmental arsenic concentrations using hair and toenails as the measure of exposure. Few have compared the difference in these measures of environmental sources of exposure. In this study we aimed to investigate risk factors for elevated hai...

  11. Prevalence of Vitamin B12 and Folate Deficiency in School Children Residing at High Altitude Regions in India.

    Science.gov (United States)

    Gupta, Aakriti; Kapil, Umesh; Ramakrishnan, Lakshmy; Pandey, Ravindra Mohan; Yadav, Chander Prakash

    2017-04-01

    To assess the prevalence of vitamin B12 and folate deficiencies among children residing at high altitude regions of Himachal Pradesh, India. A total of 215 school children in the age group of 6-18 y were included. Biochemical estimation of serum vitamin B12 and folate levels was undertaken using chemiluminescence immunoassay method. The consumption pattern of foods high in dietary vitamin B12 and folate was recorded using Food Frequency Questionnaire. The median levels (interquartile range) of serum vitamin B12 and folate were 326 (259-395) pg/ml and 7.7 (6-10) ng/ml respectively. The prevalence of vitamin B12 and folate deficiency amongst school age children was found as 7.4% and 1.5% respectively. A low prevalence of vitamin B12 and folate deficiencies was found amongst children aged 6-18 y living at high altitude regions in India. This is possibly due to high frequency of consumption of foods rich in vitamin B12 and folate.

  12. DEVELOPING A TEACHING FACTORY LEARNING MODEL TO IMPROVE PRODUCTION COMPETENCIES AMONG MECHANICAL ENGINEERING STUDENTS IN A VOCATIONAL SENIOR HIGH SCHOOL

    Directory of Open Access Journals (Sweden)

    Dadang Hidayat Martawijaya

    2013-03-01

    Full Text Available The purpose of this study is to develop a learning model that can provide vocational senior high school students with an authentic industrial working experience in the manufacturing and production sector in the very same school that they are enrolled.  An appropriate in-school industrial experience is expected to improve students’ competences and skills. A four stage research and development method was used, involving preliminary study, development, testing and model validation. The study uses both qualitative and quantitative analysis techniques to produce a six steps teaching factory learning model (TF-6M Model. Data was gathered from teachers (n= 8 of a school in Indonesia and students of class XI (n=132 who formed the experimental and the control groups in the model validation stage, and student of class XII for the preliminary study (n=35 and development test (n=98. The focus group discussion (FGD reveals that the production teacher believes that the TF-6M model can be used to improve students’ competences. Data from students shows that TF-6M Model increases students’ competences, is preferred by students, increases their time spent at work, and improves their soft and hard skills, motivation, sense of responsibility and work ethics.

  13. High-velocity gas towards the LMC resides in the Milky Way halo

    CERN Document Server

    Richter, P; Werner, K; Rauch, T

    2015-01-01

    To explore the origin of high-velocity gas in the direction of the Large Magellanic Cloud (LMC) we analyze absorption lines in the ultraviolet spectrum of a Galactic halo star that is located in front of the LMC at d=9.2 kpc distance. We study the velocity-component structure of low and intermediate metal ions in the spectrum of RXJ0439.8-6809, as obtained with the Cosmic Origins Spectrograph (COS) onboard HST, and measure equivalent widths and column densities for these ions. We supplement our COS data with a Far-Ultraviolet Spectroscopic Explorer spectrum of the nearby LMC star Sk-69 59 and with HI 21cm data from the Leiden-Argentina-Bonn (LAB) survey. Metal absorption towards RXJ0439.8-6809 is unambiguously detected in three different velocity components near v_LSR=0,+60, and +150 km/s. The presence of absorption proves that all three gas components are situated in front of the star, thus being located in the disk and inner halo of the Milky Way. For the high-velocity cloud (HVC) at v_LSR=+150 km/s we deri...

  14. The effects of a visualization-centered curriculum on conceptual understanding and representational competence in high school biology

    Science.gov (United States)

    Wilder, Anna

    The purpose of this study was to investigate the effects of a visualization-centered curriculum, Hemoglobin: A Case of Double Identity, on conceptual understanding and representational competence in high school biology. Sixty-nine students enrolled in three sections of freshman biology taught by the same teacher participated in this study. Online Chemscape Chime computer-based molecular visualizations were incorporated into the 10-week curriculum to introduce students to fundamental structure and function relationships. Measures used in this study included a Hemoglobin Structure and Function Test, Mental Imagery Questionnaire, Exam Difficulty Survey, the Student Assessment of Learning Gains, the Group Assessment of Logical Thinking, the Attitude Toward Science in School Assessment, audiotapes of student interviews, students' artifacts, weekly unit activity surveys, informal researcher observations and a teacher's weekly questionnaire. The Hemoglobin Structure and Function Test, consisting of Parts A and B, was administered as a pre and posttest. Part A used exclusively verbal test items to measure conceptual understanding, while Part B used visual-verbal test items to measure conceptual understanding and representational competence. Results of the Hemoglobin Structure and Function pre and posttest revealed statistically significant gains in conceptual understanding and representational competence, suggesting the visualization-centered curriculum implemented in this study was effective in supporting positive learning outcomes. The large positive correlation between posttest results on Part A, comprised of all-verbal test items, and Part B, using visual-verbal test items, suggests this curriculum supported students' mutual development of conceptual understanding and representational competence. Evidence based on student interviews, Student Assessment of Learning Gains ratings and weekly activity surveys indicated positive attitudes toward the use of Chemscape Chime

  15. Indoor air quality in 24 California residences designed as high-performance homes

    Energy Technology Data Exchange (ETDEWEB)

    Less, Brennan [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Mullen, Nasim [Gap, Inc., San Francisco, CA (United States); Singer, Brett [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Walker, Iain [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)

    2015-01-01

    Today’s high performance green homes are reaching previously unheard of levels of airtightness and are using new materials, technologies and strategies, whose impacts on Indoor Air Quality (IAQ) cannot be fully anticipated from prior studies. This research study used pollutant measurements, home inspections, diagnostic testing and occupant surveys to assess IAQ in 24 new or deeply retrofitted homes designed to be high performance green buildings in California. Although the mechanically vented homes were six times as airtight as non-mechanically ventilated homes (medians of 1.1 and 6.1 ACH50, n=11 and n=8, respectively), their use of mechanical ventilation systems and possibly window operation meant their median air exchange rates were almost the same (0.30 versus 0.32 hr-1, n=8 and n=8, respectively). Pollutant levels were also similar in vented and unvented homes. In addition, these similarities were achieved despite numerous observed faults in complex mechanical ventilation systems. More rigorous commissioning is still recommended. Cooking exhaust systems were used inconsistently and several suffered from design flaws. Failure to follow best practices led to IAQ problems in some cases. Ambient nitrogen dioxide standards were exceeded or nearly so in four homes that either used gas ranges with standing pilots, or in Passive House-style homes that used gas cooking burners without venting range hoods. Homes without active particle filtration had particle count concentrations approximately double those in homes with enhanced filtration. The majority of homes reported using low-emitting materials; consistent with this, formaldehyde levels were approximately half those in conventional, new CA homes built before 2008. Emissions of ultrafine particles (with diameters <100 nm) were dramatically lower on induction electric cooktops, compared with either gas or resistance electric models. These results indicate that high performance homes can achieve

  16. Permanent resident.

    Science.gov (United States)

    Fisher, John F

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  17. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

    Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  18. Evaluating the Quality of Competency Assessment in Pharmacy: A Framework for Workplace Learning

    Directory of Open Access Journals (Sweden)

    Shailly Shah

    2016-01-01

    Full Text Available Demonstration of achieved competencies is critical in the pharmacy workplace. The purpose of this study was to evaluate the quality of the competency assessment program for pharmacy residents at an academic medical center. The competency assessment program (CAP survey is a validated, 48-item instrument that evaluates the quality of an assessment program based on 12 criteria, each measured by four questions on a scale of 0 to 100. The CAP was completed by residents (n = 23 and preceptors (n = 28 from the pharmacy residency program between 2010 and 2013. Results were analyzed using descriptive statistics, Cronbach’s alpha, and non-parametric tests. Educational Consequences was the only quality criteria falling below the standard for “good quality.” Participants that completed residency training elsewhere rated the Comparability (0.04 and Meaningfulness (0.01 of the assessment program higher than those that completed residency at the academic medical center. There were no significant differences between resident and preceptor scores. Overall, the quality of the assessment program was rated highly by residents and preceptors. The process described here provides a useful framework for understanding the quality of workplace learning assessments in pharmacy practice.

  19. Fellowship trends of pathology residents.

    Science.gov (United States)

    Lagwinski, Nikolaj; Hunt, Jennifer L

    2009-09-01

    Recent changes in pathology residency education have included a decrease in the program length (from 5 years to 4 years for combined anatomic and clinical pathology training) and a national mandate for programs to assess 6 general competencies of trainees. These have undoubtedly led to changes in program curricula and in residents' desires to seek fellowship training. This study was designed to gather information about what residents are seeking from fellowship training programs. This study used an online survey to assess attitudes of residents in training programs toward fellowship training. The survey instrument had 26 questions pertaining to fellowship choices, motivations for pursuing fellowships, expectations of the fellowships, and postresidency concerns. There were 213 respondents from a mix of program types and representing each postgraduate year. Most residents will seek at least 1 or 2 fellowships after residency training. The most popular first-choice fellowship was surgical pathology (26%), followed by cytopathology (16%), hematopathology (15%), gastrointestinal pathology (10%), dermatopathology (8%), and forensic pathology (5%). The most common reasons for pursuing fellowship training were to "increase marketability" (43%) or to "become an expert in a particular area" (33%). Most trainees got their information about fellowship training programs from Internet sources. Fellowship programs will benefit from an optimally designed Web site because residents seek information predominantly from the Internet. Residents seeking fellowships are particularly concerned with selecting programs that provide job connections, an increase in their marketability, and the opportunity to develop diagnostic expertise.

  20. Characterization of Cardiac-Resident Progenitor Cells Expressing High Aldehyde Dehydrogenase Activity

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    Marc-Estienne Roehrich

    2013-01-01

    Full Text Available High aldehyde dehydrogenase (ALDH activity has been associated with stem and progenitor cells in various tissues. Human cord blood and bone marrow ALDH-bright (ALDHbr cells have displayed angiogenic activity in preclinical studies and have been shown to be safe in clinical trials in patients with ischemic cardiovascular disease. The presence of ALDHbr cells in the heart has not been evaluated so far. We have characterized ALDHbr cells isolated from mouse hearts. One percent of nonmyocytic cells from neonatal and adult hearts were ALDHbr. ALDHvery-br cells were more frequent in neonatal hearts than adult. ALDHbr cells were more frequent in atria than ventricles. Expression of ALDH1A1 isozyme transcripts was highest in ALDHvery-br cells, intermediate in ALDHbr cells, and lowest in ALDHdim cells. ALDH1A2 expression was highest in ALDHvery-br cells, intermediate in ALDHdim cells, and lowest in ALDHbr cells. ALDH1A3 and ALDH2 expression was detectable in ALDHvery-br and ALDHbr cells, unlike ALDHdim cells, albeit at lower levels compared with ALDH1A1 and ALDH1A2. Freshly isolated ALDHbr cells were enriched for cells expressing stem cell antigen-1, CD34, CD90, CD44, and CD106. ALDHbr cells, unlike ALDHdim cells, could be grown in culture for more than 40 passages. They expressed sarcomeric α-actinin and could be differentiated along multiple mesenchymal lineages. However, the proportion of ALDHbr cells declined with cell passage. In conclusion, the cardiac-derived ALDHbr population is enriched for progenitor cells that exhibit mesenchymal progenitor-like characteristics and can be expanded in culture. The regenerative potential of cardiac-derived ALDHbr cells remains to be evaluated.

  1. Real time curriculum map for internal medicine residency

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    Roberts J Mark

    2007-11-01

    Full Text Available Abstract Background To manage the voluminous formal curriculum content in a limited amount of structured teaching time, we describe the development and evaluation of a curriculum map for academic half days (AHD in a core internal medicine residency program. Methods We created a 3-year cyclical curriculum map (an educational tool combining the content, methodology and timetabling of structured teaching, comprising a matrix of topics under various specialties/themes and corresponding AHD hours. All topics were cross-matched against the ACP-ASIM in-training examination, and all hours were colour coded based on the categories of core competencies. Residents regularly updated the map on a real time basis. Results There were 208 topics covered in 283 AHD hours. All topics represented core competencies with minimal duplication (78% covered once in 3 years. Only 42 hours (15% involved non-didactic teaching, which increased after implementation of the map (18–19 hours/year versus baseline 5 hours/year. Most AHD hours (78% focused on medical expert competencies. Resident satisfaction (90% response was high throughout (range 3.64 ± 0.21, 3.84 ± 0.14 out of 4, which improved after 1 year but returned to baseline after 2 years. Conclusion We developed and implemented an internal medicine curriculum map based on real time resident input, with minimal topic duplication and high resident satisfaction. The map provided an opportunity to balance didactic versus non-didactic teaching, and teaching on medical versus non medical expert topics.

  2. Effect of High Dose Natural Ionizing Radiation on the Immune System of the Exposed Residents of Ramsar Town, Iran

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    Massoud Attar

    2007-06-01

    Full Text Available Iran is one of several countries that has regions of high dose natural ionizing radiation. Two wellknownvillages in the suburb of Ramsar Town in the Caspian Sea strip, Taleshmahaleh and Chaparsar,have background radiation that is 13 times higher than normal. This radiation is the result of Radium 226 and Radon gas both of which are highly water soluble.While people living in these regions do not suffer from any major health problems, we decided tostudy the their immune responses to infection and inflammation in order to determine if their habitat affects their immune defense mechanisms as a way of compensating for their exposure to high dose environmental ionizing radiation.Our results showed that the total serum antioxidant level in the exposed people was significantlylower than the individuals not exposed to high dose natural ionizing radiation. The exposedindividuals also had higher lymphocyte-induced IL-4 and IL-10 production, and lower IL-2 and IFN-γ production. In addition, neutrophil NBT, phagocytosis, and locomotion were higher in the exposed group. In contrast, lymphocyte proliferation in response to PHA was unaffected.We conclude that the immune system of individuals exposed to high dose ionizing radiation hasadapted to its environment by shifting from a Type 1 to a Type 2 response to promote antiinflammation.This may be because inflammatory Type 1 responses generate more free radicals thanType 2 responses, in addition to the free radicals generated as a result of high environmental radiation.Thus, the serum total antioxidant level in the exposed residents was lower than the unexposed group.

  3. Incidence of cancer among residents of high temperature geothermal areas in Iceland: a census based study 1981 to 2010

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    Kristbjornsdottir Adalbjorg

    2012-10-01

    Full Text Available Abstract Background Residents of geothermal areas are exposed to geothermal emissions and water containing hydrogen sulphide and radon. We aim to study the association of the residence in high temperature geothermal area with the risk of cancer. Methods This is an observational cohort study where the population of a high-temperature geothermal area (35,707 person years was compared with the population of a cold, non-geothermal area (571,509 person years. The cohort originates from the 1981 National Census. The follow up from 1981 to 2010 was based on record linkage by personal identifier with nation-wide death and cancer registries. Through the registries it was possible to ascertain emigration and vital status and to identify the cancer cases, 95% of which had histological verification. The hazard ratio (HR and 95% confidence intervals (CI were estimated in Cox-model, adjusted for age, gender, education and housing. Results Adjusted HR in the high-temperature geothermal area for all cancers was 1.22 (95% CI 1.05 to 1.42 as compared with the cold area. The HR for pancreatic cancer was 2.85 (95% CI 1.39 to 5.86, breast cancer 1.59 (95% CI 1.10 to 2.31, lymphoid and hematopoietic cancer 1.64 (95% CI 1.00 to 2.66, and non-Hodgkins lymphoma 3.25 (95% CI 1.73 to 6.07. The HR for basal cell carcinoma of the skin was 1.61 (95% CI 1.10 to 2.35. The HRs were increased for cancers of the nasal cavities, larynx, lung, prostate, thyroid gland and for soft tissue sarcoma; however the 95% CIs included unity. Conclusions More precise information on chemical and physical exposures are needed to draw firm conclusions from the findings. The significant excess risk of breast cancer, and basal cell carcinoma of the skin, and the suggested excess risk of other radiation-sensitive cancers, calls for measurement of the content of the gas emissions and the hot water, which have been of concern in previous studies in volcanic areas. There are indications of an exposure

  4. ENGLISH TASK TO DEVELOP THE STUDENTS’ COMMUNICATIVE COMPETENCE: A STUDY OF EDUKATIF WORK BOOK FOR JUNIOR HIGH SCHOOL STUDENTS

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    Dyah Rohma Wati

    2013-02-01

    Full Text Available This study is mainly intended to find out the extent to which tasks in English work books are designed to develop the students’ communicative competence. The objective of this study is to describe how the tasks in Edukatif work books are designed to develop students’ discourse competence, linguistic competence, actional competence, sociolinguistic competence, and strategic competence. This study is a qualitative research which involves content analysis approach. The data are the tasks in Edukatif work books used by eight grade students of the first and second semester. In collecting the data, the writer uses documentation method. The data analysis used Huberman and Miles’ concept which involves data reduction, data display and verification. The findings show that among the five competences and its components of communicative com- petence, some components are not well developed in the work books. The tasks develop all components of discourse competence except one aspect in linguistic competence, that is, phonology. The tasks develop all components of actional competence except the speech act. The tasks develop components of sociolinguistic competence except the cultural and non-verbal communicative factor. The tasks develop only one component of strategic competence, that is, time gaining strategy. The conclusion is that the tasks in Edukatif work books are sufficient to develop the students’ discourse, linguistic, and actional competence. The tasks, however, are not sufficient to develop students’ sociolinguistic and strategic competence.

  5. Tracing the evolution of competence in Haemophilus influenzae.

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    Heather Maughan

    Full Text Available Natural competence is the genetically encoded ability of some bacteria to take up DNA from the environment. Although most of the incoming DNA is degraded, occasionally intact homologous fragments can recombine with the chromosome, displacing one resident strand. This potential to use DNA as a source of both nutrients and genetic novelty has important implications for the ecology and evolution of competent bacteria. However, it is not known how frequently competence changes during evolution, or whether non-competent strains can persist for long periods of time. We have previously studied competence in H. influenzae and found that both the amount of DNA taken up and the amount recombined varies extensively between different strains. In addition, several strains are unable to become competent, suggesting that competence has been lost at least once. To investigate how many times competence has increased or decreased during the divergence of these strains, we inferred the evolutionary relationships of strains using the largest datasets currently available. However, despite the use of three datasets and multiple inference methods, few nodes were resolved with high support, perhaps due to extensive mixing by recombination. Tracing the evolution of competence in those clades that were well supported identified changes in DNA uptake and/or transformation in most strains. The recency of these events suggests that competence has changed frequently during evolution but the poor support of basal relationships precludes the determination of whether non-competent strains can persist for long periods of time. In some strains, changes in transformation have occurred that cannot be due to changes in DNA uptake, suggesting that selection can act on transformation independent of DNA uptake.

  6. High rates of hospital admission among older residents in assisted living facilities: opportunities for intervention and impact on acute care.

    Science.gov (United States)

    Hogan, David B; Amuah, Joseph E; Strain, Laurel A; Wodchis, Walter P; Soo, Andrea; Eliasziw, Misha; Gruneir, Andrea; Hagen, Brad; Teare, Gary; Maxwell, Colleen J

    2014-01-01

    Little is known about health or service use outcomes for residents of Canadian assisted living facilities. Our objectives were to estimate the incidence of admission to hospital over 1 year for residents of designated (i.e., publicly funded) assisted living (DAL) facilities in Alberta, to compare this rate with the rate among residents of long-term care facilities, and to identify individual and facility predictors of hospital admission for DAL residents. Participants were 1066 DAL residents (mean age ± standard deviation 84.9 ± 7.3 years) and 976 longterm care residents (85.4 ± 7.6 years) from the Alberta Continuing Care Epidemiological Studies (ACCES). Research nurses completed a standardized comprehensive assessment for each resident and interviewed family caregivers at baseline (2006 to 2008) and 1 year later. We used standardized interviews with administrators to generate facility- level data. We determined hospital admissions through linkage with the Alberta Inpatient Discharge Abstract Database. We used multivariable Cox proportional hazards models to identify predictors of hospital admission. The cumulative annual incidence of hospital admission was 38.9% (95% confidence interval [CI] 35.9%- 41.9%) for DAL residents and 13.7% (95% CI 11.5%-15.8%) for long-term care residents. The risk of hospital admission was significantly greater for DAL residents with greater health instability, fatigue, medication use (11 or more medications), and 2 or more hospital admissions in the preceding year. The risk of hospital admission was also significantly higher for residents from DAL facilities with a smaller number of spaces, no licensed practical and/ or registered nurses on site (or on site less than 24 hours a day, 7 days a week), no chain affiliation, and from select health regions. The incidence of hospital admission was about 3 times higher among DAL residents than among long-term care residents, and the risk of hospital admission was associated with a number of

  7. Underreporting of Lyme and Other Tick-Borne Diseases in Residents of a High-Incidence County, Minnesota, 2009.

    Science.gov (United States)

    Schiffman, E K; McLaughlin, C; Ray, J A E; Kemperman, M M; Hinckley, A F; Friedlander, H G; Neitzel, D F

    2016-07-08

    Lyme disease (LD), anaplasmosis, babesiosis and other tick-borne diseases (TBDs) attributed to Ixodes ticks are thought to be widely underreported in the United States. To identify TBD cases diagnosed in 2009, but not reported to the Minnesota Department of Health (MDH), diagnostic and procedural billing codes suggestive of tick-borne diseases were used to select medical charts for retrospective review in medical facilities serving residents of a highly endemic county in Minnesota. Of 444 illness events, 352 (79%) were not reported. Of these, 102 (29%) met confirmed or probable surveillance case criteria, including 91 (26%) confirmed LD cases with physician-diagnosed erythema migrans (EM). For each confirmed and probable LD, probable anaplasmosis and confirmed babesiosis case reported to MDH in 2009, 2.8, 1.3, 1.2 and 1.0 cases were likely diagnosed, respectively. These revised estimates provide a more accurate assessment and better understanding of the burden of these diseases in a highly endemic county.

  8. Mathematical Competences

    DEFF Research Database (Denmark)

    Westphael, Henning; Mogensen, Arne

    2013-01-01

    In this article we present the notion of Mathematical competences as a tool to describe the mathematically gifted students.......In this article we present the notion of Mathematical competences as a tool to describe the mathematically gifted students....

  9. Cultural Competency Training Requirements in Graduate Medical Education

    Science.gov (United States)

    Ambrose, Adrian Jacques H.; Lin, Susan Y.; Chun, Maria B. J.

    2013-01-01

    Background Cultural competency is an important skill that prepares physicians to care for patients from diverse backgrounds. Objective We reviewed Accreditation Council for Graduate Medical Education (ACGME) program requirements and relevant documents from the ACGME website to evaluate competency requirements across specialties. Methods The program requirements for each specialty and its subspecialties were reviewed from December 2011 through February 2012. The review focused on the 3 competency domains relevant to culturally competent care: professionalism, interpersonal and communication skills, and patient care. Specialty and subspecialty requirements were assigned a score between 0 and 3 (from least specific to most specific). Given the lack of a standardized cultural competence rating system, the scoring was based on explicit mention of specific keywords. Results A majority of program requirements fell into the low- or no-specificity score (1 or 0). This included 21 core specialties (leading to primary board certification) program requirements (78%) and 101 subspecialty program requirements (79%). For all specialties, cultural competency elements did not gravitate toward any particular competency domain. Four of 5 primary care program requirements (pediatrics, obstetrics-gynecology, family medicine, and psychiatry) acquired the high-specificity score of 3, in comparison to only 1 of 22 specialty care program requirements (physical medicine and rehabilitation). Conclusions The degree of specificity, as judged by use of keywords in 3 competency domains, in ACGME requirements regarding cultural competency is highly variable across specialties and subspecialties. Greater specificity in requirements is expected to benefit the acquisition of cultural competency in residents, but this has not been empirically tested. PMID:24404264

  10. Physical Therapy Residency and Fellowship Education: Reflections on the Past, Present, and Future.

    Science.gov (United States)

    Furze, Jennifer A; Tichenor, Carol Jo; Fisher, Beth E; Jensen, Gail M; Rapport, Mary Jane

    2016-07-01

    The physical therapy profession continues to respond to the complex and changing landscape of health care to meet the needs of patients and the demands of patient care. Consistent with this evolution is the rapid development and expansion of residency and fellowship postprofessional programs. With the interested number of applicants exceeding the number of residency and fellowship slots available, a "critical period" in the educational process is emerging. The purposes of this perspective article are: (1) to analyze the state of residency and fellowship education within the profession, (2) to identify best practice elements from other health professions that are applicable to physical therapy residency and fellowship education, and (3) to propose a working framework grounded in common domains of competence to be used as a platform for dialogue, consistency, and quality across all residency and fellowship programs. Seven domains of competence are proposed to theoretically ground residency and fellowship programs and facilitate a more consistent approach to curricular development and assessment. Although the recent proliferation of residency and fellowship programs attempts to meet the demand of physical therapists seeking advanced educational opportunities, it is imperative that these programs are consistently delivering high-quality education with a common focus on delivering health care in the context of societal needs. © 2016 American Physical Therapy Association.

  11. A Required Rotation in Clinical Laboratory Management for Pathology Residents

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    Arvind Rishi MD

    2016-05-01

    Full Text Available Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9 felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates.

  12. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Science.gov (United States)

    Hoda, Syed T.; Crawford, James M.

    2016-01-01

    Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9) felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates. PMID:28725766

  13. Beyond requirements: residency management through the Internet.

    Science.gov (United States)

    Civetta, J M; Morejón, O V; Kirton, O C; Reilly, P J; Serebriakov, I I; Dobkin, E D; D'Angelica, M; Antonetti, M

    2001-04-01

    An Internet application could collect information to satisfy documentation required by the Residency Review Committee. Beyond replacing a difficult and inefficient paper system, it would collect, process, and distribute information to administration, faculty, and residents. Descriptive study. An integrated residency of 18 services at a university teaching hospital with 4 affiliated institutions. Residency administrators, faculty, and residents. The application included a procedure recorder, resident evaluation of faculty and rotations, goals and objectives (stratified by service and resident level), and matching faculty evaluation of residents with these goals as competencies. Policies, schedules, research opportunities, clinical site information, and curriculum support were created. Degree of compliance with Residency Review Committee standards, number of deficiencies corrected, and quantity and quality of information available to administration, faculty, and residents. The Internet system increased resident compliance for faculty and rotation evaluations from 20% and 34%, respectively, to 100%, which was maintained for 22 months. These evaluations can be displayed individually, in summary grids, and as postgraduate year-specific averages. Faculty evaluations of residents can be reviewed throughout the system. The defined category report for procedures, which had deficiencies in the preceding 6 years, had none for the last 2 years. The Internet application provides Accreditation Council for Graduate Medical Education-validated operative logs to regulatory agencies. A Web-based system can satisfy requirements and provide processed data that are of better quality and more complete than our paper system. We are now able to use scarce time and personnel to nurture developing surgical residents instead of shuffling paper.

  14. The Residence for Women Students of Madrid in the Spanish Second Republic: between high culture and social splendor

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    Raquel Vázquez Ramil

    2015-01-01

    Full Text Available In October of 1915 the Board for Advanced Studies and Scientific Research (JAE opens in Madrid the Women’s Group of the Students’ Residence, called Women’s Residence (Residencia de Señoritas, with the aim of being the home of women who visited Madrid for studying in University or for getting some culture. Women’s Residence, as well as Students’ Residence, was not only a convenient accommodation; following the inspiration of the Institución Libre de Enseñanza, it provided the residents with means of intellectual encouragement and moral improvement. The cultural and social activity of the Women’s Residence, ran by María de Maeztu, was outstanding in the twenties and in the Second Republic until the dramatic cut of the Civil War. This work analyzes the period between 1931 and 1936, using documentary of the Women’s Residence Archive, hemerographic sources of that time and bibliographic sources. The first two years of the Second Republic were vibrant; from 1933 on there is a trend towards to substitute cultural events for basic formative activities directed to non University women. Nevertheless, in the years previous to the Civil War, the Women’s Residence of Madrid was a privileged stage of conferences, soirées and courses of first level, unparalleled with any other women’s educational institution of the time. How to reference this article Vázquez Ramil, R. (2015. La Residencia de Señoritas de Madrid durante la II República: entre la alta cultura y el brillo social. Espacio, Tiempo y Educación, 2(1, pp. 323-346. doi: http://dx.doi.org/10.14516/ete.2015.002.001.016

  15. Reduction of high levels of internal radio-contamination by dietary intervention in residents of areas affected by the Fukushima Daiichi nuclear plant disaster: a case series.

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    Masaharu Tsubokura

    Full Text Available Maintaining low levels of chronic internal contamination among residents in radiation-contaminated areas after a nuclear disaster is a great public health concern. However, the efficacy of reduction measures for individual internal contamination remains unknown. To reduce high levels of internal radiation exposure in a group of individuals exposed through environmental sources, we performed careful dietary intervention with identification of suspected contaminated foods, as part of mass voluntary radiation contamination screenings and counseling program in Minamisoma Municipal General Hospital and Hirata Central Hospital. From a total of 30,622 study participants, only 9 residents displayed internal cesium-137 (Cs-137 levels of more than 50 Bq/kg. The median level of internal Cs-137 contamination in these residents at the initial screening was 4,830 Bq/body (range: 2,130-15,918 Bq/body and 69.6 Bq/kg (range: 50.7-216.3 Bq/kg. All these residents with high levels of internal contamination consumed homegrown produce without radiation inspection, and often collected mushrooms in the wild or cultivated them on bed-logs in their homes. They were advised to consume distributed food mainly and to refrain from consuming potentially contaminated foods without radiation inspection and local produces under shipment restrictions such as mushrooms, mountain vegetables, and meat of wild life. A few months after the intervention, re-examination of Cs levels revealed remarkable reduction of internal contamination in all residents. Although the levels of internal radiation exposure appear to be minimal amongst most residents in Fukushima, a subset of the population, who unknowingly consumed highly contaminated foodstuffs, experienced high levels of internal contamination. There seem to be similarities in dietary preferences amongst residents with high internal contamination levels, and intervention based on pre- and post-test counseling and dietary advice from

  16. Validating clinical competence.

    Science.gov (United States)

    Chappell, Kathy; Koithan, Mary

    2012-07-01

    Professional registered nurses must be competent to provide care in today's fast-paced, highly technical clinical environment. Competency programs designed to teach and evaluate essential knowledge, skills, and abilities of registered nurses are one method organizations may use to demonstrate nursing proficiency.

  17. Breakout session: Diversity, cultural competence, and patient trust.

    Science.gov (United States)

    Dy, Christopher J; Nelson, Charles L

    2011-07-01

    The patient population served by orthopaedic surgeons is becoming increasingly more diverse, but this is not yet reflected in our workforce. As the cultural diversity of our patient population grows, we must be adept at communicating with patients of all backgrounds. WHERE ARE WE NOW?: Efforts to improve the diversity of our workforce have been successful in increasing the number of female residents, but there has been no improvement in the number of African American and Hispanic residents. There is currently no centralized effort to recruit minority and female students to the specialty of orthopaedic surgery. The American Academy of Orthopaedic Surgeons has been leading workshops to train residents and practicing surgeons in communication skills and cultural competency. WHERE DO WE NEED TO GO?: We must train the current generation of orthopaedic surgeons to become adept at interacting with patients of all backgrounds. While initiatives for crosscultural communication in orthopaedic surgery have been established, they have not yet been universally incorporated into residency training and Continuing Medical Education programs. HOW DO WE GET THERE?: We must continue to recruit the brightest students of all backgrounds, with a concerted effort to provide equal opportunities for early guidance to all trainees. Opportunities to improve diversity among orthopaedic surgeons exist at many stages in a future physician's career path, including "shadowing" in high school and college and continuing with mentorship in medical school. Additional resources should be dedicated to teaching residents about the immediate relevancy of cultural competency, and faculty should model these proficiencies during their patient interactions.

  18. Pathology Informatics Essentials for Residents: A Flexible Informatics Curriculum Linked to Accreditation Council for Graduate Medical Education Milestones.

    Science.gov (United States)

    Henricks, Walter H; Karcher, Donald S; Harrison, James H; Sinard, John H; Riben, Michael W; Boyer, Philip J; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron

    2017-01-01

    -Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. -To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. -The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. -Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). -PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

  19. Perceptions of professional practice and work environment of new graduates in a nurse residency program.

    Science.gov (United States)

    Bratt, Marilyn Meyer; Felzer, Holly M

    2011-12-01

    New nurses continue to face challenging work environments and high expectations for professional competence as they enter practice. Nurse residency programs are gaining prominence as a mechanism to ease new graduates' transition to practice. This study examined new graduates' perceptions of their professional practice competence and work environment throughout a yearlong nurse residency program. Employing a repeated measures design, data were collected at baseline, at 6 months, and at 12 months. Results showed that job satisfaction was significantly lowest at 6 months and highest at 12 months. Job stress was found to be lowest at 12 months and organizational commitment was highest at baseline. Of the variables related to professional practice, clinical decision-making was highest at 12 months and quality of nursing performance significantly increased at each measurement point. These data add to the growing evidence supporting the efficacy of nurse residency programs.

  20. The model of creation of energy-saving competence of students of high school

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    Zeer Evald

    2016-01-01

    Full Text Available This article considers the most important conditions for the creationof energy-saving competence of students – undergraduate training. The actualityof the problem is caused by low energy efficiency of industrial production, significantly reduces the competitiveness of the domestic economy and, consequently, the need to intensify activities on the rational use of energy resources. The definition of energy-saving expertise, marked its structural components (value-motivational, cognitive activity-reflexive. Stages of creationof energy-saving expertise in system of continuous vocational training: diagnosis, motivation, learning and reflective-evaluative. The possibilities of educational technology and psycho designed to work with the psychological barriers and resistance to the process of regulation of energy consumption, the production facilities at its energy efficiency and energy saving. In particular, it is recommended to use active learning methods (discussion, games, analysis of problem situations, etc., Information and communication technologies for the implementation of educational and research projects in the field of energy conservation, the development and implementation of interactive multimedia learning environments.

  1. Training residents in problem-solving treatment of depression: a pilot feasibility and impact study.

    Science.gov (United States)

    Hegel, Mark T; Dietrich, Allen J; Seville, Janette L; Jordan, Caren B

    2004-03-01

    Primary care patients with depression may prefer or require a non-pharmacological treatment such as counseling. We investigated the feasibility of teaching family medicine residents an evidence-based brief counseling intervention for depression (Problem-solving Treatment of Depression for Primary Care [PST-PC]). Eleven residents over 3 consecutive years were provided a brief training program in PST-PC. Residents were evaluated for skill acquisition, changes in self efficacy, intentions to improve their care for depression, and post-residency integration of PST-PC into their daily practice. Trainees met established criteria for competency to administer PST-PC. They improved to moderate-to-high levels of self efficacy for treating depression, including for their counseling skills, and in their intentions to improve their depression management. At up to 3 years post residency, 90% indicated they were using PST-PC, often in a modified form, and also for illnesses other than depression. They indicated they would recommend the training to new residents. The PST-PC training program evaluated in this study is feasible in residency training and appears to influence practice post residency. These findings warrant continued investigation of this training program with a larger sample of residents and evaluation of outcomes with depressed patients treated with PST-PC in real-world practice settings.

  2. Training general surgery residents in pediatric surgery: educational value vs time and cost.

    Science.gov (United States)

    Lee, Steven L; Sydorak, Roman M; Applebaum, Harry

    2009-01-01

    This study evaluated the educational value of pediatric surgery rotations, the likelihood of performing pediatric operations upon completing general surgery (GS) residency, and time and cost of training GS residents in pediatric surgery. A survey was administered to GS residents that evaluated the pediatric surgery rotation and anticipated practice intentions. A retrospective analysis (2005-2006) of operative times for unilateral inguinal hernia repair, bilateral inguinal hernia repair, and umbilical hernia repair was also performed. Procedure times were compared for operations performed by a pediatric surgeon with and without GS residents. Cost analysis was based on time differences. General surgery residents (n = 19) considered the pediatric surgery rotation to have high educational value (4.7 +/- 0.6 of 5) with extensive teaching (4.6 +/- 0.7) and operative experience (4.4 +/- 0.8). Residents listed pediatric surgery exposure, operative technique, and observed work ethic as most valuable. Upon graduation, residents expect to perform pediatric operations 2 to 3 times annually. Thirty-seven percent of residents felt competent to perform appendectomy (patients >5 years), 32% appendectomy (3-5 years), 21% gastrostomy (>1 year), and 11% inguinal herniorrhaphy (>1 year). Operative times and costs were significantly higher in operative procedures performed with a GS resident. General surgery residents considered pediatric surgery as a valuable educational experience. Residents anticipate performing pediatric operations a few times annually. Training GS residents in pediatric surgery increased operative time and cost. This information may be useful in determining the appropriate setting for resident education as well as budget planning for pediatric surgical practices.

  3. Mechanical competence of ovariectomy-induced compromised bone after single or combined treatment with high-frequency loading and bisphosphonates.

    Science.gov (United States)

    Camargos, G V; Bhattacharya, P; van Lenthe, G H; Del Bel Cury, A A; Naert, I; Duyck, J; Vandamme, K

    2015-06-01

    Osteoporosis leads to increased bone fragility, thus effective approaches enhancing bone strength are needed. Hence, this study investigated the effect of single or combined application of high-frequency (HF) loading through whole body vibration (WBV) and alendronate (ALN) on the mechanical competence of ovariectomy-induced osteoporotic bone. Thirty-four female Wistar rats were ovariectomized (OVX) or sham-operated (shOVX) and divided into five groups: shOVX, OVX-shWBV, OVX-WBV, ALN-shWBV and ALN-WBV. (Sham)WBV loading was applied for 10 min/day (130 to 150 Hz at 0.3g) for 14 days and ALN at 2 mg/kg/dose was administered 3x/week. Finite element analysis based on micro-CT was employed to assess bone biomechanical properties, relative to bone micro-structural parameters. HF loading application to OVX resulted in an enlarged cortex, but it was not able to improve the biomechanical properties. ALN prevented trabecular bone deterioration and increased bone stiffness and bone strength of OVX bone. Finally, the combination of ALN with HF resulted in an increased cortical thickness in OVX rats when compared to single treatments. Compared to HF loading, ALN treatment is preferred for improving the compromised mechanical competence of OVX bone. In addition, the association of ALN with HF loading results in an additive effect on the cortical thickness.

  4. Reflection: a critical proficiency essential to the effective development of a high competence in communication.

    Science.gov (United States)

    Adams, Cindy L; Nestel, Debra; Wolf, Peter

    2006-01-01

    Reflection, or the ability to step back from an experience and consider it critically, in an analytical, non-subjective manner, is an essential aspect of problem solving and decision making, and also of effective communication with clients and colleagues. Reflective practice has been described as the essence of professionalism and is therefore a core professional skill; rarely, however, has it been explicitly taught in veterinary curricula, and it has only a recent history in undergraduate human medical curricula. We describe here two preliminary case studies, one in a veterinary medical education context and the other within a human medical education framework, as examples of approaches to assessing a student's ability for ''reflection.'' The case studies also illustrate some of the key principles. Both of the case studies described had as their end goal the enhancement of communication skills through critical reflection. At Monash University, Australia, the majority of students were assessed as being at a level of ''reflection in development.'' The students in the Ontario Veterinary College case study showed moderately good use of self-awareness and critical reflection as a basis for modifying and integrating communication skills into practice. While both preliminary case studies point to the fact that students recognize the importance of communication and value the opportunity to practice it, few students in either case study identified the importance of reflection for lifelong learning and professional competence. Opportunities to complete critical reflection exercises in other parts of curricula and outside of communication would likely reinforce its importance as a generic skill. Ongoing scholarly approaches to teaching, learning, and evaluating reflection and self-awareness are needed.

  5. Competência social e práticas educativas parentais em adolescentes com alto e baixo rendimento acadêmico Social competence and parental practices in adolescents with high and low academic achievement

    Directory of Open Access Journals (Sweden)

    Graziela Sapienza

    2009-01-01

    Full Text Available Este trabalho investigou as relações entre competência social, práticas educativas parentais e rendimento acadêmico em adolescentes. Participaram deste estudo 66 adolescentes divididos em dois grupos: alto e baixo rendimento acadêmico. Os instrumentos utilizados foram o CBCL e o YSR (Achenbach, 1991 e o IEP (Gomide, 2006. Os resultados mostraram que adolescentes de alto rendimento acadêmico são percebidos pelos pais como socialmente competentes e são criados com mais práticas educativas parentais positivas. Esses dados indicam que o rendimento acadêmico também é influenciado pela competência social e pelo modo como os adolescentes são educados pelos pais. Esses aspectos devem ser considerados em intervenções que pretendem promover a melhoria do rendimento acadêmico e o desenvolvimento de comportamentos ajustados ao contexto escolar.This paper investigated the relations between social competence, parental practices and academic performance in adolescents. 66 adolescents took part in the study and they were divided in two groups: high and low academic performance. The tools used in this research were CBCL and YSR (Achenbach, 1991, and IEP (Gomide, 2006. The results showed that adolescents of high academic achievements are perceived by the parents as socially competent and are raised with more positive parental practices. The data indicated that academic performance is also influenced by the social competence and the way the adolescents are educated by the parents. Those aspects should be considered in interventions that aim at promoting the improvement of academic performance and development of a behavior adjusted to the school.

  6. High prevalence of HIV-1 CRF01_AE viruses among female commercial sex workers residing in Surabaya, Indonesia.

    Directory of Open Access Journals (Sweden)

    Tomohiro Kotaki

    Full Text Available BACKGROUND: Human immunodeficiency virus (HIV infection and acquired immune deficiency syndrome (AIDS cause serious health problems and have an impact on the Indonesian economy. In addition, the rapid epidemic growth of HIV is continuing in Indonesia. Commercial sex plays a significant role in the spread of HIV; therefore, in order to reveal the current HIV prevalence rate among commercial sex workers (CSWs, we conducted an epidemiological study on HIV infection among CSWs residing in Surabaya, the capital of East Java province of Indonesia with large communities of CSWs. METHODOLOGY/PRINCIPAL FINDINGS: The prevalence of HIV infection among 200 CSWs was studied. In addition, the subtype of HIV type 1 (HIV-1 and the prevalence of other blood-borne viruses, hepatitis B virus (HBV, hepatitis C virus (HCV and GB virus C (GBV-C, were studied. The prevalence rates of HIV, hepatitis B core antibody, hepatitis B surface antigen, anti-HCV antibodies and anti-GBV-C antibodies were 11%, 64%, 4%, 0.5% and 0% among CSWs involved in this study, respectively. HIV-1 CRF01_AE viral gene fragments were detected in most HIV-positive samples. In addition, most CSWs showed low awareness of sexually transmitted diseases and had unprotected sex with their clients. CONCLUSIONS/SIGNIFICANCE: The HIV prevalence rate among CSWs was significantly higher than that among the general population in Indonesia (0.2-0.4%. In addition, CSWs were at a high risk of exposure to HBV, although chronic HBV infection was less frequently established. Our results suggest the necessity of efficient prevention programs for HIV and other blood-borne viral infections among CSWs in Surabaya, Indonesia.

  7. High prevalence of HIV-1 CRF01_AE viruses among female commercial sex workers residing in Surabaya, Indonesia.

    Science.gov (United States)

    Kotaki, Tomohiro; Khairunisa, Siti Qamariyah; Sukartiningrum, Septhia Dwi; Arfijanto, M Vitanata; Utsumi, Takako; Normalina, Irine; Handajani, Retno; Widiyanti, Prihartini; Rusli, Musofa; Rahayu, Retno Pudji; Lusida, Maria Inge; Hayashi, Yoshitake; Nasronudin; Kameoka, Masanori

    2013-01-01

    Human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) cause serious health problems and have an impact on the Indonesian economy. In addition, the rapid epidemic growth of HIV is continuing in Indonesia. Commercial sex plays a significant role in the spread of HIV; therefore, in order to reveal the current HIV prevalence rate among commercial sex workers (CSWs), we conducted an epidemiological study on HIV infection among CSWs residing in Surabaya, the capital of East Java province of Indonesia with large communities of CSWs. The prevalence of HIV infection among 200 CSWs was studied. In addition, the subtype of HIV type 1 (HIV-1) and the prevalence of other blood-borne viruses, hepatitis B virus (HBV), hepatitis C virus (HCV) and GB virus C (GBV-C), were studied. The prevalence rates of HIV, hepatitis B core antibody, hepatitis B surface antigen, anti-HCV antibodies and anti-GBV-C antibodies were 11%, 64%, 4%, 0.5% and 0% among CSWs involved in this study, respectively. HIV-1 CRF01_AE viral gene fragments were detected in most HIV-positive samples. In addition, most CSWs showed low awareness of sexually transmitted diseases and had unprotected sex with their clients. The HIV prevalence rate among CSWs was significantly higher than that among the general population in Indonesia (0.2-0.4%). In addition, CSWs were at a high risk of exposure to HBV, although chronic HBV infection was less frequently established. Our results suggest the necessity of efficient prevention programs for HIV and other blood-borne viral infections among CSWs in Surabaya, Indonesia.

  8. Case-Logging Practices in Otolaryngology Residency Training: National Survey of Residents and Program Directors.

    Science.gov (United States)

    Dermody, Sarah M; Gao, William; McGinn, Johnathan D; Malekzadeh, Sonya

    2017-06-01

    Objective (1) Evaluate the consistency and manner in which otolaryngology residents log surgical cases. (2) Assess the extent of instruction and guidance provided by program directors on case-logging practices. Study Design Cross-sectional national survey. Setting Accreditation Council for Graduate Medical Education otolaryngology residency programs in the United States. Subjects and Methods US otolaryngology residents, postgraduate year 2 through graduating chiefs as of July 2016, were recruited to respond to an anonymous questionnaire designed to characterize surgical case-logging practices. Program directors of US otolaryngology residency programs were recruited to respond to an anonymous questionnaire to elucidate how residents are instructed to log cases. Results A total of 272 residents and 53 program directors completed the survey, yielding response rates of 40.6% and 49.5%, respectively. Perceived accuracy of case logs is low among residents and program directors. Nearly 40% of residents purposely choose not to log certain cases, and 65.1% of residents underreport cases performed. More than 80% of program directors advise residents to log procedures performed outside the operating room, yet only 16% of residents consistently log such cases. Conclusion Variability in surgical case-logging behaviors and differences in provided instruction highlight the need for methods to improve consistency of logging practices. It is imperative to standardize practices across otolaryngology residency programs for case logs to serve as an accurate measure of surgical competency. This study provides a foundation for reform efforts within residency programs and for the Resident Case Log System.

  9. A cross-sectional study of differences in 6-min walk distance in healthy adults residing at high altitude versus sea level

    Science.gov (United States)

    2014-01-01

    Background We sought to determine if adult residents living at high altitude have developed sufficient adaptation to a hypoxic environment to match the functional capacity of a similar population at sea level. To test this hypothesis, we compared the 6-min walk test distance (6MWD) in 334 residents living at sea level vs. at high altitude. Methods We enrolled 168 healthy adults aged ≥35 years residing at sea level in Lima and 166 individuals residing at 3,825 m above sea level in Puno, Peru. Participants completed a 6-min walk test, answered a sociodemographics and clinical questionnaire, underwent spirometry, and a blood test. Results Average age was 54.0 vs. 53.8 years, 48% vs. 43% were male, average height was 155 vs. 158 cm, average blood oxygen saturation was 98% vs. 90%, and average resting heart rate was 67 vs. 72 beats/min in Lima vs. Puno. In multivariable regression, participants in Puno walked 47.6 m less (95% CI -81.7 to -13.6 m; p < 0.01) than those in Lima. Other variables besides age and height that were associated with 6MWD include change in heart rate (4.0 m per beats/min increase above resting heart rate; p < 0.001) and percent body fat (-1.4 m per % increase; p = 0.02). Conclusions The 6-min walk test predicted a lowered functional capacity among Andean high altitude vs. sea level natives at their altitude of residence, which could be explained by an incomplete adaptation or a protective mechanism favoring neuro- and cardioprotection over psychomotor activity. PMID:24484777

  10. Penalized estimation for competing risks regression with applications to high-dimensional covariates

    DEFF Research Database (Denmark)

    Ambrogi, Federico; Scheike, Thomas H.

    2016-01-01

    and better response to the therapy. Although in the last years the number of contributions for coping with high and ultra-high-dimensional data in standard survival analysis have increased (Witten and Tibshirani, 2010. Survival analysis with high-dimensional covariates. Statistical Methods in Medical...... to the binomial model in the package timereg (Scheike and Martinussen, 2006. Dynamic Regression models for survival data New York: Springer), available through CRAN.......High-dimensional regression has become an increasingly important topic for many research fields. For example, biomedical research generates an increasing amount of data to characterize patients' bio-profiles (e.g. from a genomic high-throughput assay). The increasing complexity...

  11. Natural Competence of Xylella fastidiosa Occurs at a High Frequency Inside Microfluidic Chambers Mimicking the Bacterium's Natural Habitats

    Science.gov (United States)

    Kandel, Prem P.; Lopez, Samantha M.; Almeida, Rodrigo P. P.

    2016-01-01

    ABSTRACT Xylella fastidiosa is a xylem-limited bacterium that is the causal agent of emerging diseases in a number of economically important crops. Genetic diversity studies have demonstrated homologous recombination occurring among X. fastidiosa strains, which has been proposed to contribute to host plant shifts. Moreover, experimental evidence confirmed that X. fastidiosa is naturally competent for recombination in vitro. Here, as an approximation of natural habitats (plant xylem vessels and insect mouthparts), recombination was studied in microfluidic chambers (MCs) filled with media amended with grapevine xylem sap. First, different media were screened for recombination in solid agar plates using a pair of X. fastidiosa strains that were previously reported to recombine in coculture. The highest frequency of recombination was obtained with PD3 medium, compared to those with the other two media (X. fastidiosa medium [XFM] and periwinkle wilt [PW] medium) used in previous studies. Dissection of the media components led to the identification of bovine serum albumin as an inhibitor of recombination that was correlated to its previously known effect on inhibition of twitching motility. When recombination was performed in liquid culture, the frequencies were significantly higher under flow conditions (MCs) than under batch conditions (test tubes). The recombination frequencies in MCs and agar plates were not significantly different from each other. Grapevine xylem sap from both susceptible and tolerant varieties allowed high recombination frequency in MCs when mixed with PD3. These results suggest that X. fastidiosa has the ability to be naturally competent in the natural growth environment of liquid flow, and this phenomenon could have implications in X. fastidiosa environmental adaptation. IMPORTANCE Xylella fastidiosa is a plant pathogen that lives inside xylem vessels (where water and nutrients are transported inside the plant) and the mouthparts of insect

  12. Clinical Competence Certification: A Critical Appraisal.

    Science.gov (United States)

    Woolliscroft, James O.; And Others

    1984-01-01

    The American Board of Internal Medicine has requested that residency program directors certify the clinical competence of their candidates. The clinical evaluation exercise (CEX) was used by residents at the University of Michigan Hospitals and the results raised questions as to the validity of the CEX. (Author/MLW)

  13. Tracer travel and residence time distributions in highly heterogeneous aquifers: Coupled effect of flow variability and mass transfer

    Science.gov (United States)

    Cvetkovic, V.; Fiori, A.; Dagan, G.

    2016-12-01

    The driving mechanism of tracer transport in aquifers is groundwater flow which is controlled by the heterogeneity of hydraulic properties. We show how hydrodynamics and mass transfer are coupled in a general analytical manner to derive a physically-based (or process-based) residence time distribution for a given integral scale of the hydraulic conductivity; the result can be applied for a broad class of linear mass transfer processes. The derived tracer residence time distribution is a transfer function with parameters to be inferred from combined field and laboratory measurements. It is scalable relative to the correlation length and applicable for an arbitrary statistical distribution of the hydraulic conductivity. Based on the derived residence time distribution, the coefficient of variation and skewness of residence time are illustrated assuming a log-normal hydraulic conductivity field and first-order mass transfer. We show that for a low Damkohler number the coefficient of variation is more strongly influenced by mass transfer than by heterogeneity, whereas skewness is more strongly influenced by heterogeneity.

  14. Characteristics of nursing home residents and physical restraint: a systematic literature review.

    Science.gov (United States)

    Hofmann, Hedi; Hahn, Sabine

    2014-11-01

    To analyse and to summarise factors associated with nursing home residents' characteristics which could lead to physical restraint, and to investigate the consequences of physical restraint use for this population. Even though the application of physical restraint is highly controversial, prevalence rates show that it is a common intervention in nursing homes. Residents' characteristics seem to be important to predict the use of physical restraint. Evidence suggests that restrained nursing home residents may have physical and psychological disadvantages as a consequence of being restrained. A systematic literature research involving the databases PubMed, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Science and Cochrane Library was carried out for articles published from January 2005-November 2011. Nine Studies fulfilled the inclusion criteria and the quality assessment. Restrained residents had low activities of daily living (ADL) scores and severe cognitive impairment. Residents with low cognitive status and serious mobility impairments were at high risk to be restrained, as well as residents with previous fall and/or fracture. Repeated verbal and physical agitation was found to be positively associated with restraint use. Possible consequences of physical restraint were as follows: lower cognitive and ADL performance, higher walking dependence, furthermore falls, pressure ulcers, urinary and faecal incontinence. This systematic literature review reveals notable resident-related factors for physical restraint use. The consequences of restraint seem to negatively influence residents' physical and psychological well-being. Physical restraint seems to be an important risk factor for residents' further health problems. Resident's characteristics appear to be decisive factors for the use of physical restraint. Nurses need a high level of expertise and competence in evaluating the individual residents' situation and deciding further steps, with

  15. A pharmacogenetics service experience for pharmacy students, residents, and fellows.

    Science.gov (United States)

    Drozda, Katarzyna; Labinov, Yana; Jiang, Ruixuan; Thomas, Margaret R; Wong, Shan S; Patel, Shitalben; Nutescu, Edith A; Cavallari, Larisa H

    2013-10-14

    To utilize a comprehensive, pharmacist-led warfarin pharmacogenetics service to provide pharmacy students, residents, and fellows with clinical and research experiences involving genotype-guided therapy. First-year (P1) through fourth-year (P4) pharmacy students, pharmacy residents, and pharmacy fellows participated in a newly implemented warfarin pharmacogenetics service in a hospital setting. Students, residents, and fellows provided genotype-guided dosing recommendations as part of clinical care, or analyzed samples and data collected from patients on the service for research purposes. Students', residents', and fellows' achievement of learning objectives was assessed using a checklist based on established core competencies in pharmacogenetics. The mean competency score of the students, residents, and fellows who completed a clinical and/or research experience with the service was 97% ±3%. A comprehensive warfarin pharmacogenetics service provided unique experiential and research opportunities for pharmacy students, residents, and fellows and sufficiently addressed a number of core competencies in pharmacogenetics.

  16. Outsourcing competence

    NARCIS (Netherlands)

    Bergstra, J.; Delen, G.; van Vlijmen, B.

    2011-01-01

    The topic of this paper, competences needed for outsourcing, is organized by first providing a generic competence scheme, which is subsequently instantiated to the area of sourcing and outsourcing. Sourcing and outsourcing are positioned as different areas of activity, neither one of which is

  17. Timespacing competence

    DEFF Research Database (Denmark)

    Laursen, Helle Pia; Mogensen, Naja Dahlstrup

    2016-01-01

    Drawing on Kramsch’s (2009) conceptualization of the multilingual subject and the symbolic self, in this paper, we explore how multilingual children re-signify three intertwined myths about the bilingual student, linguistic diversity and language competence, when, in the researcher-generated acti......Drawing on Kramsch’s (2009) conceptualization of the multilingual subject and the symbolic self, in this paper, we explore how multilingual children re-signify three intertwined myths about the bilingual student, linguistic diversity and language competence, when, in the researcher....... By perceiving competences from a subjective child perspective, we learn how children do what we call timespacing competence. On that basis, we suggest paying attention to how children themselves timespace competence by focusing (more consistently) on the subjective, social, spatial and temporal dimensions...

  18. [The new residency program in neurological surgery in Spain].

    Science.gov (United States)

    Lobato, R D; Fernandez Alen, J; Alday, R; Gómez, P A; Lagares, A

    2003-09-01

    A new Residency Program in Neurological Surgery has been recently elaborated by the "Comisión Nacional de Neurocirugía" following the requirement of the National Council of Specialities. This new Program, which will replace the one proposed in 1992, has been designed in a similar way as those applied in countries providing the best neurosurgical training. Changes included deal with the definition of the speciality, and the introduction of new rotations,a resident Log Book, a Tutor with a well defined profil and commitments, a structured planning of academic and clinical objectives, a rotation or training in research, and a planning for continuous evaluation of the progress of the resident. It is likely that an appropriate application of the new Program in Spanish neurosurgical units with accreditation for training will result in formation of highly competent neurosurgeons. However, there are new challenges for improving neurosurgical training and the development of our speciality in Spain, as those related with new legislation regulating resident working hours, or some political decisions changing the mechanisms for controlling the number of resident positions per year.

  19. Why residents should teach: A literature review

    Directory of Open Access Journals (Sweden)

    Busari J

    2004-07-01

    Full Text Available Resident doctors contribute significantly to the quality of undergraduate medical training and it is assumed that by participating in the process, they also improve their own professional competency. We decided to investigate whether there is evidence to support this assumption. Our hypothesis, the physician-as-teacher rule, stated that 'A skilled teacher has an increased likelihood of becoming a competent clinician, than a skilled clinician has of becoming a competent teacher' . We conducted a literature review to search for evidence to confirm or refute this assumption. Twenty-four articles written after 1990 were identified as relevant from 132 references we generated by searching Medline. The identified articles were qualitatively reviewed to identify key research conclusions and/or main discussion points. The findings from the review were collated and discussed. None of the studies showed specific evidence of how teaching results in improved professional competence. However, there was evidence that teaching ability correlated positively with the perception of clinical competency. There was also need for improved supervision and training programmes for residents in teaching skills. The review provided evidence that teaching influenced the perceived professional competency of physicians positively. Physicians who were perceived as competent were those who taught effectively, and who had a basic understanding of teaching and learning. The review shows that training in teaching is essential for physicians, and that further research is still needed to demonstrate the effect of good teaching on professional competency.

  20. Competency assessment of nursing staff.

    Science.gov (United States)

    Whelan, Lynn

    2006-01-01

    Changes in the healthcare industry have created great challenges for leaders of acute-care organizations. One of the greatest challenges is ensuring a competent nursing staff to care for patients within this changing environment (Boylan & Westra, 1998). Patients are more acutely ill and have shorter lengths of stay, placing greater demands on nurses who must demonstrate competency in caring for increasingly complex patients in a continually changing healthcare environment. Competency is defined as "the knowledge, skills, ability and behaviors that a person possesses in order to perform tasks correctly and skillfully" (O'Shea, 2002, p. 175). Competency assessment involves more than a checklist and a test. Hospitals are required to assess, maintain, demonstrate, track, and improve the competence of the staff. Competency assessment is an ongoing process of initial development, maintenance of knowledge and skills, educational consultation, remediation, and redevelopment. Methods to assess competencies include competency fairs, Performance Based Development System and online programs. Certain key people should be involved in the development of competencies. The department managers can give input related to department-specific competencies. Experienced staff members can provide valuable insight into the competencies that need to be assessed. Educators should be involved for providing the input for the methods used to validate competencies. Competencies are an important part of the work world. They are a part of a continual process to help ensure that the organization provides a high-quality care to its customers and patients.

  1. 外科专业学位硕士研究生和北京市外科住院医师临床技能考核的对比分析%Analysis of clinical competence assessment in the graduation examination for surgical professional degree postgraduates and surgical residents in Beijing

    Institute of Scientific and Technical Information of China (English)

    康骅; 张钰鹏; 王亚军; 陈丽芬

    2016-01-01

    Objective To investigate clinical competence assessment in the graduation examination for surgical professional degree postgraduates and surgical residents in Beijing. Methods Data of clinical competence assessment of graduation examination for surgical postgraduates from Capital Medical University (CMU) and residents from Beijing surgical residency training programs in 2013 were summarized and ana-lyzed. SPSS 11.5 software was used to do t test and chi square test to the corresponding data line. Results There were 118 surgical postgraduates in clinical medicine from CMU and 274 residents from Beijing surgi-cal residency training programs, who attended final clinical competence assessment. There were significant differences between the postgraduate and resident clinical competence assessment system. The differences included their organization in charge of examination and the contents of assessment system. The assessment system of clinical competence for the surgical postgraduates did not involved communication skills, reading and analysis of laboratory tests and imaging investigation. The score of case analysis in the postgraduate group was higher than that in the resident group [(84.6±1.1) vs. (82.2±10.2), P=0.039], however the score of surgical skill assessment in postgraduate group was significantly lower than that of the resident group [(78.2 ±14.0) vs. (90.5 ±6.3), P=0.000]. In addition, the rate in the score being higher or equal to 70 of case note, case analysis and surgical skill assessment between postgraduates and residents was significantly different (P<0.05). Conclusion Clinical competence assessment system for the surgical postgraduates should be adapted to their training goal. In addition to the process assessment, the objective structured clinical skills examination (OSCE) can be as a reasonable postgraduate graduation examination mode.%目的:探讨外科专业学位硕士研究生结业临床技能考核方案和

  2. Competing perspectives during organizational socialization on the role of certified athletic trainers in high school settings.

    Science.gov (United States)

    Mensch, James; Crews, Candice; Mitchell, Murray

    2005-01-01

    When certified athletic trainers (ATCs) enter a workplace, their potential for professional effectiveness is affected by a number of factors, including the individual's ability to put acquired knowledge, skills, and attitudes into practice. This ability may be influenced by the preconceived attitudes and expectations of athletes, athletes' parents, athletic directors, physical therapists, physicians, and coaches. To examine the perspectives of high school coaches and ATCs toward the ATC's role in the high school setting by looking at 3 questions: (1) What are coaches' expectations of ATCs during different phases of a sport season? (2) What do ATCs perceive their role to be during different phases of a season? and (3) How do coaches' expectations compare with ATCs' expectations? Qualitative research design involving semistructured interviews. High schools. Twenty high school varsity basketball coaches from 10 high schools in 2 states and the ATCs assigned to these teams. For the coaches, 12 questions focused on 3 specific areas: (1) the athletic training services they received as high school basketball coaches, (2) each coach's expectations of the ATC with whom he or she was working during various phases of the season, and (3) coaches' levels of satisfaction with the athletic training services provided to their team. For the ATCs, 17 questions focused on 3 areas: (1) the ATC's background, (2) the ATC's perceived duties at different phases of the basketball season and his or her relationship with the coach, and (3) other school factors that enhanced or interfered with the ATC's ability to perform duties. Three themes emerged. Coaches had limited knowledge and understanding of ATCs' qualifications, training, professional preparation, and previous experience. Coaches simply expected ATCs to be available to complement their roles. Positive communication was identified as a critical component to a good coach-ATC relationship. Although all participants valued good

  3. Neurology for internal medicine residents: working towards a national Canadian curriculum consensus.

    Science.gov (United States)

    Lazarou, Jason; Hopyan, Julia; Panisko, Danny; Tai, Peter

    2011-01-01

    Partly due to the absence of a standardized neurology curriculum, internal medicine residents often perceive neurology lowest in terms of the level of knowledge and clinical confidence. To compare the learning needs of internal medicine residents with the perceived learning needs of neurology and internal medicine program directors and to integrate these needs by developing a focused nationwide neurology curriculum for internal medicine residents rotating through neurology. Medical residents and neurology and internal medicine program directors from programs across the Canada were asked to complete an online survey and to rank an exhaustive list of neurology topics. A modified Delphi approach was used to obtain consensus on the top 20 topics to include in the curriculum. Over 80% of residents felt their competency in neurology was average or below after completing their neurology rotation. There was very high correlation between the topics ranked by residents and staff. We were able to achieve consensus on 20 topics to be included in a neurology curriculum for internal medicine residents. Through a modified Delphi approach we were able to produce a neurology curriculum for internal medicine residents rotating through neurology based on the input of program directors across the country.

  4. Incorporating Lifelong Learning From Residency to Practice: A Qualitative Study Exploring Psychiatry Learners' Needs and Motivations.

    Science.gov (United States)

    Sockalingam, Sanjeev; Soklaridis, Sophie; Yufe, Shira; Rawkins, Sian; Harris, Ilene; Tekian, Ara; Silver, Ivan; Wiljer, David

    2017-01-01

    There has been an increased focus on lifelong learning (LLL) as a core competency to develop master learners in medical education across the learner continuum. The purpose of this study was to explore the perceptions of psychiatry residents and faculty about LLL implementation, motivation, and training needs. This qualitative study was conducted in a large, urban, multisite psychiatry training program as part of a larger mixed methods study of LLL in psychiatry education. Using a purposive sampling approach, psychiatry residents were recruited to participate in focus groups; early career psychiatrists and psychiatry educators were recruited to participate in semistructured interviews. Content analysis of interviews and focus groups was done using the iterative, inductive method of constant comparative analysis. Of the 34 individuals participating in the study, 23 were residents, six were psychiatry educators, and five were early career psychiatrists. Three predominant themes were identified in participants' transcripts related to (1) the need for LLL training in residency training; (2) the implementation of LLL in residency training and practice; and (3) the spectrum of motivation for LLL from residency training into practice. This study identified the lack of preparation for LLL in residency training and the impact of this gap for psychiatrists transitioning into practice. All participants described the importance of integrating LLL training within clinical rotations and the importance of grounding LLL within the clinical workplace early in residency training to support the delivery of effective, high-quality patient care.

  5. Competency Mapping of the Employees

    Science.gov (United States)

    Anisha, N.

    2012-10-01

    Human resource management is a process of bringing people and organizations together so that the goals of each other are met. Nowadays it is not possible to show a good financial or operating report unless your personnel relations are in order. Over the years, highly skilled and knowledge based jobs are increasing while low skilled jobs are decreasing. Competency Mapping is a process of identifying key competencies for an organization, the jobs and functions within it. Competency mapping, the buzz word in any industry is not complicated as it may appear. At the heart of any successful activity lies a competence or skill. In the recent years, various thought leaders in business strategy have emphasized the need to identify what competencies a business needs, in order to compete in a specific environment. In this article explains the why competencies needed and how is measured competency of employees in the organization.

  6. Family Factors Associated with High Academic Competence among Former Head Start Children.

    Science.gov (United States)

    Robinson, Nancy M.; Weinberg, Richard A.; Redden, David; Ramey, Sharon L.; Ramey, Craig T.

    1998-01-01

    A study of 154 Head Start children with high academic achievement found that their families reported higher educational and income levels, had fewer children, were more likely to be Caucasian, reported less prolonged depression, and had more responsive, flexible, and less restrictive parenting practices than other Head Start children. (Author/CR)

  7. Restorative Justice Conferencing, Oral Language Competence, and Young Offenders: Are These High-Risk Conversations?

    Science.gov (United States)

    Snow, Pamela

    2013-01-01

    This article is concerned with the oral language demands (both talking and listening) associated with restorative justice conferencing--an inherently highly verbal and conversational process. Many vulnerable young people (e.g., those in the youth justice system) have significant, yet unidentified language impairments, and these could compromise…

  8. Learner Identity Amid Figured Worlds: Constructing (In)competence at an Urban High School

    Science.gov (United States)

    Rubin, Beth C.

    2007-01-01

    This article explores the figured world of learning at urban Oakcity High School, describing the learner identities that were available to students amid the practices, categories, discourses and interactions of this world. My aims are 2-fold and interconnected: (1) to reframe a taken-for-granted phenomenon--that students tend to do poorly at urban…

  9. Highly efficient indoor air purification using adsorption-enhanced-photocatalysis-based microporous TiO2 at short residence time.

    Science.gov (United States)

    Lv, Jinze; Zhu, Lizhong

    2013-01-01

    A short residence time is a key design parameter for the removal of organic pollutants in catalyst-based indoor air purification systems. In this study, we synthesized a series of TiO2 with different micropore volumes and studied their removal efficiency of indoor carbonyl pollutants at a short residence time. Our results indicated that the superior adsorption capability of TiO2 with micropores improved its performance in the photocatalytic degradation of cyclohexanone, while the photocatalytic removal of the pollutant successfully kept porous TiO2 from becoming saturated. When treated with 1 mg m(-3) cyclohexanone at a relatively humidity of 18%, the adsorption amount on microporous TiO2 was 5.4-7.9 times higher than that on P25. Removal efficiency via photocatalysis followed'the same order as the adsorption amount: TiO2-5 > TiO2-20 > TiO2-60 > TiO2-180 > P25. The advantage of microporous TiO2 over P25 became more pronounced when the residence time declined from 0.072 to 0.036 s. Moreover, as the concentration of cyclohexanone deceased from 1000 ppb to 500 ppb, removal efficiency by microporous TiO2 increased more rapidly than P25.

  10. Can changes in psychosocial factors and residency explain the decrease in physical activity during the transition from high school to college or university?

    Science.gov (United States)

    Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Deliens, Tom; Deforche, Benedicte

    2015-04-01

    When students make the transition from high school to college or university, their physical activity (PA) levels decrease strongly. Consequently, it is of crucial importance to identify the determinants of this decline in PA. The study aims were to (1) examine changes in psychosocial factors in students during the transition from high school to college/university, (2) examine if changes in psychosocial factors and residency can predict changes in PA, and (3) investigate the moderating effects of residency on the relationship between changes in psychosocial factors and changes in PA. Between March 2008 and October 2010, 291 Flemish students participated in a longitudinal study, with baseline measurements during the final year of high school and follow-up measurements at the start of second year of college/university. At both time points, participants completed a questionnaire assessing demographics, active transportation, leisure-time sports, psychosocial variables, and residency. Repeated measures MANOVA analyses and multiple moderated hierarchic regression analyses were conducted. Modeling, self-efficacy, competition-related benefits, and health-related, external and social barriers decreased, while health-related benefits and time-related barriers increased from baseline to follow-up. Decreases in modeling and time-related barriers were associated with a decrease in active transportation (adjusted R(2) = 3.2%); residency, decreases in self-efficacy, competition-related benefits, and increases in health- and time-related barriers predicted a decrease in leisure-time sports (adjusted R(2) = 29.3%). Residency only moderated two associations between psychosocial factors and changes in PA. Residency and changes in psychosocial factors were mainly important to explain the decrease in leisure-time sports. Other factors such as distance to college/university are likely more important to explain the decrease in active transportation; these are worth exploring in

  11. OPPORTUNITIES OF PEDAGOGICAL MODELING IN THE SOLVING OF THE PROBLEM OF THE FORMATION OF THE DESIGN AND RESEARCH COMPETENCE OF HIGH SCHOOL STUDENTS

    Directory of Open Access Journals (Sweden)

    Инга Валерьевна Дементьева

    2013-12-01

    Full Text Available The problem of  forming high-school students’  design and research  competence can be successfully solved with the help of the realization of pedagogical model based on the systematic, person- orientated  and competence - active  approach. The aim of the research is to theoretically justify and experimentally  examine  the model of formation  of high-school students’ design and research competence.  The importance of the research is that during it the set of scientific approaches (systematic, person- orientated  and competence - active  ones as the methodological basis for projecting the model were justified and the complex of pedagogical conditions served as the guide for the further research of the problem of  high-school students’  design and research  competence formation. The methods of the analysis of pedagogical, methodological literature, theoretical modeling, as well as empiric methods of research served as the basis of the methodology of the research in the process of model approbation.   The value of  the given research is that the practice-oriented model of forming design and research competence of high school students represents the multilevel dynamic system consisting of mutually conditioned components (objective, methodological, meaningful, technological and diagnostic-effective ones and can be included into the practice of other educational institutions.DOI: http://dx.doi.org/10.12731/2218-7405-2013-11-2

  12. Competence Building

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    on the one hand, and the real world of innovation policy-making on the other, typically not speaking to each other. With this purpose in mind, this paper discusses the role of competences and competence-building in the innovation process from a perspective of innovation systems; it examines how governments...... and public agencies in different countries and different times have actually approached the issue of building, maintaining and using competences in their innovation systems; it examines what are the critical and most important issues at stake from the point of view of innovation policy, looking particularly...

  13. Assessing Professionalism and Ethics Knowledge and Skills: Preferences of Psychiatry Residents

    Science.gov (United States)

    Marrero, Isis; Bell, Michael; Dunn, Laura B.; Roberts, Laura Weiss

    2013-01-01

    Background: Professionalism is one of the fundamental expectations and a core competency in residency education. Although programs use a variety of evaluative methods, little is known about residents' views of and preferences regarding various methods of assessment. Method: The authors surveyed residents at seven psychiatry residency programs…

  14. The Arabidopsis Floral Repressor BFT DelaysFlowering by Competing with FT for FD Bindingunder High Salinity

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Soil salinity is one of the most serious agricultural problems that significantly reduce crop yields in the aridand semi-arid regions. It influences various phases of plant growth and developmental processes, such as seed germina-tion, leaf and stem growth, and reproductive propagation. Salt stress delays the onset of flowering in many plant spe-cies. We have previously reported that the Arabidopsis BROTHER OF FT AND TFL1 (BFT) acts as a floral repressor undersalt stress. However, the molecular mechanisms underlying the BFT function in the salt regulation of flowering inductionis unknown. In this work, we found that BFT delays flowering under high salinity by competing with FLOWERING LOCUST (FT) for binding to the FD transcription factor. The flowering time of FD-deficient fd-2 mutant was insensitive to highsalinity. BFT interacts with FD in the nucleus via the C-terminal domain of FD, which is also required for the interactionof FD with FT, and interferes with the FT-FD interaction. These observations indicate that BFT constitutes a distinct saltstress signaling pathway that modulates the function of the FT-FD module and possibly provides an adaptation strategythat fine-tunes photoperiodic flowering under high salinity.

  15. 美国以能力为基础的住院医师培训探析%The analysis of the competency-based residency training program in the United States of America

    Institute of Scientific and Technical Information of China (English)

    戴汉军; 蔡小军

    2012-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) has advocated the competency-based training for years.The aim of the training program is to help the graduated medical students to master the essential competencies as a medical practitioner and to improve the level of diagnosis and treatment for the patients.The implementation of the program should be based in the acquirement of the six general competencies,which runs through all aspects of the hospital work,such as medical education,clinical work and research.%美国毕业后医学教育认证委员会(Accreditation Council for Graduate Medical Education,ACGME)倡导以能力为基础的住院医师培训,其主要目标是培养职业医师所必须具备的能力,不断提高住院医师对患者的诊疗质量;其具体实施围绕6项核心能力的培养进行,贯穿于理论、临床和科研等各个方面.

  16. Leadership Competences Among Managers

    Directory of Open Access Journals (Sweden)

    Anna Baczynska

    2017-06-01

    Full Text Available Purpose: The aim of this paper is to present the results of a survey conducted among managers (N=38 in the framework of the project “Development of the Bounded Leadership Theory”. The research juxtaposes two types of variables: (1 leadership competencies outlined in Kozminski’s theory (i.e. anticipatory, visionary, value-creating, mobilizing, self-reflection with (2 three psychological predispositions of leaders, such as intelligence, personality and ability to influence others. The tested predispositions represented three groups: non-variable traits, or permanent characteristics (intelligence, partially variable characteristics (personality and variable characteristics (influence tactics. Methodology: A total of 38 middle and senior managers, students of the MBA programme at Kozminski University, took part in the survey. Participants flled out a preliminary version of the Leadership Competence Questionnaire, as well as tests pertaining to intelligence, personality and influence tactics. The hypotheses were tested using Spearman’s rho correlation. The research has brought interesting results relating to the correlation between the fve tested competencies and leadership predispositions. Findings: Permanent and partly stable characteristics do not correlate with leadership competencies, i.e. a high score in leadership competencies is not necessarily synonymous with high intelligence levels or positive personality traits. Correlations have been observed between mobilization skills and influence tactics in the surveyed sample, i.e. legitimacy and personal appeals that leaders have recourse to and, in the case of value-creating competencies, an interesting correlation with legitimacy. Originality: The study constitutes an important contribution to the extant literature, as – first and foremost – it represents a new approach to the understanding of leadership competencies. Secondly, it reveals correlations between complex skills, i

  17. Study on Fire and Water Supply System of High-rise Residence%高层住宅消防给水系统浅析

    Institute of Scientific and Technical Information of China (English)

    李春阳

    2011-01-01

    本文对高层普通住宅和商住楼在消防给水系统上的要求进行比较,从消火栓给水系统设施设置、自动喷淋、灭火系统、供水方式、车库和发电机房灭火系统和贮水池等方面对高层住宅消防给水系统进行分析和总结,探讨安全、可靠、经济实用的系统做法,希望能为同业者提供一定的参考.%The paper compares the requirement for fire and water supply system between high-rise ordinary residence and commercial residence.From aspects such as fire hydrant water supply system equipment setting, automatic sprinkler, fire suppression system, water supply mode, garage and generator room fire extinguishing system and storage tanks, the paper makes the analysis and summary for high-rise residence water supply system to explore a safe, reliable and economical systematic method, hoping to provide some reference for people in this industry.

  18. Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

    Directory of Open Access Journals (Sweden)

    Johanna Martinez

    2013-09-01

    Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

  19. Replicable Interprofessional Competency Outcomes from High-Volume, Inter-Institutional, Interprofessional Simulation

    Directory of Open Access Journals (Sweden)

    Deborah Bambini

    2016-10-01

    Full Text Available There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality.

  20. Can microbes compete with cows for sustainable protein production - A feasibility study on high quality protein

    Science.gov (United States)

    Vestergaard, Mike; Chan, Siu Hung Joshua; Jensen, Peter Ruhdal

    2016-11-01

    An increasing population and their increased demand for high-protein diets will require dramatic changes in the food industry, as limited resources and environmental issues will make animal derived foods and proteins, gradually more unsustainable to produce. To explore alternatives to animal derived proteins, an economic model was built around the genome-scale metabolic network of E. coli to study the feasibility of recombinant protein production as a food source. Using a novel model, we predicted which microbial production strategies are optimal for economic return, by capturing the tradeoff between the market prices of substrates, product output and the efficiency of microbial production. A case study with the food protein, Bovine Alpha Lactalbumin was made to evaluate the upstream economic feasibilities. Simulations with different substrate profiles at maximum productivity were used to explore the feasibility of recombinant Bovine Alpha Lactalbumin production coupled with market prices of utilized materials. We found that recombinant protein production could be a feasible food source and an alternative to traditional sources.

  1. High hydrostatic pressure: a new way to improve in vitro developmental competence of porcine matured oocytes after vitrification

    DEFF Research Database (Denmark)

    Du, Y; Pribenszky, C S; Molnár, M

    2008-01-01

    The purpose of the present study was to improve cryotolerance using high hydrostatic pressure (HHP) pretreatment of porcine in vitro matured (IVM) oocytes, to facilitate their further developmental competence after parthenogenetic activation. A total of 1668 porcine IVM oocytes were used in our...

  2. "It's Important for Them to Know Who They Are": Teachers' Efforts to Sustain Students' Cultural Competence in an Age of High-Stakes Testing

    Science.gov (United States)

    Zoch, Melody

    2017-01-01

    This article examines how four urban elementary teachers designed their literacy instruction in ways that sought to sustain students' cultural competence--maintaining their language and cultural practices while also gaining access to more dominant ones--amid expectations to prepare students for high-stakes testing. A large part of their teaching…

  3. Exploration of portfolio characteristics for the recognition of prior learning : the identification, assessment and recognition of actual competencies of highly-skilled immigrants

    NARCIS (Netherlands)

    Scholten, Astrid Marianne

    2007-01-01

    This research study explores the characteristics of the portfolio as an instrument for highly-skilled immigrants to facilitate the identification, assessment and recognition of their actual competencies in order to define guidelines for portfolio design and implementation. The two research questions

  4. Questions Remain about Whether EBM Competencies Learned in Medical School are Retained in Residency. A review of: Dorsch, Josephine L., Meenakshy K. Aiyer, Krishna Gumidyala and Lynne E. Myer. “Retention of EBM Competencies.” Medical Reference Services Quarterly 25.3 (Fall 2006: 45‐57.

    Directory of Open Access Journals (Sweden)

    Suzanne Lewis

    2007-09-01

    Full Text Available Objective – To assess medical graduates’ use of evidence based medicine (EBM in residency, self‐perception of EBM skills, attitudes toward EBM, and the impact of a formal EBM curriculum in their third undergraduate year.Design – A longitudinal follow‐up study by self‐administered questionnaire.Setting – Internal medicine residency programs in US hospitals.Subjects – A convenience sample of 2001 and 2002 graduates of the University of Illinois College of Medicine at Peoria (UICOM‐P (n=78, and their respective residency program directors (n=72.Methods – A student graduate questionnaire (SGQ was sent to all members of UICOM‐P’s 2001 and 2002 graduating classes who had completed the EBM course during their M‐3 Internal Medicine clerkship. A program director questionnaire (PDQ, similar to the SGQ, was sent to the graduates’ residency program directors. The research instrument was tested with a pilot group prior to use, but not validated. The questionnaires consisted of 4 main sections. The first section examined formal and informal EBM programs in the graduates’ residency curriculum. The second section consisted of a self‐assessment of EBM skills by the residents and an assessment of those skills by their program directors. The third section asked graduates to compare their EBM skills to those of their fellow residents who had not been students at UICOM‐P. Similarly, in the third section of the PDQ, program directors were asked to compare the EBM skills of UICOM‐P graduates and non‐UICOM‐P graduates participating in the residency program. The last section concerned professional and demographic characteristics. Copies of the surveys were mailed out to non‐responders after 6 weeks. Results were collated but statistical analysis was not applied.Main results – The response rate was 32% for residents and 35% for program directors. The number of incomplete surveys was not reported. Forty‐four percent of all

  5. Triticale adaption and competence assessment result in the high lands of Ethiopia.

    Science.gov (United States)

    Legesse, Wasihun

    2014-01-01

    Triticale is a crop that resulted from the addition of chromosomes of wheat (Triticum aestivum ) and rye cereals (Secale cereale). The crop came on the market as bread cereal in the 1980s. Different varieties were released. Triticale is a high yielding crop when compared with tef, wheat and barley, particularly on locations with soil nutrient deficiency. The study was initiated with the question to which extent the growing of triticale crop (Triticosecale Wittmack) improves food security, and which factors can play a major role for its successful adoption, particularly in major food insecure areas of Ethiopia. The study has three main objectives: (1) to investigate the adaptability of triticale to the Ethiopian agro-ecological conditions, particularly in areas with low soil fertility, hence this is a crop considered to provide considerably a higher harvest under low agricultural inputs, such as fertilizer, insects and pests sprays; (2) to analyze the injera--and bread-baking quality of the crop in comparison with tef (a staple cereal limited to Ethiopia) and wheat cereals, and examine the acceptance by consumers of these products made from this grain. The study was conducted in the two major triticale producing districts (wereda), Farta and Estie of the South Gondar Administrative Zone in the Amhara Region, Ethiopia. The production of crops and the adoption of triticale as a new technology by smallholder farmers are influenced by several factors such as family size, age, gender and education of the household head, availability of agricultural extension services and farm credits, and labour. Despite the high yield and widespread adoption of triticale crop in the study areas and the Amhara Region at large, it faced some amount of resistance from a few farmers and some agriculturalists. This is because of the possibility of soil nutrients exploitation by the triticale plant, with a consequent drop of nutrition for the succeeding crops. This is however, a hardly valid

  6. Achieving organisational competence for clinical leadership: the role of high performance work systems.

    Science.gov (United States)

    Leggat, Sandra G; Balding, Cathy

    2013-01-01

    While there has been substantial discussion about the potential for clinical leadership in improving quality and safety in healthcare, there has been little robust study. The purpose of this paper is to present the results of a qualitative study with clinicians and clinician managers to gather opinions on the appropriate content of an educational initiative being planned to improve clinical leadership in quality and safety among medical, nursing and allied health professionals working in primary, community and secondary care. In total, 28 clinicians and clinician managers throughout the state of Victoria, Australia, participated in focus groups to provide advice on the development of a clinical leadership program in quality and safety. An inductive, thematic analysis was completed to enable the themes to emerge from the data. Overwhelmingly the participants conceptualised clinical leadership in relation to organisational factors. Only four individual factors, comprising emotional intelligence, resilience, self-awareness and understanding of other clinical disciplines, were identified as being important for clinical leaders. Conversely seven organisational factors, comprising role clarity and accountability, security and sustainability for clinical leaders, selective recruitment into clinical leadership positions, teamwork and decentralised decision making, training, information sharing, and transformational leadership, were seen as essential, but the participants indicated they were rarely addressed. The human resource management literature includes these seven components, with contingent reward, reduced status distinctions and measurement of management practices, as the essential organisational underpinnings of high performance work systems. The results of this study propose that clinical leadership is an organisational property, suggesting that capability frameworks and educational programs for clinical leadership need a broader organisation focus. The paper

  7. Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.

    Directory of Open Access Journals (Sweden)

    Jameson D Voss

    Full Text Available We sought to evaluate whether residence at high altitude is associated with the development of obesity among those at increased risk of becoming obese. Obesity, a leading global health priority, is often refractory to care. A potentially novel intervention is hypoxia, which has demonstrated positive long-term metabolic effects in rats. Whether or not high altitude residence confers benefit in humans, however, remains unknown. Using a quasi-experimental, retrospective study design, we observed all outpatient medical encounters for overweight active component enlisted service members in the U.S. Army or Air Force from January 2006 to December 2012 who were stationed in the United States. We compared high altitude (>1.96 kilometers above sea level duty assignment with low altitude (<0.98 kilometers. The outcome of interest was obesity related ICD-9 codes (278.00-01, V85.3x-V85.54 by Cox regression. We found service members had a lower hazard ratio (HR of incident obesity diagnosis if stationed at high altitude as compared to low altitude (HR 0.59, 95% confidence interval [CI] 0.54-0.65; p<0.001. Using geographic distribution of obesity prevalence among civilians throughout the U.S. as a covariate (as measured by the Centers for Disease Control and Prevention and the REGARDS study also predicted obesity onset among service members. In conclusion, high altitude residence predicts lower rates of new obesity diagnoses among overweight service members in the U.S. Army and Air Force. Future studies should assign exposure using randomization, clarify the mechanism(s of this relationship, and assess the net balance of harms and benefits of high altitude on obesity prevention.

  8. Vocational High School Effectiveness Standard ISO 9001: 2008 for Achievement Content Standards, Standard Process and Competency Standards Graduates

    Directory of Open Access Journals (Sweden)

    Yeni Ratih Pratiwi

    2014-06-01

    Full Text Available Efektivitas Sekolah Menengah Kejuruan Berstandar ISO 9001:2008 terhadap Pencapaian Standar Isi, Standar Proses dan Standar Kompetensi Lulusan Abstract: The purpose of this study was to determine differences in the effectiveness of the achievement of the content standards, process standards, and competency standards in vocational already standard ISO 9001: 2008 with CMS that has not been standardized ISO 9001: 2008 both in public schools and private schools. Data collection using the questionnaire enclosed Likert scale models. Analysis of data using one-way ANOVA using SPSS. The results showed: (1 there is no difference in effectiveness between public SMK ISO standard ISO standards with private SMK (P = 0.001; (2 there are differences in the effectiveness of public SMK SMK ISO standards with ISO standards have not (P = 0.000; (3 there are differences in the effectiveness of public SMK ISO standards with private vocational yet ISO standards (P = 0.000; (4 there are differences in the effectiveness of the private vocational school with vocational standard ISO standard ISO country has not (P = 0.015; (5 there are differences in the effectiveness of the private vocational bertandar ISO with private vocational yet standardized ISO (P = 0.000; (6 there was no difference in the effectiveness of public SMK has not been standardized by the ISO standard ISO private SMK yet. Key Words: vocational high school standards ISO 9001: 2008, the standard content, process standards, competency standards Abstrak: Tujuan penelitian ini untuk mengetahui perbedaan efektivitas pencapaian standar isi, standar proses, dan standar kompetensi lulusan pada SMK yang sudah berstandar ISO 9001:2008 dengan SMK yang belum berstandar ISO 9001:2008 baik pada sekolah negeri maupun sekolah swasta. Pengumpulan data menggunakan kuisioner tertutup model skala likert. Analisis data menggunakan ANOVA one way menggunakan program SPSS. Hasil penelitian menunjukkan: (1 ada perbedaan

  9. Prolonged control of replication-competent dual- tropic human immunodeficiency virus-1 following cessation of highly active antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Salgado Maria

    2011-12-01

    Full Text Available Abstract Background While initiation of highly active antiretroviral therapy (HAART during primary HIV-1 infection occasionally results in transient control of viral replication after treatment interruption, the vast majority of patients eventually experience a rebound in plasma viremia. Results Here we report a case of a patient who was started on HAART during symptomatic primary infection and who has subsequently maintained viral loads of + T cells. In addition, he does not have any known protective HLA alleles. Thus it is unlikely that he was destined to become a natural elite controller or suppressor. The mechanism of control of viral replication is unclear; he is infected with a CCR5/CXCR4 dual-tropic virus that is fully replication-competent in vitro. In addition, his spouse, who transmitted the virus to him, developed AIDS. The patient's CD4+ T cells are fully susceptible to HIV-1 infection, and he has low titers of neutralizing antibodies to heterologous and autologous HIV-1 isolates. Furthermore, his CD8+ T cells do not have potent HIV suppressive activity. Conclusion This report suggests that some patients may be capable of controlling pathogenic HIV-1 isolates for extended periods of time after the cessation of HAART through a mechanism that is distinct from the potent cytotoxic T lymphocyte (CTL mediated suppression that has been reported in many elite suppressors.

  10. Do high-nickel leaves shed by the nickel hyperaccumulator Alyssum murale inhibit seed germination of competing plants?

    Science.gov (United States)

    Zhang, Lan; Angle, J Scott; Chaney, Rufus L

    2007-01-01

    Elemental allelopathy suggests that nickel (Ni)-rich leaves shed by hyperaccumulators inhibit the germination and growth of nearby plant species. Here, the germination of eight herbaceous species following addition of Alyssum murale biomass or Ni(NO3)2, with the same Ni level added to soil, was assessed. The distribution of Ni in soil was tested by determining Ni phytoavailability and speciation over time. Phytoavailable Ni in soil amended with biomass declined rapidly over time due to Ni binding to iron (Fe)/manganese (Mn) oxides in the soil. No significant effects on seed germination were observed. Unlike the Ni complex in Alyssum biomass, more Ni remained soluble and phytoavailable in soil amended with Ni(NO3)2, thus significantly inhibiting seed germination. High-Ni leaves shed by hyperaccumulators did not appear to create a 'toxic zone' around the plants and inhibit germination or growth of competing plants. The lack of an allelopathic effect was probably related to low Ni availability.

  11. Radiology resident teaching skills improvement: impact of a resident teacher training program.

    Science.gov (United States)

    Donovan, Andrea

    2011-04-01

    Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills. Copyright © 2011 AUR. Published by

  12. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  13. Introducing "optimal challenges" in resident training

    DEFF Research Database (Denmark)

    Sørensen, Anette Bagger; Christensen, Mette Krogh

    Background: Residents are often caught between two interests: the resident’s desire to participate in challenging learning situations and the department’s work planning. However, these interests may clash if they are not coordinated by the senior doctors, and challenging learning situations risk...... being subject to work planning. Summary of work: Inspired by Csikszentmihalyi’s concept of optimal challenges, an intervention study aimed at introducing a more suitable planning of residents' learning in terms of optimal allocation of educational patient contacts. The objective was to coordinating...... residents’ individual competences and learning needs with patient characteristics in order to match each resident with a case (an outpatient or a patient) that meets the learning needs of the resident and thus pose an optimal challenge to the resident. Summary of results: The preliminary results show...

  14. Assessing competencies during education in psychiatry.

    Science.gov (United States)

    Humphrey, Holly J; Marcangelo, Michael; Rodriguez, Elizabeth R; Spitz, Deborah

    2013-06-01

    The utilization of competencies in medical education is relatively recent. In 1999 the United States Accreditation Council for Graduate Medical Education (ACGME) established six main competencies. Since then, the American Board of Psychiatry and Neurology have approved a specific list of competencies for their specialities in each of the ACGME's core competency areas. Assessment of competencies in both medical students and residents can be achieved through such methods as structured case discussion, direct observation, simulation, standardized patients, and 360-degree assessments, etc. Each assessment methodology has specific applications in the discipline of psychiatry. This paper reviews the different methods for assessing competencies with specific examples in psychiatric education. It is not intended as a comprehensive review of all assessment methods, but to provide examples and strategies to guide psychiatric educators in their practice. Students and residents were intentionally separated because there are differences in the teaching goals and objectives, and thus in the assessment purposes and design. Students are general, undifferentiated physicians-in-training who need to learn about psychiatric nosology, examinations, and treatment. Residents are mental health professionals who need more in-depth supervision in order to hone skills in all the specialized areas that arise in psychiatric practices, making supervision a vital part of residency programs.

  15. Radiology residents' experience with intussusception reduction.

    Science.gov (United States)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L; Li, Chin-Shang

    2011-06-01

    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model.

  16. The emotional intelligence of pediatric residents - a descriptive cross-sectional study.

    Science.gov (United States)

    McLeod, Scott A; Sonnenberg, Lyn K

    2017-02-01

    Emotional Intelligence (EI) is a type of social intelligence. Excellent scores are achieved by displaying high levels of empathy in interpersonal relationships, strong skills in managing stressful situations as well as other personal competencies. Many of the social competencies that EI describes may have a direct impact on patient care. The objective of this study was to describe EI of pediatric residents and to identify if there are EI skills that should be selected for targeted intervention. This was a cross-sectional study administering the EQ-i 2.0© psychometric instrument to pediatric residents at the University of Alberta. Thirty-five residents completed the EQ-i 2.0© (100% response rate). Their overall EI score was not significantly different than a normative group of college-educated professionals. Residents had relative strengths in the subcategories of Emotional expression, Interpersonal Relationships, Empathy, and Impulse Control (all p<0.05). Areas of relative weakness were in the subcategories of Stress Tolerance, Assertiveness, Independence, and Problem Solving (all p<0.05). The EI of pediatric residents is consistent with that of other professionals. Educational interventions may be useful in the areas of weakness to enhance the physician-patient relationship.

  17. The emotional intelligence of pediatric residents – a descriptive cross-sectional study

    Science.gov (United States)

    McLeod, Scott A.; Sonnenberg, Lyn K.

    2017-01-01

    Background Emotional Intelligence (EI) is a type of social intelligence. Excellent scores are achieved by displaying high levels of empathy in interpersonal relationships, strong skills in managing stressful situations as well as other personal competencies. Many of the social competencies that EI describes may have a direct impact on patient care. The objective of this study was to describe EI of pediatric residents and to identify if there are EI skills that should be selected for targeted intervention. Methods This was a cross-sectional study administering the EQ-i 2.0© psychometric instrument to pediatric residents at the University of Alberta. Results Thirty-five residents completed the EQ-i 2.0© (100% response rate). Their overall EI score was not significantly different than a normative group of college-educated professionals. Residents had relative strengths in the subcategories of Emotional expression, Interpersonal Relationships, Empathy, and Impulse Control (all p<0.05). Areas of relative weakness were in the subcategories of Stress Tolerance, Assertiveness, Independence, and Problem Solving (all p<0.05). Conclusion The EI of pediatric residents is consistent with that of other professionals. Educational interventions may be useful in the areas of weakness to enhance the physician-patient relationship. PMID:28344715

  18. Ongoing deficits in resident training for minimally invasive surgery.

    Science.gov (United States)

    Park, Adrian; Witzke, Donald; Donnelly, Michael

    2002-01-01

    Patient preference has driven the adoption of minimally invasive surgery (MIS) techniques and altered surgical practice. MIS training in surgical residency programs must teach new skill sets with steep learning curves to enable residents to master key procedures. Because no nationally recognized MIS curriculum exists, this study asked experts in MIS which laparoscopic procedures should be taught and how many cases are required for competency. Expert recommendations were compared to the number of cases actually performed by residents (Residency Review Committee [RRC] data). A detailed survey was sent nationwide to all surgical residency programs (academic and private) known to offer training in MIS and/or have a leader in the field. The response rate was approximately 52%. RRC data were obtained from the resident statistics summary report for 1998-1999. Experts identified core procedures for MIS training and consistently voiced the opinion that to become competent, residents need to perform these procedures many more times than the RRC data indicate they currently do. At present, American surgical residency programs do not meet the suggested MIS case range or volume required for competency. Residency programs need to be restructured to incorporate sufficient exposure to core MIS procedures. More expert faculty must be recruited to train residents to meet the increasing demand for laparoscopy.

  19. A multi-institutional study of the emotional intelligence of resident physicians.

    Science.gov (United States)

    McKinley, Sophia K; Petrusa, Emil R; Fiedeldey-Van Dijk, Carina; Mullen, John T; Smink, Douglas S; Scott-Vernaglia, Shannon E; Kent, Tara S; Black-Schaffer, W Stephen; Phitayakorn, Roy

    2015-01-01

    Although emotional intelligence (EI) may have a role in the development of Accreditation Council for Graduate Medical Education core competencies, few studies have measured resident EI across specialties. This study aimed to describe the EI of resident physicians across multiple specialties. Three hundred twenty five surgery, pediatric, and pathology residents at 3 large academic institutions were invited to complete the psychometrically validated Trait Emotional Intelligence Questionnaire. The response rate was 42.8% (n = 139). Global EI of all residents (101.0 ± 8.1) was comparable with, but less variable than, the general population sample and was not statistically different between specialties. Compared with the norm sample, residents in the 3 specialty groups demonstrated unique combinations of areas of relative high and low development. There exist distinct strengths and opportunities for the development for surgery, pediatrics, and pathology residents. Future investigations could use EI profiling to create educational interventions to develop specific areas of EI and assess correlation with resident performance. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Teaching Our Students, Our Residents and Ourselves.

    Science.gov (United States)

    Kayhan, Zeynep

    2014-02-01

    Even though postgraduate medical education has been the focus of interest in anaesthesiology education, in a broader sense the entire medical community can be considered appropriate learners of anaesthesiology. Anaesthesiologists are equipped to teach physiology, pharmacology, resuscitation, pain management, perioperative assessment, and medical technology. For residency training, an approach based on competencies, skills and professionalism should be used instead of the traditional "apprenticeship" model. When teaching ourselves as qualified anaesthesiologists, areas of continuing professional development, academic career training and continuing medical education should be taken into account. Whereas the responsibility for undergraduate medical education rests with university medical schools, postgraduate medical education is carried out by universities and/or the national health authorities/services. Establishment of partnerships between health-care services and universities should be central to the provision of postgraduate education so as not to dissociate various stages of education. When determining educational strategies, institutional preferences, target populations and their learning styles should be taken into account. To this end, especially for high risk situations simulation-based approaches, scenarios, standardized patients, research, mentoring, journal clubs, seminars, lectures, case discussions, bed-side discussions, courses, games and portfolios have been and are being used widely. Departments of anaesthesiology should establish and maintain a strong presence in undergraduate medical education. Besides being good clinicians, anaesthesiologists should understand all aspects of education and educational outcome in order to better teach students, residents and themselves. Quality of education and the teaching environment should continually be evaluated within the context of quality assurance.

  1. Prevalence of Vitamin D deficiency and associated risk factors among children residing at high altitude in Shimla district, Himachal Pradesh, India

    Science.gov (United States)

    Kapil, Umesh; Pandey, Ravindra Mohan; Goswami, Ravinder; Sharma, Brij; Sharma, Neetu; Ramakrishnan, Lakshmy; Singh, Gajendra; Sareen, Neha; Sati, Hem Chandra; Gupta, Aakriti; Sofi, Nighat Yaseen

    2017-01-01

    Introduction: Vitamin D is important for bone development in children. A high prevalence of Vitamin D deficiency (VDD) has been documented from different parts of India. However, limited data are available on VDD among children residing at high altitude region of country. Objectives: To assess the prevalence of VDD and associated risk factors among children in the age group of 6–18 years in Shimla, Himachal Pradesh. Methods: A community-based cross-sectional study was conducted in the year 2014–2015. A total of 626 children in the age group of 6–18 years were enrolled from 30 clusters which were identified using population proportionate to size sampling method. A minimum of 20 children in the age group of 6–18 years per cluster were selected using random number tables. The data on socioeconomic status, physical activity, sunlight exposure, and biochemical parameters of bone and mineral metabolism were assessed. Results: Ninety-three percent of school-age children were found Vitamin D deficient as per serum 25(OH) D levels of <20 ng/ml. The prevalence was significantly higher among females. Conclusion: A high prevalence of VDD was found in children residing in high altitude region. PMID:28217519

  2. CREATING OF BILINGUAL COMPETENCES OF HIGH SCHOOL STUDENTS BY MEANS OF PROJECT ACTIVITIES IN CONDITIONS OF INFORMATIZATION OF HIGH EDUCATION

    Directory of Open Access Journals (Sweden)

    G. A. Kruchinina

    2015-01-01

    Full Text Available Public information and communication space is a favorable environment for the development of bilingualism. Modern communication bilingual techniques may be more effective with the use of computer technology. The article investigates the necessity and possibility of the use of information and communication technologies in the project activities at the professional training of bilingual foreign language in high school. The combination of a method of projects and information and communication technologies (ICT in the teaching of foreign languages allows you to save interest in learning through the creative potential of a student, increasing motivation, independence and initiative. Using information and communication technologies, along with other modern pedagogical technologies (such as cooperative learning, project methodology, and others. helps to implement the studentcentered approach to learning, providing individualization and differentiation of education taking into account the abilities of students, their level of training; to form a stable motivation of foreign language activities in the classroom through the use of authentic materials, discuss pressing issues; to improve the skills of education and self-education, to move from reproductive assimilation of information to interactive and productive forms of education. The article presents the results of the study to assess the degree of attraction for students of various activities with the use of ICT in professional and bilingual foreign language training.

  3. Residency Allocation Database

    Data.gov (United States)

    Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

  4. Assessing groundwater residence time in a highly anthropized unconfined aquifer using bomb peak 14C and reconstructed irrigation water 3H of irrigation water

    OpenAIRE

    Baudron, Paul; Barbecot, Florent; Gillon, Marina; Garcia Arostegui, Jose Luis; Travi, Yves; Leduc, Christian; Gomariz Castillo, Francisco; Martinez-Vicente, David

    2013-01-01

    Radiocarbon decay is rarely used to assess the residence time of modern groundwater due to the low resolution of its long half-life in comparison to the expected range of ages. Nonetheless, the modern 14C peak induced by the nuclear bomb tests traces efficiently the impacts of recent human activities on groundwater recharge, as well as for tritium. A simple lumped parameter model (LPM) was implemented in order to assess the interest of 14C and 3H nuclear peaks in a highly anthropized aquifer ...

  5. Role of journal club in Canadian ophthalmology residency training: a national survey of program directors.

    Science.gov (United States)

    Mullen, Sarah J; Sabri, Kourosh

    2016-06-01

    To conduct a national survey of journal club curricula in Canadian ophthalmology residency programs. Cross-sectional web-based survey. Fifteen Royal College of Physicians and Surgeons of Canada (RCPSC) ophthalmology residency program directors. The 15 RCPSC ophthalmology residency program directors were invited to participate in a 31-item online survey. The survey inquired about the purpose, educational goals, and structure of journal club. Basic statistics were performed to compare responses across institutions. Thirteen of the 15 program directors replied, representing an 87% response rate. Twelve (92%) institutions maintained a journal club. All of the program directors surveyed felt that journal club had educational value. Resident attendance was typically mandatory (75%) and correspondingly high across programs. There was 100% agreement that randomized controlled trials were most often selected for review. The primary journal club objectives were for residents to develop critical appraisal skills and to conduct a literature search (67%). Formal teaching and evaluation of these skills were not prioritized by any program. Seventeen percent felt the most important objective was to impact clinical practice. Canadian ophthalmology program directors expressed high levels of satisfaction that journal club was effective in meeting its stated objectives. This indicates that the teaching model promoted resident critical appraisal skills; however, objective evaluation methods to assess resident competence in evidence-based medicine were not described by any respondents. As RCSPC ophthalmology programs transition to competency-based medical education, program directors may consider modifying journal club curriculum, broadening its utility toward a means of outcome assessment. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  6. Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation

    National Research Council Canada - National Science Library

    Michele Fang; Eric Linson; Manish Suneja; Ethan F Kuperman

    2017-01-01

    .... Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP...

  7. Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

    Directory of Open Access Journals (Sweden)

    Teresita M. Hogan

    2014-07-01

    Full Text Available Introduction: The demands of our rapidly expanding older population strain many emergency departments (EDs, and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Methods: Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results: 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score. Attitudes trended to more negative in successive post-graduate year (PGY levels. Conclusion: EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels. [West J Emerg Med. 2014;15(4:511–517.

  8. Burnout, anxiety, depression, and social skills in medical residents.

    Science.gov (United States)

    Pereira-Lima, K; Loureiro, S R

    2015-01-01

    The medical residency is recognized as a risk period for the development of burnout and mental health problems, such as anxiety and depression, which have impact on the physician and clientele alike. There is a need for studies that address conditions of risk and protection for the development of such problems. This study aimed to verify the rates of burnout, anxiety, and depression presented by resident physicians, as well as the associations of these problems with social skills, as potential protective factors. The hypothesis was defined that the problems (burnout, anxiety, and depression) would be negatively associated with social skills. A total of 305 medical residents, of both genders, of different specialties, from clinical and surgical areas of a Brazilian university hospital were evaluated using the following standardized self-report instruments: Burnout Syndrome Inventory, Social Skills Inventory, and the Patient Health Questionnaire-4. High rates of burnout and mental health problems were verified and social skills were negatively associated with burnout dimensions such as emotional exhaustion, emotional detachment, and dehumanization, but positively associated with personal accomplishment. Furthermore, residents with indicators of problems presented significantly lower social skills means than those of residents without indicators of burnout, anxiety, or depression. More studies are needed, which include other types of instruments in addition to self-report ones and evaluate not only social skills but also social competence in the professional practice. These should adopt intervention and longitudinal designs that allow the continuity or overcoming of the problems to be verified. Since social skills can be learned, the results of the study highlight the importance of developing the interpersonal skills of the professionals during the training of resident physicians in order to improve their practice.

  9. Forming key competences from the position of competence approach

    OpenAIRE

    Latypova E. R.

    2012-01-01

    Teaching foreign languages pursues practical, educational, bringing-up and developing aims in non-linguistic educational institution. The practical aim in teaching foreign languages is preparation of a highly trained specialist, which masters key competences and can work hard on his specialty according to world standards and is ready to act in professional communication with foreigners. New requirements direct the system of education toward competence approach. The main aim of competence appr...

  10. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

    van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

    2008-01-01

    Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report ques

  11. Suicidal Thoughts Among Medical Residents with Burnout

    NARCIS (Netherlands)

    van der Heijden, Frank; Dillingh, Gea; Bakker, Arnold; Prins, Jelle

    2008-01-01

    Objectives: Recent research showed that medical residents have a high risk for developing burnout. The present study investigates the prevalence of burnout and its relationship with suicidal thoughts among medical residents. Methods: All Dutch medical residents (n = 5126) received a self-report

  12. Competencies: requirements and acquisition

    NARCIS (Netherlands)

    Kuenn, A.C.; Meng, C.M.; Peters, Z.; Verhagen, A.M.C.

    2013-01-01

    Higher education is given the key task to prepare the highly talented among the young to fulfil highly qualified roles in the labour market. Successful labour market performance of graduates is generally associated with the acquisition of the correct competencies. Education as an individual investme

  13. Developing Soldier Cultural Competency

    Science.gov (United States)

    2006-03-03

    providing Soldiers a “ tourist ” level of understanding which does not adequately prepare them to be culturally competent and effective. The one exception is...cultures use high-context, indirect communications. High- 7 context groups view the low context groups as abrupt and rude in their messages, while low

  14. Physiological and self assessed psychological stress induced by a high fidelity simulation course among third year anaesthesia and critical care residents: an observational study.

    Science.gov (United States)

    Geeraerts, Pr Thomas

    2017-06-22

    The use of high-fidelity simulators in Medicine can improve knowledge, behavior and practice but may be associated with significant stress. Our objective was to measure physiological and psychological self-assessed intensity of stress before and after a planned simulation training session among third year anesthesia and critical care residents. A convenience sample of 27 residents participating in a simulation training course was studied. Stress was evaluated by self-assessment using a numerical scale and by salivary amylase concentration before and after the session. Technical and non-technical (using the Aberdeen Anaesthetists' Non Technical Skills scale) performances were assessed through videotapes analysis. The median stress score was 5 [2-8] before and 7 [2-10] after the simulation session (ptechnical performance. Simulation-induced stress, as measured by self-assessment and biological parameter, is high before the session and increases significantly during the course. While this stress did not seem to impact performance negatively, it should be taken into account. Copyright © 2017. Published by Elsevier Masson SAS.

  15. Above- and below-ground competition in high and low irradiance: tree seedling responses to a competing liana Byttneria grandifolia

    NARCIS (Netherlands)

    Chen, J.Y.; Bongers, F.; Cao, K.F.; Cai, Z.Q.

    2008-01-01

    Abstract: In tropical forests, trees compete not only with other trees, but also with lianas, which may limit tree growth and regeneration. Liana effects may depend on the availability of above- and below-ground resources and differ between tree species. We conducted a shade house experiment to test

  16. Investigating the Competence of Classroom Teachers in Terms of Nominating the Students with High Creativity and Gender-Biased Decisions

    Science.gov (United States)

    Sahin, Feyzullah

    2016-01-01

    The main purpose of this study was to analyse the classroom teachers' competence in identifying above-average creative students, and their gender-bias during the identification process. A descriptive survey model was employed as a research method. A total of 317 elementary school students took part in this study. As data collecting tools, a…

  17. Increases in positive self-views among high school students: birth-cohort changes in anticipated performance, self-satisfaction, self-liking, and self-competence.

    Science.gov (United States)

    Twenge, Jean M; Campbell, W Keith

    2008-11-01

    Previous research has produced contradictory findings on generational change in positive self-views. We examined 13 items measuring self-views in the Monitoring the Future study, a large national study of high school students conducted between 1975 and 2006 (in this analysis, ns between 4,698 and 29,673). Relative to high school students in the 1970s, those in 2006 were more likely to predict that they would be "very good" spouses, parents, and workers; were more satisfied with themselves; and scored higher on self-esteem items measuring self-liking. The 2006 students also reported earning higher grades and being more intelligent. However, 2006 students scored lower on two self-esteem items measuring self-competence than did students in 1975. These results suggest that there has been a small increase in positive self-views across the generations, but that it has not been accompanied by an increase in general self-competence.

  18. Teaching prenatal ultrasound to family medicine residents.

    Science.gov (United States)

    Dresang, Lee T; Rodney, William MacMillan; Dees, Jason

    2004-02-01

    Prenatal ultrasound is a powerful diagnostic tool, but there has been little research on how to teach ultrasound to family physicians. The available evidence supports teaching through didactics followed by supervised scanning. Didactic topics include physics and machine usage, indications, fetal biometry, anatomic survey, practice management, ethical issues, and resources. Supervised scanning reinforces the didactic components of training. A "hand-on-hand" supervised scanning technique is recommended for the transmission of psychomotor skills in these sessions. Curricula for teaching ultrasound should include information on which residents will be taught prenatal ultrasound, who will teach them, how to create time for learning ultrasound skills, and how to test for competency. The literature suggests that competency can be achieved within 25-50 supervised scans. Measures of competency include examination and qualitative analysis of scanning. Competency-based testing needs further development because no uniform standards have been established.

  19. Teaching high-value, cost-conscious care to residents: the Alliance for Academic Internal Medicine–American College of Physicians Curriculum.

    Science.gov (United States)

    Smith, Cynthia D

    2012-08-21

    Health care expenditures are projected to reach nearly 20% of the U.S. gross domestic product by 2020. Up to $765 billion of this spending has been identified as potentially avoidable; many of the avoidable costs have been attributed to unnecessary services. Postgraduate trainees have historically received little specific training in the stewardship of health care resources and minimal feedback on resource utilization and its effect on the cost of care. This article describes a new curriculum that was developed collaboratively by the Alliance for Academic Internal Medicine and the American College of Physicians to address this training gap. The curriculum introduces a simple, stepwise framework for delivering high-value care and focuses on teaching trainees to incorporate high-value, cost-conscious care principles into their clinical practice. It consists of ten 1-hour, case-based, interactive sessions designed to be flexibly incorporated into the existing conference structure of a residency training program.

  20. A theory-informed, process-oriented Resident Scholarship Program

    Directory of Open Access Journals (Sweden)

    Satid Thammasitboon

    2016-06-01

    Full Text Available Background: The Accreditation Council for Graduate Medical Education requires residency programs to provide curricula for residents to engage in scholarly activities but does not specify particular guidelines for instruction. We propose a Resident Scholarship Program that is framed by the self-determination theory (SDT and emphasize the process of scholarly activity versus a scholarly product. Methods: The authors report on their longitudinal Resident Scholarship Program, which aimed to support psychological needs central to SDT: autonomy, competence, and relatedness. By addressing those needs in program aims and program components, the program may foster residents’ intrinsic motivation to learn and to engage in scholarly activity. To this end, residents’ engagement in scholarly processes, and changes in perceived autonomy, competence, and relatedness were assessed. Results: Residents engaged in a range of scholarly projects and expressed positive regard for the program. Compared to before residency, residents felt more confident in the process of scholarly activity, as determined by changes in increased perceived autonomy, competence, and relatedness. Scholarly products were accomplished in return for a focus on scholarly process. Conclusions: Based on our experience, and in line with the SDT, supporting residents’ autonomy, competence, and relatedness through a process-oriented scholarship program may foster the curiosity, inquisitiveness, and internal motivation to learn that drives scholarly activity and ultimately the production of scholarly products.

  1. Intravascular Residence Time Determination for the Cyanide Antidote Dimethyl Trisulfide in Rat by Using Liquid-Liquid Extraction Coupled with High Performance Liquid Chromatography

    Science.gov (United States)

    De Silva, Deepthika; Lee, Steven; Duke, Anna; Angalakurthi, Siva; Chou, Ching-En; Ebrahimpour, Afshin; Thompson, David E.

    2016-01-01

    These studies represent the first report on the intravascular residence time determinations for the cyanide antidote dimethyl trisulfide (DMTS) in a rat model by using high performance liquid chromatography coupled with ultraviolet absorption spectroscopy (HPLC-UV). The newly developed sample preparation included liquid-liquid extraction by cyclohexanone. The calibration curves showed a linear response for DMTS concentrations between 0.010 and 0.30 mg/mL with R2 = 0.9994. The limit of detection for DMTS via this extraction method was 0.010 mg/mL, and the limit of quantitation was 0.034 mg/mL. Thus this calibration curve provided a tool for determining DMTS in the range between 0.04 and 0.30 mg/mL. Rats were given 20 mg/kg DMTS dose (in 15% Polysorbate 80) intravenously, and blood samples were taken 15, 60, 90, 120, and 240 min after DMTS injections. The data points were plotted as DMTS concentration in RBCs versus time, and the intravascular residence time was determined graphically. The results indicated a half-life of 36 min in a rat model, suggesting that the circulation time is long enough to provide a reasonable time interval for cyanide antagonism. PMID:28053802

  2. Intravascular Residence Time Determination for the Cyanide Antidote Dimethyl Trisulfide in Rat by Using Liquid-Liquid Extraction Coupled with High Performance Liquid Chromatography

    Directory of Open Access Journals (Sweden)

    Deepthika De Silva

    2016-01-01

    Full Text Available These studies represent the first report on the intravascular residence time determinations for the cyanide antidote dimethyl trisulfide (DMTS in a rat model by using high performance liquid chromatography coupled with ultraviolet absorption spectroscopy (HPLC-UV. The newly developed sample preparation included liquid-liquid extraction by cyclohexanone. The calibration curves showed a linear response for DMTS concentrations between 0.010 and 0.30 mg/mL with R2 = 0.9994. The limit of detection for DMTS via this extraction method was 0.010 mg/mL, and the limit of quantitation was 0.034 mg/mL. Thus this calibration curve provided a tool for determining DMTS in the range between 0.04 and 0.30 mg/mL. Rats were given 20 mg/kg DMTS dose (in 15% Polysorbate 80 intravenously, and blood samples were taken 15, 60, 90, 120, and 240 min after DMTS injections. The data points were plotted as DMTS concentration in RBCs versus time, and the intravascular residence time was determined graphically. The results indicated a half-life of 36 min in a rat model, suggesting that the circulation time is long enough to provide a reasonable time interval for cyanide antagonism.

  3. Investigating interpersonal competencies of cardiac surgery teams.

    Science.gov (United States)

    Fleming, Mark; Smith, Steven; Slaunwhite, Jason; Sullivan, John

    2006-02-01

    Successful cardiac surgery requires highly skilled individuals to interact effectively in a variety of complex situations. Although cardiac surgery requires individuals to have the requisite medical knowledge and skills, interpersonal competencies are vital to any successful cardiac surgery. Surgeons, anesthesiologists, perfusionists, nurses and residents must communicate effectively in order to ensure a successful patient outcome. Breakdowns in communication, decision-making or leadership could lead to adverse patient outcomes. Realizing that human error is responsible for many adverse patient outcomes, we attempted to understand the team processes involved in cardiac surgery. An adaptation of the Operating Room Management Attitudes Questionnaire was used to gather a variety of responses related to group decision-making and communication. The results indicate inherent group differences based on factors such as seniority and occupational group membership. The implications of the research findings and suggestions for future research are discussed in detail.

  4. Enhancement of faba bean competitive ability by arbuscular mycorrhizal fungi is highly correlated with dynamic nutrient acquisition by competing wheat

    OpenAIRE

    Qiao, Xu; Bei, Shuikuan; Li, Chunjie; Dong, Yan; Li, Haigang; Christie, Peter; Zhang, Fusuo; ZHANG, JUNLING

    2015-01-01

    The mechanistic understanding of the dynamic processes linking nutrient acquisition and biomass production of competing individuals can be instructive in optimizing intercropping systems. Here, we examine the effect of inoculation with Funneliformis mosseae on competitive dynamics between wheat and faba bean. Wheat is less responsive to mycorrhizal inoculation. Both inoculated and uninoculated wheat attained the maximum instantaneous N and P capture approximately five days before it attained ...

  5. Religious competence as cultural competence

    Science.gov (United States)

    2012-01-01

    Definitions of cultural competence often refer to the need to be aware and attentive to the religious and spiritual needs and orientations of patients. However, the institution of psychiatry maintains an ambivalent attitude to the incorporation of religion and spirituality into psychiatric practice. This is despite the fact that many patients, especially those from underserved and underprivileged minority backgrounds, are devotedly religious and find much solace and support in their religiosity. I use the case of mental health of African Americans as an extended example to support the argument that psychiatric services must become more closely attuned to religious matters. I suggest ways in which this can be achieved. Attention to religion can aid in the development of culturally competent and accessible services, which in turn, may increase engagement and service satisfaction among religious populations. PMID:22421686

  6. Enhancement of faba bean competitive ability by arbuscular mycorrhizal fungi is highly correlated with dynamic nutrient acquisition by competing wheat.

    Science.gov (United States)

    Qiao, Xu; Bei, Shuikuan; Li, Chunjie; Dong, Yan; Li, Haigang; Christie, Peter; Zhang, Fusuo; Zhang, Junling

    2015-01-01

    The mechanistic understanding of the dynamic processes linking nutrient acquisition and biomass production of competing individuals can be instructive in optimizing intercropping systems. Here, we examine the effect of inoculation with Funneliformis mosseae on competitive dynamics between wheat and faba bean. Wheat is less responsive to mycorrhizal inoculation. Both inoculated and uninoculated wheat attained the maximum instantaneous N and P capture approximately five days before it attained the maximum instantaneous biomass production, indicating that wheat detected the competitor and responded physiologically to resource limitation prior to the biomass response. By contrast, the instantaneous N and P capture by uninoculated faba bean remained low throughout the growth period, and plant growth was not significantly affected by competing wheat. However, inoculation substantially enhanced biomass production and N and P acquisition of faba bean. The exudation of citrate and malate acids and acid phosphatase activity were greater in mycorrhizal than in uninoculated faba bean, and rhizosphere pH tended to decrease. We conclude that under N and P limiting conditions, temporal separation of N and P acquisition by competing plant species and enhancement of complementary resource use in the presence of AMF might be attributable to the competitive co-existence of faba bean and wheat.

  7. Competencies in Teaching English.

    Science.gov (United States)

    Purves, Alan C.

    This paper discusses suggested requirements for a competency-based English teacher training program on the high school or college level. The author argues that an English teacher needs to demonstrate a basic knowledge of the subject matter in three areas: the structure and history of the English language, rhetorical theory and practice, and…

  8. Impact of a family medicine resident wellness curriculum: a feasibility study

    Directory of Open Access Journals (Sweden)

    Christine Runyan

    2016-06-01

    Full Text Available Background: Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives: The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods: The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results: Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions: This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction.

  9. Impact of a family medicine resident wellness curriculum: a feasibility study

    Science.gov (United States)

    Runyan, Christine; Savageau, Judith A.; Potts, Stacy; Weinreb, Linda

    2016-01-01

    Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction. PMID:27282276

  10. Pathology informatics essentials for residents: A flexible informatics curriculum linked to accreditation council for graduate medical education milestones

    Directory of Open Access Journals (Sweden)

    Walter H Henricks

    2016-01-01

    Full Text Available Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics have been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: The objective of the study is to develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016. Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

  11. Competency-based education: a new model for teaching orthopaedics.

    Science.gov (United States)

    Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K

    2013-01-01

    The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.

  12. The problem resident behavior guide: strategies for remediation.

    Science.gov (United States)

    Williamson, Kelly; Quattromani, Erin; Aldeen, Amer

    2016-04-01

    In 2012, the ACGME supplemented the core competencies with outcomes-based milestones for resident performance within the six competency domains. These milestones address the knowledge, skills, abilities, attitudes, and experiences that a resident is expected to progress through during the course of training. Even prior to the initiation of the milestones, there was a paucity of EM literature addressing the remediation of problem resident behaviors and there remain few readily accessible tools to aid in the implementation of a remediation plan. The goal of the "Problem Resident Behavior Guide" is to provide specific strategies for resident remediation based on deficiencies identified within the framework of the EM milestones. The "Problem Resident Behavior Guide" is a written instructional manual that provides concrete examples of remediation strategies to address specific milestone deficiencies. The more than 200 strategies stem from the experiences of the authors who have professional experience at three different academic hospitals and emergency medicine residency programs, supplemented by recommendations from educational leaders as well as utilization of valuable education adjuncts, such as focused simulation exercises, lecture preparation, and themed ED shifts. Most recommendations require active participation by the resident with guidance by faculty to achieve the remediation expectations. The ACGME outcomes-based milestones aid in the identification of deficiencies with regards to resident performance without providing recommendations on remediation. The Problem Resident Behavior Guide can therefore have a significant impact by filling in this gap.

  13. Training Internal Medicine Residents in Social Medicine and Research-Based Health Advocacy: A Novel, In-Depth Curriculum.

    Science.gov (United States)

    Basu, Gaurab; Pels, Richard J; Stark, Rachel L; Jain, Priyank; Bor, David H; McCormick, Danny

    2017-04-01

    Health disparities are pervasive worldwide. Physicians have a unique vantage point from which they can observe the ways social, economic, and political factors impact health outcomes and can be effective advocates for enhanced health outcomes and health equity. However, social medicine and health advocacy curricula are uncommon in postgraduate medical education. In academic year (AY) 2012, the Cambridge Health Alliance internal medicine residency program transformed an elective into a required social medicine and research-based health advocacy curriculum. The course has three major innovations: it has a yearlong longitudinal curriculum, it is required for all residents, and all residents complete a group research-based health advocacy project within the curricular year. The authors describe the structure, content, and goals of this curriculum. Over the last four years (AYs 2012-2015), residents (17/32; 53%) have rated the overall quality of the course highly (mean = 5.2, where 6 = outstanding; standard deviation = 0.64). In each year since the new course has been implemented, all scholarly work from the course has been presented at conferences by 31 resident presenters and/or coauthors. The course seems to enhance the residency program's capacity to recruit high-caliber residents and faculty members. The authors are collecting qualitative and quantitative data on the impact of the course. They will use their findings to advocate for a national health advocacy competency framework. Recommendations about how to initiate or further develop social medicine and health advocacy curricula are offered.

  14. Anatomical and hemodynamic evaluations of the heart and pulmonary arterial pressure in healthy children residing at high altitude in China

    Directory of Open Access Journals (Sweden)

    Hai-Ying Qi

    2015-06-01

    Conclusions: Children living at high altitude in China have significantly higher mPAP, dilated right heart and slower regression of right ventricular hypertrophy in the first 14 years of life. Systolic and diastolic functions of both ventricles were reduced with a paradoxically higher CI. There was no significant difference in these features between the Hans and the Tibetans. These values provide references for the care of healthy children and the sick ones with cardiopulmonary diseases at high altitude.

  15. Effects of high-fidelity patient simulation led clinical reasoning course: Focused on nursing core competencies, problem solving, and academic self-efficacy.

    Science.gov (United States)

    Lee, JuHee; Lee, Yoonju; Lee, Senah; Bae, Juyeon

    2016-01-01

    To examine the effects of high-fidelity patient simulation (HFPS) led clinical reasoning course among undergraduate nursing students. A quasi-experimental study of non-equivalent control group pretest-post test design was applied. A total of 49 senior nursing students participated in this study. The experimental group consisted of the students who took the "clinical reasoning" course (n = 23) while the control group consisted of students who did not (n = 26). Self-administered scales including the nursing core competencies, problem solving, academic self-efficacy, and Kolb learning style inventory were analyzed quantitatively using SPSS version 20.0. Data analysis was conducted using one-way ancova due to a significant difference in nursing core competencies between the experimental group and control group. There was a significant improvement in nursing core competencies in the experimental group (F = 7.747, P = 0.008). The scores of problem solving and academic self-efficacy were higher in the experimental group after the HFPS led clinical reasoning course without statistical difference. There is a need for the development of effective instructional methods to improve learning outcomes in nursing education. Future research is needed related to simulation education as well as management strategies so that learning outcomes can be achieved within different students' learning style. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

  16. Resident Characteristics Report

    Data.gov (United States)

    Department of Housing and Urban Development — The Resident Characteristics Report summarizes general information about households who reside in Public Housing, or who receive Section 8 assistance. The report...

  17. Self-evaluation: how well do surgery residents judge performance on a rotation?

    Science.gov (United States)

    Gow, Kenneth W

    2013-05-01

    Surgical trainees are evaluated based on the Accreditation Council for Graduate Medical Education 6 core competencies. The ability for a learner to recognize strengths and weaknesses in these areas allows for critical self-improvement. Surgery residents rotating on a pediatric surgery rotation for 1 academic year were asked at an exit interview to provide a self-evaluation within the 6 core competencies on a Likert scale from 1 to 5. Self-evaluation scores were compared with a final group consensus attending evaluation. Further analyses included comparing residents as follows: less than R3 (junior residents) versus R3 (senior residents) residents, general surgery versus non-general surgery residents, university versus community residents, residents in the first half of the academic year versus residents in the second half, and top one third- and lowest one third-performing residents. Statistical analysis was performed using Student t tests with significance at P surgery residents, and highest one third-performing residents compared with junior residents, non-general surgery residents, and lowest one third-performing residents. There were no differences between self-evaluations and attending evaluations when comparing university with community residents and residents in the first half of the academic year with residents in the second half of the academic year. Residents appear to have a more critical self-analysis than attending surgeons, with senior residents, general surgery residents, and highest one third-performing residents being the most critical of their own performance. Poorly performing residents appeared to lack insight into their abilities. This method of self-evaluation helps trainees reflect on their performance and highlights trainees who lack self-awareness and need counseling for improvement. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. A museum-based urban teacher residency program's approach to strengthening the STEM pipeline: Channeling highly qualified Earth Science teachers into high needs schools

    Science.gov (United States)

    Ustunisik, G. K.; Zirakparvar, N. A.

    2015-12-01

    Channeling better prepared Earth Science teachers into secondary schools with low achievement rates in STEM subjects is essential to ensuring that the students attending these schools are ultimately afforded the opportunity to take advantage of projected growth in the global geoscience workforce. Here, a museum-based urban teacher residency (UTR) program's approach to building subject specific content knowledge and research experience in Earth Science teacher candidates is described. In the museum-based program, graduate-level science courses and research experiences are designed and implemented specifically for the UTR by active Earth and Space research scientists that account for almost half of the program's faculty. Because these courses and research experiences are designed specifically for the teacher candidates, they are different than many science courses and research experiences available to pre-service teachers in a university setting. At the same time, the museum-based program is the only UTR to incorporate such a rigorous science curriculum, and some possible advantages and disadvantages of the program's approach are also considered here. While the impact of the program's approach on student achievement rates has yet to be evaluated, there is promise in the well documented links between a teacher's own experience with the practice of science and that teacher's ability to leverage effective pedagogical content knowledge in the teaching of science. Because the museum-based program's science curriculum is balanced against the educational coursework and teaching residencies that necessarily form the program's backbone, the museum's approach to strengthening the teacher candidate's science background may also inform the faculty and administration of other UTRs in cases where one of their program goals is to further expand their teacher candidate's content knowledge and practical subject matter experience.

  19. Emotional problems of residents in psychiatry.

    Science.gov (United States)

    Russell, A T; Pasnau, R O; Taintor, Z C

    1975-03-01

    The authors used a questionnaire technique to determine the magnitude of the problem of emotional illness and poor performance during psychiatric residency, the procedures that are used to screen for or help disturbed residents, and characteristics that differentiate residents who are at risk. The data indicated that residents who have problems that lead to termination are rarely free of emotional disturbance. The general belief that women, foreign medical graduates, and minority group members are at higher risk for problems during residency was not supported; however, younger residents and transfers from other programs appeared to be at risk. A disturbing finding was the high rate of suicide reported. The authors stress the need for further work with the "marginal" resident and for research on screening and supportive procedures.

  20. Assessment of indoor radiation dose received by the residents of natural high background radiation areas of coastal villages of Kanyakumari district, Tamil Nadu, India

    Energy Technology Data Exchange (ETDEWEB)

    Deva Jayanthi, D., E-mail: d.devajayanthi@gmail.co [Department of Physics, Women' s Christian College, Nagercoil 629001 (India); Maniyan, C.G. [Environmental Assessment Division, BARC, Mumbai 400085 (India); Perumal, S. [Department of Physics and Research Centre, S.T.Hindu College, Nagercoil 629002 (India)

    2011-07-15

    Radiation exposure and effective dose received through two routes of exposure, viz. external and internal, via inhalation, by residents of 10 villages belonging to Natural High Background Radiation Areas (NHBRA) of coastal regions of Kanyakumari District and Tamil Nadu in India were studied. While the indoor gamma radiation levels were monitored using Thermo Luminescent Dosimeters (TLDs), the indoor radon and thoron gas concentrations were measured using twin chamber dosimeters employing Solid State Nuclear Track Detectors (SSNTDs, LR-115-II). The average total annual effective dose was estimated and found to be varying from 2.59 to 8.76 mSv. -- Highlights: {yields} The effective dose received by the villages of Natural High Background Area (NHBRA) such as Enayam, Midalam and Mel Midalam is high when compared with other study areas. {yields} The high dose indicates higher concentration of radioactive nuclides like Thorium and Uranium in the soil. {yields} As radiation is harmful to human life, the external and internal doses can be reduced by removing the monazite content present in the soil by mineral separation. {yields} Contribution from vegetables, fruits, fish and other non vegetarian items are also being examined. {yields} These results along with other socio-economic factors can throw considerable light on the epidemiological impacts due to low levels of chronic exposure.

  1. The Ideal Resident Doctor: Á Resident's Perspective

    African Journals Online (AJOL)

    trainer relationship can only then be imagined. ... like these lend themselves to personal and cultural ... An ideal resident's clinical options .... of humanistic and professional values, the lack of .... graduate medical education should do more in mak-.

  2. Minimum Competency Testing and the Handicapped.

    Science.gov (United States)

    Wildemuth, Barbara M.

    This brief overview of minimum competency testing and disabled high school students discusses: the inclusion or exclusion of handicapped students in minimum competency testing programs; approaches to accommodating the individual needs of handicapped students; and legal issues. Surveys of states that have mandated minimum competency tests indicate…

  3. Competency Mapping of Teachers in Tertiary Education

    Science.gov (United States)

    Sugumar, V. Raji

    2009-01-01

    Competency of teachers assumes a lot of importance in the era of knowledge society who are expected to produce students of high calibre. In India however competency development and mapping still remains an unexplored process. Not much study has been done on competency mapping in higher education sector, thus the present study is ventured upon. The…

  4. A Research Review of Nurse Teachers' Competencies

    Science.gov (United States)

    Zlatanovic, Tatjana; Havnes, Anton; Mausethagen, Sølvi

    2017-01-01

    The conceptions of what constitutes nursing competence and how such competence is taught and learned are changing, due to rapid changes in in the health sector. Nurse teachers' competencies for providing high-quality, up-to-date nursing education, are developing accordingly. This paper reviews the existing research on nurse teachers' competencies…

  5. Teaching and learning the physician manager role: psychiatry residents' perspectives.

    Science.gov (United States)

    Stergiopoulos, Vicky; Maggi, Julie; Sockalingam, Sanjeev

    2010-01-01

    Despite widespread consensus that additional training in administration is needed to prepare physicians for practice, little is known about how best to teach managerial competencies and how to integrate teaching into existing postgraduate curricula. This study aimed to elicit resident perspectives on administrative curriculum development following exposure to a pilot physician manager curriculum at the University of Toronto. The authors held five focus groups of psychiatry residents at the University of Toronto during 2008, engaging 40 trainees. Resident perspectives on barriers to teaching and learning administrative skills, preferred curriculum content and format and suggestions for integration of administrative training into the residency programme were elicited. Identified barriers to learning include lack of physician manager role clarity, dearth of learning opportunities and multiple competing demands on residents' time. Residents value a formal administrative curriculum and propose additional opportunities for experiential learning such as elective rotations and mentorship opportunities. Suggested strategies for integrating administrative teaching into residency include faculty development, rotation-specific administrative objectives and end of rotation resident evaluations. Our findings provide valuable learner input into an emerging educational framework aiming to address barriers to teaching administrative skills during residency and facilitate longitudinal reinforcement of learning.

  6. Long Blood Residence and Large Tumor Uptake of Ruthenium Sulfide Nanoclusters for Highly Efficient Cancer Photothermal Therapy

    Science.gov (United States)

    Lu, Zhuoxuan; Huang, Feng-ying; Cao, Rong; Zhang, Liming; Tan, Guang-hong; He, Nongyue; Huang, Jie; Wang, Guizhen; Zhang, Zhijun

    2017-01-01

    Transition metal sulfide (TMS) holds great potential in cancer photothermal therapy (PTT) because of the high absorbance in the near-infrared (NIR) region. The short blood circulation time and limited tumor accumulation of TMS-based photothermal agents, however, limit their applications. Herein, we design a novel TMS-based PTT agent, ruthenium sulfide-based nanoclusters (NCs), to overcome the current limitations. We firstly develop a simple method to prepare oleic acid coated ruthenium sulfide nanodots (OA-RuS1.7 NDs) and assemble them into water-soluble NCs via sequentially coating with denatured bovine serum albumin (dBSA) and poly(ethylene glycol) (PEG). The obtained PEG-dBSA-RuS1.7 NCs possess excellent photothermal conversion ability. More significantly, they exhibit enhanced blood circulation time and tumor-targeting efficiency in vivo compared with other TMS-based PTT nanoagents, which may be attributed to their appropriate hydrodynamic diameter (~70 nm) and an ideal charge (~0 mV). These characteristics help the PEG-dBSA-RuS1.7 NCs to escape the removal by the reticuloendothelial system (RES) and kidney. All these advantages enable the PEG-dBSA-RuS1.7 NCs to selectively concentrate in tumor sites and effectively ablate the cancer cells upon NIR irradiation. PMID:28139763

  7. Characterizing wild bird contact and seropositivity to highly pathogenic avian influenza A (H5N1) virus in Alaskan residents.

    Science.gov (United States)

    Reed, Carrie; Bruden, Dana; Byrd, Kathy K; Veguilla, Vic; Bruce, Michael; Hurlburt, Debby; Wang, David; Holiday, Crystal; Hancock, Kathy; Ortiz, Justin R; Klejka, Joe; Katz, Jacqueline M; Uyeki, Timothy M

    2014-09-01

    Highly pathogenic avian influenza A (HPAI) H5N1 viruses have infected poultry and wild birds on three continents with more than 600 reported human cases (59% mortality) since 2003. Wild aquatic birds are the natural reservoir for avian influenza A viruses, and migratory birds have been documented with HPAI H5N1 virus infection. Since 2005, clade 2.2 HPAI H5N1 viruses have spread from Asia to many countries. We conducted a cross-sectional seroepidemiological survey in Anchorage and western Alaska to identify possible behaviors associated with migratory bird exposure and measure seropositivity to HPAI H5N1. We enrolled rural subsistence bird hunters and their families, urban sport hunters, wildlife biologists, and a comparison group without bird contact. We interviewed participants regarding their exposures to wild birds and collected blood to perform serologic testing for antibodies against a clade 2.2 HPAI H5N1 virus strain. Hunters and wildlife biologists reported exposures to wild migratory birds that may confer risk of infection with avian influenza A viruses, although none of the 916 participants had evidence of seropositivity to HPAI H5N1. We characterized wild bird contact among Alaskans and behaviors that may influence risk of infection with avian influenza A viruses. Such knowledge can inform surveillance and risk communication surrounding HPAI H5N1 and other influenza viruses in a population with exposure to wild birds at a crossroads of intercontinental migratory flyways. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  8. The transition to competency-based pediatric training in the United Arab Emirates.

    Science.gov (United States)

    Ibrahim, Halah; Al Tatari, Hossam; Holmboe, Eric S

    2015-04-01

    Although competency-based medical education has become the standard for physician training in the West, many developing countries have not yet adopted competency-based training. In 2009 in the United Arab Emirates, the government regulatory and operational authorities for healthcare in Abu Dhabi mandated a wide-scale reform of the emirate's postgraduate residency programs to the competency-based framework of the newly formed Accreditation Council for Graduate Medical Education-International (ACGME-I). This article briefly describes the rationale for competency-based medical education and provides an overview of the transition from traditional, time-based residency training to competency-based postgraduate medical education for the Pediatrics residency programs in Abu Dhabi. We will provide data on the initial impact of this transition on resident performance and patient outcomes in a Pediatrics residency program in an academic medical center in the United Arab Emirates.

  9. Teaching core competencies of reconstructive microsurgery with the use of standardized patients.

    Science.gov (United States)

    Son, Ji; Zeidler, Kamakshi R; Echo, Anthony; Otake, Leo; Ahdoot, Michael; Lee, Gordon K

    2013-04-01

    The Accreditation Council of Graduate Medical Education has defined 6 core competencies that residents must master before completing their training. Objective structured clinical examinations (OSCEs) using standardized patients are effective educational tools to assess and teach core competencies. We developed an OSCE specific for microsurgical head and neck reconstruction. Fifteen plastic surgery residents participated in the OSCE simulating a typical new patient consultation, which involved a patient with oral cancer. Residents were scored in all 6 core competencies by the standardized patients and faculty experts. Analysis of participant performance showed that although residents performed well overall, many lacked proficiency in systems-based practice. Junior residents were also more likely to omit critical elements of the physical examination compared to senior residents. We have modified our educational curriculum to specifically address these deficiencies. Our study demonstrates that the OSCE is an effective assessment tool for teaching and assessing all core competencies in microsurgery.

  10. Suicide Risk Assessments: Which Suicide Risk Factors Psychiatric Residents Consider Significant?

    OpenAIRE

    Wang, Sheng-Min; Hwang, Sunyoung; Yeon, Bora; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-01-01

    Objective Patients visiting the emergency department (ED) after a suicide attempt are generally assessed for suicide risk by psychiatric residents. Psychiatric residents' competence in evaluating the risk posed by the patients who attempted suicide is critical to preventing suicide. Methods We investigated factors considered important by psychiatric residents when evaluating suicide risk. This study included 140 patients admitted to the ED after attempting suicide. Psychiatric residents rated...

  11. Vitamin D deficiency awareness among African migrant women residing in high-rise public housing in Melbourne, Australia: a qualitative study.

    Science.gov (United States)

    Pirrone, Alana; Capetola, Teresa; Riggs, Elisha; Renzaho, Andre

    2013-01-01

    The aims of this study were: 1) to explore the individual perceptions, experience and understandings of vitamin D deficiency (VDD) amongst African migrant women residing in high-rise public housing, 2) to identify the most useful sources of information about VDD among this population, and 3) to document the barriers and enablers to addressing VDD. The Health Belief Model was used to guide the study. Convenience sampling was used with women living in particular high-rise public housing. Five focus group discussions were conducted (n=30). Thematic analysis was used to code and categorise the data to develop a deeper, conceptual understanding of the issue. We found that participants were aware of VDD and could identify the impacts that VDD had on their health. Barriers to addressing VDD included the women's: 1) living conditions in Australia, 2) risk of skin cancer, and 3) cultural roles in the family. The most positive strategy for preventing and addressing VDD was peer information sharing. This study has highlighted the significant need for health promotion strategies to combat VDD in this population. Future health promoting public health strategies for this population should encompass community based peer education programs. This study demonstrates the critical role of qualitative inquiry in gaining a deeper understanding of VDD in a particular migrant community. It is clear that this issue requires a coordinated solution that must involve the community themselves. Health care professionals must take into consideration the multiple barriers that exist to address VDD which is a significant public health issue.

  12. Forming key competences from the position of competence approach

    Directory of Open Access Journals (Sweden)

    Latypova E. R.

    2012-06-01

    Full Text Available Teaching foreign languages pursues practical, educational, bringing-up and developing aims in non-linguistic educational institution. The practical aim in teaching foreign languages is preparation of a highly trained specialist, which masters key competences and can work hard on his specialty according to world standards and is ready to act in professional communication with foreigners. New requirements direct the system of education toward competence approach. The main aim of competence approach in teaching foreign languages is an intensifying of practical studying.

  13. Supporting At-Risk Youth and Their Families to Manage and Prevent Diabetes: Developing a National Partnership of Medical Residency Programs and High Schools.

    Directory of Open Access Journals (Sweden)

    Liana Gefter

    Full Text Available The Stanford Youth Diabetes Coaches Program (SYDCP is a school based health program in which Family Medicine residents train healthy at-risk adolescents to become diabetes self-management coaches for family members with diabetes. This study evaluates the impact of the SYDCP when disseminated to remote sites. Additionally, this study aims to assess perceived benefit of enhanced curriculum.From 2012-2015, 10 high schools and one summer camp in the US and Canada and five residency programs were selected to participate. Physicians and other health providers implemented the SYDCP with racial/ethnic-minority students from low-income communities. Student coaches completed pre- and posttest surveys which included knowledge, health behavior, and psychosocial asset questions (i.e., worth and resilience, as well as open-ended feedback questions. T-test pre-post comparisons were used to determine differences in knowledge and psychosocial assets, and open and axial coding methods were used to analyze qualitative data.A total of 216 participating high school students completed both pre-and posttests, and 96 nonparticipating students also completed pre- and posttests. Student coaches improved from pre- to posttest significantly on knowledge (p<0.005 in 2012-13, 2014 camp, and 2014-15; worth (p<0.1 in 2014-15; problem solving (p<0.005 in 2014 camp and p<0.1 in 2014-15; and self-efficacy (p<0.05 in 2014 camp. Eighty-two percent of student coaches reported that they considered making a behavior change to improve their own health as a result of program participation. Qualitative feedback themes included acknowledgment of usefulness and relevance of the program, appreciation for physician instructors, knowledge gain, pride in helping family members, improved relationships and connectedness with family members, and lifestyle improvements.Overall, when disseminated, this program can increase health knowledge and some psychosocial assets of at-risk youth and holds

  14. Training Experiences of Family Medicine Residents on Behavioral Health Rotations.

    Science.gov (United States)

    Zubatsky, Max; Brieler, Jay; Jacobs, Christine

    2017-09-01

    Although accreditation guidelines for residency in family medicine include behavioral health curriculum, little is known about resident learning activities in real world training. Our study explored residents' perceptions about and exposure to specific activities during their behavioral health rotations. Family medicine residents (N=84) recruited via faculty list serves completed a survey about their experiences during behavioral health rotations. The survey included quantitative Likert scale questions, along with open-ended questions on which a qualitative content analysis was performed. Open-ended responses indicated that many residents receive constructive observation and collaboration opportunities during their training month. However, residents wanted more time to practice behavioral health skills beyond the rotation, more practice in psychotherapy skills, and additional education on medication management. Most residents (62%) received either limited or no training in couples or family therapy during their behavioral health rotation. Residents who reported more behavioral health knowledge gain during the rotation also reported higher self-perceived competency using Motivational Interviewing (M=3.82, P<.01). While family medicine as a discipline is based on the biopsychosocial model of care, residents reported deficits in education about family systems. Residents desire additional opportunities to learn psychotherapy techniques and practice counseling skills. Family medicine residency programs and faculty may consider supplementing their core behavioral curriculum to include these content areas.

  15. Describing a residency program developed for newly graduated nurse practitioners employed in retail health settings.

    Science.gov (United States)

    Thabault, Paulette; Mylott, Laura; Patterson, Angela

    2015-01-01

    Retail health clinics are an expanding health care delivery model and an emerging new practice site for nurse practitioners (NPs). Critical thinking skills, clinical competence, interprofessional collaboration, and business savvy are necessary for successful practice in this highly independent and autonomous setting. This article describes a pilot residency partnership program aimed at supporting new graduate NP transition to practice, reducing NP turnover, and promoting academic progression. Eight new graduate NPs were recruited to the pilot and paired with experienced clinical NP preceptors for a 12-month program that focused on increasing clinical and business competence in the retail health setting. The residency program utilized technology to facilitate case conferences and targeted Webinars to enhance learning and peer-to-peer sharing and support. An on-line doctoral-level academic course that focused on interprofessional collaboration in health care, population health, and business concepts was offered. Both NPs and preceptors were highly satisfied with the academic-service residency program between MinuteClinic and Northeastern University School of Nursing in Boston, MA. New NPs particularly valued the preceptor model, the clinical case conferences, and business Webinars. Because their priority was in gaining clinical experience and learning the business acumen relevant to managing the processes of care, they did not feel ready for the doctoral course and would have preferred to take later in their practice. The preceptors valued the academic course and felt that it enhanced their precepting and leadership skills. At the time of this article, 6 months post completion of the residency program, there has been no turnover. Our experience supports the benefits for residency programs for newly graduated NPs in retail settings. The model of partnering with academia by offering a course within a service organization's educational programs can enable academic

  16. Neurocritical care education during neurology residency

    Science.gov (United States)

    Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

    2012-01-01

    Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

  17. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette K.; O'Neill, Lotte Dyhrberg; Hansen, Dorthe H.;

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand......Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world...... of the topic. Methods We performed a mixed methods study. All regional residency program directors (N = 157) were invited to participate in an e-survey about residents in difficulty. Survey data were combined with database data on demographical characteristics of the background population (N = 2399...

  18. Southern Nevada residents` views about the Yucca Mountain high-level nuclear waste repository and related issues: A comparative analysis of urban and rural survey data

    Energy Technology Data Exchange (ETDEWEB)

    Krannich, R.S.; Little, R.L. [Utah State Univ., Logan, UT (United States); Mushkatel, A.; Pijawka, K.D.; Jones, P. [Arizona State Univ., Tempe, AZ (United States)

    1991-10-01

    two separate surveys were undertaken in 1988 to ascertain southern Nevadans` views about the Yucca Mountain repository and related issues. The first of these studies focused on the attitudes and perceptions of residents in the Las Vegas metropolitan area. The second study addressed similar issues, but focused on the views of residents in six rural communities in three counties adjacent to the Yucca Mountain site. However, parallel findings from the two data sets have not been jointly analyzed in order to identify ways in which the views and orientations of residents in the rural and urban study areas may be similar or different. The purpose of this report is to develop and present a comparative assessment of selected issues addressed in the rural and urban surveys. Because both urban and rural populations would potentially be impacted by the Yucca Mountain repository, such an analysis will provide important insights into possible repository impacts on the well-being of residents throughout southern Nevada.

  19. Geriatric core competencies for family medicine curriculum and enhanced skills: care of elderly.

    Science.gov (United States)

    Charles, Lesley; Triscott, Jean A C; Dobbs, Bonnie M; McKay, Rhianne

    2014-06-01

    There is a growing mandate for Family Medicine residency programs to directly assess residents' clinical competence in Care of the Elderly (COE). The objectives of this paper are to describe the development and implementation of incremental core competencies for Postgraduate Year (PGY)-I Integrated Geriatrics Family Medicine, PGY-II Geriatrics Rotation Family Medicine, and PGY-III Enhanced Skills COE for COE Diploma residents at a Canadian University. Iterative expert panel process for the development of the core competencies, with a pre-defined process for implementation of the core competencies. Eighty-five core competencies were selected overall by the Working Group, with 57 core competencies selected for the PGY-I/II Family Medicine residents and an additional 28 selected for the PGY-III COE residents. The core competencies follow the CanMEDS Family Medicine roles. Both sets of core competencies are based on consensus. Due to demographic changes, it is essential that Family Physicians have the required skills and knowledge to care for the frail elderly. The core competencies described were developed for PGY-I/II Family Medicine residents and PGY-III Enhanced Skills COE, with a focus on the development of geriatric expertise for those patients that would most benefit.

  20. High average daily intake of PCDD/Fs and serum levels in residents living near a deserted factory producing pentachlorophenol (PCP) in Taiwan: Influence of contaminated fish consumption

    Energy Technology Data Exchange (ETDEWEB)

    Lee, C.C. [Department of Environmental and Occupational Health, Medical College, National Cheng Kung University, Tainan, Taiwan (China); Research Center of Environmental Trace Toxic Substances, Medical College, National Cheng Kung University, Tainan, Taiwan (China); Lin, W.T. [Department of Environmental and Occupational Health, Medical College, National Cheng Kung University, Tainan, Taiwan (China); Liao, P.C. [Department of Environmental and Occupational Health, Medical College, National Cheng Kung University, Tainan, Taiwan (China); Research Center of Environmental Trace Toxic Substances, Medical College, National Cheng Kung University, Tainan, Taiwan (China); Su, H.J. [Department of Environmental and Occupational Health, Medical College, National Cheng Kung University, Tainan, Taiwan (China); Research Center of Environmental Trace Toxic Substances, Medical College, National Cheng Kung University, Tainan, Taiwan (China); Chen, H.L. [Department of Industrial Safety and Health, Hung Kuang University, Taichung, 34 Chung Chie Rd. Sha Lu, Taichung 433, Taiwan (China)]. E-mail: hsiulin@sunrise.hk.edu.tw

    2006-05-15

    An abandoned pentachlorophenol plant and nearby area in southern Taiwan was heavily contaminated by dioxins, impurities formed in the PCP production process. The investigation showed that the average serum PCDD/Fs of residents living nearby area (62.5 pg WHO-TEQ/g lipid) was higher than those living in the non-polluted area (22.5 and 18.2 pg WHO-TEQ/g lipid) (P < 0.05). In biota samples, average PCDD/F of milkfish in sea reservoir (28.3 pg WHO-TEQ/g) was higher than those in the nearby fish farm (0.15 pg WHO-TEQ/g), and Tilapia and shrimp showed the similar trend. The average daily PCDD/Fs intake of 38% participants was higher than 4 pg WHO-TEQ/kg/day suggested by the world health organization. Serum PCDD/F was positively associated with average daily intake (ADI) after adjustment for age, sex, BMI, and smoking status. In addition, a prospective cohort study is suggested to determine the long-term health effects on the people living near factory. - Inhabitants living near a deserted PCP factory are exposed to high PCDD/F levels.

  1. Equipping Residents to Address Alcohol and Drug Abuse: The National SBIRT Residency Training Project

    Science.gov (United States)

    Pringle, Janice L.; Kowalchuk, Alicia; Meyers, Jessica Adams; Seale, J. Paul

    2012-01-01

    Background The Screening, Brief Intervention and Referral to Treatment (SBIRT) service for unhealthy alcohol use has been shown to be one of the most cost-effective medical preventive services and has been associated with long-term reductions in alcohol use and health care utilization. Recent studies also indicate that SBIRT reduces illicit drug use. In 2008 and 2009, the Substance Abuse Mental Health Service Administration funded 17 grantees to develop and implement medical residency training programs that teach residents how to provide SBIRT services for individuals with alcohol and drug misuse conditions. This paper presents the curricular activities associated with this initiative. Methods We used an online survey delivery application (Qualtrics) to e-mail a survey instrument developed by the project directors of 4 SBIRT residency programs to each residency grantee's director. The survey included both quantitative and qualitative data. Results All 17 (100%) grantees responded. Respondents encompassed residency programs in emergency medicine, family medicine, pediatrics, obstetrics-gynecology, psychiatry, surgery, and preventive medicine. Thirteen of 17 (76%) grantee programs used both online and in-person approaches to deliver the curriculum. All 17 grantees incorporated motivational interviewing and validated screening instruments in the curriculum. As of June 2011, 2867 residents had been trained, and project directors reported all residents were incorporating SBIRT into their practices. Consistently mentioned challenges in implementing an SBIRT curriculum included finding time in residents' schedules for the modules and the need for trained faculty to verify resident competence. Conclusions The SBIRT initiative has resulted in rapid development of educational programs and a cohort of residents who utilize SBIRT in practice. Skills verification, program dissemination, and sustainability after grant funding ends remain ongoing challenges. PMID:23451308

  2. Pathology residency training: time for a new paradigm.

    Science.gov (United States)

    Domen, Ronald E; Baccon, Jennifer

    2014-06-01

    The exponential growth of the field of pathology over the past several decades has created challenges for residency training programs. These challenges include the ability to train competent pathologists in 4 years, an increased demand for fellowship training, and the structuring and completion of maintenance of certification. The authors feel that pathology residency training has reached a critical point and that a new paradigm for training is required.

  3. Non-invasive bone competence analysis by high-resolution pQCT: an in vitro reproducibility study on structural and mechanical properties at the human radius.

    Science.gov (United States)

    Mueller, Thomas L; Stauber, Martin; Kohler, Thomas; Eckstein, Felix; Müller, Ralph; van Lenthe, G Harry

    2009-02-01

    Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength. Bone strength depends, among others, on bone density, bone geometry and its internal architecture. With the recent introduction of a new generation high-resolution 3D peripheral quantitative computed tomography (HR-pQCT) system, direct quantification of structural bone parameters has become feasible. Furthermore, it has recently been demonstrated that bone mechanical competence can be derived from HR-pQCT based micro-finite element modeling (microFE). However, reproducibility data for HR-pQCT-derived mechanical indices is not well-known. Therefore, the aim of this study was to quantify reproducibility of HR-pQCT-derived indices. We measured 14 distal formalin-fixed cadaveric forearms three times and analyzed three different regions for each measurement. For each region cortical and trabecular parameters were determined. Reproducibility was assessed with respect to precision error (PE) and intraclass correlation coefficient (ICC). Reproducibility values were found to be best in all three regions for the full bone compartment with an average PE of 0.79%, followed by the cortical compartment (PE=1.19%) and the trabecular compartment with an average PE of 2.31%. The mechanical parameters showed similar reproducibility (PE=0.48%-2.93% for bone strength and stiffness, respectively). ICC showed a very high reproducibility of subject-specific measurements, ranging from 0.982 to 1.000, allowing secure identification of individual donors ranging from healthy to severely osteoporotic subjects. From these in vitro results we conclude that HR-pQCT derived morphometric and mechanical parameters are highly reproducible such that differences in bone structure and strength can be detected with a reproducibility error smaller than 3%; hence, the technique has a high potential to become a tool for detecting bone quality and bone competence of individual subjects.

  4. Education for Professional Chaplains: Should Certification Competencies Shape Curriculum?

    Science.gov (United States)

    Fitchett, George; Tartaglia, Alexander; Massey, Kevin; Jackson-Jordon, Beth; Derrickson, Paul E

    2015-01-01

    The growing importance of professional chaplains in patient-centered care has raised questions about education for professional chaplaincy. One recommendation is that the curricula of Clinical Pastoral Education (CPE) residency programs make use of the chaplaincy certification competencies. To determine the adoption of this recommendation, we surveyed CPE supervisors from 26 recently re-accredited, stipended CPE residency programs. We found the curricula of 38% of these programs had substantive engagement with the certification competencies, 38% only introduced students to the competences, and 23% of the programs made no mention of them. The majority of the supervisors (59%) felt engagement with the competencies should be required while 15% were opposed to such a requirement. Greater engagement with chaplaincy certification competencies is one of several approaches to improvements in chaplaincy education that should be considered to ensure that chaplains have the training needed to function effectively in a complex and changing healthcare environment.

  5. Co-Dependency and Resident Assistants.

    Science.gov (United States)

    Hetherington, Cheryl; Kerr, Barbara

    1988-01-01

    Proposes that an important psychological variable, codependence, may help to account for the phenomenon of burnout among resident assistants and other high-achieving, socially able college students. Explores characteristics of codependency. Suggests ways that institutional policy can help to decrease resident assistant burnout and related…

  6. Co-Dependency and Resident Assistants.

    Science.gov (United States)

    Hetherington, Cheryl; Kerr, Barbara

    1988-01-01

    Proposes that an important psychological variable, codependence, may help to account for the phenomenon of burnout among resident assistants and other high-achieving, socially able college students. Explores characteristics of codependency. Suggests ways that institutional policy can help to decrease resident assistant burnout and related…

  7. Resident-to-Resident Aggression in Long-Term Care Facilities: An Understudied Problem

    OpenAIRE

    Rosen, Tony; Pillemer, Karl; Lachs, Mark

    2008-01-01

    Resident-to-resident aggression (RRA) between long-term care residents includes negative and aggressive physical, sexual, or verbal interactions that in a community setting would likely be construed as unwelcome and have high potential to cause physical or psychological distress in the recipient. Although this problem potentially has high incidence and prevalence and serious consequences for aggressors and victims, it has received little direct attention from researchers to date. This article...

  8. Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Elisabeth Wiken Telenius

    Full Text Available Dementia is among the leading causes of functional loss and disability in older adults. Research has demonstrated that nursing home patients without dementia can improve their function in activities of daily living, strength, balance and mental well being by physical exercise. The evidence on effect of physical exercise among nursing home patients with dementia is scarce and ambiguous. Thus, the primary objective of this study was to investigate the effect of a high intensity functional exercise program on the performance of balance in nursing home residents with dementia. The secondary objective was to examine the effect of this exercise on muscle strength, mobility, activities of daily living, quality of life and neuropsychiatric symptoms.This single blinded randomized controlled trial was conducted among 170 persons with dementia living in nursing homes. Mean age was 86.7 years (SD = 7.4 and 74% were women. The participants were randomly allocated to an intervention (n = 87 or a control group (n = 83. The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks. The control condition was leisure activities.The intervention group improved the score on Bergs Balance Scale by 2.9 points, which was significantly more than the control group who improved by 1.2 points (p = 0.02. Having exercised 12 times or more was significantly associated with improved strength after intervention (p<0.05. The level of apathy was lower in the exercise group after the intervention, compared to the control group (p = 0.048.The results from our study indicate that a high intensity functional exercise program improved balance and muscle strength as well as reduced apathy in nursing home patients with dementia.ClinicalTrials.gov NCT02262104.

  9. How to fulfill residents' training needs and public service missions in outpatient general internal medicine? An observational pilot study.

    Science.gov (United States)

    Junod Perron, Noelle; Humair, Jean-Paul; Gaspoz, Jean-Michel

    2012-07-12

    QUESTION UNDER STUDY/PRINCIPLES: Ambulatory care is a mandatory component of post-graduate training in general internal medicine. Academic outpatient clinics face challenges in training residents in terms of exposure to sufficient patient case-mix, diversity of clinical activities and continuity of care while fulfilling their mission to provide care to vulnerable populations. We report the development and evaluation of a new postgraduate curriculum in ambulatory care in Geneva, Switzerland, designed to overcome such challenges. The content of learning activities was adapted to core competencies and learning objectives. In the new 2-year curriculum, residents had their working week divided into 2½ days of continuity clinic over two years, and 2½ days of 6 to 12 months rotations (e.g., walk-in clinics). Team work was consolidated through the creation of subunits including an attending physician, 1-2 senior residents during one year and 6- to 8 residents, who met in bi-monthly meetings with other health professionals. In both local and national surveys, residents and senior residents expressed an overall global satisfaction with the new curriculum. Nursing and administrative staff were less satisfied, because of reduced residents' time in each unit. Interprofessional meetings were highly appreciated for both patient care and team building. Management of residents' absences became more complex. The new curriculum met its goals in gaining residents' satisfaction and in reinforcing interprofessional collaboration although management of human resources became more complex. It also gave insights into challenges to be addressed when disseminating a new curriculum, such as strong leadership, educational expertise and management skills and tools.

  10. Implementation and evaluation of a novel research education rotation for Royal College of Physicians and Surgeons emergency medicine residents.

    Science.gov (United States)

    Abu-Laban, Riyad B; Jarvis-Selinger, Sandra; Newton, Lana; Chung, Brian

    2013-07-01

    Royal College of Physicians and Surgeons (RCPS) emergency medicine (EM) residents must complete a scholarly project; however, significant variation exists in Canadian EM resident research education and facilitation. We developed and implemented a novel mandatory research education rotation for RCPS EM residents intended to increase knowledge, faculty/resident collaborations, and, ultimately, scholarly output. This 4-week rotation took place in the fall of 2011 and consisted of 37 faculty-led didactic, critical appraisal, and workshop seminars. Exposure to faculty research and resulting opportunities and the development of resident research projects were integrated into the rotation. Twelve participating residents completed daily evaluations and took part in an exit focus group analyzed using a constant comparative method. Knowledge acquisition was assessed with a pre/post comprehensive examination instrument evaluated by a paired t-test. Evaluations indicated generally high satisfaction throughout the rotation. Focus group analysis indicated that residents felt two important but competing goals existed: developing a research project and developing critical appraisal skills. The research knowledge of all participants improved significantly (mean/SD examination change +35.4%/+10.4%, range +20.0% to +53.6%, p < 0.001), and several new resident/faculty research collaborations arose from the rotation. A rotation of this nature is an efficient and effective means to increase research and critical appraisal knowledge and faculty/resident collaborations. As a result of our positive experience, the rotation will continue annually and has been expanded to include pediatric EM fellows. Longitudinal tracking of the participating trainee cohort will remain ongoing to assess the scholarly output impact of the rotation.

  11. Simulation Activity in Otolaryngology Residencies.

    Science.gov (United States)

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  12. Rain Forest Dance Residency.

    Science.gov (United States)

    Watson, Dawn

    1997-01-01

    Outlines the author's experience as a dancer and choreographer artist-in-residence with third graders at a public elementary school, providing a cultural arts experience to tie in with a theme study of the rain forest. Details the residency and the insights she gained working with students, teachers, and theme. (SR)

  13. Global health education in general preventive medicine residencies.

    Science.gov (United States)

    Bussell, Scottie A; Kihlberg, Courtney J; Foderingham, Nia M; Dunlap, Julie A; Aliyu, Muktar H

    2015-05-01

    Opportunities for global health training during residency are steadily increasing. For example, surveys show that more than half of residency programs now offer international electives. Residency programs are increasingly recognizing that global health training improves communication skills, fosters awareness of health disparities, and inspires careers in primary care and public health. Although research has focused on global health education in other specialties, there is a paucity of research on global health training in public health and general preventive medicine (GPM). We sought to describe the extent of global health training across GPM residencies, capture the perspectives of program directors regarding competencies residents need for careers in global health, and identify program directors' perceived barriers to providing global health training. The survey was sent electronically to 42 U.S. GPM residency program directors from September to October 2013. Twenty-three completed surveys were returned. Information from residencies that did not complete the study survey was collected through a predefined search protocol. Data analysis was performed from February through July 2014. Among program directors completing the survey, the most common types of reported global health education were courses (n=17), followed by international rotations (n=10). Ten program directors indicated that resident(s) were involved in global health training, research, or service initiatives. Commonly perceived barriers included funding (87%), scheduling (56.5%), and partnership and sustainability (34.8%). Through global health coursework, research, and practicum rotations, GPM residents could acquire skills, knowledge, and attitudes contributing to careers in global health.

  14. Coping with disaster: relocating a residency program.

    Science.gov (United States)

    Conlay, Lydia A; Searle, Nancy S; Gitlin, Melvin C

    2007-08-01

    In September 2005, in the aftermath of Hurricane Katrina, the Tulane University School of Medicine relocated temporarily from New Orleans to the Baylor College of Medicine in Houston, Texas. For Tulane's residency program in anesthesiology, a training consortium was formed in Texas consisting of the University of Texas at Houston, Baylor College of Medicine, the University of Texas Medical Branch at Galveston, and the M.D. Anderson Cancer Center. The authors explain the collaborative process that allowed the consortium to find spaces to accommodate Tulane's 30 anesthesiology residents within 30 days after they left New Orleans, and they offer reflections and recommendations. The residents were grateful to continue training close to home, and for maintaining the Tulane program. The consortium successfully provided an administrative and academic framework, logistical support, clinical capacity for the residents to complete the required numbers and types of cases, and integration into preexisting didactic programs. Communications represented a major challenge; the importance of having an up-to-date disaster plan, including provisions for communication using more than one modality or provider, cannot be underestimated. Other challenges included resuming a training program without basic information regarding medical credentials or training status, competing for resources with businesses that had also relocated, maintaining a coordinated decision-making process, and managing the behavioral sequelae after the disaster. Of the original 30 Tulane residents, 23 (77%) relocated to Houston. Seventeen (74%) of those who relocated either graduated or returned with the program to New Orleans. The program has retained its status of full accreditation.

  15. A pilot structured resident orientation curriculum improves the confidence of incoming first-year obstetrics and gynecology residents.

    Science.gov (United States)

    Hiraoka, Mark; Kamikawa, Ginny; McCartin, Richard; Kaneshiro, Bliss

    2013-11-01

    A prospective, observational study was performed to evaluate a pilot orientation curriculum which involved all 7 incoming obstetrics and gynecology residents in June 2012. The objective of this study was to assess how a structured orientation curriculum, which employs an evaluation of baseline competency, affects the confidence of incoming first-year obstetrics and gynecology residents. The curriculum included didactic lectures, online modules, simulation, and mock clinical scenarios. Pre- and post-course surveys were conducted online via SurveyMonkey™ and were sent to all incoming obstetrics and gynecology residents. All seven incoming obstetrics and gynecology residents completed the orientation curriculum which included evaluations at the end of the orientation to assess baseline competency prior to taking part in clinical care. Confidence levels improved in all 27 elements assessed. Statistically significant improvement in confidence levels occurred in cognitive skills such as obstetric emergency management (2.9 vs 3.9, P< .05) and technical skills such as knot tying (3.9 vs. 4.6, P< .05). Certain teaching skills also demonstrated statistically significant improvements. A structured orientation program which improves resident self-confidence levels and demonstrates baseline competencies in certain clinical areas can be valuable for many residency training programs.

  16. A Required Rotation in Clinical Laboratory Management for Pathology Residents: Five-Year Experience at Hofstra Northwell School of Medicine.

    Science.gov (United States)

    Rishi, Arvind; Hoda, Syed T; Crawford, James M

    2016-01-01

    Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9) felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates.

  17. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh;

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand......Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world...... such as the Scandinavian countries, where healthcare systems are slightly different. The aim of this study was to examine prevalence and characteristics of residents in difficulty in one out of three postgraduate medical training regions in Denmark, and to produce both a quantifiable overview and in-depth understanding...

  18. An International Study in Competency Education: Postcards from Abroad. CompetencyWorks Issue Brief

    Science.gov (United States)

    Bristow, Sara Frank; Patrick, Susan

    2014-01-01

    "An International Study in Competency Education: Postcards from Abroad" seeks to highlight components of competency education in international practice, to inform US policymakers and decision makers seeking to implement high-quality competency pathways at the state or local level. Other countries are studying our innovations, and we are…

  19. Under the microscope: assessing surgical aptitude of otolaryngology residency applicants.

    Science.gov (United States)

    Carlson, Matthew L; Archibald, David J; Sorom, Abraham J; Moore, Eric J

    2010-06-01

    Application to otolaryngology residency is a highly competitive process. Programs identify the best candidates by evaluating academic performance in medical school, board scores, research experience, performance during an interview, and letters of recommendation. Unfortunately, none of these metrics completely assess an applicant's capacity to learn and perform surgical skills. We describe a direct assessment of an applicant's ability for rapid surgical skill acquisition, manual dexterity, and response to stress that can be performed during the interview process. A retrospective study at an academic otolaryngology residency program. After orientation, applicants were seated at a microsurgical training station and allotted 20 minutes to suture an incision using 10-0 nylon suture on a latex practice card. Their performance was graded using a 1-to-5 scoring system for the following categories: microscope use, respect for tissue, instrument handling, knot tying and suture control, skills acquisition, and attitude toward the exercise. Applicants were given some instruction and assessed on their ability to incorporate what they had learned into their technique. The average total applicant score was 23.2, standard deviation (SD) 3.6 (maximum 30); 13.4% of applicants scored 1 SD above the mean. The value of applicant screening tests in predicting surgical competency is controversial. We describe a direct assessment tool that may prove useful in identifying outliers, both high and low, to aid in final applicant ranking.

  20. Practice management education during surgical residency.

    Science.gov (United States)

    Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest

    2008-12-01

    Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

  1. An Initial Investigation of the Generalization of a School-Based Social Competence Intervention for Youth with High-Functioning Autism

    Directory of Open Access Journals (Sweden)

    Carla Schmidt

    2011-01-01

    Full Text Available This study evaluated the impact of generalization of the Social Competence Intervention-Adolescent (SCI-A curriculum in a school setting for individuals with high-functioning autism or Asperger's Syndrome (=6. This study examined to what degree the generalization of the SCI-A curriculum could be measured when delivered in a school setting. Across the six participants preliminary results suggest improvement on teacher reports of social skills and executive functioning. Some improvements were also evident in direct measures of facial-expression recognition. Data collected in the nonintervention settings indicated that some generalization of social interaction skills may have occurred for all six participants. Future research directions are discussed.

  2. iSocial: delivering the Social Competence Intervention for Adolescents (SCI-A) in a 3D virtual learning environment for youth with high functioning autism.

    Science.gov (United States)

    Stichter, Janine P; Laffey, James; Galyen, Krista; Herzog, Melissa

    2014-02-01

    One consistent area of need for students with autism spectrum disorders is in the area of social competence. However, the increasing need to provide qualified teachers to deliver evidence-based practices in areas like social competence leave schools, such as those found in rural areas, in need of support. Distance education and in particular, 3D Virtual Learning, holds great promise for supporting schools and youth to gain social competence through knowledge and social practice in context. iSocial, a distance education, 3D virtual learning environment implemented the 31-lesson social competence intervention for adolescents across three small cohorts totaling 11 students over a period of 4 months. Results demonstrated that the social competence curriculum was delivered with fidelity in the 3D virtual learning environment. Moreover, learning outcomes suggest that the iSocial approach shows promise for social competence benefits for youth.

  3. Histidine-rich glycoprotein binds fibrin(ogen) with high affinity and competes with thrombin for binding to the gamma'-chain.

    Science.gov (United States)

    Vu, Trang T; Stafford, Alan R; Leslie, Beverly A; Kim, Paul Y; Fredenburgh, James C; Weitz, Jeffrey I

    2011-09-01

    Histidine-rich glycoprotein (HRG) is an abundant protein that binds fibrinogen and other plasma proteins in a Zn(2+)-dependent fashion but whose function is unclear. HRG has antimicrobial activity, and its incorporation into fibrin clots facilitates bacterial entrapment and killing and promotes inflammation. Although these findings suggest that HRG contributes to innate immunity and inflammation, little is known about the HRG-fibrin(ogen) interaction. By immunoassay, HRG-fibrinogen complexes were detected in Zn(2+)-supplemented human plasma, a finding consistent with a high affinity interaction. Surface plasmon resonance determinations support this concept and show that in the presence of Zn(2+), HRG binds the predominant γ(A)/γ(A)-fibrinogen and the γ-chain elongated isoform, γ(A)/γ'-fibrinogen, with K(d) values of 9 nm. Likewise, (125)I-labeled HRG binds γ(A)/γ(A)- or γ(A)/γ'-fibrin clots with similar K(d) values when Zn(2+) is present. There are multiple HRG binding sites on fibrin(ogen) because HRG binds immobilized fibrinogen fragment D or E and γ'-peptide, an analog of the COOH terminus of the γ'-chain that mediates the high affinity interaction of thrombin with γ(A)/γ'-fibrin. Thrombin competes with HRG for γ'-peptide binding and displaces (125)I-HRG from γ(A)/γ'-fibrin clots and vice versa. Taken together, these data suggest that (a) HRG circulates in complex with fibrinogen and that the complex persists upon fibrin formation, and (b) by competing with thrombin for γ(A)/γ'-fibrin binding, HRG may modulate coagulation. Therefore, the HRG-fibrin interaction may provide a novel link between coagulation, innate immunity, and inflammation.

  4. Assessment of emergency medicine residents: a systematic review

    Science.gov (United States)

    Colmers-Gray, Isabelle N.; Walsh, Kieran; Chan, Teresa M.

    2017-01-01

    Background Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment. Methods We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 – June 2014. MeSH terms included “assessment,” “residency,” and “emergency medicine.” We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident. Two reviewers screened abstracts, reviewed full text studies, and abstracted data. Reporting of assessment-related costs was a secondary outcome. Results The search returned 879 articles; 137 articles were full-text reviewed; 73 met inclusion criteria. Half of the studies (54.8%) were pilot projects and one-quarter (26.0%) described fully implemented assessment tools/programs. Assessment tools (n=111) comprised 12 categories, most commonly: simulation-based assessments (28.8%), written exams (28.8%), and direct observation (26.0%). Median assessment frequency (n=39 studies) was twice per month/rotation (range: daily to once in residency). No studies thoroughly reported costs. Conclusion EM resident assessment commonly uses simulation or direct observation, done once-per-rotation. Implemented assessment systems and assessment-associated costs are poorly reported. Moving forward, routine publication will facilitate transitioning to competency-based medical education. PMID:28344722

  5. Preparing residents in training to become health-care leaders: a pilot project.

    Science.gov (United States)

    Gurrera, Ronald J; Dismukes, Rodney; Edwards, Matthew; Feroze, Usama; Nakshabandi, Firas; Tanaka, Gen; Tang, Michael

    2014-12-01

    The aim of this study is to describe a successful and exportable training module that addresses Next Accreditation System (NAS) behavioral milestones for leadership competencies. A novel leadership training module, which required the creation of original business plans by teams of residents, was incorporated into a psychiatry PGY-2 training curriculum. In the creation and presentation of their business plans, the residents demonstrated competencies in the NAS functional domains of interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Residents who responded with feedback after completing the course were very positive about their experience. The leadership training module described here allowed residents to acquire and demonstrate many of the competencies specified in leadership-oriented NAS milestones. The module did not require additional funding or a formal rotation or "track," is scalable to accommodate any number of residents and can be modified based on available local teaching resources.

  6. Personal health care of internal medicine residents

    Directory of Open Access Journals (Sweden)

    Venkataraman Palabindala

    2012-01-01

    Full Text Available Medical residents, as part of their job to balance the demands of their work with caring for themselves so as to be mentally, emotionally, and physically sound to stay clinically competent. While regulatory and legislative attempts at limiting medical resident work hours have materialized but have yet to attain passage, there are fairly little data looking into how residents cope up with their demands and yet attend to their own personal health.Anonymous mailed survey.Three hundred and thirty-seven residents from all internal medicine residency programs within United States.We conducted a survey in the form of a questionnaire that was sent by e-mail to the program directors of various internal medicine residency programs within the United States, and responses were collected between May 19 and June 21, 2009. Response was well appreciated with total number of participants of 337 with even demographical distribution in gender, residency year, AMG/IMG, age group. Seventy-one percent of the residents felt that they would prefer getting admitted to their own hospital for any acute medical or surgical condition. Of the 216 residents who have had received health care in the past, almost half of them chose their own hospital because of the proximity, while 45% did not choose their own hospital despite proximity. Two out of three residents missed their doctors appointments or cancelled them due to demands of medical training. Only half of the residents have a primary care physician and almost 80% of them did not have their yearly health checkup. Close to 30% held back information regarding their social and sexual history from their provider because of privacy and confidentiality concerns. Eighty percent of residents never received information about barriers that physicians may face in obtaining care for their socially embarrassing conditions. Seventy percent felt that their performance then was suboptimal because of that health condition and also felt

  7. Evaluating Community Health Advisor (CHA) Core Competencies: The CHA Core Competency Retrospective Pretest/Posttest (CCCRP).

    Science.gov (United States)

    Story, Lachel; To, Yen M

    2016-05-01

    Health care and academic systems are increasingly collaborating with community health advisors (CHAs) to provide culturally relevant health interventions that promote sustained community transformation. Little attention has been placed on CHA training evaluation, including core competency attainment. This study identified common CHA core competencies, generated a theoretically based measure of those competencies, and explored psychometric properties of that measure. A concept synthesis revealed five CHA core competencies (leadership, translation, guidance, advocacy, and caring). The CHA Core Competency Retrospective Pretest/Posttest (CCCRP) resulted from that synthesis, which was administered using multiple approaches to individuals who previously received CHA training (N= 142). Exploratory factor analyses revealed a two-factor structure underlying the posttraining data, and Cronbach's alpha indicated high internal consistency. This study suggested some CHA core competencies might be more interrelated than previously thought, and two major competencies exist rather than five and supported the CCCRP's use to evaluate core competency attainment resulting from training.

  8. Center of Competence in High Temperature Corrosion, HTC. Report of activities during stage 3, 2000-10-01--2003-12-31

    Energy Technology Data Exchange (ETDEWEB)

    Johansson, Lars-Gunnar [Chalmers Univ. of Technology, Goeteborg (Sweden). Dept. of Inorganic Chemistry

    2004-09-01

    HTC, the Swedish High Temperature Corrosion Centre, is a Swedish national competence centre jointly financed by the Swedish National Energy Agency, Chalmers Univ. of Technology and twelve member companies. HTC research has the following objectives: Improved materials performance resulting in increased service life of installations leading to lower maintenance and repair costs. Improved process performance resulting in improved energy efficiency and decreased emissions to the environment To achieve this, HTC aims to establish new and fundamental knowledge on High-Temperature Corrosion. The following research themes are pursued: High temperature corrosion in combustion gases and under deposits; Interaction of corrosion and mechanical factors such as erosion and fatigue. Main achievements during stage 3: HTC is at the cutting edge of science in certain areas of high temperature corrosion research. e.g., on the effect of water vapor on the corrosion of FeCr alloys, on the oxidation of platinum aluminide coatings and on the kinetics of the reactions at the oxide-gas interface.

  9. Promoting Scholarship during Child and Adolescent Psychiatry Residency

    Science.gov (United States)

    Mezzacappa, Enrico; Hamoda, Hesham M.; DeMaso, David R.

    2012-01-01

    Background: In 2003, the Institute of Medicine (IOM) drew attention to the critical national shortage of psychiatrist-researchers and the need for competency-based curricula to promote research training during psychiatry residency as one way to address this shortage at the institutional level. Here, the authors report on the adaptation,…

  10. Exploring the Changing Landscape of Surgical Residency Training

    NARCIS (Netherlands)

    C.J. Hopmans (Niels)

    2017-01-01

    textabstractWithin the past decade, the structure and format of surgical residency training has changed radically by the introduction of competency-based training programs, the progressive fragmentation of general surgery into subspecialties, and the implementation of stringent work hour restriction

  11. High-fidelity simulation in the nonmedical domain: practices and potential transferable competencies for the medical field

    Directory of Open Access Journals (Sweden)

    Carron PN

    2011-05-01

    Full Text Available Pierre-Nicolas Carron, Lionel Trueb, Bertrand YersinEmergency Service, University Hospital Center, Lausanne, SwitzerlandAbstract: Simulation is a promising pedagogical tool in the area of medical education. High-fidelity simulators can reproduce realistic environments or clinical situations. This allows for the practice of teamwork and communication skills, thereby enhancing reflective reasoning and experiential learning. Use of high-fidelity simulators is not limited to the medical and aeronautical fields, but has developed in a large number of nonmedical organizations as well. The techniques and pedagogical tools which have evolved through the use of nonmedical simulations serve not only as teaching examples but also as avenues which can help further the evolution of the concept of high-fidelity simulation in the field of medicine. This paper presents examples of high-fidelity simulations in the military, maritime, and aeronautical fields. We compare the implementation of high-fidelity simulation in the medical and nonmedical domains, and discuss the possibilities and limitations of simulators in medicine, based on recent nonmedical applications.Keywords: high-fidelity simulation, crew resource management, experiential learning

  12. Airborne Cladosporium and other fungi in damp versus reference residences

    Science.gov (United States)

    Pasanen, A.-L.; Niininen, M.; Kalliokoski, P.; Nevalainen, A.; Jantunen, M. J.

    Our previous study (Nevalainen et al., 1991, Envir. Int.17, 299-302) showed that airborne counts of total viable fungal spores in damp residences did not remarkably differ from those in reference residences. The results of the present study confirmed this finding. Indoor air spore counts varied considerably from residence to residence and even within the same residence. Thus, the counts were only occasionally high in the damp residences. Counts of airborne Cladosporium spp. spores and yeast cells were significantly higher in the damp residences than in the reference ones. The difference of yeast cell counts between the residence groups was explained by the difference in outdoor air, whereas Cladosporium spp. spores were mainly derived from indoors. Prevalence of Aspergillus spp. spores was also slightly higher in the damp residences than in the reference ones.

  13. Multi-institutional validation of a web-based core competency assessment system.

    Science.gov (United States)

    Tabuenca, Arnold; Welling, Richard; Sachdeva, Ajit K; Blair, Patrice G; Horvath, Karen; Tarpley, John; Savino, John A; Gray, Richard; Gulley, Julie; Arnold, Teresa; Wolfe, Kevin; Risucci, Donald A

    2007-01-01

    The Association of Program Directors in Surgery and the Division of Education of the American College of Surgeons developed and implemented a web-based system for end-of-rotation faculty assessment of ACGME core competencies of residents. This study assesses its reliability and validity across multiple programs. Each assessment included ratings (1-5 scale) on 23 items reflecting the 6 core competencies. A total of 4241 end-of-rotation assessments were completed for 332 general surgery residents (> or =5 evaluations each) at 5 sites during the 2004-2005 and 2005-2006 academic years. The mean rating for each resident on each item was computed for each academic year. The mean rating of items representing each competency was computed for each resident. Additional data included USMLE and ABSITE scores, PGY, and status in program (categorical, designated preliminary, and undesignated preliminary). Coefficient alpha was greater than 0.90 for each competency score. Mean ratings for each competency increased significantly (p competencies at all PGY levels. Competency ratings of PGY 1 residents correlated significantly with USMLE Step I, ranging from (r = 0.26, p competencies correlated significantly with the 2006 ABSITE Total Percentile Score (range: r = 0.20, p core competencies are internally consistent. The pattern of statistically significant correlations between competency ratings and USMLE and ABSITE scores supports the postdictive and concurrent validity, respectively, of faculty perceptions of resident knowledge. The pattern of increased ratings as a function of PGY supports the construct validity of faculty ratings of resident core competencies.

  14. Topography Of Helicobacter Pylori Gastritis In Different Biopsy Sites Of Gastric Mucosa Of Residents Of A High Risk Area For Gastric Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Mikaeili J

    2004-08-01

    Full Text Available Background: Many recent studies have examined potential risk factors of H. pylori gastritis to improve our understanding of the early events in gastric carcinogenesis. We evaluated the extent and topography of chronic gastritis in a high risk area for gastric cardia cancer and investigated the critical role of H.pylori, risk index and age in its pathogenesis. Materials and Methods: During a national population-based endoscopic survey, we enrolled 508 participants aged ≥40 from urban and rural areas of Meshkin-Shahr, Ardebil province of Iran. After informed consent, all underwent complete upper GI endoscopy. At least one mucosal biopsy was obtained from 6 standard sites: three of antrum (sites 1, 2, 3, two of corpus (sites 4, 5 and one of cardia (site 6. Severity, activity and combined inflammatory scores (CIS of chronic gastritis and H.pylori infection status were assessed according to modified Sydney Classification of Gastritis. Statistical effects of H.pylori, age, gender, and residency place on mean gastritis severity, activity and CIS were separately calculated in each site. Results: Total of 508 participants with mean age (±SD of 54.6(±SD were enrolled. 234(46.1% were male and 274(53.9% were female. Histologically 80.5% of cases were H.pylori positive. Mean activity scores of all sites except for site 5 are significantly (P<0.01 higher in H.pylori + cases. Mean CIS of all sites was significantly (P<0.01 higher in H.pylori + patients. In 44% of infected subjects, CIS of the corpus was at least equally as severe as that in antrum. Also in 54% of H.pylori + cases, cardia’s CIS was ≥ than antral CIS. Age had a significant (P<0.01 negative relationship with CIS of antral site, but this relationship in cardia was positive and more potent. Conclusion: H.pylori is the main cause of gastritis activity in all sites of stomach; this causality is more potent in antrum and cardia. Continuous cardia inflammation in advanced age may contribute to

  15. Training needs for general dentistry residents to place and restore two-implant-retained mandibular overdentures.

    Science.gov (United States)

    Malmstrom, Hans; Xiao, Jin; Romanos, Georgios E; Ren, Yan-Fang

    2015-01-01

    Implant therapy is rapidly becoming a standard of care for replacing missing dentition. Predoctoral dental curricula include some training in the implant restorative phase but offer limited exposure to the surgical phase, so it is important for postdoctoral general dentistry residency programs to provide competency training in all phases of implant therapy. The aim of this study was to determine the training needed for general dentistry residents to achieve competence in this area, specifically by defining the number of clinical experiences necessary in both the surgical and prosthetic phases of implant-retained mandibular overdenture construction (IRMOD). Fifteen Advanced Education in General Dentistry (AEGD) residents at one academic dental institution placed two implants in a total of 50 patients with edentulous mandibles and subsequently restored them with IRMOD. The supervising faculty member and the residents evaluated the competency level on a five-point scale after each implant placement and prosthetic case completion. According to the faculty evaluations, the residents achieved surgical competence after placing two implants in four to six cases and prosthetic management competence after restoring two to four cases of IRMOD. All 50 patients were satisfied with the treatment outcomes of IRMOD. This study concluded that general dentistry residents could potentially achieve competence in both the surgical and prosthetic phases of implant therapy while enrolled in an AEGD program.

  16. Professional communication competences of nurses.

    Science.gov (United States)

    Włoszczak-Szubzda, Anna; Jarosz, Mirosław Jerzy

    2012-01-01

    Dissonance between the high 'technical' professionalism of nurses and the relatively low level of patient satisfaction with care received is a phenomenon observed in many countries. Many studies show that it occurs in the case of an inadequate interpersonal communication between nurses and patients. Three basic scopes of communication competences were involved in the research process: a) motivation, b) knowledge, c) skills, and the following three methods were used: 1) documentation analysis (standards, plans and educational programmes); 2) diagnostic survey concerning professional communication competences of nurses in nursing care--a questionnaire form designed by the authors; 3) self-reported communication skills in nursing care--adjective check list. The study group covered a total number of 108 respondents in the following subgroups: 1) professional nurses who, as a rule, were not trained in interpersonal communication (42 respondents); students of nursing covered by a standard educational programme (46 respondents); 3) students of nursing who, in addition to a standard educational programme, attended extra courses in professional interpersonal communications nursing (20 respondents). The data obtained were subjected to statistical analysis with the use of descriptive statistics and hypothesis testing. The results of studies indicate poor efficacy of shaping communication competences of nurses based on education in the area of general psychology and general interpersonal communication. Communication competences acquired during undergraduate nursing education, are subject to regression during occupational activity. Methods of evaluating communication competences are useful in constructing group and individual programmes focused on specific communication competences rather than on general communication skills.

  17. Supplementary Educational Models in Canadian Neurosurgery Residency Programs.

    Science.gov (United States)

    Ryu, Won Hyung A; Chan, Sonny; Sutherland, Garnette R

    2017-03-01

    The proposed implementation of work hour restrictions has presented a significant challenge of maintaining the quality of resident education and ensuring adequate hands-on experience that is essential for novice surgeons. To maintain the level of resident surgical competency, revision of the apprentice model of surgical education to include supplementary educational methods, such as laboratory and virtual reality (VR) simulations, have become frequent topics of discussion. We aimed to better understand the role of supplementary educational methods in Canadian neurosurgery residency training. An online survey was sent to program directors of all 14 Canadian neurosurgical residency programs and active resident members of the Canadian Neurosurgical Society (N=85). We asked 16 questions focusing on topics of surgeon perception, current implementation and barriers to supplementary educational models. Of the 99 surveys sent, 8 out of 14 (57%) program directors and 37 out of 85 (44%) residents completed the survey. Of the 14 neurosurgery residency programs across Canada, 7 reported utilizing laboratory-based teaching within their educational plan, while only 3 programs reported using VR simulation as a supplementary teaching method. The biggest barriers to implementing supplementary educational methods were resident availability, lack of resources, and cost. Work-hour restrictions threaten to compromise the traditional apprentice model of surgical training. The potential value of supplementary educational methods for surgical education is evident, as reported by both program directors and residents across Canada. However, availability and utilization of laboratory and VR simulations are limited by numerous factors such as time constrains and lack of resources.

  18. A case-based approach for teaching professionalism to residents with online discussions

    Directory of Open Access Journals (Sweden)

    MARK T. NADEAU

    2016-01-01

    Full Text Available Introduction: Programs must demonstrate that their residents are taught and assessed in professionalism. Most programs struggle with finding viable ways to teach and assess this critical competency. UTHSCSA Family and Community Medicine Residency developed an innovative option for interactive learning and assessment of residents in this competency which would be transferrable to other programs and specialties. Methods: The innovative approach uses an asynchronous online format on Blackboard. Threaded discussions on Blackboard require thoughtful reflective writing after case assessment and critical evaluation of other resident posts. Participation, content and progress of all resident postings are monitored by administrative staff and faculty. Faculty can further engage the residents at any point to deepen the discussion and learning. Results: 100% of all senior residents attained the required learning objectives. All were actively engaged in the assignments. Six cases have been developed using a Learning Matrix to demonstrate evaluation areas from the specialty specific competencies. Written feedback from residents verified the validity of case content in context of their current clinical practice. Postings by residents have provided value and insight for the faculty to access the professional development of our Family Medicine residents. The Clinical Competency Committee evaluates all third year residents using this information specific to the professionalism milestones. By using an asynchronous online approach to case discussion, all residents are involved with all aspects of this curriculum. Conclusions: More specific measurable learning outcomes are possible using this approach. Resident participation and engagement is easier to track and monitor than a lecture-based format and easier to capture valuable data than relying on evaluation feedback. Our Annual Review process will identify areas for improvement in the existing cases and help

  19. Is older adult care mediated by caregivers’ cultural stereotypes? The role of competence and warmth attribution

    Science.gov (United States)

    Fernández-Ballesteros, Rocío; Bustillos, Antonio; Santacreu, Marta; Schettini, Rocio; Díaz-Veiga, Pura; Huici, Carmen

    2016-01-01

    Purpose The purpose of this study is to examine, from the stereotype content model (SCM) perspective, the role of the competence and warmth stereotypes of older adults held by professional caregivers. Methods A quasi-experimental design, ex post facto with observational analyses, was used in this study. The cultural view on competence and warmth was assessed in 100 caregivers working in a set of six residential geriatric care units (three of them organized following a person-centered care approach and the other three providing standard geriatric care). In order to assess caregivers’ cultural stereotypical views, the SCM questionnaire was administered. To evaluate the role of caregivers’ cultural stereotypes in their professional performance as well as in older adult functioning, two observational scales from the Sistema de Evaluación de Residencias de Ancianos (assessment system for older adults residences)-RS (staff functioning and residents’ functioning) were applied. Results Caregivers’ cultural views of older adults (compared to young people) are characterized by low competence and high warmth, replicating the data obtained elsewhere from the SCM. Most importantly, the person-centered units predict better staff performance and better resident functioning than standard units. Moreover, cultural stereotyping of older adult competence moderates the effects of staff performance on resident functioning, in line with the findings of previous research. Conclusion Our results underline the influence of caregivers’ cultural stereotypes on the type of care, as well as on their professional behaviors and on older adult functioning. Caregivers’ cultural stereotypes could be considered as a central issue in older adult care since they mediate the triangle of care: caregivers/older adults/type of care; therefore, much more attention should be paid to this psychosocial care component. PMID:27217736

  20. Assessment of Innovation Competency

    DEFF Research Database (Denmark)

    Nielsen, Jan Alexis

    2015-01-01

    of the recorded talk in interaction that occurred in teacher group discussion sessions at 5 upper secondary schools. Based on the analysis, it was possible to extrapolate assessment criteria for 5 subcompetencies relevant to innovation (creative competency, collaboration competency, navigation competency, action...... competency, and communication competency) as well as assessment criteria for a number of skills relevant to these subcompetencies. These assessment criteria, it is argued, largely resonate with existing literature and they provide a detailed glimpse into how assessment of innovation competency could...

  1. Ecological residence: theory and application in China

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    This paper makes an overall introduction of ecological residence (ER), a new type of eco-building and studies its origin, definition, status quo and characteristics. Firstly, it shapes like a forest seen from afar and like a garden seen inside; secondly, its environment should be up to the natural level; thirdly, designing, management, green energy utilization and sanitation should be up to environmental standard;fourthly, the green ecology concept is not only applied to building but also rooted in the residents. In this paper, the features of ecological residence are summarized- coziness,health, high-efficiency and beauty, and principles of ecological residence are proposed - ecology-based, human-oriented,local-conditions-based and systematic. Also, techniques, problems and various understandings are discussed for the enhancement of ecological residence.

  2. iSocial: Delivering the Social Competence Intervention for Adolescents (SCI-A) in a 3D Virtual Learning Environment for Youth with High Functioning Autism

    Science.gov (United States)

    Stichter, Janine P.; Laffey, James; Galyen, Krista; Herzog, Melissa

    2014-01-01

    One consistent area of need for students with autism spectrum disorders is in the area of social competence. However, the increasing need to provide qualified teachers to deliver evidence-based practices in areas like social competence leave schools, such as those found in rural areas, in need of support. Distance education and in particular, 3D…

  3. A Social Competence Intervention for Young Children with High Functioning Autism and Asperger Syndrome: A Pilot Study

    Science.gov (United States)

    Minne, Elizabeth Portman; Semrud-Clikeman, Margaret

    2012-01-01

    The key features of Asperger Syndrome (AS) and high functioning autism (HFA) include marked and sustained impairment in social interactions. A multi-session, small group program was developed to increase social perception based on the assumption perceptual or interpretive problems underlying these social difficulties. Additionally, the group…

  4. A Methodology to Assess Diagnostic Competence in Anatomical Pathology Examinations for Pathology Residents Metodología para evaluar la competencia diagnóstico de exámenes anatomopatológicos en residentes de Anatomía Patológica

    Directory of Open Access Journals (Sweden)

    Caridad Socorro Castro

    2011-02-01

    Full Text Available Background: For years, the tools for learning assessment of physicians in specialization programs have had an empirical character, leading to problems in the quality of the process. Very often, these tools do not measure the fulfilment of proposed educational objectives and grades awarded to students do not reflect their practical achievements and professional skills. Objective: To develop a methodology to assess diagnostic competence in anatomical pathology examinations for Pathology residents. Method: Development research conducted in the University Hospital of Cienfuegos between 2008 and 2010. In addition to theoretical and empirical methods, experts’ criteria were applied to validate the proposal. Results: A logical, stages-based design of a general methodology was created. A tool including indicators and standards was conformed to assess skills and knowledge while interns performe key activities of their specialty. The methodology was validated through experts’ criteria. Conclusions: Teachers and tutors of this specialty are now provided with an unprecedented methodological tool. Its usefulness lies in a more objective assessment of knowledge and skills for diagnostic biopsies, cytology and autopsies. This procedures support diagnostic competence in pathological examinations, which is ultimately pathologists’ key role. The present methodological design can be adapted and applied in the evaluation of interns from other specialties.Fundamento: Durante años los instrumentos para la evaluación del aprendizaje de médicos en especialización han tenido un carácter empírico, lo cual ha conllevado a problemas en la calidad del proceso, pues con relativa frecuencia dichos instrumentos no miden el cumplimiento de los objetivos educacionales propuestos y las calificaciones otorgadas no expresan de forma objetiva el aprovechamiento de los

  5. The Colorado Humanitarian Surgical Skills Workshop: A Cadaver-Based Workshop to Prepare Residents for Surgery in Austere Settings.

    Science.gov (United States)

    Lin, Yihan; Mukhopadhyay, Swagoto; Meguid, Robert A; Kuwayama, David P

    2017-08-29

    Interest in humanitarian surgery is high among surgical and obstetric residents. The Colorado Humanitarian Surgical Skills Workshop is an annual 2-day course exposing senior residents to surgical techniques essential in low- and middle-income countries but not traditionally taught in US residencies. We evaluated the course's ability to foster resident comfort, knowledge, and competence in these skills. The cohort of course participants was studied prospectively. Participants attended didactic sessions followed by skills sessions using cadavers. Sample areas of focus included general surgery (mesh-free hernia repair), orthopedics (powerless external fixation), and neurosurgery (powerless craniotomy). Before and after the course, participants answered a questionnaire assessing confidence with taught skills; took a knowledge-based test composed of multiple choice and open-ended questions; and participated in a manual skills test of tibial external fixation. The Center for Surgical Innovation, University of Colorado School of Medicine. A total of 12 residents (11 general surgical and 1 obstetric) from ten US institutions. After the course, participants perceived increased confidence in performing all 27 taught procedures and ability to practice in low- and middle-income countries. In knowledge-based testing, 10 of 12 residents demonstrated improvement on multiple choice questioning and 9 of 12 residents demonstrated improvement on open-ended questioning with structured scoring. In manual skills testing, all external fixator constructs demonstrated objective improvement on structured scoring and subjective improvement on stability assessment. For senior residents interested in humanitarian surgery, a combination of skills-focused teaching and manual practice led to self-perceived and objective improvement in relevant surgical knowledge and skills. The Colorado Humanitarian Surgical Skills Workshop represents an effective model for transmitting essential surgical

  6. Struggling to be self-directed: residents' paradoxical beliefs about learning.

    Science.gov (United States)

    Nothnagle, Melissa; Anandarajah, Gowri; Goldman, Roberta E; Reis, Shmuel

    2011-12-01

    Self-directed learning (SDL) skills serve as the basis for physician lifelong learning; however, residency training does not typically emphasize SDL skills. To understand residents' needs regarding SDL curricula, the authors used qualitative methods to examine the residency learning culture and residents' views of SDL. The authors conducted individual, in-depth, semistructured interviews with all 13 final-year residents at the Brown University Family Medicine Residency Program. Interviews were audio taped and transcribed verbatim. Using an iterative individual and group process, four researchers conducted a qualitative analysis of the transcripts, identifying major themes and higher-order interpretations. Major themes included resident beliefs about learning, the learning culture in residency, and developmental progress in learning. Four paradoxes emerged in the analysis: (1) Residents understand and value the concept of SDL, but they engage in limited goal setting and reflection and report lack of skills to manage their own learning, particularly in the clinical setting. (2) Despite being immersed in what aims to be a learner-centered culture, many residents still value traditional, teacher-centered approaches. (3) Residents recognize patient care as the most powerful stimulus for SDL, but they often perceive patient care and learning as competing priorities. (4) Residents desire external guidance for SDL. Graduating residents lacked confidence in their SDL skills and their ability to manage their learning, especially in clinical settings. Fostering SDL skills during residency will likely require training and guidance for SDL as well as changes in the structure and culture of residency.

  7. Training in Cognitive Behavioral Therapy in Psychiatry Residency: An Overview for Educators

    Science.gov (United States)

    Sudak, Donna M.

    2009-01-01

    In January 2001, Accreditation Council of Graduate Medical Education accredited general psychiatry training programs were charged with the requirement to train residents in cognitive-behavioral therapy (CBT) to a level of competence. Programs were given the responsibility to delineate standards for trainees, to determine measures of competence,…

  8. High average daily intake of PCDD/Fs and serum levels in residents living near a deserted factory producing pentachlorophenol (PCP) in Taiwan: influence of contaminated fish consumption

    Energy Technology Data Exchange (ETDEWEB)

    Lee Ching-Chang; Lin Wu-Ting; Liao Po-Chi; Su Huey-Jen [Dept. of Environmental and Occupational Health/Research Center of Environmental Trace Toxic substances, Medical Coll., National Cheng Kung Univ., Tainan (Taiwan); Chen Hsiu-Lin [Inst. of Basic Medical Sciences, Medical Coll., National Cheng Kung Univ., Tainan (Taiwan)

    2004-09-15

    Many reports have suggested that PCDD/Fs (polychlorinated dibenzo-p-dioxins and dibenzofurans) contribute to immune deficiency, liver damage, human carcinogenesis, and neuromotor maturation in children. Therefore, beginning in 1999, the Taiwan Environmental Protection Agency (EPA) conducted a survey to determine serum levels of PCDD/Fs in the general populations living around 19 incinerators in Taiwan. Relatively high average serum PCDD/F levels were unexpectedly found in Tainan city, a less industrialized area in southwestern Taiwan, than in other urban areas. We therefore reviewed the usage history of the land and found that a factory situated between Hsien-Gong Li and Lu-Erh Li, two administrative units of Tainan city, had been manufacturing pentachlorophenol (PCP) between 1967 and 1982. PCDD/Fs are formed as byproducts in the PCP manufacturing process. Exposure to PCP and its derivatives via the food chain is the most significant intake route of PCDD/Fs in consumers in the European Union (EU). In Japan, in addition to combustion processes, PCP and chlornitrofen (CNP) have also been identified as the major sources of PCDD/Fs in Tokyo Bay7. A preliminary investigation showed that the soil in the PCP factory and sediments in the sea reservoir (13 hectares) near the deserted factory were seriously contaminated with PCDD/Fs (260-184,000 and 20-6220 pg I-TEQ/g, respectively), levels higher than those in other countries. Therefore, the aim of this study was to compare the PCDD/F levels of fish meat in the sea reservoir and the serum in inhabitants living in the vicinity of the closed PCP plant and other nearby areas. The data from human and other biota samples might clarify the transmission pathway of the PCDD/F contaminants from the PCP factory to local residents, provide information about the exposure status of those living in the vicinity of the deserted PCP factory, and also lead to useful suggestions for controlling PCDD/F accumulation in those living near such

  9. Quantitative TCR:pMHC Dissociation Rate Assessment by NTAmers Reveals Antimelanoma T Cell Repertoires Enriched for High Functional Competence.

    Science.gov (United States)

    Gannon, Philippe O; Wieckowski, Sébastien; Baumgaertner, Petra; Hebeisen, Michaël; Allard, Mathilde; Speiser, Daniel E; Rufer, Nathalie

    2015-07-01

    Experimental models demonstrated that therapeutic induction of CD8 T cell responses may offer protection against tumors or infectious diseases providing that T cells have sufficiently high TCR/CD8:pMHC avidity for efficient Ag recognition and consequently strong immune functions. However, comprehensive characterization of TCR/CD8:pMHC avidity in clinically relevant situations has remained elusive. In this study, using the novel NTA-His tag-containing multimer technology, we quantified the TCR:pMHC dissociation rates (koff) of tumor-specific vaccine-induced CD8 T cell clones (n = 139) derived from seven melanoma patients vaccinated with IFA, CpG, and the native/EAA or analog/ELA Melan-A(MART-1)(26-35) peptide, binding with low or high affinity to MHC, respectively. We observed substantial correlations between koff and Ca(2+) mobilization (p = 0.016) and target cell recognition (p tumor-reactive T cell clones derived from patients vaccinated with the low-affinity (native) peptide expressed slower koff rates than those derived from patients vaccinated with the high-affinity (analog) peptide (p tumor-specific T cells bearing TCRs with high TCR/CD8:pMHC avidity (p < 0.0001). Altogether, TCR:pMHC interaction kinetics correlated strongly with T cell functions. Our study demonstrates the feasibility and usefulness of TCR/CD8:pMHC avidity assessment by NTA-His tag-containing multimers of naturally occurring polyclonal T cell responses, which represents a strong asset for the development of immunotherapy. Copyright © 2015 by The American Association of Immunologists, Inc.

  10. Legal Impediments in the EU to New Technologies in the Example of E-Residency

    Directory of Open Access Journals (Sweden)

    Tanel Kerikmäe

    2015-12-01

    Full Text Available Estonia has created of itself the image of an e-state that is being supported with novel ICT-solutions, the perhaps most renowned of which is e-residency. However, created as a governmental start-up in the national best interest, e-residency could be of marginal relevance in light of global digital identity management. Purely national digital identity or an e-residency grants its holder several rights unknown to, or at least unapplied in a majority of the EU Member States and in the world more generally. But currently it lies on a vacillating legal pedestal which has resulted in copious administrative issues and proposed legal amendments already during its first year of implementation. Concerns, such as the administrative capacity of Estonia to handle potentially 10 million customers of national e-services, arise due to contingent legal footing. On this basis, efficiency of e-residency is critically analysed from the perspective of an autoschediastic regulatory framework presuming high-level administrative competence yet leaving the scope and limits of the functions of the public authorities legally unfurnished and isolated from the EU legal space.

  11. Evaluation of Resident Communication Skills and Professionalism: A Matter of Perspective?

    Science.gov (United States)

    Brinkman, William B.; Geraghty, Sheela R.; Lanphear, Bruce P.; Khoury, Jane C.; del Rey, Javier A. Gonzalez; DeWitt, Thomas G.; Britto, Maria T.

    2007-01-01

    Objective: Evaluation procedures that rely solely on attending physician ratings may not identify residents who display poor communication skills or unprofessional behavior. Inclusion of non-physician evaluators should capture a more complete account of resident competency. No published reports have examined the relationship between resident…

  12. Acting as Standardized Patients Enhances Family Medicine Residents' Self-Reported Skills in Palliative Care

    Science.gov (United States)

    Sittikariyakul, Pat; Jaturapatporn, Darin; Kirshen, A. J.

    2015-01-01

    Recent publications have confirmed the use of standardized patients (SPs) in improving clinical skills and enhancing competency. Little research has studied the benefits residents may themselves gain in palliative care playing the role of SPs. Nineteen Family Medicine residents were recruited as standardized patients (FMR-SPs) for a mandatory…

  13. Evaluating the Effectiveness of Rating Instruments for a Communication Skills Assessment of Medical Residents

    Science.gov (United States)

    Iramaneerat, Cherdsak; Myford, Carol M.; Yudkowsky, Rachel; Lowenstein, Tali

    2009-01-01

    The investigators used evidence based on response processes to evaluate and improve the validity of scores on the Patient-Centered Communication and Interpersonal Skills (CIS) Scale for the assessment of residents' communication competence. The investigators retrospectively analyzed the communication skills ratings of 68 residents at the…

  14. Competencies: A New Sector.

    Science.gov (United States)

    Brophy, Monica; Kiely, Tony

    2002-01-01

    Job analysis of managers in 42 Irish three-star hotels identified the following key management competencies and associated behavioral indicators. The results were used to develop a competency framework for management development. (Contains 29 references.) (SK)

  15. Competencies for midwifery teachers.

    Science.gov (United States)

    Thompson, Joyce E

    2002-12-01

    Saving women's lives with cost-quality effective midwifery care is based on sound pre-service and ongoing education. Effective midwifery education requires competent, caring, and compassionate teachers. In this paper, I address the basic competencies required of midwives who teach others to be midwives. These competencies are important regardless of level of student taught, type of educational programme, or number of years of midwifery experience that learners bring to the educational setting. The competencies are based on the midwifery philosophy, values and model of care. Competent midwifery teachers must be competent midwifery clinicians for their primary role is to set the boundaries of safety for each level of learner. Formal preparation for teaching, understanding how adults learn, understanding how to develop an appropriate plan for learning (curriculum), and developing competency in a variety of teaching methods for both theory and clinical practice are included in the competencies discussed in this paper.

  16. Developing mathematical modelling competence

    DEFF Research Database (Denmark)

    Blomhøj, Morten; Jensen, Tomas Højgaard

    2003-01-01

    In this paper we introduce the concept of mathematical modelling competence, by which we mean being able to carry through a whole mathematical modelling process in a certain context. Analysing the structure of this process, six sub-competences are identified. Mathematical modelling competence...... cannot be reduced to these six sub-competences, but they are necessary elements in the development of mathematical modelling competence. Experience from the development of a modelling course is used to illustrate how the different nature of the sub-competences can be used as a tool for finding...... the balance between different kinds of activities in a particular educational setting. Obstacles of social, cognitive and affective nature for the students' development of mathematical modelling competence are reported and discussed in relation to the sub-competences....

  17. Burnout Syndrome During Residency.

    Science.gov (United States)

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-10-01

    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  18. COACHES' PERCEPTIONS OF COMPETENCE AND ACKNOWLEDGEMENT OF TRAINING NEEDS RELATED TO PROFESSIONAL COMPETENCES

    Directory of Open Access Journals (Sweden)

    Sofia Santos

    2010-03-01

    Full Text Available The purpose of the present study was to examine coaches' perceptions of competence and acknowledgement of training needs related to professional competences according to the professional experience and academic education. The participants were 343 coaches from several sports, who answered to a questionnaire that includes a scale focused on perceptions of competence and another scale on acknowledgment of training needs. An exploratory factor analysis with Maximum Likelihood Factoring was used with Oblimin rotation for the identification of emergent factors. Comparison on coaches' perceptions in function of coaching experience and coaches' academic background were made applying One-way ANOVA and Tukey's post hoc multiple comparisons. Factor analysis on coaches' perceptions of competence and acknowledgement of training needs made apparent three main areas of competences, i.e. competences related to annual and multi-annual planning; competences related to orientation towards practice and competition; and personal and coaching education competences. Coaches' perceptions were influenced by their experience, as low experienced coaches rated themselves at lower levels of competence and with more training needs; also coaches with high education, in Physical Education or others, perceived themselves as more competent than coaches with no higher education. Finally, the majority of the coaches perceived themselves to be competent but, nevertheless, they indicated to have training needs, which brings an important feedback to coach education. This suggests that coaches are interested in increasing their knowledge and competence in a broad range of areas which should be considered in future coach education programs

  19. Experience with Emergency Ultrasound Training by Canadian Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Daniel J. Kim

    2014-05-01

    Full Text Available Introduction: Starting in 2008, emergency ultrasound (EUS was introduced as a core competency to the Royal College of Physicians and Surgeons of Canada (Royal College emergency medicine (EM training standards. The Royal College accredits postgraduate EM specialty training in Canada through 5-year residency programs. The objective of this study is to describe both the current experience with and the perceptions of EUS by Canadian Royal College EM senior residents. Methods: This was a web-based survey conducted from January to March 2011 of all 39 Canadian Royal College postgraduate fifth-year (PGY-5 EM residents. Main outcome measures were characteristics of EUS training and perceptions of EUS. Results: Survey response rate was 95% (37/39. EUS was part of the formal residency curriculum for 86% of respondents (32/37. Residents most commonly received training in focused assessment with sonography for trauma, intrauterine pregnancy, abdominal aortic aneurysm, cardiac, and procedural guidance. Although the most commonly provided instructional material (86% [32/37] was an ultrasound course, 73% (27/37 of residents used educational resources outside of residency training to supplement their ultrasound knowledge. Most residents (95% [35/37] made clinical decisions and patient dispositions based on their EUS interpretation without a consultative study by radiology. Residents had very favorable perceptions and opinions of EUS. Conclusion: EUS training in Royal College EM programs was prevalent and perceived favorably by residents, but there was heterogeneity in resident training and practice of EUS. This suggests variability in both the level and quality of EUS training in Canadian Royal College EM residency programs.

  20. 基于胜任力的高校高层次人才培养的探析%Exploration on High-level Personnel Cultivating Based on Competency in University

    Institute of Scientific and Technical Information of China (English)

    王懿; 刘卫东

    2012-01-01

    本文将胜任力理论与高校高层次人才培养实践相结合,阐述了胜任力理论的基本内涵,分析了高校高层次人才培养存在的问题以及基于胜任力的高层次人才培养的意义,探讨了高层次人才胜任力研究的步骤和方法,为高校高层次人才培养改革提供一个新的思路.%On the basis of competency theory and high-level personnel cultivating of university, the study stated simply connotation of competency, analysed problem of high-level personnel cultivating of university, and importance of high-level personnel cultivating based on competency in university, and explored process and method about analysis of high-level personnel competency, in order to offer a reference for reform of high-level personnel cultivating.

  1. Competing structural ordering tendencies in new high-TC ferromagnetic Fe-Co-based Heusler alloys from ab initio investigations

    Energy Technology Data Exchange (ETDEWEB)

    Dannenberg, Antje; Gruner, Markus; Entel, Peter [Faculty of Physics, University of Duisburg-Essen, 47048 Duisburg (Germany); Wuttig, Manfred [Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742 (United States)

    2011-07-01

    Fe-Co-based Heuslers are candidates for new ferromagnetic shape memory alloys (FSMA) as they promise higher operation temperatures compared with prototype Ni2MnGa. Of interest are also the corresponding binary systems FeZn and Fe3Ga which show a huge magnetostriction. We present results of ab initio and Monte Carlo calculations regarding structural, magnetic, and electronic properties of Fe2CoGa1-xZnx alloys in conventional X2YZ and inverse (XY)XZ Heusler structures. All systems exhibit high Curie temperatures TC. The preference of the cubic inverse structures is believed to originate from the bcc-like environment of two inequivalent Fe atoms and their strong hybridization with the Co- states. Weakening the Co-Fe hybridization by substitution of Ga by Zn reduces this preference and leads to higher TC but simultaneously reduces the miscibility. Despite the strong spin-dependent Fe-Co hybridization we find a localized character of the spin moments. Extraordinary Z-elements like Cu, Ag, and Au or further enhancement of the Zn content induces a martensitic instability also in the inverse structures. Thus, we conclude that it is possible to find new FSMA with rather high Curie temperatures.

  2. Analysis of Resident Case Logs in an Anesthesiology Residency Program

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested;

    2016-01-01

    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the...

  3. Breaking bad news: A communication competency for ophthalmology training programs.

    Science.gov (United States)

    Hilkert, Sarah M; Cebulla, Colleen M; Jain, Shelly Gupta; Pfeil, Sheryl A; Benes, Susan C; Robbins, Shira L

    As the ophthalmology accreditation system undergoes major changes, training programs must evaluate residents in the 6 core competencies, including appropriately communicating bad news. Although the literature is replete with recommendations for breaking bad news across various non-ophthalmology specialties, no formal training programs exist for ophthalmology. There are many valuable lessons to be learned from our colleagues regarding this important skill. We examine the historic basis for breaking bad news, explore current recommendations among other specialties, and then evaluate a pilot study in breaking bad news for ophthalmology residents. The results of this study are limited by a small number of residents at a single academic center. Future studies from multiple training programs should be conducted to further evaluate the need and efficacy of formal communication skills training in this area, as well as the generalizability of our pilot training program. If validated, this work could serve as a template for future ophthalmology resident training and evaluation in this core competency.

  4. Assessing intern core competencies with an objective structured clinical examination.

    Science.gov (United States)

    Short, Matthew W; Jorgensen, Jennifer E; Edwards, John A; Blankenship, Robert B; Roth, Bernard J

    2009-09-01

    Residents are evaluated using Accreditation Council for Graduate Medical Education (ACGME) core competencies. An Objective Structured Clinical Examination (OSCE) is a potential evaluation tool to measure these competencies and provide outcome data. Create an OSCE to evaluate and demonstrate improvement in intern core competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice before and after internship. From 2006 to 2008, 106 interns from 10 medical specialties were evaluated with a preinternship and postinternship OSCE at Madigan Army Medical Center. The OSCE included eight 12-minute stations that collectively evaluated the 6 ACGME core competencies using human patient simulators, standardized patients, and clinical scenarios. Interns were scored using objective and subjective criteria, with a maximum score of 100 for each competency. Stations included death notification, abdominal pain, transfusion consent, suture skills, wellness history, chest pain, altered mental status, and computer literature search. These stations were chosen by specialty program directors, created with input from board-certified specialists, and were peer reviewed. All OSCE testing on the 106 interns (ages 25 to 44 [average, 28.6]; 70 [66%] men; 65 [58%] allopathic medical school graduates) resulted in statistically significant improvement in all ACGME core competencies: patient care (71.9% to 80.0%, P core competencies and test for interval improvement. The OSCE is a valuable assessment tool to provide outcome measures on resident competency performance and evaluate program effectiveness.

  5. Suitability of Sour Crude Processing and Resid Hydrotreating Technologies

    Institute of Scientific and Technical Information of China (English)

    Sun Lili

    2005-01-01

    This article has analyzed the environment and tasks confronting China's petroleum refining industry, and has referred to principles for selecting the resid processing technologies and viability of various combination technologies for resid processing. Taking into account the actual commercial practice of resid hydrogenation units, this article has also discussed methods for processing high-sulfur inferior crudes as well as the suitability of resid hydrogenation technology.

  6. Building Project Competence

    DEFF Research Database (Denmark)

    Pemsel, Sofia; Wiewiora, Anna

    This research investigates the development of project competence, and particularly, three related dynamic capabilities (shifting, adapting, leveraging) that contribute to project competence development. In doing so, we make use of the emerging literature on knowledge governance and theorize how k...... of dynamic capability building promoting project competence development....

  7. Addressing the mandate for hand-off education: a focused review and recommendations for anesthesia resident curriculum development and evaluation.

    Science.gov (United States)

    Lane-Fall, Meghan B; Brooks, Amber K; Wilkins, Sara A; Davis, Joshua J; Riesenberg, Lee Ann

    2014-01-01

    The Accreditation Council for Graduate Medical Education requires that residency programs teach residents about handoffs and ensure their competence in this communication skill. Development of hand-off curricula for anesthesia residency programs is hindered by the paucity of evidence regarding how to conduct, teach, and evaluate handoffs in the various settings where anesthesia practitioners work. This narrative review draws from literature in anesthesia and other disciplines to provide recommendations for anesthesia resident hand-off curriculum development and evaluation.

  8. A social competence intervention for young children with high functioning autism and Asperger syndrome: a pilot study.

    Science.gov (United States)

    Minne, Elizabeth Portman; Semrud-Clikeman, Margaret

    2012-11-01

    The key features of Asperger Syndrome (AS) and high functioning autism (HFA) include marked and sustained impairment in social interactions. A multi-session, small group program was developed to increase social perception based on the assumption perceptual or interpretive problems underlying these social difficulties. Additionally, the group format espoused a play therapy orientation and the use of sociodramatic play was the primary therapeutic modality used. Qualitative analyses of the data resulted in an explanation of the key changes in social interactions that took place through the course of the intervention. Although each participant's experience in this group was unique, all children in this program demonstrated improvements in their social interactions, as they experienced development both emotionally and behaviorally. Findings suggest that, despite their rigid interests and behavior patterns, the social limitations of these children improved when provided with the necessary environmental resources.

  9. From time-based to competency-based standards: core transitional competencies in plastic surgery.

    Science.gov (United States)

    Lutz, Kristina; Yazdani, Arjang; Ross, Douglas

    2015-01-01

    Competency-based medical education is becoming increasingly prevalent and is likely to be mandated by the Royal College in the near future. The objective of this study was to define the core technical competencies that should be possessed by plastic surgery residents as they transition into their senior (presently postgraduate year 3) years of training. A list of potential core competencies was generated using a modified Delphi method that included the investigators and 6 experienced, academic plastic surgeons from across Canada and the United States. Generated items were divided into 7 domains: basic surgical skills, anesthesia, hand surgery, cutaneous surgery, esthetic surgery, breast surgery, and craniofacial surgery. Members of the Delphi group were asked to rank particular skills on a 4-point scale with anchored descriptors. Item reduction resulted in a survey consisting of 48 skills grouped into the aforementioned domains. This self-administered survey was distributed to all Canadian program directors (n = 11) via e-mail for validation and further item reduction. The response rate was 100% (11/11). Using the average rankings of program directors, 26 "core" skills were identified. There was agreement of core skills across all domains except for breast surgery and esthetic surgery. Of them, 7 skills were determined to be above the level of a trainee at this stage; a further 15 skills were agreed to be important, but not core, competencies. Overall, 26 competencies have been identified as "core" for plastic surgery residents to possess as they begin their senior, on-service years. The nature of these skills makes them suitable for teaching in a formal, simulated environment, which would ensure that all plastic surgery trainees are competent in these tasks as they transition to their senior years of residency. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Teaching professionalism to residents.

    Science.gov (United States)

    Klein, Eileen J; Jackson, J Craig; Kratz, Lyn; Marcuse, Edgar K; McPhillips, Heather A; Shugerman, Richard P; Watkins, Sandra; Stapleton, F Bruder

    2003-01-01

    The need to teach professionalism during residency has been affirmed by the Accreditation Council for Graduate Medical Education, which will require documentation of education and evaluation of professionalism by 2007. Recently the American Academy of Pediatrics has proposed the following components of professionalism be taught and measured: honesty/integrity, reliability/responsibility, respect for others, compassion/empathy, self-improvement, self-awareness/knowledge of limits, communication/collaboration, and altruism/advocacy. The authors describe a curriculum for introducing the above principles of professionalism into a pediatrics residency that could serve as a model for other programs. The curriculum is taught at an annual five-day retreat for interns, with 11 mandatory sessions devoted to addressing key professionalism issues. The authors also explain how the retreat is evaluated and how the retreat's topics are revisited during the residency, and discuss general issues of teaching and evaluating professionalism.

  11. Competences, competences assessment, validity of instruments, Preschool Education

    Directory of Open Access Journals (Sweden)

    Rigoberto Marín Uribe

    2012-05-01

    Full Text Available The purpose of this article is to describe the design process, validation and assurance of an instrument for the assessment of the success level of competences in preschool children. Initially is presented a theoretical and contextual framework of the competences in preschool. With this, it is problematized about the absence of tools for that the educators could perform the diagnostic evaluation of competences required in the reform of preschool education 2004. In the design of the instrument, the concept of “situation” is central. The validation and assurance included a process of pilotage with 512 preschool children with the implementing in practice of three different ways of application of the instrument. The results show high levels of assurance and power of discrimination that allow to distinguish significantly people by age and socioeconomic level, not finding differences by genre.

  12. Incorporation of lean methodology into pharmacy residency programs.

    Science.gov (United States)

    John, Natalie; Snider, Holly; Edgerton, Lisa; Whalin, Laurie

    2017-03-15

    The implementation of lean methodology into pharmacy residency programs at a community teaching hospital is described. New Hanover Regional Medical Center, a community teaching hospital in southeastern North Carolina, fully adopted a lean culture in 2010. Given the success of lean strategies organizationally, this methodology was used to assist with the evaluation and development of its pharmacy residency programs in 2014. Lean tools and activities have also been incorporated into residency requirements and rotation learning activities. The majority of lean events correspond to the required competency areas evaluating leadership and management, teaching, and education. These events have included participation in and facilitation of various lean problem-solving and communication tools. The application of the 4 rules of lean has resulted in enhanced management of the programs and provides a set of tools by which continual quality improvement can be ensured. Regular communication and direct involvement of all invested parties have been critical in developing and sustaining new improvements. In addition to program enhancements, lean methodology offers novel methods by which residents may be incorporated into leadership activities. The incorporation of lean methodology into pharmacy residency programs has translated into a variety of realized and potential benefits for the programs, the preceptors and residents, and the health system. Specific areas of growth have included quality-improvement processes, the expansion of leadership opportunities for residents, and improved communication among program directors, preceptors, and residents. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  13. The Effects of Abortion Training on Family Medicine Residents' Clinical Experience.

    Science.gov (United States)

    Summit, Aleza K; Gold, Marji

    2017-01-01

    RHEDI, Reproductive Health Education in Family Medicine, offers technical assistance and funding to family medicine residency programs to support integrated opt-out abortion and reproductive health training for residents. This study assessed the impact of this enhanced training on residents' reproductive health experience. Investigator-developed pre- and post-surveys were administered online to 214 residents at 12 family medicine residency programs before and after their RHEDI training experience. Surveys addressed experience in contraception and abortion, attitudes around abortion provision, and post-residency intentions. Descriptive statistics were generated, and statistical tests were performed to assess changes after training. Surveys had a 90% response rate. After the RHEDI enhanced reproductive health rotation, residents reported increased experience in contraception provision, early pregnancy ultrasound, aspiration and medication abortion, and miscarriage management. After training, residents with experience in IUD insertion increased from 85% to 99%, and contraceptive implant insertion experience rose from 60% to 85%. Residents who had performed any abortions increased from 15% to 79%, and self-rated competency in abortion increased. Finally, almost all residents agreed that early abortion was within the scope of family medicine, and training confirmed residents' intentions to provide reproductive health services after residency. Integrated training in reproductive health, with an emphasis on abortion, increases residents' experience and underscores their understanding of the role of these services in family medicine. Increasing the number of family medicine residency programs that offer this training could help prepare family physicians to meet their patients' needs for reproductive health services.

  14. Integrated bariatric surgery residency

    Directory of Open Access Journals (Sweden)

    Eltorai AE

    2014-11-01

    Full Text Available Adam EM Eltorai Warren Alpert Medical School of Brown University, RI, USA Abstract: Obesity is a major public health concern. Given its lasting efficacy for improving obesity and obesity-related diseases, bariatric surgery is an increasingly common treatment option. As the implementation of the Affordable Care Act progresses, the impending physician shortage will become more severe. Thus there will be an even greater need for doctors specialized in the management and treatment of obese patients. The development of integrated bariatric surgery residency programs could be considered and is discussed herein. Keywords: obesity, bariatric surgery, integrated residency, surgery education

  15. Competence without a competence pheromone in a natural isolate of Streptococcus infantis

    DEFF Research Database (Denmark)

    Ween, O; Teigen, S; Gaustad, P

    2002-01-01

    Many streptococcal species belonging to the mitis and anginosus phylogenetic groups are known to be naturally competent for genetic transformation. Induction of the competent state in these bacteria is regulated by a quorum-sensing mechanism consisting of a secreted peptide pheromone encoded by com......C and a two-component regulatory system encoded by comDE. Here we report that a natural isolate of a mitis group streptococcus (Atu-4) is competent for genetic transformation even though it has lost the gene encoding the competence pheromone. In contrast to other strains, induction of competence in Atu-4...... development. These results indicate that mutations in ComD or ComE have resulted in a gain-of-function phenotype that allows competence without a competence pheromone. A highly similar strain lacking comC was isolated independently from another individual, suggesting that strains with this phenotype are able...

  16. Evidence of clinical competence.

    Science.gov (United States)

    Lejonqvist, Gun-Britt; Eriksson, Katie; Meretoja, Riitta

    2012-06-01

    This cross-sectional research used a qualitative questionnaire to explore clinical competence in nursing. The aim was to look for evidence of how clinical competence showed itself in practice. In the research, the views from both education and working life are combined to broadly explore and describe clinical competence from the perspective of students, clinical preceptors and teachers. The questions were formulated on how clinical competence is characterised and experienced, what contributes to it and how it is maintained, and on the relation between clinical competence and evidence-based care. The answers were analysed by inductive content analysis. The results showed that clinical competence in practice is encountering, knowing, performing, maturing and improving. Clinical competence is an ongoing process, rather than a state and manifests itself in an ontological and a contextual dimension.

  17. Strategic Imperative of Human Resource Leadership Competencies

    Science.gov (United States)

    Rajini, G.; Gomathi, S.

    2010-01-01

    Using multiple constituencies approach, variances in competencies in human resource leadership have been studied as this is becoming highly significant in India's globalisation efforts. Previous research in leadership orientation focused on localisation of human resource competencies rather than its globalisation. For this, human resource…

  18. Strategic Imperative of Human Resource Leadership Competencies

    Science.gov (United States)

    Rajini, G.; Gomathi, S.

    2010-01-01

    Using multiple constituencies approach, variances in competencies in human resource leadership have been studied as this is becoming highly significant in India's globalisation efforts. Previous research in leadership orientation focused on localisation of human resource competencies rather than its globalisation. For this, human resource…

  19. Differences in Communication Competence among Administrator Social Styles.

    Science.gov (United States)

    Snavely, William B.; Walters, Ellen V.

    1983-01-01

    Assessed coworkers' perceptions of public school superintendents' behavior related to social style (assertiveness, responsiveness, versatility) and interpersonal communication competence (empathy, social anxiety, listening, self-disclosure, flexibility). Found that superintendents with highly responsive styles were perceived as more competent than…

  20. Financial debt of orthopedic residents.

    Science.gov (United States)

    Hwang, John S; Beebe, Kathleen S; Benevenia, Joseph; Karanfilian, Briette; Berberian, Wayne S

    2012-04-01

    Many orthopedic residents accrue considerable debt by residency graduation. These debts for graduating medical students continue to increase due to the yearly increase of medical school tuition. The purpose of this study was to examine the causes of financial debt, as well the effects of debt on orthopedic residents.Orthopedic residents from postgraduate years 1 to 5 (N=27) completed an anonymous, optional financial survey. The survey asked questions regarding the characteristics of the residents' debt and their concern caused by their debt. All residents from our institute (N=27) voluntarily participated in the survey. The residents consisted of 4 (15%) women and 23 (85%) men, with 14 (56%) single residents and 12 (44%) married residents. No statistically significant difference existed in total debt >$100,000 between single and married residents or men and women. Forty-eight percent (n=13) of the residents had medical educational debt >$100,000, whereas 45% (n=12) had total debt >$200,000. Residents with total debt >$100,000 were concerned about their debt, whereas 1 of 4 residents with orthopedic residents financially and may cause stress and hinder their medical training. Appropriate measures should be taken to help residents properly manage their debt and to provide supplemental assistance with their financial struggles.

  1. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Repeated Hospital Transfers and Associated Outcomes by Residency Time Among Nursing Home Residents in Taiwan.

    Science.gov (United States)

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang; Liu, Chia-Yih

    2016-11-01

    Nursing home residents' repeated transfers to hospital are costly and can lead to in-hospital complications and high mortality for frail residents. However, no research has examined the trajectory of residents' symptoms over their nursing home residency and its relationship to hospital transfer. The purpose of this retrospective chart-review study was to examine associations between nursing home residents' characteristics, including length of residency, and repeated hospital transfers as well as the trajectory of transfers during residency. For this retrospective study, we reviewed 583 residents' charts in 6 randomly selected nursing homes from northern Taiwan. Data were analyzed by descriptive statistics, chi-squared tests, and 1-way analysis of variance. About half of nursing home residents who had been transferred to hospital (n = 320) were transferred more than twice during their residency (50.97%). Residents who had been transferred 1, 2, 3, or ≥4 times differed significantly in length of residency (F = 3.85, P = .01), physical status (F = 2.65, P = .05), medical history of pneumonia (χ(2) = 13.03, P = .01), and fractures (χ(2) = 8.52, P = .04). Residents with different numbers of transfers differed significantly in their reasons for transfer, that is, falls (χ(2) = 13.01, P = .01) and tube problems (χ(2) = 8.87, P = .03). Among 705 total transfers, fever was the top reason for transfer, and transfer prevalence increased with nursing home residency. To decrease the chance of residents' hospital transfer, nursing home staff should be educated about recognizing and managing fever symptoms, infection-control programs such as influenza vaccination should be initiated, and fall-prevention/education programs should be started when residents first relocate to nursing homes. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  3. A Fine Arts Residency.

    Science.gov (United States)

    Riggs, Patricia L.

    1982-01-01

    A four-week writer-in-residence program designed to stimulate the creativity of K-5 students was held in the Briar Glen Library Media Center, Wheaton, Illinois, with poet Joan Colby. This description of the program includes information on planning, funding, and future plans. (CHC)

  4. Selection of Anesthesiology Residents.

    Science.gov (United States)

    Baker, J. David, III; And Others

    1993-01-01

    Selection data for all Medical University of South Carolina anesthesiology residency applicants (about 200 per year) and the 8 selected per year were compared for 4 years. Results showed standardized test scores, grades, and class ranks of those selected were not higher than of others, but interview and recommendation scores were higher.…

  5. Summer lodge residency

    OpenAIRE

    Morrad, Annie

    2015-01-01

    The summer lodge residency was based in Nottingham from June 29th to July 10th Each of the artists was given a studio space and technical facilities. There were discussion points and meals, a seminar day, open presentations and reflection time.

  6. Sophisticated Epistemologies of Physics versus High-Stakes Tests: How Do Elite High School Students Respond to Competing Influences about How to Learn Physics?

    Science.gov (United States)

    Yerdelen-Damar, Sevda; Elby, Andrew

    2016-01-01

    This study investigates how elite Turkish high school physics students claim to approach learning physics when they are simultaneously (i) engaged in a curriculum that led to significant gains in their epistemological sophistication and (ii) subject to a high-stakes college entrance exam. Students reported taking surface (rote) approaches to…

  7. The relative effects of competence and likability on interpersonal attraction.

    Science.gov (United States)

    Singh, Ramadhar; Tor, Xue Ling

    2008-04-01

    Undergraduate students in Singapore (N = 80) learned about the competence (low vs. high) and likability (low vs. high) of a future interaction partner and indicated their attraction toward that stranger. The effect of likability was two times as large as that of competence. Because of the additive effects of the two manipulated factors on attraction, the authors interpreted the preference for lovable fools over competent jerks as an outcome of a generalized supremacy of likability over competence.

  8. Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

    Science.gov (United States)

    Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

    2016-01-01

    Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Knowledge of ACGME core competencies. Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1-10 vs > 10), and number of rotations taught per year (1-6 vs 7-12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10-12 rotations per year) were more likely to provide competency-based teaching. Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies.

  9. The relationship between impaired driving crashes and beliefs about impaired driving: do residents in high crash rate counties have greater concerns about impaired driving?

    Science.gov (United States)

    Beck, Kenneth H; Yan, Alice F; Wang, Min Qi; Kerns, Timothy J; Burch, Cynthia A

    2009-04-01

    The purpose of this investigation was to examine the relationship between impaired driving crashes and public beliefs and concerns about impaired driving across each of Maryland's twenty-four counties (including Baltimore City). It was hypothesized that residents of counties that experience higher impaired driving crashes would express more concerns about impaired driving and perceive more risks about driving impaired than residents of counties that have lower rates of impaired driving. Data for alcohol impaired driving crashes were obtained for the years 2004-2006. These data were compared to public opinion data that was obtained annually by random-digit-dial telephone surveys from 2004 to 2007. Concerns about drunk driving as well as perceptions of the likelihood of being stopped by the police if one were to drive after having too much to drink were related to counties with higher serious impaired driving crash rates, as were perceptions that the police and the legal system were too lenient. Perceptions about the likelihood of being stopped by the police were higher in those counties with more impaired driving enforcement activity. Perceptions of concern appear to be shaped more by crash exposure than enforcement activity. Campaigns that address impaired driving prevention should substantially increase enforcement, strengthen the adjudication process of impaired drivers, and emphasize the potential seriousness of drinking-driving crashes in their promotional activities.

  10. The relative importance of competing pathways for the formation of high-molecular-weight peroxides in the ozonolysis of organic aerosol particles

    Directory of Open Access Journals (Sweden)

    M. Mochida

    2006-01-01

    Full Text Available High-molecular-weight (HMW organic compounds are an important component of atmospheric particles, although their origins, possibly including in situ formation pathways, remain incompletely understood. This study investigates the formation of HMW organic peroxides through reactions involving stabilized Criegee intermediates (SCI's. The model system is methyl oleate (MO mixed with dioctyl adipate (DOA and myristic acid (MA in submicron aerosol particles, and Criegee intermediates are formed by the ozonolysis of the double bond in methyl oleate. An aerosol flow tube coupled to a quadrupole aerosol mass spectrometer (AMS is employed to determine the relative importance of different HMW organic peroxides following the ozonolysis of different mixing mole fractions of MO in DOA and MA. Possible peroxide products include secondary ozonides (SOZ's, α-acyloxyalkyl hydroperoxides and α-acyloxyalkyl alkyl peroxides (αAAHP-type compounds, diperoxides, and monoperoxide oligomers. Of these, the AMS data identify two SOZ's as major HMW products in the ozonolysis of pure methyl oleate as well as in an inert matrix of DOA to as low as 0.04 mole fraction MO. In comparison, in mixed particles of MO and MA, αAAHP-type compounds form in high yields for MO mole fractions of 0.5 or less, suggesting that SCI's efficiently attack the carboxylic acid group of myristic acid. The reactions of SCI's with carboxylic acid groups to form αAAHP-type compounds therefore compete with those of SCI's with aldehydes to form SOZ's, provided that both types of functionalities are present at significant concentrations. The results therefore suggest that SCI's in atmospheric particles contribute to the transformation of carboxylic acids and other protic groups into HMW organic peroxides.

  11. Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta

    Directory of Open Access Journals (Sweden)

    Patten Scott

    2005-06-01

    Full Text Available Abstract Background Despite the critical importance of well-being during residency training, only a few Canadian studies have examined stress in residency and none have examined well-being resources. No recent studies have reported any significant concerns with respect to perceived stress levels in residency. We investigated the level of perceived stress, mental health and understanding and need for well-being resources among resident physicians in training programs in Alberta, Canada. Methods A mail questionnaire was distributed to the entire resident membership of PARA during 2003 academic year. PARA represents each of the two medical schools in the province of Alberta. Results In total 415 (51 % residents participated in the study. Thirty-four percent of residents who responded to the survey reported their life as being stressful. Females reported stress more frequently than males (40% vs. 27%, p Residents highly valued their colleagues (67%, program directors (60% and external psychiatrist/psychologist (49% as well-being resources. Over one third of residents wished to have a career counselor (39% and financial counselor (38%. Conclusion Many Albertan residents experience significant stressors and emotional and mental health problems. Some of which differ among genders. This study can serve as a basis for future resource application, research and advocacy for overall improvements to well-being during residency training.

  12. Global Health Simulation During Residency

    Directory of Open Access Journals (Sweden)

    Jane R. Rosenman MD

    2016-08-01

    Full Text Available Resident participation in international health electives (IHEs has been shown to be beneficial, yet not all residents have the opportunity to participate. We sought to determine whether participating in simulated global health cases, via the standardized Simulation Use for Global Away Rotations (SUGAR curriculum, was useful for all pediatric residents, not merely those planning to go on an IHE. Pediatric residents in our program took part in 2 SUGAR cases and provided feedback via an online survey. Thirty-six of 40 residents participated (90%; 72% responded to the survey. Three of 10 residents not previously planning to work in resource-limited settings indicated participation in SUGAR made them more likely to do so. Nearly all residents (88% felt SUGAR should be part of the residency curriculum. All felt better prepared for working cross-culturally. While designed to prepare trainees for work in resource-limited settings, SUGAR may be beneficial for all residents.

  13. [HOLDING OBJECTIVE STRUCTURED CLINICAL EXAMINATIONS FOR ANESTHESIOLOGY AND INTENSIVE CARE CLINICAL RESIDENCY IN STATE GRADUATES CERTIFICATION].

    Science.gov (United States)

    Schegolev, A V; Andreenko, A A; Ershov, E N; Lahin, R E; Makarenko, E P

    2016-01-01

    The modern system of medical education requires objective methods to assess clinical competence of medical specialists. Application of objective structured clinical examination (OSCE) during the final certification of graduates of clinical residency allows to evaluate the theoretical knowledge, manual skills. Enabling simulation scenarios in the program makes it possible to objectively evaluate the important non-technical skills of anesthesiologists, identify gaps in the system of training and modify it. The experience of the objective structured clinical examination as part of the state certification of graduates of clinical residency of the Department ofAnesthesiology and Intensive Care, Military MedicalAcademy after C M Kirov allows us to consider this technique in an objective way a comprehensive assessment of the competence of health professionals. Students confirmed its highly realistic, they have revealed the presence of emotional stress during the simulation sessions, the majority agreed that the simulation session increased the level of their readiness to address these situations in clinical practice. Staff of the department is planning to testing and introduction rating scales into a system of assessment, to improved exam program, increasing the number of clinical scenarios for simulation sessions.

  14. Competing For industry Resources

    Energy Technology Data Exchange (ETDEWEB)

    Arnstad, Marit

    1998-12-31

    This presentation by Norway`s Minister of Petroleum and Energy describes (1) Norway in the energy picture, (2) oil market developments, (3) the establishment of an energy policy and (4) the investment level of the Norwegian petroleum activities. Value creation from Norwegian petroleum resources is directly connected with the commercial companies` participation in the activities. Thus, it has been a main challenge for Norway to establish a balanced petroleum policy and a legal framework. Presumably Norway will remain a prospective and attractive petroleum province for a long time. Over the years, Norway has developed three very competent and competitive national oil companies and a significant national supply industry. This industry is highly competitive internationally. Many new petroleum provinces are opening up for foreign investors and energy consumption of the world is expected to increase significantly the next 20 - 30 years. This implies increased demand for the products, but also strong competition for industry resources

  15. Leadership Training in Otolaryngology Residency.

    Science.gov (United States)

    Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

    2017-06-01

    Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

  16. Resident-to-resident violence triggers in nursing homes.

    Science.gov (United States)

    Snellgrove, Susan; Beck, Cornelia; Green, Angela; McSweeney, Jean C

    2013-11-01

    Certified nurses' assistants (CNAs) employed by a rural nursing home in Northeast Arkansas described their perceptions of resident-to-resident violence in order to provide insight on factors, including unmet needs, that may trigger the phenomenon. Semistructured interviews were conducted with 11 CNAs. Data were analyzed using content analysis and constant comparison. Two categories of triggers emerged from the data-active and passive. Active triggers involved the actions of other residents that were intrusive in nature, such as wandering into a residents' personal space, taking a resident's belongings, and so forth. Passive triggers did not involve the actions of residents but related to the internal and external environment of the residents. Examples were factors such as boredom, competition for attention and communication difficulties. Results indicate that there are factors, including unmet needs within the nursing home environment that may be identified and altered to prevent violence between residents.

  17. Residents in difficulty—just slower learners? A case-control study

    DEFF Research Database (Denmark)

    O'Neill, Lotte; Norberg, Karen; Thomsen, Maria;

    2014-01-01

    -examinations and the time it took to complete medical school were significant individual predictors of subsequent difficulties (deceleration, transferral or dropout) in residency whereas average medical school grades were not. CONCLUSIONS Residents in difficulty eventually reached similar competence levels as controls...... that not all learners reach the same level of competence for all activities at exactly the same time. This study seems to support the logic of such an approach to these residents in difficulty....... practicing doctors. The aim of this study was to examine if a sample of Danish residents in difficulty tended to struggle already in medical school, and to determine whether administratively observable performance indicators in medical school could predict difficulties in residency. METHODS The study design...

  18. Competency-based education in anesthesiology: history and challenges.

    Science.gov (United States)

    Ebert, Thomas J; Fox, Chris A

    2014-01-01

    The Accreditation Council for Graduate Medical Education is transitioning to a competency-based system with milestones to measure progress and define success of residents. The confines of the time-based residency will be relaxed. Curriculum must be redesigned and assessments will need to be precise and in-depth. Core anesthesiology faculty will be identified and will be the "trained observers" of the residents' progress. There will be logistic challenges requiring creative management by program directors. There may be residents who achieve "expert" status earlier than the required 36 months of clinical anesthesia education, whereas others may struggle to achieve acceptable status and will require additional education time. Faculty must accept both extremes without judgment. Innovative new educational opportunities will need to be created for fast learners. Finally, it will be important that residents embrace this change. This will require programs to clearly define the specific aims and measurement endpoints for advancement and success.

  19. SOCIO-PSYCHOLOGICAL CHARACTERISTICS OF THIS PHENOMENON INTERCULTURAL COMPETENCE (THE EXAMPLE IRKUTSK AREA

    Directory of Open Access Journals (Sweden)

    Alexandra Mikhailovna Zakharova

    2015-02-01

    Full Text Available This article presents the results of a socio-psychological study of intercultural competence in the Irkutsk region. A questionnaire was developed for the study, consisting of nine sections (the territorial section, historical section, a section of culture and symbolism, the population section, section of nationalities, religions, traditions and customs of the section, the section of the main attractions of the region of Lake Baikal and 36 closed issues. This methodology allows to reveal CMT respondent in each block, and compare them. The survey involved representatives of Buryat and Russian nationalities. All data about results of research are shown in the form of percent. Found that the level of intercultural competence can be introduced at three levels: high, medium, low. In a study in the Irkutsk region has identified the level of intercultural competence is above average. We also found that the level of intercultural competence is affected by independent variables such as age, education, place of residence, nationality and the length of their stay in the region.

  20. Residents' and faculty's beliefs about the ideal clinical teacher.

    Science.gov (United States)

    Masunaga, Hiromi; Hitchcock, Maurice A

    2010-02-01

    The objective of this study was to examine how residents and faculty in family medicine compare in their beliefs about ideal clinical teaching. We studied 205 residents and 148 faculty in family medicine who completed the Clinical Teaching Perception Inventory (CTPI) online between April 2001 and July 2008. The participants ranked 28 single-word descriptors that characterized clinical teachers along a 7-point-scale ranging from "least like my ideal teacher" to "most like my ideal teacher." Both residents and faculty indicated that the ideal clinical teachers should be stimulating, encouraging, competent, and communicating and should not be conventional, cautious, or controlling. However, residents rated probing and innovative significantly lower than did faculty. Clinical faculty and residents in family medicine have a shared view of the ideal clinical teacher. However, residents and faculty differed in their ratings on the descriptors "Probing" and "Innovative." This difference might at least in part stem from where residents and faculty are located along a continuum from novice to mature expert.

  1. High average daily intake of PCDD/Fs and serum levels in residents living near a deserted factory producing pentachlorophenol (PCP) in Taiwan: influence of contaminated fish consumption.

    Science.gov (United States)

    Lee, C C; Lin, W T; Liao, P C; Su, H J; Chen, H L

    2006-05-01

    An abandoned pentachlorophenol plant and nearby area in southern Taiwan was heavily contaminated by d