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Sample records for high competency residents

  1. 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.

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

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

    2011-01-01

    Background 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. Objective 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. Methods 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. Results 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. Discussion 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

  3. Ophthalmology resident surgical competency: a national survey.

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    Binenbaum, Gil; Volpe, Nicholas J

    2006-07-01

    To describe the prevalence, management, and career outcomes of ophthalmology residents who struggle with surgical competency and to explore related educational issues. Fourteen-question written survey. Fifty-eight program directors at Accreditation Council on Graduate Medical Education-accredited, United States ophthalmology residency programs, representing a total of 2179 resident graduates, between 1991 and 2000. Study participants completed a mailed, anonymous survey whose format combined multiple choice and free comment questions. Number of surgically challenged residents, types of problems identified, types of remediation, final departmental decision at the end of residency, known career outcomes, and residency program use of microsurgical skills laboratories and applicant screening tests. One hundred ninety-nine residents (9% overall; 10% mean per program) were labeled as having trouble mastering surgical skills. All of the programs except 2 had encountered such residents. The most frequently cited problems were poor hand-eye coordination (24%) and poor intraoperative judgment (22%). Most programs were supportive and used educational rather than punitive measures, the most common being extra practice-laboratory time (32%), scheduling cases with the best teaching surgeon (23%), and counseling (21%). Nearly one third (31%) of residents were believed to have overcome their difficulties before graduation. Other residents were encouraged to pursue medical ophthalmology (22%) or to obtain further surgical training through a fellowship (21%) or a supervised practice setting (12%); these residents were granted a departmental statement of satisfactory completion of residency for Board eligibility. Twelve percent were asked to leave residency. Of reported career outcomes, 92% of residents were practicing ophthalmology, 65% as surgical and 27% as medical ophthalmologists. Ninety-eight percent of residency programs had microsurgical practice facilities, 64% had a formal

  4. OB/GYN boot cAMP using high-fidelity human simulators: enhancing residents' perceived competency, confidence in taking a leadership role, and stress hardiness.

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    Pliego, Jose F; Wehbe-Janek, Hania; Rajab, M Hasan; Browning, Jeff L; Fothergill, Russell E

    2008-01-01

    To evaluate the effectiveness of an obstetrical and gynecologic (Ob/Gyn) Boot Camp simulation training on perceived technical competency, confidence in a leadership role, and stress hardiness of resident training. We conducted a prospective pilot study on the effectiveness of an Ob/Gyn Boot Camp on resident training. Residents participated in an intensive immersion in clinical simulation of common obstetrical emergencies including shoulder dystocia, neonatal resuscitation, postpartum hemorrhage, and ruptured ectopic pregnancy. After the training, residents completed a Web-based survey on their perceptions of how the Ob/Gyn Boot Camp affected their 1) technical competency in the assessment and management of their patients, 2) confidence in taking a leadership role, and 3) stress hardiness. Residents rated their perceptions on a Likert scale of 1 to 5, 1 = poor to 5 = excellent. Twenty-three (14 Ob/Gyn and 9 family medicine) residents participated in this pilot study. Eighteen (78%) residents completed the online survey; 4 Ob/Gyn and 1 family medicine resident did not complete the survey. The residents reported that the simulation training stimulated an interest in learning key skills for obstetrical and gynecologic emergencies. Ob/Gyn residents reported significant improvement in their perceived technical competence and stress hardiness after the Boot Camp. However both Ob/Gyn and family medicine residents reported no significant improvement of confidence in their leadership abilities during obstetrical emergencies after the Boot Camp. Boot Camp simulation training early in the curriculum has the potential for enhancing residents' self-assessments of confidence, competency, and stress hardiness in managing obstetrical emergencies.

  5. Are All Competencies Equal in the Eyes of Residents? A Multicenter Study of Emergency Medicine Residents' Interest in Feedback.

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    Bentley, Suzanne; Hu, Kevin; Messman, Anne; Moadel, Tiffany; Khandelwal, Sorabh; Streich, Heather; Noelker, Joan

    2017-01-01

    Feedback, particularly real-time feedback, is critical to resident education. The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment, and many programs use them to provide focused resident feedback. The purpose of this study was to evaluate EM residents' level of interest in receiving real-time feedback on each of the 23 competencies/sub-competencies. This was a multicenter cross-sectional study of EM residents. We surveyed participants on their level of interest in receiving real-time on-shift feedback on each of the 23 competencies/sub-competencies. Anonymous paper or computerized surveys were distributed to residents at three four-year training programs and three three-year training programs with a total of 223 resident respondents. Residents rated their level of interest in each milestone on a six-point Likert-type response scale. We calculated average level of interest for each of the 23 sub-competencies, for all 223 respondents and separately by postgraduate year (PGY) levels of training. One-way analyses of variance were performed to determine if there were differences in ratings by level of training. The overall survey response rate across all institutions was 82%. Emergency stabilization had the highest mean rating (5.47/6), while technology had the lowest rating (3.24/6). However, we observed no differences between levels of training on any of the 23 competencies/sub-competencies. Residents seem to ascribe much more value in receiving feedback on domains involving high-risk, challenging procedural skills as compared to low-risk technical and communication skills. Further studies are necessary to determine whether residents' perceived importance of competencies/sub-competencies needs to be considered when developing an assessment or feedback program based on these 23 EM competencies/sub-competencies.

  6. 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

  7. 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…

  8. Recommended integrative medicine competencies for family medicine residents.

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    Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia

    2013-01-01

    The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.

  9. 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.

  10. Resident self-other assessor agreement: influence of assessor, competency, and performance level.

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    Lipsett, Pamela A; Harris, Ilene; Downing, Steven

    2011-08-01

    To review the literature on self-assessment in the context of resident performance and to determine the correlation between self-assessment across competencies in high- and low-performing residents and assessments performed by raters from a variety of professional roles (peers, nurses, and faculty). Retrospective analysis of prospectively collected anonymous self-assessment and multiprofessional (360) performance assessments by competency and overall. University-based academic general surgical program. Sixty-two residents rotating in general surgery. Mean difference for each self-assessment dyad (self-peer, self-nurse, and self-attending physician) by resident performance quartile, adjusted for measurement error, correlation coefficients, and summed differences across all competencies. Irrespective of self-other dyad, residents asked to rate their global performance overestimated their skills. Residents in the upper quartile underestimated their specific skills while those in the lowest-performing quartile overestimated their abilities when compared with faculty, peers, and especially nurse raters. Moreover, overestimation was greatest in competencies related to interpersonal skills, communication, teamwork, and professionalism. Rater, level of performance, and the competency being assessed all influence the comparison of the resident's self-assessment and those of other raters. Self-assessment of competencies related to behavior may be inaccurate when compared with raters from various professions. Residents in the lowest-performing quartile are least able to identify their weakness. These data have important implications for residents, program directors, and the public and suggest that strategies that help the lowest-performing residents recognize areas in need of improvement are needed.

  11. 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.

  12. [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

  13. 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.

  14. Development of geriatric competencies for emergency medicine residents using an expert consensus process.

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    Hogan, Teresita M; Losman, Eve D; Carpenter, Christopher R; Sauvigne, Karen; Irmiter, Cheryl; Emanuel, Linda; Leipzig, Rosanne M

    2010-03-01

    The emergency department (ED) visit rate for older patients exceeds that of all age groups other than infants. The aging population will increase elder ED patient utilization to 35% to 60% of all visits. Older patients can have complex clinical presentations and be resource-intensive. Evidence indicates that emergency physicians fail to provide consistent high-quality care for elder ED patients, resulting in poor clinical outcomes. The objective was to develop a consensus document, "Geriatric Competencies for Emergency Medicine Residents," by identified experts. This is a minimum set of behaviorally based performance standards that all residents should be able to demonstrate by completion of their residency training. This consensus-based process utilized an inductive, qualitative, multiphase method to determine the minimum geriatric competencies needed by emergency medicine (EM) residents. Assessments of face validity and reliability were used throughout the project. In Phase I, participants (n=363) identified 12 domains and 300 potential competencies. In Phase II, an expert panel (n=24) clustered the Phase I responses, resulting in eight domains and 72 competencies. In Phase III, the expert panel reduced the competencies to 26. In Phase IV, analysis of face validity and reliability yielded a 100% consensus for eight domains and 26 competencies. The domains identified were atypical presentation of disease; trauma, including falls; cognitive and behavioral disorders; emergent intervention modifications; medication management; transitions of care; pain management and palliative care; and effect of comorbid conditions. The Geriatric Competencies for EM Residents is a consensus document that can form the basis for EM residency curricula and assessment to meet the demands of our aging population. Copyright (c) 2010 by the Society for Academic Emergency Medicine.

  15. Are All Competencies Equal in the Eyes of Residents? A Multicenter Study of Emergency Medicine Residents’ Interest in Feedback

    Science.gov (United States)

    Bentley, Suzanne; Hu, Kevin; Messman, Anne; Moadel, Tiffany; Khandelwal, Sorabh; Streich, Heather; Noelker, Joan

    2017-01-01

    Introduction Feedback, particularly real-time feedback, is critical to resident education. The emergency medicine (EM) milestones were developed in 2012 to enhance resident assessment, and many programs use them to provide focused resident feedback. The purpose of this study was to evaluate EM residents’ level of interest in receiving real-time feedback on each of the 23 competencies/sub-competencies. Methods This was a multicenter cross-sectional study of EM residents. We surveyed participants on their level of interest in receiving real-time on-shift feedback on each of the 23 competencies/sub-competencies. Anonymous paper or computerized surveys were distributed to residents at three four-year training programs and three three-year training programs with a total of 223 resident respondents. Residents rated their level of interest in each milestone on a six-point Likert-type response scale. We calculated average level of interest for each of the 23 sub-competencies, for all 223 respondents and separately by postgraduate year (PGY) levels of training. One-way analyses of variance were performed to determine if there were differences in ratings by level of training. Results The overall survey response rate across all institutions was 82%. Emergency stabilization had the highest mean rating (5.47/6), while technology had the lowest rating (3.24/6). However, we observed no differences between levels of training on any of the 23 competencies/sub-competencies. Conclusion Residents seem to ascribe much more value in receiving feedback on domains involving high-risk, challenging procedural skills as compared to low-risk technical and communication skills. Further studies are necessary to determine whether residents’ perceived importance of competencies/sub-competencies needs to be considered when developing an assessment or feedback program based on these 23 EM competencies/sub-competencies. PMID:28116012

  16. Perspective of ophthalmology residents in the United States about residency programs and competency in relation to the International Council of Ophthalmology guidelines.

    Science.gov (United States)

    Abdelfattah, Nizar Saleh; Radwan, Ahmed E; Sadda, Srinivas R

    2016-09-01

    To evaluate the perspective of ophthalmology residents in the US about their residency programs and compare the competency of residency programs to international competency levels set by the International Council of Ophthalmology (ICO). A cross-sectional web-based survey extracted from the ICO published competency standards was sent to program directors of ophthalmology residency programs in the US to forward it to current PGY-3, 4 residents, and residency graduates from 2011 to 2014. Eighty-seven responses were received, comprising 61 residents and 26 graduates. Most respondents were highly satisfied with their programs (93.6%). Clinic-based training was rated satisfactorily. Insufficient exposure to low-vision rehabilitation (38.5%), refraction and contact lenses prescription (38.5%), and vitreo-retinal surgeries (38.5%) was reported. Respondents were satisfied with their overall surgical experiences, with the vast majority (>83%) rating case volume, complexity, and variety as satisfactory or better. A significant group stated they had insufficient exposure to extra-capsular cataract extraction (26.3%), refractive surgery (19.7%), and orbital surgery (64.5%). All graduates surveyed passed their Ophthalmic Knowledge Assessment Program (OKAP) examinations, and 72% felt their residency programs adequately prepared them for the examinations. All respondents reported insufficient training in certain nonclinical areas, such as practice management, staffing, and administration skills. Ophthalmology residents in the US express high levels of satisfaction with their residency training programs. While most programs adequately address most ICO core objectives, certain curriculum modifications should be considered.

  17. Longitudinal Associations of Autonomy, Relatedness, and Competence with the Well-being of Nursing Home Residents.

    Science.gov (United States)

    Kloos, Noortje; Trompetter, Hester R; Bohlmeijer, Ernst T; Westerhof, Gerben J

    2018-02-24

    As proposed by the self-determination theory, satisfying nursing home residents' needs for autonomy, relatedness, and competence may improve their well-being. This is the first study to test the longitudinal relations of the satisfaction of these three basic psychological needs to the subjective well-being of nursing home residents and to determine whether a balance among the satisfaction of the three needs is important for well-being. Participants in this longitudinal survey study included 128 physically frail residents (mean age 85 years) at four Dutch nursing homes. Satisfaction of the three basic psychological needs was measured at baseline, and depressive feelings and life satisfaction 5-8 months later. Absolute differences between the three basic need satisfaction scores were summed to create a score of need satisfaction balance. All three needs were related to both well-being measures over time, although autonomy had the strongest relationships. Only autonomy and competence were uniquely associated with depressive feelings, and only autonomy was uniquely associated with life satisfaction. The need satisfaction balance score was related to well-being independent of the autonomy and relatedness scores. These results confirm that all three basic psychological needs are important for nursing home residents' well-being, with autonomy having the strongest and most consistent relationship to their well-being. Additionally, high satisfaction of one need does not compensate for low satisfaction of another. Supporting residents' needs for autonomy, relatedness, and competence should, therefore, have a central role in nursing home culture-change interventions.

  18. 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…

  19. Differences between medical student and faculty perceptions of the competencies needed for the first year of residency

    Directory of Open Access Journals (Sweden)

    Sophie Fürstenberg

    2017-11-01

    competency for entrustment decisions in the first year of residency, medical students rate competencies regarding patient communication very highly while physicians rate competencies required for patient managements significantly higher for entrustment decision. Undergraduate medical curricula seem to prepare students well with respect to patient-centeredness but need to be developed more specifically to prepare students equally well for patient management competencies which are required in the first year of residency for entrustment decisions from the attendings perspective.

  20. Differences between medical student and faculty perceptions of the competencies needed for the first year of residency.

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    Fürstenberg, Sophie; Harendza, Sigrid

    2017-11-09

    regarding patient communication very highly while physicians rate competencies required for patient managements significantly higher for entrustment decision. Undergraduate medical curricula seem to prepare students well with respect to patient-centeredness but need to be developed more specifically to prepare students equally well for patient management competencies which are required in the first year of residency for entrustment decisions from the attendings perspective.

  1. Field-based generation and social validation managers and staff competencies for small community residences.

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    Thousand, J S; Burchard, S N; Hasazi, J E

    1986-01-01

    Characteristics and competencies for four staff positions in community residences for individuals with mental retardation were identified utilizing multiple empirical and deductive methods with field-based practitioners and field-based experts. The more commonly used competency generation methods of expert opinion and job performance analysis generated a high degree of knowledge and skill-based competencies similar to course curricula. Competencies generated by incumbent practitioners through open-ended methods of personal structured interview and critical incident analysis were ones which related to personal style, interpersonal interaction, and humanistic orientation. Although seldom included in staff, paraprofessional, or professional training curricula, these latter competencies include those identified by Carl Rogers as essential for developing an effective helping relationship in a therapeutic situation (i.e., showing liking, interest, and respect for the clients; being able to communicate positive regard to the client). Of 21 core competency statements selected as prerequisites to employment for all four staff positions, the majority (17 of 21) represented interpersonal skills important to working with others, including responsiveness to resident needs, personal valuation of persons with mental retardation, and normalization principles.

  2. The electronic residency application service application can predict accreditation council for graduate medical education competency-based surgical resident performance.

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    Tolan, Amy M; Kaji, Amy H; Quach, Chi; Hines, O Joe; de Virgilio, Christian

    2010-01-01

    Program directors often struggle to determine which factors in the Electronic Residency Application Service (ERAS) application are important in the residency selection process. With the establishment of the Accreditation Council for Graduate Medical Education (ACGME) competencies, it would be important to know whether information available in the ERAS application can predict subsequent competency-based performance of general surgery residents. This study is a retrospective correlation of data points found in the ERAS application with core competency-based clinical rotation evaluations. ACGME competency-based evaluations as well as technical skills assessment from all rotations during residency were collected. The overall competency score was defined as an average of all 6 competencies and technical skills. A total of77 residents from two (one university and one community based university-affiliate) general surgery residency programs were included in the analysis. Receiving honors for many of the third year clerkships and AOA membership were associated with a number of the individual competencies. USMLE scores were predictive only of Medical Knowledge (p = 0.004). Factors associated with higher overall competency were female gender (p = 0.02), AOA (p = 0.06), overall number of honors received (p = 0.04), and honors in Ob/Gyn (p = 0.03) and Pediatrics (p = 0.05). Multivariable analysis showed honors in Ob/Gyn, female gender, older age, and total number of honors to be predictive of a number of individual core competencies. USMLE scores were only predictive of Medical Knowledge. The ERAS application is useful for predicting subsequent competency based performance in surgical residents. Receiving honors in the surgery clerkship, which has traditionally carried weight when evaluating a potential surgery resident, may not be as strong a predictor of future success. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights

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

    Directory of Open Access Journals (Sweden)

    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

  4. Implementation of an Integrated Orthopedic Curriculum to Increase Clinical and Procedural Competency amongst Pediatric Residents

    Science.gov (United States)

    2017-04-05

    to Increase Clinical and Procedural Competency Amongst Pediatric Residents presented at/published to APPD Conference, Anaheim, CA, 5-8 April 2017 in...Increase Clinical and Procedural Competency amongst Pediatric Residents 7. FUNDING RECEIVED FOR THIS STUDY? 0 YES l8] t-’O FUNDING SOURCE 8. DO YOU NEED...and Procedural Competency amongst Pediatric Residents Sarah Nelin MD, Taneishia Jones, MD, Jason Beachler MD, Michelle Lawson MD, Bryan Lawson, MD

  5. Resident Self-Assessment and Learning Goal Development: Evaluation of Resident-Reported Competence and Future Goals.

    Science.gov (United States)

    Li, Su-Ting T; Paterniti, Debora A; Tancredi, Daniel J; Burke, Ann E; Trimm, R Franklin; Guillot, Ann; Guralnick, Susan; Mahan, John D

    2015-01-01

    To determine incidence of learning goals by competency area and to assess which goals fall into competency areas with lower self-assessment scores. Cross-sectional analysis of existing deidentified American Academy of Pediatrics' PediaLink individualized learning plan data for the academic year 2009-2010. Residents self-assessed competencies in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas and wrote learning goals. Textual responses for goals were mapped to 6 ACGME competency areas, future practice, or personal attributes. Adjusted mean differences and associations were estimated using multiple linear and logistic regression. A total of 2254 residents reported 6078 goals. Residents self-assessed their systems-based practice (51.8) and medical knowledge (53.0) competencies lowest and professionalism (68.9) and interpersonal and communication skills (62.2) highest. Residents were most likely to identify goals involving medical knowledge (70.5%) and patient care (50.5%) and least likely to write goals on systems-based practice (11.0%) and professionalism (6.9%). In logistic regression analysis adjusting for postgraduate year (PGY), gender, and degree type (MD/DO), resident-reported goal area showed no association with the learner's relative self-assessment score for that competency area. In the conditional logistic regression analysis, with each learner serving as his or her own control, senior residents (PGY2/3+s) who rated themselves relatively lower in a competency area were more likely to write a learning goal in that area than were PGY1s. Senior residents appear to develop better skills and/or motivation to explicitly turn self-assessed learning gaps into learning goals, suggesting that individualized learning plans may help improve self-regulated learning during residency. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  6. Self-assessment on the competencies and reported improvement priorities for pediatrics residents.

    Science.gov (United States)

    Li, Su-Ting T; Tancredi, Daniel J; Burke, Ann E; Guillot, Ann; Guralnick, Susan; Trimm, R Franklin; Mahan, John D

    2012-12-01

    Self-assessment and self-directed learning are essential to becoming an effective physician. To identify factors associated with resident self-assessment on the competencies, and to determine whether residents chose areas of self-assessed relative weakness as areas for improvement in their Individualized Learning Plan (ILP). We performed a cross-sectional analysis of the American Academy of Pediatrics' PediaLink ILP database. Pediatrics residents self-assessed their competency in the 6 Accreditation Council for Graduate Medical Education competencies using a color-coded slider scale with end anchors "novice" and "proficient" (0-100), and then chose at least 1 competency to improve. Multivariate regression explored the relationship between overall confidence in core competencies, sex, level of training, and degree (MD or DO) status. Correlation examined whether residents chose to improve competencies in which they rated themselves as lower. A total of 4167 residents completed an ILP in academic year 2009-2010, with residents' ratings improving from advanced beginner (48 on a 0-100 scale) in postgraduate year-1 residents (PGY-1s) to competent (75) in PGY-3s. Residents rated themselves as most competent in professionalism (mean, 75.3) and least competent in medical knowledge (mean, 55.8) and systems-based practice (mean, 55.2). In the adjusted regression model, residents' competency ratings increased by level of training and whether they were men. In PGY-3s, there was no difference between men and women. Residents selected areas for improvement that correlated to competencies where they had rated themselves lower (P knowledge and systems-based practice, even as PGY-3s. Residents tended to choose subcompetencies, which they rated as lower to focus on improving.

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

    Science.gov (United States)

    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…

  8. Next generation leadership: a profile of self-rated competencies among administrative resident and fellows.

    Science.gov (United States)

    Helfand, Brad; Cherlin, Emily; Bradley, Elizabeth H

    2005-01-01

    Healthcare executives and program faculty have voiced concerns that early careerists lack needed competencies for future leadership in the increasingly complex healthcare industry. However, empirical studies of early careerists' competency levels are limited. We sought to describe administrative fellows' and residents' (n = 78, response rate 73.6%) self-rated competency in several key areas and assess how these ratings differed by individuals' gender, age, prior work experience, year of graduate training, and type of degree program. Respondents rated their competence particularly high (41.7% of respondents rated themselves "A") in the domain of interpersonal and emotional intelligence, which included being an effective team leader and member, coaching and developing others, self-awareness, and self-regulation. Lower ratings were in the domains of facilities management and in development and fundraising. Compared to males, females rated their competency in the financial skills domain lower (P-value = 0.04). Age, prior work experience, year of graduate training, and type of degree program were not significantly associated with self-rated competency in any area. These results provide early evidence that may help program faculty and preceptors consider pedagogical approaches that reflect students' vocalized needs and may help to design strategies that effectively cultivate next generation leadership.

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

    Science.gov (United States)

    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.

  10. Competency Assessment in Family Medicine Residency: Observations, Knowledge-Based Examinations, and Advancement.

    Science.gov (United States)

    Mainous, Arch G; Fang, Bo; Peterson, Lars E

    2017-12-01

    The Family Medicine (FM) Milestones are competency-based assessments of residents in key dimensions relevant to practice in the specialty. Residency programs use the milestones in semiannual reviews of resident performance from the time of entry into the program to graduation. Using a national sample, we investigated the relationship of FM competency-based assessments to resident progress and the complementarity of milestones with knowledge-based assessments in FM residencies. We used midyear and end-of-year milestone ratings for all FM residents in Accreditation Council for Graduate Medical Education-accredited programs during academic years 2014-2015 and 2015-2016. The milestones contain 22 items across 6 competencies. We created a summative index across the milestones. The American Board of Family Medicine database provided resident demographics and in-training examination (ITE) scores. We linked information to the milestone data. The sample encompassed 6630 FM residents. The summative milestone index increased, on average, for each cohort (postgraduate year 1 [PGY-1] to PGY-2 and PGY-2 to PGY-3) at each assessment. The correlation between the milestone index that excluded the medical knowledge milestone and ITE scores was r  = .195 ( P  ITE scores and composite milestone assessments were higher for residents who advanced than for those who did not. Competency-based assessment using the milestones for FM residents seems to be a viable multidimensional tool to assess the successful progression of residents.

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

    Science.gov (United States)

    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.

  12. Family medicine residency program directors attitudes and knowledge of family medicine CAM competencies.

    Science.gov (United States)

    Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia; Bonakdar, Robert

    2013-01-01

    Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate whether residency programs are implementing such competencies into their curriculum using an online survey tool. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. A survey was distributed by the Council of Academic Family Medicine (CAFM) Educational Research Alliance to RDs via e-mail. The survey was distributed to 431 RDs. Of those who received it, 212 responded, giving a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into the residency curriculum. Forty-five percent of RDs were aware of the competencies. In terms of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum; yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%); and financial resources (29%). While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers that prevent residencies from implementing the STFM CAM/IM competencies. © 2013 Elsevier Inc. All rights reserved.

  13. Remediation in the Context of the Competencies: A Survey of Pediatrics Residency Program Directors

    Science.gov (United States)

    Riebschleger, Meredith P.; Haftel, Hilary M.

    2013-01-01

    Background The 6 competencies defined by the Accreditation Council for Graduate Medical Education provide the framework of assessment for trainees in the US graduate medical education system, but few studies have investigated their impact on remediation. Methods We obtained data via an anonymous online survey of pediatrics residency program directors. For the purposes of the survey, remediation was defined as “any form of additional training, supervision, or assistance above that required for a typical resident.” Respondents were asked to quantify 3 groups of residents: (1) residents requiring remediation; (2) residents whose training was extended for remediation purposes; and (3) residents whose training was terminated owing to issues related to remediation. For each group, the proportion of residents with deficiencies in each of the 6 competencies was calculated. Results In all 3 groups, deficiencies in medical knowledge and patient care were most common; deficiencies in professionalism and communication were moderately common; and deficiencies in systems-based practice and practice-based learning and improvement were least common. Residents whose training was terminated were more likely to have deficiencies in multiple competencies. Conclusion Although medical knowledge and patient care are reported most frequently, deficiencies in any of the 6 competencies can lead to the need for remediation in pediatrics residents. Residents who are terminated are more likely to have deficits in multiple competencies. It will be critical to develop and refine tools to measure achievement in all 6 competencies as the graduate medical education community may be moving further toward individualized training schedules and competency-based, rather than time-based, training. PMID:24404228

  14. 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

  15. Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

    Science.gov (United States)

    Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

    2009-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

  16. Assessing and counseling the obese patient: Improving resident obesity counseling competence.

    Science.gov (United States)

    Iyer, Shwetha; Jay, Melanie; Southern, William; Schlair, Sheira

    To evaluate obesity counseling competence among residents in a primary care training program METHODS: We delivered a 3h obesity curriculum to 28 Primary Care residents and administered a pre-curriculum and post curriculum survey looking specifically at self-assessed obesity counseling competence. Nineteen residents completed both the pre curriculum survey and the post curriculum survey. The curriculum had a positive impact on residents' ability to ascertain patient's stage of change, use different methods to obtain diet history (including 24h recall, food record or food frequency questionnaire), respond to patient's questions regarding treatment options, assist patients in setting realistic goals for weight loss based on making permanent lifestyle changes, and use of motivational interviewing to change behavior. When looking at the 5As domains, there was a significant improvement in the domains of Assess, Advise, and Assist. The proportion of residents with a lower level of self-assessed obesity counseling competence reduced from 75% before the curriculum to 37.5% (p=0.04) after the curriculum. Our curriculum addressing weight loss counseling using the 5As model increased obesity counseling competence among residents in a primary care internal medicine residency program. Copyright © 2018 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  17. Competencies for first year residents - physicians' views from medical schools with different undergraduate curricula.

    Science.gov (United States)

    Fürstenberg, Sophie; Schick, Kristina; Deppermann, Jana; Prediger, Sarah; Berberat, Pascal O; Kadmon, Martina; Harendza, Sigrid

    2017-09-07

    Frameworks like the CanMEDS model depicting professional roles and specific professional activities provide guidelines for postgraduate education. When medical graduates start their residency, they should possess certain competencies related to communication, management and professionalism while other competencies will be refined during postgraduate training. Our study aimed to evaluate the relevance of different competencies for a first year resident required for entrustment decision from the perspective of physicians from medical faculties with different undergraduate medical curricula. Nine hundred fifty-two surgeons and internists from three medical schools with different undergraduate medical curricula were invited to rank 25 competencies according to their relevance for first year residents. The rankings were compared between universities, specialties, physicians' positions, and gender. Two hundred two physicians participated, 76 from Hamburg University, 44 from Oldenburg University, and 82 from Technical University Munich. No significant differences were found regarding the top 10 competencies relevant for first year residents between the universities. 'Responsibility' was the competency with the highest rank overall. Internists ranked 'Structure, work planning and priorities' higher while surgeons ranked 'Verbal communication with colleagues and supervisors' higher. Consultants evaluated 'Active listening to patients' more important than department directors and residents. Female physicians ranked 'Verbal communication with colleagues and supervisors' and 'Structure, work planning and priorities' significantly higher while male physicians ranked 'Scientifically and empirically grounded method of working' significantly higher. Physicians from universities with different undergraduate curricula principally agreed on the competencies relevant for first year residents. Some differences between physicians from different positions, specialties, and gender were

  18. The communication competency of medical students, residents and consultants

    NARCIS (Netherlands)

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

    Objective: The model of expert performance predicts that neither physicians in training nor experienced physicians will reach an expert level in communication. This study tested this hypothesis. Methods: Seventy-one students, twenty-five residents and fourteen consultants performed a 'breaking bad

  19. Competencies "plus": the nature of written comments on internal medicine residents' evaluation forms.

    Science.gov (United States)

    Ginsburg, Shiphra; Gold, Wayne; Cavalcanti, Rodrigo B; Kurabi, Bochra; McDonald-Blumer, Heather

    2011-10-01

    Comments on residents' in-training evaluation reports (ITERs) may be more useful than scores in identifying trainees in difficulty. However, little is known about the nature of comments written by internal medicine faculty on residents' ITERs. Comments on 1,770 ITERs (from 180 residents in postgraduate years 1-3) were analyzed using constructivist grounded theory beginning with an existing framework. Ninety-three percent of ITERs contained comments, which were frequently easy to map onto traditional competencies, such as knowledge base (n = 1,075 comments) to the CanMEDs Medical Expert role. Many comments, however, could be linked to several overlapping competencies. Also common were comments completely unrelated to competencies, for instance, the resident's impact on staff (813), or personality issues (450). Residents' "trajectory" was a major theme (performance in relation to expected norms [494], improvement seen [286], or future predictions [286]). Faculty's assessments of residents are underpinned by factors related and unrelated to traditional competencies. Future evaluations should attempt to capture these holistic, integrated impressions.

  20. Otolaryngology Resident Education and the Accreditation Council for Graduate Medical Education Core Competencies: A Systematic Review.

    Science.gov (United States)

    Faucett, Erynne A; Barry, Jonnae Y; McCrary, Hilary C; Saleh, Ahlam A; Erman, Audrey B; Ishman, Stacey L

    2018-04-01

    To date, there have been no reports in the current literature regarding the use of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in otolaryngology residency training. An evaluation may help educators address these core competencies in the training curriculum. To examine the quantity and nature of otolaryngology residency training literature through a systematic review and to evaluate whether this literature aligns with the 6 core competencies. A medical librarian assisted in a search of all indexed years of the PubMed, Embase, Education Resources Information Center (via EBSCOhost), Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Methodology Register), Thomson Reuters Web of Science (Science Citation Index Expanded, Social Sciences Citation Index Expanded, Conference Proceedings Citation Index-Science, and Conference Proceedings Citation Index-Social Science and Humanities), Elsevier Scopus, and ClinicalTrials.gov databases to identify relevant English-language studies. Included studies contained original human data and focused on otolaryngology resident education. Data regarding study design, setting, and ACGME core competencies addressed were extracted from each article. Initial searches were performed on May 20, 2015, and updated on October 4, 2016. In this systematic review of 104 unique studies, interpersonal communication skills were reported 15 times; medical knowledge, 48 times; patient care, 44 times; practice-based learning and improvement, 31 times; professionalism, 15 times; and systems-based practices, 10 times. Multiple studies addressed more than 1 core competency at once, and 6 addressed all 6 core competencies. Increased emphasis on nonclinical core competencies is needed, including professionalism, interpersonal and communication skills, and systems-based practices in the otolaryngology residency training curriculum. A formal curriculum

  1. 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.

  2. Obstetric and Gynecologic Ultrasound Curriculum and Competency Assessment in Residency Training Programs

    DEFF Research Database (Denmark)

    Abuhamad, Alfred; Minton, Katherine K; Benson, Carol B

    2018-01-01

    in Medicine assembled a multisociety task force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency assessment tools were developed based on existing national...... and international guidelines for the performance of obstetric and gynecologic ultrasound examinations and thus are intended to represent the minimum requirement for such training. By expert consensus, the curriculum was developed for each year of training, criteria for each competency assessment image were...... that the criteria set forth in this document will evolve with time. The task force also encourages use of ultrasound simulation in residency training and expects that simulation will play a significant part in the curriculum and the competency assessment process. Incorporating this training curriculum...

  3. Obstetric and gynecologic ultrasound curriculum and competency assessment in residency training programs

    DEFF Research Database (Denmark)

    Abuhamad, Alfred; Minton, Katherine K; Benson, Carol B

    2018-01-01

    in Medicine assembled a multisociety task force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency assessment tools were developed based on existing national...... and international guidelines for the performance of obstetric and gynecologic ultrasound examinations and thus are intended to represent the minimum requirement for such training. By expert consensus, the curriculum was developed for each year of training, criteria for each competency assessment image were...... that the criteria set forth in this document will evolve with time. The task force also encourages use of ultrasound simulation in residency training and expects that simulation will play a significant part in the curriculum and the competency assessment process. Incorporating this training curriculum...

  4. Putting residents in the office: an effective method to teach the systems-based practice competency.

    Science.gov (United States)

    Pulcrano, Marisa; Chahine, A Alfred; Saratsis, Amanda; Divine-Cadavid, Jamie; Narra, Vinod; Evans, Stephen R T

    2015-01-01

    Systems-based practice (SBP) was 1 of 6 core competencies established by the Accreditation Council for Graduate Medical Education and has proven to be one of the most difficult to effectively implement. This pilot study presents an immersion workshop as an effective tool to teach the SBP competency in a way that could easily be integrated into a residency curriculum. In 2006, 16 surgical residents rotated through 3 stations for 30 minutes each: coding and billing, scheduling operations and return appointments, and patient check-in. Participants were administered a pretest and posttest questionnaire evaluating their knowledge of SBP, and were asked to evaluate the workshop. Outpatient clinic at MedStar Georgetown University Hospital, Washington, DC. Residents in the general surgery residency training program at MedStar Georgetown University Hospital. Most residents (62.5%) improved their score after the workshop, whereas 31.25% showed no change and 6.25% demonstrated a decrease in score. Overall within their training levels, all groups demonstrated an increase in mean test score. Postgraduate year-2 residents demonstrated the greatest change in mean score (20%), whereas postgraduate year-4 residents demonstrated the smallest change in mean score (3.3%). An immersion workshop where general surgery residents gained direct exposure to SBP concepts in situ was an effective and practical method of integrating this core competency into the residency curriculum. Such a workshop could complement more formal didactic teaching and be easily incorporated into the curriculum. For example, this workshop could be integrated into the ambulatory care requirement that each resident must fulfill as part of their clinical training. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. 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 sim...... similar to those of their peers in other countries, and if a longer duration of the incorporation of the CanMEDS competency framework into curricula as well as management training had an influence on these perceptions....

  6. 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

  7. 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…

  8. Improved competence after a palliative care course for internal medicine residents

    NARCIS (Netherlands)

    Mulder, S. F.; Bleijenberg, G.; Verhagen, S. C.; Stuyt, P. M. J.; Schijven, M. P.; Tack, C. J.

    2009-01-01

    Residents report that they received inadequate teaching in palliative care and low levels of comfort and skills when taking care of dying patients. This study describes the effects of a problem-based palliative care course on perceived competence and knowledge in a representative Dutch cohort of

  9. 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,…

  10. 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

  11. Curriculum reform for residency training: competence, change, and opportunities for leadership.

    Science.gov (United States)

    Fraser, Amy B; Stodel, Emma J; Chaput, Alan J

    2016-07-01

    Certain pressures stemming from within the medical community and from society in general, such as the need for increased accountability in resident training and restricted resident duty hours, have prompted a re-examination of methods for training physicians. Leaders in medical education in North America and around the world champion competency-based medical education (CBME) as a solution. The Department of Anesthesiology at the University of Ottawa launched Canada's first CBME program for anesthesiology residents on July 1, 2015. In this paper, we discuss the opportunities and challenges associated with CBME and delineate the elements of the new CBME program at the University of Ottawa. Review of the current literature. Competency-based medical education addresses some of the challenges associated with physician training, such as ensuring that specialists are competent in all key areas and reducing training costs. In principle, competency-based medical education can better meet the needs of patients, providers, and other stakeholders in the healthcare system, but its success will depend on support from all involved. As CBME is implemented, anesthesiologists have the opportunity to become leaders in innovation and medical education. The University of Ottawa has implemented a CBME program with a twofold purpose, namely, to focus learning opportunities on the development of the specific competencies required of practicing anesthesiologists and to test the effectiveness of a reduction in the length of training. Canadian anesthesia residency programs will soon transition to CBME in order to promote better transparency, accountability, fairness, fiscal responsibility, and patient safety. Competency-based medical education offers significant potential advantages for healthcare stakeholders.

  12. 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

  13. Effect of field notes on confidence and perceived competence: survey of faculty and residents.

    Science.gov (United States)

    Laughlin, Tom; Brennan, Amy; Brailovsky, Carlos

    2012-06-01

    To evaluate the effectiveness of field notes in assessing teachers' confidence and perceived competence, and the effect of field notes on residents' perceptions of their development of competence. A faculty and resident survey completed 5 years after field notes were introduced into the program. Five Dalhousie University family medicine sites--Fredericton, Moncton, and Saint John in New Brunswick, and Halifax and Sydney in Nova Scotia. First- and second-year family medicine residents (as of May 2009) and core family medicine faculty. Residents' outcome measures included beliefs about the effects of field notes on performance, learning, reflection, clinical skills development, and feedback received. Faculty outcome measures included beliefs about the effect of field notes on guiding feedback, teaching, and reflection on clinical practice. Forty of 88 residents (45.5%) participated. Fifteen of 50 faculty (30.0%) participated, which only permitted a discussion of trends for faculty. Residents believed field note-directed feedback reinforced their performance (81.1%), helped them learn (67.6%), helped them reflect on practice and learning (66.7%), and focused the feedback they received, making it more useful (62.2%) (P note-directed feedback helped with clinical skills development (P notes helped to provide more focused (86.7%) and effective feedback (78.6%), improved teaching (75.0%), and encouraged reflection on their own clinical practice (73.3%). Most surveyed residents believed field note use improved the feedback they received and helped them to develop competence through improved performance, learning, reflection, and clinical skills development. The trends from faculty information suggested faculty believed field notes were an effective teaching, feedback, and reflection tool.

  14. 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.

  15. Resident dashboards: helping your clinical competency committee visualize trainees' key performance indicators.

    Science.gov (United States)

    Friedman, Karen A; Raimo, John; Spielmann, Kelly; Chaudhry, Saima

    2016-01-01

    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. 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. 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. 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.

  16. 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.

  17. Professionalism: A Core Competency, but What Does it Mean? A Survey of Surgery Residents.

    Science.gov (United States)

    Dilday, Joshua C; Miller, Elizabeth A; Schmitt, Kyle; Davis, Brian; Davis, Kurt G

    2017-10-27

    Professionalism is 1 of the 6 core competencies of the Accreditation Council of Graduate Medical Education. Despite its obvious importance, it is poorly defined in the literature and an understanding of its meaning has not been evaluated on surgical trainees. The American College of Surgeons (ACS) has previously published tenets of surgical professionalism. However, surgery residents may not share similar views on professionalism as those of the ACS. Surgical residents of all levels at 2 surgery residencies located in the same city were interviewed regarding their personal definitions, thoughts, and experiences regarding professionalism during their training. They were then queried regarding 20 points of professionalism as outlined by the ACS tenets of professionalism. The study utilized the surgery residencies at William Beaumont Army Medical Center and Texas Tech University Health Science Center in El Paso, Texas. All general surgery residents at each program were invited to participate in the study. Eighteen residents volunteered to take the survey and be interviewed. The definitions of professionalism centered on clinical competence. Surgery residents conveyed experiences with both professional and unprofessional behavior. Seven of the 20 ACS tenets of professionalism were unanimously agreed upon. There were key differences between resident definitions and those as outlined by the ACS. The least agreed upon ACS tenets of professionalism include professionalism education, public education, and public health. Surgical trainees express personal experiences in both professional and unprofessional behavior. Their definitions of professionalism are not as expansive as those of the ACS and seem to focus on patient and colleague interaction. Due to the lack of congruency, a tailored curriculum for professionalism based upon ACS tenets appears warranted. Published by Elsevier Inc.

  18. Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

    Science.gov (United States)

    Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

    2010-09-01

    Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory

  19. 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 value for difference from pre-curriculum 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 training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT

  20. Evaluation of clinical teaching quality in competency-based residency training in Lithuania.

    Science.gov (United States)

    Vaižgėlienė, Eglė; Padaiga, Žilvinas; Rastenytė, Daiva; Tamelis, Algimantas; Petrikonis, Kęstutis; Fluit, Cornelia

    2017-12-01

    In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into the competency-based medical education curriculum (CBME). In 2015, we implemented the validated EFFECT questionnaire together with the EFFECT-System for quality assessment of clinical teaching in residency training. The aim of this study was to investigate the influence of characteristics of the resident (year of training) and clinical teacher (gender, age, and type of academic position) on teaching quality, as well as to assess areas for teaching quality improvement. Residents from 7 different residency study programs filled out 333 EFFECT questionnaires evaluating 146 clinical teachers. We received 143 self-evaluations of clinical teachers using the same questionnaire. Items were scored on a 6-point Likert scale. Main outcome measures were residents' mean overall (MOS), mean subdomain (MSS) and clinical teachers' self-evaluation scores. The overall comparisons of MOS and MSS across study groups and subgroups were done using Student's t test and ANOVA for trend. The intraclass correlation coefficient (ICC) was calculated in order to see how residents' evaluations match with self-evaluations for every particular teacher. To indicate areas for quality improvement items were analyzed subtracting their mean score from the respective (sub)domain score. MOS for domains of "role modeling", "task allocation", "feedback", "teaching methodology" and "assessment" valued by residents were significantly higher than those valued by teachers (Pevaluation questionnaires were rated significantly higher by residents in role modeling subdomains (Phigher than the female teachers (Phigher (Pevaluations of clinical teachers are influenced by teachers' age, gender, year of residency training, type of teachers' academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers

  1. 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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

    Purpose: To develop an entry-to-practice quality and safety competency profile for radiation oncology residency. Methods and Materials: 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. Results: 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. Conclusions: This quality and safety competency profile may inform minimum training standards for radiation oncology residency programs.

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

    Energy Technology Data Exchange (ETDEWEB)

    Adleman, Jenna [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Gillan, Caitlin [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Caissie, Amanda [Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia (Canada); Saint John Regional Hospital, Saint John, New Brunswick (Canada); Davis, Carol-Anne [Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia (Canada); Nova Scotia Cancer Centre, Halifax, Nova Scotia (Canada); Liszewski, Brian [Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); McNiven, Andrea [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Giuliani, Meredith, E-mail: Meredith.Giuliani@rmp.uhn.ca [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario (Canada)

    2017-06-01

    Purpose: To develop an entry-to-practice quality and safety competency profile for radiation oncology residency. Methods and Materials: 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. Results: 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. Conclusions: This quality and safety competency profile may inform minimum training standards for radiation oncology residency programs.

  4. Motivation, amount of interaction, length of residence and ESL learners’ pragmatic competence

    Directory of Open Access Journals (Sweden)

    Zohre R Eslami

    2014-01-01

    Full Text Available This study examined how motivation for learning English, the amount of contact with English, and length of residence in the target language area affects Korean graduate students’ English pragmatic skills. The study attempted to account for differential pragmatic development among 50 graduate-level Korean students in relation to individual factors mentioned above. The data were collected using three types of elicitation instruments: a written background questionnaire, a discourse completion test, and the mini-Attitude/Motivation Test Battery. Descriptive and inferential statistics (correlation coefficients, and multiple regressions were used to analyze the data. The findings of the study revealed that (a the level of motivation had a positive and moderate relationship with the ESL learners’ L2 pragmatic competence and (b the amount of L2 contact and length of residence had only a weak and insignificant impact on the participants’ pragmatic competence.

  5. Description of a developmental criterion-referenced assessment for promoting competence in internal medicine residents.

    Science.gov (United States)

    Varney, Andrew; Todd, Christine; Hingle, Susan; Clark, Michael

    2009-09-01

    End-of- rotation global evaluations can be subjective, produce inflated grades, lack interrater reliability, and offer information that lacks value. This article outlines the generation of a unique developmental criterion-referenced assessment that applies adult learning theory and the learner, manager, teacher model, and represents an innovative application to the American Board of Internal Medicine (ABIM) 9-point scale. We describe the process used by Southern Illinois University School of Medicine to develop rotation-specific, criterion-based evaluation anchors that evolved into an effective faculty development exercise. The intervention gave faculty a clearer understanding of the 6 Accreditation Council for Graduate Medical Education competencies, each rotation's educational goals, and how rotation design affects meaningful work-based assessment. We also describe easily attainable successes in evaluation design and pitfalls that other institutions may be able to avoid. Shifting the evaluation emphasis on the residents' development of competence has made the expectations of rotation faculty more transparent, has facilitated conversations between program director and residents, and has improved the specificity of the tool for feedback. Our findings showed the new approach reduced grade inflation compared with the ABIM end-of-rotation global evaluation form. We offer the new developmental criterion-referenced assessment as a unique application of the competences to the ABIM 9-point scale as a transferable model for improving the validity and reliability of resident evaluations across graduate medical education programs.

  6. 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.

  7. 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.

  8. 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

  9. Competencies Used to Evaluate High School Coaches.

    Science.gov (United States)

    Gratto, John

    1983-01-01

    Studies of how to evaluate high school coaches' effectiveness found that most respondents felt that principals, athletic directors, and coaches should jointly arrive at a method of evaluation. Coaching competencies rated most highly included prevention and care of athletic injuries, supervision, and consistent discipline. Other valued competencies…

  10. 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.

  11. Innovative web-based multimedia curriculum improves cardiac examination competency of residents.

    Science.gov (United States)

    Criley, Jasminka M; Keiner, Jennifer; Boker, John R; Criley, Stuart R; Warde, Carole M

    2008-03-01

    Proper diagnosis of cardiac disorders is a core competency of internists. Yet numerous studies have documented that the cardiac examination (CE) skills of physicians have declined compared with those of previous generations of physicians, attributed variously to inadequate exposure to cardiac patients and lack of skilled bedside teaching. With growing concerns about ensuring patient safety and quality of care, public and professional organizations are calling for a renewed emphasis on the teaching and evaluation of clinical skills in residency training. The objective of the study was to determine whether Web training improves CE competency, whether residents retain what they learn, and whether a Web-based curriculum plus clinical training is better than clinical training alone. Journal of Hospital Medicine 2008;3:124-133. (c) 2008 Society of Hospital Medicine. This was a controlled intervention study. The intervention group (34 internal and family medicine interns) participated in self-directed use of a Web-based tutorial and three 1-hour teaching sessions taught by a hospitalist. Twenty-five interns from the prior year served as controls. We assessed overall CE competency and 4 subcategories of CE competency: knowledge, audio skills, visual skills, and audio-visual integration. The over mean score of the intervention group significantly improved, from 54 to 66 (P = .002). This improvement was retained (63.5, P = .05). When compared with end-of-year controls, the intervention group had significantly higher end-of-year CE scores (57 vs. 63.5, P = .05), knowledge (P = .04), and audio skills (P = .01). At the end of the academic year, all improvements were retained (P better than clinical training alone. (c) 2008 Society of Hospital Medicine.

  12. [What and how to evaluate clinical-surgical competence. The resident and staff surgeon perspective].

    Science.gov (United States)

    Cervantes-Sánchez, Carlos Roberto; Chávez-Vizcarra, Paola; Barragán-Ávila, María Cristina; Parra-Acosta, Haydee; Herrera-Mendoza, Renzo Eduardo

    2016-01-01

    Evaluation is a means for significant and rigorous improvement of the educational process. Therefore, competence evaluation should allow assessing the complex activity of medical care, as well as improving the training process. This is the case in the evaluation process of clinical-surgical competences. A cross-sectional study was designed to measure knowledge about the evaluation of clinical-surgical competences for the General Surgery residency program at the Faculty of Medicine, Universidad Autónoma de Chihuahua (UACH). A 55-item questionnaire divided into six sections was used (perception, planning, practice, function, instruments and strategies, and overall evaluation), with a six level Likert scale, performing a descriptive, correlation and comparative analysis, with a significance level of 0.001. In both groups perception of evaluation was considered as a further qualification. As regards tools, the best known was the written examination. As regards function, evaluation was considered as a further administrative requirement. In the correlation analysis, evaluation was perceived as qualification and was significantly associated with measurement, assessment and accreditation. In the comparative analysis between residents and staff surgeons, a significant difference was found as regards the perception of the evaluation as a measurement of knowledge (Student t test: p=0.04). The results provide information about the concept we have about the evaluation of clinical-surgical competences, considering it as a measure of learning achievement for a socially required certification. There is confusion as regards the perception of evaluation, its function, goals and scopes as benefit for those evaluated. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  13. Socialization of Perceived Academic Competence among Highly Competent Children.

    Science.gov (United States)

    Phillips, Deborah A.

    1987-01-01

    Academically competent third-graders and their parents were studied to (1) determine whether the illusion of incompetence documented in fifth graders appears in younger children; and (2) examine the influence that parents exert on their children's development of self-perceptions of academic competence. (PCB)

  14. The use of standardized patients in the plastic surgery residency curriculum: teaching core competencies with objective structured clinical examinations.

    Science.gov (United States)

    Davis, Drew; Lee, Gordon

    2011-07-01

    As of 2006, the Accreditation Council for Graduate Medical Education had defined six "core competencies" of residency education: interpersonal communication skills, medical knowledge, patient care, professionalism, practice-based learning and improvement, and systems-based practice. Objective structured clinical examinations using standardized patients are becoming effective educational tools, and the authors developed a novel use of the examinations in plastic surgery residency education that assesses all six competencies. Six plastic surgery residents, two each from postgraduate years 4, 5, and 6, participated in the plastic surgery-specific objective structured clinical examination that focused on melanoma. The examination included a 30-minute videotaped encounter with a standardized patient actor and a postencounter written exercise. The residents were scored on their performance in all six core competencies by the standardized patients and faculty experts on a three-point scale (1 = novice, 2 = moderately skilled, and 3 = proficient). Resident performance was averaged for each postgraduate year, stratified according to core competency, and scored from a total of 100 percent. Residents overall scored well in interpersonal communications skills (84 percent), patient care (83 percent), professionalism (86 percent), and practice-based learning (84 percent). Scores in medical knowledge showed a positive correlation with level of training (86 percent). All residents scored comparatively lower in systems-based practice (65 percent). The residents reported unanimously that the objective structured clinical examination was realistic and educational. The objective structured clinical examination provided comprehensive and meaningful feedback and identified areas of strengths and weakness for the residents and for the teaching program. The examination is an effective assessment tool for the core competencies and a valuable adjunct to residency training.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Incorporating cultural competency into the general surgery residency curriculum: a preliminary assessment.

    Science.gov (United States)

    Chun, Maria B J; Young, Keane G M; Jackson, David S

    2009-08-01

    In response to the growing diversity of the United States population and concerns with health disparities, formal training in cross-cultural care has become mandatory for all medical specialties, including surgery. The aim of this study was to assess the readiness of a general surgery residency program to incorporate cultural competency initiatives into its curriculum. Eighteen surgical teaching faculty (at a community-based hospital with a university affiliation) voluntarily participated in a qualitative study to share their views on cultural competency and to discuss ways that it could potentially be incorporated into the curriculum. Reflective of current definitions of cultural competency, faculty viewed the term culture broadly (i.e., beyond race and ethnicity). Suggested instructional methods varied, with some noting that exposure to different cultures was helpful. Others stated the importance of faculty serving as role models. Most faculty in this study appear open to cultural training, but desire a clear understanding of what that would entail and how it can be taught. They also acknowledged the lack of time to address cultural issues. Taking into consideration these and other concerns, planned curricular interventions are also presented.

  17. Resident learning across the full range of core competencies through a transitions of care curriculum.

    Science.gov (United States)

    Pavon, Juliessa M; Pinheiro, Sandro O; Buhr, Gwendolen T

    2018-01-01

    The authors developed a Transitions of Care (TOC) curriculum to teach and measure learner competence in performing TOC tasks for older adults. Internal medicine interns at an academic residency program received the curriculum, which consisted of experiential learning, self-study, and small group discussion. Interns completed retrospective pre/post surveys rating their confidence in performing five TOC tasks, qualitative open-ended survey questions, and a self-reflection essay. A subset of interns also completed follow-up assessments. For all five TOC tasks, the interns' confidence improved following completion of the TOC curriculum. Self-confidence persisted for up to 3 months later for some but not all tasks. According to the qualitative responses, the TOC curriculum provided interns with learning experiences and skills integral to performing safe care transitions. The TOC curriculum and a mixed-method assessment approach effectively teaches and measures learner competency in TOC across all six Accreditation Council for Graduate Medical Education competency domains.

  18. How Do Emergency Medicine Residency Programs Structure Their Clinical Competency Committees? A Survey.

    Science.gov (United States)

    Doty, Christopher I; Roppolo, Lynn P; Asher, Shellie; Seamon, Jason P; Bhat, Rahul; Taft, Stephanie; Graham, Autumn; Willis, James

    2015-11-01

    The Accreditation Council for Graduate Medical Education (ACGME) recently has mandated the formation of a clinical competency committee (CCC) to evaluate residents across the newly defined milestone continuum. The ACGME has been nonproscriptive of how these CCCs are to be structured in order to provide flexibility to the programs. No best practices for the formation of CCCs currently exist. We seek to determine common structures of CCCs recently formed in the Council of Emergency Medicine Residency Directors (CORD) member programs and identify unique structures that have been developed. In this descriptive study, an 18-question survey was distributed via the CORD listserv in the late fall of 2013. Each member program was asked questions about the structure of its CCC. These responses were analyzed with simple descriptive statistics. A total of 116 of the 160 programs responded, giving a 73% response rate. Of responders, most (71.6%) CCCs are chaired by the associate or assistant program director, while a small number (14.7%) are chaired by a core faculty member. Program directors (PDs) chair 12.1% of CCCs. Most CCCs are attended by the PD (85.3%) and selected core faculty members (78.5%), leaving the remaining committees attended by any core faculty. Voting members of the CCC consist of the residency leadership either with the PD (53.9%) or without the PD (36.5%) as a voting member. CCCs have an average attendance of 7.4 members with a range of three to 15 members. Of respondents, 53.1% of CCCs meet quarterly while 37% meet monthly. The majority of programs (76.4%) report a system to match residents with a faculty mentor or advisor. Of respondents, 36% include the resident's faculty mentor or advisor to discuss a particular resident. Milestone summaries (determination of level for each milestone) are the primary focus of discussion (93.8%), utilizing multiple sources of information. The substantial variability and diversity found in our CORD survey of CCC structure

  19. 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

  20. 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.

  1. Addressing Professionalism, Social, and Communication Competencies in Surgical Residency Via Integrated Humanities Workshops: A Pilot Curriculum.

    Science.gov (United States)

    Colvin, Jennifer; French, Judith; Siperstein, Allan; Capizzani, Tony R; Krishnamurthy, Vikram D

    We aimed to conduct professionalism and social competencies (PSC) training by integrating humanities into structured workshops, and to assess reception of this curriculum by first-year surgical residents. An IRB-approved, pilot curriculum consisting of 4 interactive workshops for surgical interns was developed. The workshops were scheduled quarterly, often in small group format, and supplemental readings were assigned. Humanities media utilized to illustrate PSC included survival scenarios, reflective writing, television portrayals, and social media. Emphasis was placed on recognizing personal values and experiences that influence judgment and decision-making, using social media responsibly, identifying and overcoming communication barriers related to generational changes in training (especially technology and work-life balance), and tackling stereotypes of surgeons. Anonymous and voluntary pre- and postcurriculum surveys were administered. Univariate analysis of responses was performed with JMP Pro v12 using Fisher's exact, χ 2 , and Students' t-tests for categorical and continuous variables. The study took place at the Cleveland Clinic in Cleveland, OH, within the general surgery program. Surgical interns at the Cleveland Clinic were included in the study. A total of 16 surgical interns completed the curriculum. Sixteen surgical interns participated in the curriculum: 69% were domestic medical school graduates (DG) and 31% were international medical school graduates (IMG). Overall, the majority (81%) of residents had received PSC courses during medical school: 100% of DG compared to 40% of IMG (p = 0.02). Before beginning the curriculum, 86% responded that additional PSC training would be useful during residency, which increased to 94% upon completion (p = 0.58). Mean number of responses supporting the usefulness of PSC training increased from 1.5 ± 0.2 before the curriculum to 1.75 ± 0.2 upon completion (p = 0.4). When describing public and medical student

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

    Directory of Open Access Journals (Sweden)

    Eusang Ahn

    2016-12-01

    Full Text Available 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.

  3. 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.

  4. What Shape is Your Resident in? Using a Radar Plot to Guide a Milestone Clinical Competency Discussion.

    Science.gov (United States)

    Harrington, David T; Miner, Thomas J; Ng, Thomas; Charpentier, Kevin P; Richardson, Pam; Cioffi, William G

    2015-01-01

    One of the challenges for program directors (PDs) is to sort and weight the tidal wave of assessments that training programs create in the modern Milestone era. We evaluated whether the use of a radar plot (RP) would be helpful in sorting data and providing a graphic representation of each resident's progress. Using at least 2 different types of assessments for each of the 16 surgical Milestones, the data were ranked and weighted by a predetermined method embedded in a computerized workbook (Excel). This process created a unique 16-spoked RP for each resident (Fig. below). The RP allowed the faculty to see areas of weakness (shown by concavity) and allowed an overall grade calculated as a ratio of the area of the smooth outer circle (faculty expectations, triangles) and the resident's unique radar shape (resident performance, squares). To help us validate our new tool, we looked at whether residents with recent remedial issues "looked" different from residents without remedial issues. Of our 30 categorical residents, 8 had significant areas of concavities, suggesting possible areas of improvement. Of these 8 residents, 4 had been on a remediation program in the last 18 months. The average ratio of performance/expectations was 0.709. The 4 residents on recent remediation had a ratio of 0.616 when compared with 0.723 for the residents without remedial issues (p < 0.009). Many exciting challenges await PDs, as we evolve to a competency-based evaluation system. The use of an evaluation summary tool using RPs may aid PDs in leading clinical competency discussions and in monitoring a resident's progress over time. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Simulation for Teaching Orthopaedic Residents in a Competency-based Curriculum: Do the Benefits Justify the Increased Costs?

    Science.gov (United States)

    Nousiainen, Markku T; McQueen, Sydney A; Ferguson, Peter; Alman, Benjamin; Kraemer, William; Safir, Oleg; Reznick, Richard; Sonnadara, Ranil

    2016-04-01

    Although simulation-based training is becoming widespread in surgical education and research supports its use, one major limitation is cost. Until now, little has been published on the costs of simulation in residency training. At the University of Toronto, a novel competency-based curriculum in orthopaedic surgery has been implemented for training selected residents, which makes extensive use of simulation. Despite the benefits of this intensive approach to simulation, there is a need to consider its financial implications and demands on faculty time. This study presents a cost and faculty work-hours analysis of implementing simulation as a teaching and evaluation tool in the University of Toronto's novel competency-based curriculum program compared with the historic costs of using simulation in the residency training program. All invoices for simulation training were reviewed to determine the financial costs before and after implementation of the competency-based curriculum. Invoice items included costs for cadavers, artificial models, skills laboratory labor, associated materials, and standardized patients. Costs related to the surgical skills laboratory rental fees and orthopaedic implants were waived as a result of special arrangements with the skills laboratory and implant vendors. Although faculty time was not reimbursed, faculty hours dedicated to simulation were also evaluated. The academic year of 2008 to 2009 was chosen to represent an academic year that preceded the introduction of the competency-based curriculum. During this year, 12 residents used simulation for teaching. The academic year of 2010 to 2011 was chosen to represent an academic year when the competency-based curriculum training program was functioning parallel but separate from the regular stream of training. In this year, six residents used simulation for teaching and assessment. The academic year of 2012 to 2013 was chosen to represent an academic year when simulation was used equally

  6. Validation of the behavior and concept based assessment of professionalism competence in postgraduate first-year residents

    Directory of Open Access Journals (Sweden)

    Ying-Ying Yang

    2013-04-01

    Conclusion: The current study suggests that the p-OSCE, p-360° evaluation, and p-mini-CEX are feasible methods for evaluating professionalism in clinical training of PGY1 residents. Combination of the above three evaluations, participation, and support from multiple constituencies and multiple representatives provides good reliability and adds credibility in the assessment of professionalism competence.

  7. [Professional competence of the graduates of the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise'].

    Science.gov (United States)

    Kovalev, A V; Romanenko, G Kh; Makarov, I Yu; Zharov, V V; Bereznikov, A V

    The objective of the present study was the definition of the basic professional competences of the graduates of the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise'. The program for the acquirement of the basic knowledge, skills, and professional competences needed to be trained in the speciality 31.08.10 'forensic medical expertise' has been elaborated in the framework of the more extensive program for the clinical residency and internship intended for the training of the highly qualified specialists in this discipline. The preliminary list of basic professional competences of a graduate from the clinical residency and internship has been formulated in accordance with the program for the training of a competitive and highly qualified forensic medical experts. The practical professional activities are considered to be an indispensable component of the training and educational process for a future forensic medical expert. It is believed that the strengthening of this training component will greatly contribute to the improvement of the quality of training of such specialists.

  8. Towards a concept of Communicative Competence in Health: a qualitative study in medical residents

    Directory of Open Access Journals (Sweden)

    Rodolfo A. Cabrales

    2015-06-01

    Full Text Available Despite the wealth of literature surrounding the importance of effective communication in the clinical practice, there is a dearth of consensus in the literature on what communicative competence in health (CCH is, and the practices of meaningful health communication. Seventeen residents (17 were invited to share their thoughts on the concept of communicative competence in health and on difficulties they encounter during their clinical practice related with communication. The aim of this study was to gain a better understanding of CCH with emphasis on the implications in the medical curriculum, teaching, learning and assessment. Three focus group discussions were conducted with the clinical supervisor. The results were audio-taped, transcribed verbatim and analyzed using principles from grounded theory for qualitative data analysis. The 135 open codes and defined axial codes were discussed and a number of conceptual frameworks were utilized to disentangle the concept of CCH. The focus group themes related to the concept of communication in health, its importance and difficulties, the role of the physician and health personnel. The participants felt their own training did not prepare them to establish effective communication with patients and relatives. Some barriers include lack of time and lack of institutional priority given to communication issues. The techniques originating from grounded theory permitted to define a broader concept of CCH with the following three specific scopes: biological perspective (objective world, social (social world and subjective world (expressive-aesthetic. This new concept of CCH is central to understanding how the health communication process occurs, where a myriad of individual (physician, patient, staff, relatives, organizational and societal interrelated factors influence health decisions and practice. These components need to be addressed by medicine schools, health institutions and other stakeholders in

  9. 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.

  10. 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.

  11. 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

  12. Self-perceived competence among medical residents in skills needed to care for patients with advanced dementia versus metastatic cancer.

    Science.gov (United States)

    Manu, Erika; Marks, Adam; Berkman, Cathy S; Mullan, Patricia; Montagnini, Marcos; Vitale, Caroline A

    2012-06-01

    To examine medical residents' perceived competence in caring for patients with dementia we conducted an online survey of all 120 second, third and fourth-year residents in Internal Medicine, Medicine/Pediatrics, and Family Medicine at University of Michigan. A structured survey elicited residents' training, experience, confidence, and perceived career needs for skills in estimating prognosis, symptom management, and communication in caring for patients with dementia, compared to patients with metastatic cancer. Among the 61 (51 %) respondents, a majority report lower confidence in assessing prognosis and eliciting treatment wishes in patients with dementia (vs. metastatic cancer), and in performing skills integral to the care of patients with dementia, including the ability to assess caregiver needs, decisional capacity, advise on place of care, and manage agitation, despite viewing these skills as important to their future careers. These findings support the need for enhanced education on optimal care of patients with advanced dementia.

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

    International Nuclear Information System (INIS)

    Jippes, Erik; Engelen, Jo M.L. van; Brand, Paul L.P.; Oudkerk, Matthijs

    2010-01-01

    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.)

  14. High-Impact Practices for Cultural Competency

    Science.gov (United States)

    Talbani, Aziz

    2013-01-01

    The world has closely-knitted economic, social, and cultural relations that offer greater entrepreneurial and professional opportunities than ever before. Students in the 21st century global society will live and work in a rapidly changing social, economic, and political world; they will require global cultural competencies to be successful. Study…

  15. Assessing the New Competencies for Resident Education: A Model from an Emergency Medicine Program.

    Science.gov (United States)

    Reisdorff, Earl J.; Hayes, Oliver W.; Carlson, Dale J.; Walker, Gregory L.

    2001-01-01

    Based on the experience of Michigan State University's emergency medicine residency program, proposes a practical method for modifying an existing student evaluation format. The model provides a template other programs could use in assessing residents' acquisition of the knowledge, skills, and attitudes reflected in the six general competencies…

  16. Evaluation of clinical teaching quality in competency-based residency training in Lithuania

    Directory of Open Access Journals (Sweden)

    Eglė Vaižgėlienė

    2017-12-01

    Conclusions: Resident evaluations of clinical teachers are influenced by teachers’ age, gender, year of residency training, type of teachers’ academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers educational support and the implementation of e-portfolio.

  17. 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.

  18. Industrial Internship and Entrepreneurship Competencies on Vocational High School Students

    Science.gov (United States)

    Wendi, H. F.; Kusumah, I. H.

    2018-02-01

    The purpose of the research is to explore the influence of internship and vocational skill to student’s entrepreneurship competencies. The research used ex post facto approach. Population in this research is all students of Vocational High School in Bandung, Indonesia. The sample of 40 respondents was determined by proportional random sampling technique. The data were collected by instrument questionnaire and test. Data analysis used descriptive statistics and multiple linear regression. The results show that almost half students have a low the competencies of an entrepreneur. The hypothesis testing shows many the influence of factory teaching has a positive and significant effect on the competencies of an entrepreneur. Similarly, vocational skills have positive influence and significant on the competencies of an entrepreneur. Respectively, the influence of factory teaching and vocational skills expertise collectively have the effect on the competencies of an entrepreneur. Therefore, the influence of factory teaching and vocational skills are effective to student’s entrepreneurship cap competencies.

  19. A Study Identifying and Validating Competencies Needed for Mid-Managers That Work in Housing and Residence Life at Colleges and Universities in the United States of America

    Science.gov (United States)

    Morrison, Hassel Andre

    2016-01-01

    The researcher identified a gap in the knowledge of competencies needed for midmanagers that work in housing and residence life at the southeast colleges and universities in the United States. The purpose of this study was to identify and develop a consensus on competencies needed by mid-managers. The review of the literature describes and…

  20. Why wait until residency? Competency-based education in longitudinal integrated clerkships.

    Science.gov (United States)

    Gentles, John Quinn

    2017-02-01

    This essay was selected as the winner of the 2015 Canadian Undergraduate Surgical Education Committee student essay competition. It was written in response to the prompt: "How is your school preparing you for residency - be it surgical or medical?".

  1. Raising the bar for the care of seriously ill patients: results of a national survey to define essential palliative care competencies for medical students and residents.

    Science.gov (United States)

    Schaefer, Kristen G; Chittenden, Eva H; Sullivan, Amy M; Periyakoil, Vyjeyanth S; Morrison, Laura J; Carey, Elise C; Sanchez-Reilly, Sandra; Block, Susan D

    2014-07-01

    Given the shortage of palliative care specialists in the United States, to ensure quality of care for patients with serious, life-threatening illness, generalist-level palliative care competencies need to be defined and taught. The purpose of this study was to define essential competencies for medical students and internal medicine and family medicine (IM/FM) residents through a national survey of palliative care experts. Proposed competencies were derived from existing hospice and palliative medicine fellowship competencies and revised to be developmentally appropriate for students and residents. In spring 2012, the authors administered a Web-based, national cross-sectional survey of palliative care educational experts to assess ratings and rankings of proposed competencies and competency domains. The authors identified 18 comprehensive palliative care competencies for medical students and IM/FM residents, respectively. Over 95% of survey respondents judged the competencies as comprehensive and developmentally appropriate (survey response rate = 72%, 71/98). Using predefined cutoff criteria, experts identified 7 medical student and 13 IM/FM resident competencies as essential. Communication and pain/symptom management were rated as the most critical domains. This national survey of palliative care experts defines comprehensive and essential palliative care competencies for medical students and IM/FM residents that are specific, measurable, and can be used to report educational outcomes; provide a sequence for palliative care curricula in undergraduate and graduate medical education; and highlight the importance of educating medical trainees in communication and pain management. Next steps include seeking input and endorsement from stakeholders in the broader medical education community.

  2. Raising the Bar for the Care of Seriously Ill Patients: Results of a National Survey to Define Essential Palliative Care Competencies for Medical Students and Residents

    Science.gov (United States)

    Schaefer, Kristen G.; Chittenden, Eva H.; Sullivan, Amy M.; Periyakoil, Vyjeyanth S.; Morrison, Laura J.; Carey, Elise C.; Sanchez-Reilly, Sandra; Block, Susan D.

    2014-01-01

    Purpose Given the shortage of palliative care specialists in the U.S., to ensure quality of care for patients with serious, life-threatening illness, generalist-level palliative care competencies need to be defined and taught. The purpose of this study was to define essential competencies for medical students and internal medicine and family medicine (IM/FM) residents through a national survey of palliative care experts. Method Proposed competencies were derived from existing Hospice and Palliative Medicine fellowship competencies, and revised to be developmentally appropriate for students and residents. In spring 2012, the authors administered a web-based, national cross-sectional survey of palliative care educational experts to assess ratings and rankings of proposed competencies and competency domains. Results The authors identified 18 comprehensive palliative care competencies for medical students and IM/FM residents, respectively. Over 95% of survey respondents judged the competencies as comprehensive and developmentally appropriate (survey response rate=72%, 71/98). Using predefined cut-off criteria, experts identified 7 medical student and 13 IM/FM resident competencies as essential. Communication and pain/symptom management were rated as the most critical domains. Conclusions This national survey of palliative care experts defines comprehensive and essential palliative care competencies for medical students and IM/FM residents that are specific, measurable, and can be used to report educational outcomes; provide a sequence for palliative care curricula in undergraduate and graduate medical education; and highlight the importance of educating medical trainees in communication and pain management. Next steps include seeking input and endorsement from stakeholders in the broader medical education community. PMID:24979171

  3. Sendai High Court rejects residents' appeal to nullify gov't permit for Fukushima II-1

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    The Sendai High Court on March 20 rejected an appeal made by 33 residents in Naraha-cho, Fukushima Prefecture, to nullify the government permit for Tokyo Electric Power Co.'s plan to establish Fukushima II Nuclear Power Plant Unit 1 (1,100 MW, BWR) near their homes, upholding the Fukushima District Court's 1984 ruling that the government's examination is adequate to ensure safety of the Unit. The plaintiffs are considering taking the case to the Supreme Court. This is the first ruling on the safety of a nuclear power plant in Japan, after the Chernobyl accident in 1986. Unit 1 is currently in operation. Presiding Judge Yoshio Ishikawa approved almost entirely the government's arguments except that on the competence of the plaintiff. The judgement said that the 33 residents living within the radius of fifty and several kilometers from the reactor facilities have plaintiff competency, because if the safety of the reactor facilities could not be assured, the facilities could possibly present a grave danger to the lives and health of the residents. The ruling said that issuing the reactor installation permit was committed to the government's special technical discretion. (N.K.)

  4. Routine training is not enough: structured training in family planning and abortion improves residents' competency scores and intentions to provide abortion after graduation more than ad hoc training.

    Science.gov (United States)

    Macisaac, Laura; Vickery, Zevidah

    2012-03-01

    Abortion provision remains threatened by the paucity of physicians trained to provide them. Lack of training during residency has been cited by obstetrician and gynecologist (ob-gyn) physicians as a reason for not including abortion in their practice. We administered surveys on interest, competency and intention to provide abortions to two groups of ob-gyn residents: one experiencing a new comprehensive and structured family planning rotation, and another group at our affiliate hospital's residency program receiving "ad hoc" training during their routine gynecology rotations. Surveys were anonymous and blinded to investigator. The structured family planning rotation group compared to the ad hoc group reported significantly increased competency score using a Likert scale in manual vacuum aspiration (MVA) (4.5 vs. 1; p=.003) and had a higher proportion reporting intent to provide office MVA postresidency (100% vs. 39%; p=.01) and being trained to 22.5 weeks' vs. 12 weeks' gestation (p=.005). In bivariate analysis, competency in MVA was associated with higher intentions to provide MVA after residency (p=.007). A structured rotation in family planning and abortion for obstetrics/gynecology residents results in increases in competency and intentions to provide abortion, and an association between the two. In-hospital structured training proved to be superior to ad hoc training in our affiliate institution in improving competency and intention to provide abortion after residency. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies.

    Science.gov (United States)

    Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

    2018-01-01

    Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

  6. Teaching leadership in trauma resuscitation: Immediate feedback from a real-time, competency-based evaluation tool shows long-term improvement in resident performance.

    Science.gov (United States)

    Gregg, Shea C; Heffernan, Daithi S; Connolly, Michael D; Stephen, Andrew H; Leuckel, Stephanie N; Harrington, David T; Machan, Jason T; Adams, Charles A; Cioffi, William G

    2016-10-01

    Limited data exist on how to develop resident leadership and communication skills during actual trauma resuscitations. An evaluation tool was developed to grade senior resident performance as the team leader during full-trauma-team activations. Thirty actions that demonstrated the Accreditation Council for Graduate Medical Education core competencies were graded on a Likert scale of 1 (poor) to 5 (exceptional). These actions were grouped by their respective core competencies on 5 × 7-inch index cards. In Phase 1, baseline performance scores were obtained. In Phase 2, trauma-focused communication in-services were conducted early in the academic year, and immediate, personalized feedback sessions were performed after resuscitations based on the evaluation tool. In Phase 3, residents received only evaluation-based feedback following resuscitations. In Phase 1 (October 2009 to April 2010), 27 evaluations were performed on 10 residents. In Phase 2 (April 2010 to October 2010), 28 evaluations were performed on nine residents. In Phase 3 (October 2010 to January 2012), 44 evaluations were performed on 13 residents. Total scores improved significantly between Phases 1 and 2 (p = 0.003) and remained elevated throughout Phase 3. When analyzing performance by competency, significant improvement between Phases 1 and 2 (p competencies (patient care, knowledge, system-based practice, practice-based learning) with the exception of "communication and professionalism" (p = 0.56). Statistically similar scores were observed between Phases 2 and 3 in all competencies with the exception of "medical knowledge," which showed ongoing significant improvement (p = 0.003). Directed resident feedback sessions utilizing data from a real-time, competency-based evaluation tool have allowed us to improve our residents' abilities to lead trauma resuscitations over a 30-month period. Given pressures to maximize clinical educational opportunities among work-hour constraints, such a model may help

  7. Longitudinal associations of autonomy, relatedness, and competence with the well-being of nursing home residents

    NARCIS (Netherlands)

    Trompetter, H.R.; Bohlmeijer, E.T.; Westerhof, G.J.; Kloos, N.

    2018-01-01

    Background and Objective. As proposed by the self-determination theory, satisfying nursing home residents’ needs for autonomy, relatedness, and competence may improve their well-being. This is the first study to test the longitudinal relations of the satisfaction of these three basic psychological

  8. 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…

  9. Modern requirements to the formation of professional competence of neonatologists in residency

    Directory of Open Access Journals (Sweden)

    T.M. Klimenko

    2017-02-01

    Full Text Available The article deals with the problems of training physicians in pediatrics, namely neonatology, in terms of reforms according to the Law of Ukraine “On Higher Education” entered into force in 2014, and the introduction of the new form of specialists’ training — residency.

  10. 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…

  11. Spaced education in medical residents: An electronic intervention to improve competency and retention of medical knowledge.

    Directory of Open Access Journals (Sweden)

    Jason Matos

    Full Text Available Spaced education is a novel method that improves medical education through online repetition of core principles often paired with multiple-choice questions. This model is a proven teaching tool for medical students, but its effect on resident learning is less established. We hypothesized that repetition of key clinical concepts in a "Clinical Pearls" format would improve knowledge retention in medical residents.This study investigated spaced education with particular emphasis on using a novel, email-based reinforcement program, and a randomized, self-matched design, in which residents were quizzed on medical knowledge that was either reinforced or not with electronically-administered spaced education. Both reinforced and non-reinforced knowledge was later tested with four quizzes.Overall, respondents incorrectly answered 395 of 1008 questions (0.39; 95% CI, 0.36-0.42. Incorrect response rates varied by quiz (range 0.34-0.49; p = 0.02, but not significantly by post-graduate year (PGY1 0.44, PGY2 0.33, PGY3 0.38; p = 0.08. Although there was no evidence of benefit among residents (RR = 1.01; 95% CI, 0.83-1.22; p = 0.95, we observed a significantly lower risk of incorrect responses to reinforced material among interns (RR = 0.83, 95% CI, 0.70-0.99, p = 0.04.Overall, repetition of Clinical Pearls did not statistically improve test scores amongst junior and senior residents. However, among interns, repetition of the Clinical Pearls was associated with significantly higher test scores, perhaps reflecting their greater attendance at didactic sessions and engagement with Clinical Pearls. Although the study was limited by a low response rate, we employed test and control questions within the same quiz, limiting the potential for selection bias. Further work is needed to determine the optimal spacing and content load of Clinical Pearls to maximize retention amongst medical residents. This particular protocol of spaced education, however, was unique and

  12. 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.

  13. 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.

  14. 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.

  15. Expectations of clinical teachers and faculty regarding development of the CanMEDS-Family Medicine competencies: Laval developmental benchmarks scale for family medicine residency training.

    Science.gov (United States)

    Lacasse, Miriam; Théorêt, Johanne; Tessier, Sylvie; Arsenault, Louise

    2014-01-01

    The CanMEDS-Family Medicine (CanMEDS-FM) framework defines the expected terminal enabling competencies (EC) for family medicine (FM) residency training in Canada. However, benchmarks throughout the 2-year program are not yet defined. This study aimed to identify expected time frames for achievement of the CanMEDS-FM competencies during FM residency training and create a developmental benchmarks scale for family medicine residency training. This 2011-2012 study followed a Delphi methodology. Selected faculty and clinical teachers identified, via questionnaire, the expected time of EC achievement from beginning of residency to one year in practice (0, 6, 12, […] 36 months). The 15-85th percentile intervals became the expected competency achievement interval. Content validity of the obtained benchmarks was assessed through a second Delphi round. The 1st and 2nd rounds were completed by 33 and 27 respondents, respectively. A developmental benchmarks scale was designed after the 1st round to illustrate expectations regarding achievement of each EC. The 2nd round (content validation) led to minor adjustments (1.9±2.7 months) of intervals for 44 of the 92 competencies, the others remaining unchanged. The Laval Developmental Benchmarks Scale for Family Medicine clarifies expectations regarding achievement of competencies throughout FM training. In a competency-based education system this now allows identification and management of outlying residents, both those excelling and needing remediation. Further research should focus on assessment of the scale reliability after pilot implementation in family medicine clinical teaching units at Laval University, and corroborate the established timeline in other sites.

  16. High School Physical Sciences Teachers' Competence in Some ...

    African Journals Online (AJOL)

    Teachers' lack of competence in cognitive skills and strategies would be an important limiting factor in the successful implementation of the Physical Sciences curriculum. An urgent need ... Keywords: Cognitive skills, thinking skills, questions testing skills, problem solving, teacher training, high school physical science ...

  17. Health. Nevada Competency-Based Adult High School Diploma Project.

    Science.gov (United States)

    Nevada Univ., Las Vegas. Coll. of Education.

    This document is one of ten curriculum guides developed by the Nevada Competency-Based Adult High School Diploma (CBAHSD) Project. This curriculum guide on health is divided into ten topics. The topics included are Nutrition, Reproduction, Menstruation, Contraception, Alcohol Abuse, Tobacco, Immunization, Disease, Accident Prevention, and…

  18. Dermatology discharge continuity clinic enhances resident autonomy and insight into transitions-of-care competencies: a cross-sectional survey study.

    Science.gov (United States)

    Rana, Jasmine; Mostaghimi, Arash

    2017-05-15

    Dermatology residents perform consults on hospitalized patients, but are often limited in their ability to follow-up with these patients after discharge, leading to inadequate follow-up and understanding of post-discharge transitions of care. In 2013, a discharge continuity clinic (DCC) staffed by the inpatient consult dermatology resident and attending dermatologist was established at one of the four adult hospital sites residents rotate through in the Harvard Combined Dermatology Residency Program. Resident perceptions about the DCC and their educational experience on inpatient consult rotations with a DCC and without a DCC were obtained using a cross-sectional survey instrument in June 2016. Self-reported data from a multi-year cohort of dermatology residents (n = 14 of 20, 70% response rate) reveals that the DCC enabled resident autonomy and resident satisfaction in care of their patients,insight into the disease-related challenges and the broader social context during transitions of care from inpatient to outpatient settings, and more enriching learning experiences than inpatient consult rotations without a DCC. Dermatology residents self-report participation in an inpatient consult rotation with aDCC supports their autonomy and achievement of post-discharge transitions-of-care competencies.

  19. Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies

    Directory of Open Access Journals (Sweden)

    Waterbrook AL

    2018-05-01

    Full Text Available Anna L Waterbrook,1 Karen C Spear Ellinwood,2 T Gail Pritchard,3 Karen Bertels,1 Ariel C Johnson,4 Alice Min,1 Lisa R Stoneking1 1Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA; 2Department of Obstetrics and Gynecology, The University of Arizona College of Medicine, Tucson, AZ, USA; 3Department of Pediatrics, The University of Arizona College of Medicine, Tucson, AZ, USA; 4College of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management are challenging for a supervising emergency medicine (EM physician to evaluate in real-time on shift while also managing a busy emergency department (ED. This study examines residents’ perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills.Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones.Results: Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2. Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received

  20. Exploring Staff Clinical Knowledge and Practice with LGBT Residents in Long-Term Care: A Grounded Theory of Cultural Competency and Training Needs.

    Science.gov (United States)

    Donaldson, Weston V; Vacha-Haase, Tammi

    2016-01-01

    Existing literature shows that LGBT residents are likely to face suboptimal care in LTC facilities due to prejudice and discriminatory policies. The aim of this project was to assess the LGBT cultural competency of staff working in LTC facilities, identify their current training needs, and develop a framework for understanding LGBT cultural competency among LTC staff and providers. This grounded theory study comprised data from focus groups of interdisciplinary staff from three LTC facilities. Results suggested that LTC staff struggle with how to be sensitive to LGBT residents' needs. Tension appeared to exist between wanting to provide an equal standard of care to all LTC residents and fearing they would show "favoritism" or "special treatment," which might be viewed as unprofessional. Participants indicated training could help to address the ambivalence they experience about providing sensitive care to subpopulations of residents who face stigma and oppression. LTC staff stand to benefit from cultural competency training focused on LGBT residents. Training should be not only informational in nature, but also facilitate greater self-awareness and self-efficacy with respect to providing care to LGBT people.

  1. 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.

  2. Increasing STEM Competence in Urban, High Poverty Elementary School Populations

    Directory of Open Access Journals (Sweden)

    Sueanne McKinney

    2017-10-01

    Full Text Available Enhancing STEM competence (e.g., interests, knowledge, skills, and dispositions among urban, high poverty, elementary school populations in the United States (U.S. is and remains a growing national concern, especially since Science, Technology, Engineering and Mathematics (STEM competence is and will continue to be a necessary requisite for gainful employment in the future, according to workforce development experts. In an attempt to address this gap, many urban elementary schools have begun to offer STEM-related programs to increase STEM learning at an early age. STEM competence (interest, knowledge, skills, and dispositions, however, remains low. This paper results in a matrix used to analyze children's fictional literary selections and a model that argues that elementary teachers, as the first point of contact with young students, can affect STEM competence. By adopting a more culturally responsive pedagogy that attends to the 21st Century Learning Skills and the Next Generation Science Standards, teachers can choose literature that serves to excite and reinforce STEM learning.

  3. The impact of residents' training in Electronic Medical Record (EMR) use on their competence: report of a pragmatic trial.

    Science.gov (United States)

    Reis, Shmuel; Sagi, Doron; Eisenberg, Orit; Kuchnir, Yosi; Azuri, Joseph; Shalev, Varda; Ziv, Amitai

    2013-12-01

    Even though Electronic Medical Records (EMRs) are increasingly used in healthcare organizations there is surprisingly little theoretical work or educational programs in this field. This study is aimed at comparing two training programs for doctor-patient-computer communication (DPCC). 36 Family Medicine Residents (FMRs) participated in this study. All FMRs went through twelve identical simulated encounters, six pre and six post training. The experiment group received simulation based training (SBT) while the control group received traditional lecture based training. Performance, attitude and sense of competence of all FMRs improved, but no difference was found between the experiment and control groups. FMRs from the experiment group evaluated the contribution of the training phase higher than control group, and showed higher satisfaction. We assume that the mere exposure to simulation served as a learning experience and enabled deliberate practice that was more powerful than training. Because DPCC is a new field, all participants in such studies, including instructors and raters, should receive basic training of DPCC skills. Simulation enhances DPCC skills. Future studies of this kind should control the exposure to simulation prior to the training phase. Training and assessment of clinical communication should include EMR related skills. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

    Science.gov (United States)

    Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

    2015-03-01

    The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence

  5. [An evaluation of the clinical competence of a population of specialist physicians educated by the medical internship and residency system].

    Science.gov (United States)

    Pujol, R; Busquet, J; Feliu, E; Castellsague, J; Gómez Sáez, J M; Martínez Carretero, J M; Rozman, C

    1995-10-21

    The quality of physicians who have undergone resident official training (MIR) should logically be better than that of the remaining physicians who were not able to enter into this official training. The present study was designed with the aim of verifying this hypothesis. A sample of physicians who underwent the MIR examination in 1982 and who upon passing the same were permitted to initiate the MIR training in 1983 was selected. The group was subdivided into MIR and no MIR and according to the specialty followed. When the physicians were practicing as specialists two types of surveys were carried out with one being by telephone and the other personal in which the personal characteristics, preparation for the MIR test, professional satisfaction and personal motivation were analyzed. The pharmaceutic prescriptions of both groups were analyzed according to indicators of the Servei Català de la Salut (Catalonian Health Service) and the opinion of colleagues of each of the members of each group was evaluated with another questionnaire. The written resolution of hypothetical clinical cases were given to each of the individuals included. A level of global competence defined as a percentage for the following components was identified using: curricular evaluation (10%), professional satisfaction (20%), personal motivation (10%), hypothetical case resolution (35%) and peer opinion (25%). The global competence of the physicians trained under the MIR system was greater than that of the no MIR group (p < 0.01). On analysis by sections the differences of greatest note were observed in the resolution of hypothetical cases (p < 0.0001), curricular evaluation (p < 0.0001) and the quality of pharmaceutical prescription (p < 0.0001). The differences were less of note in comparison of personal motivation (p < 0.02) and professional satisfaction (p < 0.02). No differences were observed in peer opinion. The professional quality of physicians trained by MIR who presented for the 1982

  6. Enhancing pediatric safety: assessing and improving resident competency in life-threatening events with a computer-based interactive resuscitation tool

    International Nuclear Information System (INIS)

    Lerner, Catherine; Gaca, Ana M.; Frush, Donald P.; Ancarana, Anjanette; Hohenhaus, Sue; Seelinger, Terry A.; Frush, Karen

    2009-01-01

    Though rare, allergic reactions occur as a result of administration of low osmolality nonionic iodinated contrast material to pediatric patients. Currently available resuscitation aids are inadequate in guiding radiologists' initial management of such reactions. To compare radiology resident competency with and without a computer-based interactive resuscitation tool in the management of life-threatening events in pediatric patients. The study was approved by the IRB. Radiology residents (n=19; 14 male, 5 female; 19 certified in basic life support/advanced cardiac life support; 1 certified in pediatric advanced life support) were videotaped during two simulated 5-min anaphylaxis scenarios involving 18-month-old and 8-year-old mannequins (order randomized). No advance warning was given. In half of the scenarios, a computer-based interactive resuscitation tool with a response-driven decision tree was available to residents (order randomized). Competency measures included: calling a code, administering oxygen and epinephrine, and correctly dosing epinephrine. Residents performed significantly more essential interventions with the computer-based resuscitation tool than without (72/76 vs. 49/76, P<0.001). Significantly more residents appropriately dosed epinephrine with the tool than without (17/19 vs. 1/19; P<0.001). More residents called a code with the tool than without (17/19 vs. 14/19; P = 0.08). A learning effect was present: average times to call a code, request oxygen, and administer epinephrine were shorter in the second scenario (129 vs. 93 s, P=0.24; 52 vs. 30 s, P<0.001; 152 vs. 82 s, P=0.025, respectively). All the trainees found the resuscitation tool helpful and potentially useful in a true pediatric emergency. A computer-based interactive resuscitation tool significantly improved resident performance in managing pediatric emergencies in the radiology department. (orig.)

  7. The coordination of problem solving strategies: when low competence sources exert more influence on task processing than high competence sources.

    Science.gov (United States)

    Quiamzade, Alain; Mugny, Gabriel; Darnon, Céline

    2009-03-01

    Previous research has shown that low competence sources, compared to highly competent sources, can exert influence in aptitudes tasks in as much as they induce people to focus on the task and to solve it more deeply. Two experiments aimed at testing the coordination between self and source's problem solving strategies as a main explanation of such a difference in influence. The influence of a low versus high competence source has been examined in an anagram task that allows for distinguishing between three response strategies, including one that corresponds to the coordination between the source's strategy and participants' own strategy. In Study 1 the strategy suggested by the source was either relevant and useful or irrelevant and useless for solving the task. Results indicated that participants used the coordination strategy in a larger extend when they had been confronted to a low competence rather than a highly competent source but only when the source displayed a strategy that was useful to solve the task. In Study 2 the source's strategy was always relevant and useful, but a decentring procedure was introduced for half of the participants. This procedure induced participants to consider other points of view than their own. Results replicated the difference observed in Study 1 when no decentring was introduced. The difference however disappeared when decentring was induced, because of an increase of the high competence source's influence. These results highlight coordination of strategies as one mechanism underlying influence from low competence sources.

  8. Changes in Perceived Supervision Quality After Introduction of Competency-Based Orthopedic Residency Training: A National 6-Year Follow-Up Study.

    Science.gov (United States)

    van Vendeloo, Stefan N; Brand, Paul L P; Kollen, Boudewijn J; Verheyen, Cees C P M

    2018-04-27

    To evaluate the perceived quality of the learning environment, before and after introduction of competency-based postgraduate orthopedic education. From 2009 to 2014, we conducted annual surveys among Dutch orthopedic residents. The validated Dutch Residency Educational Climate Test (D-RECT, 50 items on 11 subscales) was used to assess the quality of the learning environment. Scores range from 1 (poor) to 5 (excellent). Dynamic cohort follow-up study. All Dutch orthopedic residents were surveyed during annual compulsory courses. Over the 6-year period, 641 responses were obtained (response rate 92%). Scores for "supervision" (95% CI for difference 0.06-0.28, p = 0.002) and "coaching and assessment" (95% CI 0.11-0.35, p < 0.001) improved significantly after introduction of competency-based training. There was no significant change in score on the other subscales of the D-RECT. After the introduction of some of the core components of competency-based postgraduate orthopedic education the perceived quality of "supervision" and "coaching and assessment" improved significantly. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. 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

  10. How do clinical competency committees use different sources of data to assess residents' performance on the internal medicine milestones?A mixed methods pilot study.

    Science.gov (United States)

    Ekpenyong, Andem; Baker, Elizabeth; Harris, Ilene; Tekian, Ara; Abrams, Richard; Reddy, Shalini; Park, Yoon Soo

    2017-10-01

    This study examines how Clinical Competency Committees (CCCs) synthesize assessment data to make judgments about residents' clinical performances. Between 2014 and 2015, after four six-month reporting periods to the Accreditation Council for Graduate Medical Education (ACGME), 7 of 16 CCC faculty at Rush University Medical Center completed questionnaires focused on their perspectives about rating residents on their achievement of the milestones and participated in a focus group. Qualitative data were analyzed using grounded theory. Milestones ratings for two six-month ACGME reporting cycles (n = 100 categorical residents) were also analyzed. CCC members weighted resident rotation ratings highest (weight = 37%), followed by faculty rotation comments (weight = 27%) and personal experience with residents (weight = 14%) for making judgments about learner's milestone levels. Three assessment issues were identified from qualitative analyses: (1) "design issues" (e.g. problems with available data or lack thereof); (2) "synthesis issues" (e.g. factors influencing ratings and decision-making processes) and (3) "impact issues" (e.g. how CCC generated milestones ratings are used). Identifying factors that affect assessment at all stages of the CCC process can contribute to improving assessment systems, including support for faculty development for CCCs. Recognizing challenges in synthesizing first and second-hand assessment data is an important step in understanding the CCC decision-making process.

  11. Star River, A Champion of High-end Residence

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Star River(or Star Bay), an elite works of Hong Yu Group, is located in Sijixinghe Road, Chaoyang District, Beijing. It is a distinguished residence area, occupying land of 300 thousand sq.meters. The north side is a forest garden with 1600 or more mu, the eastern side is a green belt with more than 2000 mu.

  12. Fifth-year internal medicine residents in Spain: A survey on education, assessment of competencies and job perspectives.

    Science.gov (United States)

    Macía-Rodríguez, C; López Reboiro, M L; Martín Iglesias, D; González-Munera, A; Moreno Diaz, J; Montaño Martínez, A; Ortiz Llauradó, G; Demelo-Rodríguez, P; Muñoz Muñoz, C; Salgado Ordoñez, F

    2018-06-14

    Specialist training is based on the gradual acquisition of expertise, skills and responsibilities. The aim of this study is to determine the opinion of residents regarding their training. This was a cross-sectional descriptive study based on an online survey of 5th-year residents during February and March 2017. A total of 194 residents (62.8% of the total) responded to the survey, 62.9% of whom were women and 50% of whom were younger than 30years, representing hospitals from all levels and from the 17 autonomous communities. More than 80% of the residents choose the specialty once again and believed that the duration of the residence was appropriate; however, 76.3% would eliminate some of their rotations. Most of the residents did not know the objectives of each rotation, and 37.1% felt they were not adequately supervised. Some 82.5% would change the evaluation system, and 68.0% would favour performing an excellence test. Most of the residents had published at least one article or performed one presentation at a congress; however, only 27.8% had completed a doctoral thesis. Although 74.7% of the internists believed they would find employment, only 28.4% had an offer 1month after completing their residence. The residents are satisfied with their training, although there is still a deficit in supervision and dissatisfaction with the method of assessing their knowledge and the precarious job market during the first year for specialists. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  13. Pretraining and posttraining assessment of residents' performance in the fourth accreditation council for graduate medical education competency: patient communication skills.

    Science.gov (United States)

    Chandawarkar, Rajiv Y; Ruscher, Kimberly A; Krajewski, Aleksandra; Garg, Manish; Pfeiffer, Carol; Singh, Rekha; Longo, Walter E; Kozol, Robert A; Lesnikoski, Beth; Nadkarni, Prakash

    2011-08-01

    Structured communication curricula will improve surgical residents' ability to communicate effectively with patients. A prospective study approved by the institutional review board involved 44 University of Connecticut general surgery residents. Residents initially completed a written baseline survey to assess general communication skills awareness. In step 1 of the study, residents were randomized to 1 of 2 simulations using standardized patient instructors to mimic patients receiving a diagnosis of either breast or rectal cancer. The standardized patient instructors scored residents' communication skills using a case-specific content checklist and Master Interview Rating Scale. In step 2 of the study, residents attended a 3-part interactive program that comprised (1) principles of patient communication; (2) experiences of a surgeon (role as physician, patient, and patient's spouse); and (3) role-playing (3-resident groups played patient, physician, and observer roles and rated their own performance). In step 3, residents were retested as in step 1, using a crossover case design. Scores were analyzed using Wilcoxon signed rank test with a Bonferroni correction. Case-specific performance improved significantly, from a pretest content checklist median score of 8.5 (65%) to a posttest median of 11.0 (84%) (P = .005 by Wilcoxon signed rank test for paired ordinal data)(n = 44). Median Master Interview Rating Scale scores changed from 58.0 before testing (P = .10) to 61.5 after testing (P = .94). Difference between overall rectal cancer scores and breast cancer scores also were not significant. Patient communication skills need to be taught as part of residency training. With limited training, case-specific skills (herein, involving patients with cancer) are likely to improve more than general communication skills.

  14. Preparing Secondary Stem Teachers for High-Need Schools: Challenges of an Urban Residency Program

    Science.gov (United States)

    Garza, Rubén; Duchaine, Ellen L.; Reynosa, Raymond

    2013-01-01

    Teaching residency programs that blend coursework with clinical experiences have emerged nationwide to prepare aspiring teachers for the demanding reality of teaching in high-need urban schools. The Teaching Residency Program for Critical Shortage Areas was created to help urban school districts with the challenge of recruiting and retaining…

  15. 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.

  16. 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.

  17. Analysis of ICT Literacy Competence among Vocational High School Teachers

    Science.gov (United States)

    Nurhabibah; Setiawan, A.; Yanti, H.; Miraj, Y. Z.; Yannuar

    2018-02-01

    To realize learning quality in Vocational Secondary School, and to achieve educational goal, teacher competence is needed. The application of ICT Literacy in vocational secondary school is intended to upgrade teachers’ knowledge, skill and competence in ICT. This paper is aimed to describe the process of teachers’ competence adaptation to ICT integrity in learning in Vocational Secondary School. This study use descriptive method with literature study and documentation technique. The source in this study is research journal and research report book. The study result showed that teachers lack of self-confident in using ICT, and gender factor influence ICT integration in which the level of ICT literacy in male is higher than female. The group of young teachers aged 21-40 have higher level of ICT literacy compared with the older group. Demographic factor in ICT literacy competence are gender, education level and age. This study suggest that teachers enhance the ability in ICT literacy competence, increase their knowledge and knowledge creation in each aspect of ICT literacy competence.

  18. 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

  19. Competency of Psychiatric Residents in the Treatment of People with Severe Mental Illness before and after a Community Psychiatry Rotation

    Science.gov (United States)

    Randall, Melinda; Romero-Gonzalez, Mauricio; Gonzalez, Gerardo; Klee, Anne; Kirwin, Paul

    2011-01-01

    Objective: Psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency…

  20. 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

  1. Physical fitness in children with high motor competence is different from that in children with low motor competence.

    Science.gov (United States)

    Haga, Monika

    2009-10-01

    Physical therapists often treat children with low motor competence. Earlier studies have demonstrated poor physical fitness outcomes and a reduced level of physical activity for these children compared with their peers with normal motor skills. The aim of this study was to examine how physical fitness developed over time in 2 groups of children: those with a low level of competence in motor skills (low motor competence [LMC]), and those with a high level of competence in motor skills (high motor competence [HMC]). From an initial sample of 67 children, a group of 18 was identified as having HMC or LMC on the Movement Assessment Battery for Children and was selected for the present study. Eight children (3 girls and 5 boys) comprised the LMC group, and 10 children (4 girls and 6 boys) made up the HMC group. A longitudinal design was implemented, and physical fitness in the 2 groups was evaluated by measuring different fitness components over a period of 32 months. A mixed-effects analysis of variance revealed significant main effects for group and for time but no group x time interaction effect. The LMC group performed less well on all physical fitness measures than the HMC group, and both groups scored significantly higher on the physical fitness test after a period of 32 months. The lack of a significant interaction effect indicated that the relative differences in physical fitness outcomes between the groups were relatively constant over time. This study was limited by the small sample size and lack of assessment of anthropometric variables and children's perceived self-efficacy. Children with LMC are likely to have poor physical fitness compared with children with HMC. The differences in physical fitness outcomes between the groups were relatively constant over time. Given that various physical fitness components are linked to different health outcomes, these consequences are matters of concern for both current health status and later health status in children

  2. High School Physical Sciences Teachers' Competence in Some ...

    African Journals Online (AJOL)

    NICO

    emphasis on critical thinking and reasoning abilities of students, would need teachers who ... of competence in cognitive skills and strategies would be an important limiting factor in ... Cognitive skills, thinking skills, questions testing skills, problem solving, teacher ... strategies to investigate and solve problems in a variety of.

  3. High Level Competence: A Tool for Coping with Organizational Change

    Science.gov (United States)

    Heilmann, Pia

    2007-01-01

    Purpose: The purpose of this paper is to find out and understand the different competence development needs of managers and their ways of learning. The examined managers work in middle management in Finnish information and communication technology sector (ICT) and paper business sector. Design/methodology/approach: The research was qualitative by…

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

    Directory of Open Access Journals (Sweden)

    SEDIGHEH EBRAHIMI

    2015-10-01

    Full Text Available Introduction: 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 selfdirected assessment. This study is an attempt to identify the quality of pediatrics residency educational programs regarding predetermined standards. Methods: 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. Results: 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%. Conclusion: Accreditation is an important step

  5. 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.

  6. Teaching quality: High school students' autonomy and competence.

    Science.gov (United States)

    León, Jaime; Medina-Garrido, Elena; Ortega, Miriam

    2018-05-01

    How teachers manage class learning and interact with students affects students’ motivation and engagement. However, it could be that the effect of students’ representation of teaching quality on the students’ motivation varies between classes. Students from 90 classes participated in the study. We used multilevel random structural equation modeling to analyze whether the relationship of the students’ perception of teaching quality (as an indicator of the students’ mental representation) and students’ motivation varies between classes, and if this variability depends on the class assessment of teaching quality (as an indicator of teaching quality). The effect of teachers’ structure on the regression slope of student perception of student competence was .127. The effect of teachers’ autonomy support on the regression slope of student perception of student autonomy was .066. With this study we contribute a more detailed description of the relationship between teaching quality, competence and autonomy.

  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. Factors Related to Competency Test Performance for High School Learning Disabled Students.

    Science.gov (United States)

    Hall, Julia; And Others

    1985-01-01

    This study explored some factors associated with learning disabled high school students who passed the North Carolina Minimum Competency Test on the second administration. Factors examined include reading score on the first competency test, intelligence quotient, locus of control, mother's education, teacher support, student/teacher ratio, and…

  9. High- and Low-Risk Characteristics of Youth: The Five Cs of Competency.

    Science.gov (United States)

    McWhirter, J. Jeffries; And Others

    1994-01-01

    Identifies and discusses five basic skill strengths or skill deficits that mark critical difference between low-risk and high-risk youth. The "Five Cs of Competency" described include critical school competencies, concept of self and self-esteem, communication skills, coping ability, and control. Contends that these characteristics discriminate…

  10. Athletes' Perceptions of Coaching Competency Scale II-High School Teams

    Science.gov (United States)

    Myers, Nicholas D.; Chase, Melissa A.; Beauchamp, Mark R.; Jackson, Ben

    2010-01-01

    The purpose of this validity study was to improve measurement of athletes' evaluations of their head coach's coaching competency, an important multidimensional construct in models of coaching effectiveness. A revised version of the Coaching Competency Scale (CCS) was developed for athletes of high school teams (APCCS II-HST). Data were collected…

  11. Health effects in residents of regions with high background radiation

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Possible health problems created by high natural levels of background radiation are hard to detect, partly because the health problems involved would exist to some degree irrespective of radiation exposure, partly because other factors affect the incidence of such problems, and partly because the differences between normal background radiation levels and radiation levels found in most high-radiation areas are not extreme. Nevertheless, the need to know about such health effects is evident, and so various studies conducted over the past 30 years have sought to determine whether those effects exist and what they are. Overall, however, the fragmentary and uncertain nature of many of these findings makes it hard to draw firm conclusions about the health risks involved or the desirability of countermeasures. So despite considerable efforts and some progress over the past three decades, the need for a clear quantitative assessment of the consequences is as great as ever

  12. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.; Komarov, E.

    1983-01-01

    Studies carried out in various countries and by the World Health Organization on health effects of exposure of populations to high levels of natural background radiation result in observations of different significance. There are indications of changes in chromosome aberration rate; Down's syndrome has been observed to be possibly related to radiation exposure; malignant neoplasms in bone apparently correspond to high concentrations of 226 Ra in drinking water. Although various researchers have looked for them, effects have not been demonstrated regarding cancer mortality (other than malignant neoplasms involving bone), gross congenital abnormalities, fertility index, growth and development, hereditary disease (other than the possibility of Down's syndrome), infant mortality, longevity, multiple births, sex ratio, or spontaneous abortion rate. On the basis of reported data clear quantitative conception of the risk of low-level radiation from natural sources could not be developed and feasibility studies of further epidemiological programmes should be organized. The possibility of reducing the collective population dose from natural sources could be further explored and a basis for necessary legal action on establishment of standards for possible sources of natural radiation, such as building materials, fertilizers, natural gas and water, might be developed. (author)

  13. Impact of an Event Reporting System on Resident Complication Reporting in Plastic Surgery Training: Addressing an ACGME and Plastic Surgery Milestone Project Core Competency.

    Science.gov (United States)

    Parikh, Rajiv P; Snyder-Warwick, Alison; Naidoo, Sybill; Skolnick, Gary B; Patel, Kamlesh B

    2017-11-01

    The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement. Unfortunately, current methods for capturing a comprehensive profile of complications may significantly underestimate the true occurrence of complications. Therefore, the objectives of this study are to evaluate an intervention for complication reporting and compare this to current practice, in a plastic surgery training program. This is a preintervention and postintervention study evaluating resident reporting of complications on a plastic surgery service. The intervention was an online event reporting system developed by department leadership and patient safety experts. The cohorts consisted of all patients undergoing surgery during two separate 3-month blocks bridged by an implementation period. A trained reviewer recorded complications, and this served as the reference standard. Fisher's exact test was used for binary comparisons. There were 32 complications detected in 219 patients from June to August of 2015 and 35 complications in 202 patients from October to December of 2015. The proportion of complications reported in the preintervention group was nine of 32 (28.1 percent). After the intervention, this significantly increased to 32 of 35 (91.4 percent) (p < 0.001). An intervention using an event reporting system, supported by departmental leadership, led to significant improvements in complication reporting by plastic surgery residents.

  14. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Although the health effects of radiation doses in occupationally exposed persons had received attention, it was not until the 1950s, when the atmospheric atom bomb tests of the United States and the Soviet Union had raised the level of environmental radioactivity, that the long-term effects of low-level radiation dosage became a matter of popular concern throughout the world. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) was created, and the World Health Organization (WHO) appointed an expert committee to provide advice concerning radiation and human health. In its first report, the WHO expert committee identified several areas of high natural radiation where studies of the exposed population might possibly provide information concerning the effects of chromic low-level radiation dosage

  15. High school Physical Sciences teachers' competence in some basic cognitive skills

    OpenAIRE

    Selvaratnam, Mailoo

    2011-01-01

    The successful implementation of the national high school Physical Sciences curriculum in South Africa, which places strong emphasis on critical thinking and reasoning abilities of students, would need teachers who are competent in cognitive skills and strategies. The main objectives of this study were to test South African high school Physical Sciences teachers' competence in the cognitive skills and strategies needed for studying Physical Sciences effectively and also to identify possible r...

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

    Science.gov (United States)

    Warrington, Steven J; Beeson, Michael S; Fire, Frank L

    2013-05-01

    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. 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. 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. A simulation stethoscope may be a useful adjunct to

  17. 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

  18. Calculation of high-rise construction limitations for non-resident housing fund in megacities

    Directory of Open Access Journals (Sweden)

    Iliashenko Oksana

    2018-01-01

    Full Text Available The paper is devoted to topical issues of urban planning in terms of high-rise construction of a non-resident housing stock in relation to megacities. We consider this issue taking into account the limitations of natural, communal and social resources. The problem is especially acute for the overwhelming majority of the state capitals, as well as cities with historical heritage that are of great interest due to the rapid development of tourism and the high mobility of the population in the world. The growth of the population of many states capitals led to the use of high-rise buildings as a non-resident housing stock. However, there are a number of restrictions on the high-rise construction of non-resident housing stock in megacities. The authors formalize the problem of determining the optimal ratio of the volume of urban buildings belonging to the high-rise buildings types and intended for non-residents to a common housing fund. We conduct economic calculations to determine the quantitative indicators. It can be used as the basis for administrative measures aimed at limiting the people flow arriving with the intention of temporarily deploying in megacities.

  19. Calculation of high-rise construction limitations for non-resident housing fund in megacities

    Science.gov (United States)

    Iliashenko, Oksana; Krasnov, Sergey; Sergeev, Sergey

    2018-03-01

    The paper is devoted to topical issues of urban planning in terms of high-rise construction of a non-resident housing stock in relation to megacities. We consider this issue taking into account the limitations of natural, communal and social resources. The problem is especially acute for the overwhelming majority of the state capitals, as well as cities with historical heritage that are of great interest due to the rapid development of tourism and the high mobility of the population in the world. The growth of the population of many states capitals led to the use of high-rise buildings as a non-resident housing stock. However, there are a number of restrictions on the high-rise construction of non-resident housing stock in megacities. The authors formalize the problem of determining the optimal ratio of the volume of urban buildings belonging to the high-rise buildings types and intended for non-residents to a common housing fund. We conduct economic calculations to determine the quantitative indicators. It can be used as the basis for administrative measures aimed at limiting the people flow arriving with the intention of temporarily deploying in megacities.

  20. High-speed Internet Use and Academic Gratifications in the College Residence.

    Science.gov (United States)

    Matthews, Denise; Schrum, Lynne

    2003-01-01

    A multimethod exploration of undergraduates' high-speed Internet use in residence halls took a uses-and-gratifications approach and revealed Internet use as integral to students' lives. Students' negative comments about Internet distractions from academic work led to identification of an individual difference variable, internal locus of control of…

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

    DEFF Research Database (Denmark)

    Ambrogi, Federico; Scheike, Thomas H.

    2016-01-01

    of competing events. The direct binomial regression model of Scheike and others (2008. Predicting cumulative incidence probability by direct binomial regression. Biometrika 95: (1), 205-220) is reformulated in a penalized framework to possibly fit a sparse regression model. The developed approach is easily...... Research 19: (1), 29-51), the research regarding competing risks is less developed (Binder and others, 2009. Boosting for high-dimensional time-to-event data with competing risks. Bioinformatics 25: (7), 890-896). The aim of this work is to consider how to do penalized regression in the presence...... implementable using existing high-performance software to do penalized regression. Results from simulation studies are presented together with an application to genomic data when the endpoint is progression-free survival. An R function is provided to perform regularized competing risks regression according...

  2. Nutrition status in residents in the high background radiation area of Yangjiang, China

    International Nuclear Information System (INIS)

    Lei Shujie; Li Xiaojuan; Sun Quanfu; Wei Lvxin; Gen Jiwu; Wen Cuiju; Tan Huizhen; Zou Jianmin

    2007-01-01

    Objective: To investigate the current status of nutrition and examine the difference between inhabitants in the high background radiation area (HBRA) and the control area (CA). Methods: Sixty and sixty-five male farmers aged 50 and over were randomly selected from HBRA and CA, respectively. Information on dwelling history, history of disease, medical treatment and X-ray examination were collected by interview. Body height and weight were measured, and BMIs were calculated. Serum levels of total protein, albumin and globulin, triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low- density lipoprotein cholesterol (LDL-C), Apo A1 and Apo B were measured. Results: There was difference in BMI distribution between the two groups. Averages of total biochemistry indexes measured were in normal range in the two groups. With adjustment to age distribution, the serum levels of total protein, albumin and triacylglycerol (TG) of residents in CA were higher than those in HBRA; high-density lipoprotein cholesterol level was higher in HBRA than that in CA. Conclusions: This serum assay of nutrients in HBRA and CA residents confirmed the results obtained from previous surveys. Both HBRA and CA residents have similar nutrition status, residents in CA consumed more animal protein and fat compared with those in HBRA. (authors)

  3. The Relation between Reflection-Impulsivity and Perceived Competence in Junior High School Children

    OpenAIRE

    桜井, 茂男

    1990-01-01

    The purpose of this study was to investigate the relation between perceived competence and reflection-impulsivity in junior high school students. Two scales, i. e. , the Perceived Competence Scale for Children developed by Sakurai (1983) and the Matching Familiar Figures (MFF) test developed by Sugihara (1977) , were administrated to 70 eighth male students and 70 eighth female students. The performance, Impulsivity (I) score, and Efficiency (E) score (see Salkind & Wright, 1977) in MFF test ...

  4. High School Leadership: The Challenge of Managing Resources and Competencies

    Science.gov (United States)

    Alsaaty, Falih M.; Morris, Archie, III

    2015-01-01

    High schools play a vital role in achieving and reflecting American ideals and culture. They provide the foundation for the country's economic, social, and political systems as well as the impetus for its scientific progress and technological superiority. The purpose of this study was to explore the challenges facing high schools' leadership in…

  5. 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.

  6. A Narrative Review of High-Quality Literature on the Effects of Resident Duty Hours Reforms.

    Science.gov (United States)

    Lin, Henry; Lin, Emery; Auditore, Stephanie; Fanning, Jon

    2016-01-01

    To summarize current high-quality studies evaluating the effect and efficacy of resident duty hours reforms (DHRs) on patient safety and resident education and well-being. The authors searched PubMed and Medline in August 2012 and again in May 2013 for literature (1987-2013) about the effects of DHRs. They assessed the quality of articles using the Medical Education Research Study Quality Instrument (MERSQI) scoring system. They considered randomized controlled trials (RCTs), partial RCTs, and all studies with a MERSQI score ≥ 14 to be "high-quality" methodology studies. A total of 72 high-quality studies met inclusion criteria. Most studies showed no change or slight improvement in mortality and complication rates after DHRs. Resident well-being was generally improved, but there was a perceived negative impact on education (knowledge acquisition, skills, and cognitive performance) following DHRs. Eleven high-quality studies assessed the impact of DHR interventions; all reported a neutral to positive impact. Seven high-quality studies assessed costs associated with DHRs and demonstrated an increase in hospital costs. The results of most studies that allow enough time for DHR interventions to take effect suggest a benefit to patient safety and resident well-being, but the effect on the quality of training remains unknown. Additional methodologically sound studies on the impact of DHRs are necessary. Priorities for future research include approaches to optimizing education and clinical proficiency and studies on the effect of intervention strategies on both education and patient safety. Such studies will provide additional information to help improve duty hours policies.

  7. 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…

  8. 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.

  9. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

    Yee, Don; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George

    2005-01-01

    Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents was the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada

  10. 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. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. Full House: A Retrospective Analysis of High Sexually Transmitted Infection Prevalence among Adult Film Actors at a Singular Residence.

    Science.gov (United States)

    Kendrick, Katherine; Brown, Veronica; Lords, Caleb; Matthias, James; Henning, Ian; Blackmore, Carina; Likos, Anna

    2016-09-01

    During a routine human immunodeficiency virus (HIV) investigation, Florida Department of Health staff identified a house (house A) in which over 150 individuals had resided at least briefly. Further investigation revealed that house A is used by the producer of a small adult film production company to board his actors. This report describes sexually transmitted infection (STI) prevalence among male actors in gay adult films residing in a common Florida residence. LexisNexis Accurint was used to identify house A residents since October 2002 when the producer arrived. Information on STIs and interview data were obtained from Florida's STI surveillance system. An infection was considered to be associated with residence in house A if the date of diagnosis occurred 6 months before an individual's residence start date through 6 months after his residence end date. Excluding the producer, 150 men resided in house A starting from September 2003 to July 2015. Forty-six individuals had a reported case of HIV, syphilis, gonorrhea, and/or chlamydia with 92 infections total. Forty-two (46%) infections among 24 men were considered associated with residence in house A. LexisNexis Accurint was a useful tool for identifying house A residents, a highly mobile and highly sexually active population. There is a high prevalence of STIs among residents, but it is unclear where transmission is occurring. Settings like house A are good candidates for HIV pre-exposure prophylaxis and active STI screenings and may be an opportunity for public health officials to intervene in high-risk groups to reduce STI rates in the community.

  12. 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…

  13. Social Competence Intervention for Elementary Students with Aspergers Syndrome and High Functioning Autism

    Science.gov (United States)

    Stichter, Janine P.; O'Connor, Karen V.; Herzog, Melissa J.; Lierheimer, Kristin; McGhee, Stephanie D.

    2012-01-01

    Despite frequent reports of academic success, individuals with high functioning autism or Aspergers Syndrome (HFA/AS) often manifest deficits in social abilities. These deficits can lead to daily difficulties, and negative long-term outcomes. Deficits in social competency are evident in this population from an early age, as children with HFA/AS…

  14. American Government. Nevada Competency-Based Adult High School Diploma Project.

    Science.gov (United States)

    Nevada Univ., Las Vegas. Coll. of Education.

    This document is one of ten curriculum guides developed by the Nevada Competency-Based Adult High School Diploma (CBAHSD) Project. This curriculum guide on American government is divided into fourteen topics. The topics included are: definition of "State"; left to right political spectrum; Dictatorship vs. Democracy; Capitalism,…

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

    OpenAIRE

    Gísladóttir, Þórdís; Haga, Monika; Sigmundsson, Hermundur

    2013-01-01

    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 (...

  16. Relationships between Parenting Practices, Social Engagement, Academic Competency, and High School Dropout

    Science.gov (United States)

    Bedrossian, Alfred

    2017-01-01

    The purpose of this study was to investigate the relationships between parenting practices, social engagement, academic competency, and high school dropout. The study revealed students whose parents practiced Reactive Communication along with students that exhibited Truancy and Disciplinary Issues were more likely to drop out. Conversely, students…

  17. 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…

  18. Chromosome translocation in residents of the high background radiation areas in southern China

    International Nuclear Information System (INIS)

    Hayata, Isamu; Minamihisamatsu, Masako; Wang Chunyan; Wei Zhang; Chen Deqing; Morishima, Hiroshige; Yuan Yongling; Wei Luxin; Sugahara, Tsutomu

    2000-01-01

    We performed a cytogenetical study using chromosome painting analysis on 9 residents of the naturally high background radiation areas (HBRA) and 8 residents of the control areas in southern China. The estimated dose (air kerma) of each resident measured by an electric pocket dosimeter showed 2.20-4.23 mGy/year in HBRA and 0.56-0.70 mGy/year in the control areas. A total of 14,096 cells (1,566 cells/case) in the former and 17,522 cells (2,190 cells/case) in the latter were analyzed. Children, both in HBRA and in the control areas, had translocations at low frequencies. The frequency of translocations among elder individuals varied widely and it was not possible to detect dose effect although it was detected in dicentrics. The effect of radiation on the induction of chromosome aberrations, which have a statistically potential risk of causing malignant or congenital diseases, seems to be less significant than those of metabolic factors and/or mutagenic agents (excluding radiation) even in HBRA in China. (author)

  19. High-Fidelity Contrast Reaction Simulation Training: Performance Comparison of Faculty, Fellows, and Residents.

    Science.gov (United States)

    Pfeifer, Kyle; Staib, Lawrence; Arango, Jennifer; Kirsch, John; Arici, Mel; Kappus, Liana; Pahade, Jay

    2016-01-01

    Reactions to contrast material are uncommon in diagnostic radiology, and vary in clinical presentation from urticaria to life-threatening anaphylaxis. Prior studies have demonstrated a high error rate in contrast reaction management, with smaller studies using simulation demonstrating variable data on effectiveness. We sought to assess the effectiveness of high-fidelity simulation in teaching contrast reaction management for residents, fellows, and attendings. A 20-question multiple-choice test assessing contrast reaction knowledge, with Likert-scale questions assessing subjective comfort levels of management of contrast reactions, was created. Three simulation scenarios that represented a moderate reaction, a severe reaction, and a contrast reaction mimic were completed in a one-hour period in a simulation laboratory. All participants completed a pretest and a posttest at one month. A six-month delayed posttest was given, but was optional for all participants. A total of 150 radiologists participated (residents = 52; fellows = 24; faculty = 74) in the pretest and posttest; and 105 participants completed the delayed posttest (residents = 31; fellows = 17; faculty = 57). A statistically significant increase was found in the one-month posttest (P < .00001) and the six-month posttest scores (P < .00001) and Likert scores (P < .001) assessing comfort level in managing all contrast reactions, compared with the pretest. Test scores and comfort level for moderate and severe reactions significantly decreased at six months, compared with the one-month posttest (P < .05). High-fidelity simulation is an effective learning tool, allowing practice of "high-acuity" situation management in a nonthreatening environment; the simulation training resulted in significant improvement in test scores, as well as an increase in subjective comfort in management of reactions, across all levels of training. A six-month refresher course is suggested, to maintain knowledge and comfort level in

  20. Nurse and resident satisfaction in magnet long-term care organizations: do high involvement approaches matter?

    Science.gov (United States)

    Rondeau, Kent V; Wagar, Terry H

    2006-04-01

    This study examines the association of high involvement nursing work practices with employer-of-choice (magnet) status in a sample of Canadian nursing homes. In response to a severe shortage of registered nursing personnel, it is imperative for health care organizations to more effectively recruit and retain nursing personnel. Some long-term care organizations are developing employee-centred cultures that allow them to effectively enhance nurse and resident satisfaction. At the same time, many nursing homes have adopted progressive nursing workplace practices (high involvement work practices) that emphasize greater employee empowerment, participation and commitment. A mail survey was sent to the director of nursing in 300 nursing homes in western Canada. In total, 125 useable questionnaires were returned and constituted the data set for this study. Separate ordinary least squares regressions are performed with magnet strength, nurse satisfaction and resident satisfaction used as dependent variables. Nursing homes that demonstrate strong magnet (employer-of-choice) characteristics are more likely to have higher levels of nurse and patient satisfaction, even after controlling for a number of significant factors at the establishment level. Magnet nursing homes are more likely to have progressive participatory decision-making cultures and much more likely to spend considerable resources on job-related training for their nursing staff. The presence of high involvement work practices is not found to be a significant predictor in magnet strength, nurse or resident satisfaction. Merely adopting more high involvement nursing work practices may be insufficient for nursing homes, which desire to become 'employers-of-choice' in their marketplaces, especially if these practices are adopted without a concomitant investment in nurse training or an enhanced commitment to establishing a more democratic and participatory decision-making style involving all nursing staff.

  1. Geometry strategic competence of junior high school students based on sex difference

    Science.gov (United States)

    Nugraheni, Zahra; Budiyono, Slamet, Isnandar

    2017-12-01

    There are different structures of male and female brain as it caused the difference of spatial and mathematical ability. This study examined whether there was different geometry strategic competence between sexes. There were 60 students given scholastic task of geometry strategic competence. The score obtained was analyzed by using independent t-test to compare the mean value of score between two groups. To determine the natural differences in strategy use between sexes, the score obtained was classified into high, medium, and low level. Semi-structured interview was conducted to six students (3 girls and 3 boys) who represented each level as subjects. By quantitative analyzing, obtained that there was no different in geometry strategic competence between girl and boy. Further, by qualitative analyzing known that girl students had more positive attitude than boys toward mathematics problem in the low score level and had the same strategic competence with boys in the medium scorelevel. Then, in the high scorelevel, boy students were tend to use insight strategies to solve problems whereas girls likely to use algorithm strategies.

  2. 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…

  3. A Development English Language Learning Management Strategies Model to Enhance Communicative Competence for High School Students

    Directory of Open Access Journals (Sweden)

    Thitiya Ruennakarn

    2017-09-01

    Full Text Available The objectives for this research are to 1 build a development English language learning management strategies model to enhance communicative competence for high school students 2 study the results of using the model. A target group is seven English teachers in Pibulwittayalai School and the sample for studying the results of model to students are ten English club students in Pibulwittayalai School.The research tools are focus group discussion forms, communication plans, English skills evaluation forms, communicative competence test, communicative competence evaluation forms and 21st century skills evaluation forms. This model is examined by connoisseurship.The statistics for analyzing data are frequency, percentage, mean, standard deviation and Wilcoxon test. The results of the research were as follows: 1. The development English language learning management strategies model to enhance communicative competence for high school students had4components ; 1 SWOT–Analysis, 2 strategy development, 3 strategy assessment and 4 strategy adjustment.This model had 6 strategies such as 1 genius academic strategy 2 English through AEC 3 English through World Class 4 enhancing for genius academic in communication with foreigners 5 enhancing English through world class standard and 6 enhancing for potential in English skills learning through world class standard. These were merged as only one strategy as “ Development of students’ potential for communication”. 2. The results of using the model comprised of 2.1 The results to teachers were teachers could analyze SWOT- analysis for determining strength, weakness,opportunity and threat about English language learning management, received guideline and could appropriately and efficiently construct strategies of English language learning management to enhance communicative competence. 2.2 The results to students: The students had 4 English skills, such as listening,speaking, reading and writing. It was

  4. DEVELOPING A MODEL OF COMPETENCY AND EXPERTISE CERTIFICATION TESTS FOR VOCATIONAL HIGH SCHOOL STUDENTS

    Directory of Open Access Journals (Sweden)

    Pardjono Pardjono

    2015-12-01

    Full Text Available This study aims to: (1 develop, produce, and investigate the appropriateness model of competency and expertise certification tests for vocational high school (VHS students of the Mechanical Engineering expertise competency.To attain the objectives, the researcher conducted a research and development study consisting of 10 steps. The research product was validated by experts, VHS teachers, and lecturers at Mechanical Engineering Education through Focus Group Discussion (FGD, and the field tryout conducted at SMK Warga Surakarta and SMK Bhineka Karya Simo, Boyolali, Central Java. The results of the study are. (1 The study produces a model of Competency and Expertise Certification Tests Based on the School Production Unit (CECT_SPU for VHS Students of the Mechanical Engineering Expertise Competency; (2 The CECT_SPU model satisfies the criteria for a good modelby a mean score of 3.557; (3 The mean score of the model implementation in the tryouts were 3.670 in the individual tryout and 3.730 in the small-group tryout;  (4 The CECT_SPU model satisfies the criteria for an effective modelby a mean score of 3.730; (5 The CECT_SPU model satisfies the criteria for an efficient modelby a mean score of 3.780; (6 The CECT_SPU model satisfies the criteria for a practical model; by a mean score of 3.700.

  5. 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.

  6. 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…

  7. A ‘How-To-Guide’ for teaching and assessing Collaborator Role competencies in family medicine residency and health professional training programs

    OpenAIRE

    Newton, Christie; Kopansky-Giles, Deborah; Eyre, Alison; Balkou, Steve

    2017-01-01

    Introduction: Collaborative practice competencies are essential for safe, effective practice in today’s health care system. Providing learners with formal teaching and assessment opportunities is a requirement for accreditation in medicine and other health professional programs.  However, identifying and assessing a trainee’s ability to competently collaborate in practice across educational contexts remains challenging. Further, without common assessment tools for collaborative practice teach...

  8. High-Intensity Telemedicine Decreases Emergency Department Use by Senior Living Community Residents.

    Science.gov (United States)

    Shah, Manish N; Wasserman, Erin B; Wang, Hongyue; Gillespie, Suzanne M; Noyes, Katia; Wood, Nancy E; Nelson, Dallas; Dozier, Ann; McConnochie, Kenneth M

    2016-03-01

    The failure to provide timely acute illness care can lead to adverse consequences or emergency department (ED) use. We evaluated the effect on ED use of a high-intensity telemedicine program that provides acute illness care for senior living community (SLC) residents. We performed a prospective cohort study over 3.5 years. Six SLCs cared for by a primary care geriatrics practice were intervention facilities, with the remaining 16 being controls. Consenting patients at intervention facilities could access telemedicine for acute illness care. Patients were provided patient-to-provider, real-time, or store-and-forward high-intensity telemedicine (i.e., technician-assisted with resources beyond simple videoconferencing) to diagnose and treat acute illnesses. The primary outcome was the rate of ED use. We enrolled 494 of 705 (70.1%) subjects/proxies in the intervention group; 1,058 subjects served as controls. Control and intervention subjects visited the ED 2,238 and 725 times, respectively, with 47.3% of control and 43.4% of intervention group visits resulting in discharge home. Among intervention subjects, ED use decreased at an annualized rate of 18% (rate ratio [RR]=0.82; 95% confidence interval [CI], 0.70-0.95), whereas in the control group there was no statistically significant change in ED use (RR=1.01; 95% CI, 0.95-1.07; p=0.009 for group-by-time interaction). Primary care use and mortality were not significantly different. High-intensity telemedicine significantly reduced ED use among SLC residents without increasing other utilization or mortality. This alternative to traditional acute illness care can enhance access to acute illness care and should be integrated into population health programs.

  9. Development of Competency-Based Articulated Automotive Program. Big Bend Community College and Area High Schools. Final Report.

    Science.gov (United States)

    Buche, Fred; Cox, Charles

    A competency-based automotive mechanics curriculum was developed at Big Bend Community College (Washington) in order to provide the basis for an advanced placement procedure for high school graduates and experienced adults through a competency assessment. In order to create the curriculum, Big Bend Community College automotive mechanics…

  10. 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.

  11. Identification of potentially competing Afrotropical and Palaearctic ...

    African Journals Online (AJOL)

    Identification of potentially competing Afrotropical and Palaearctic bird species in the Sahel. Jared M Wilson, Will RL Cresswell. Abstract. Areas experiencing a seasonal influx of migrants may be expected to have a high potential for competition between resident and migrant populations. Described differences in foraging ...

  12. Low risk of pulmonary tuberculosis of residents in high background radiation area, Yangjiang, China

    International Nuclear Information System (INIS)

    Li Xiaojuan; Sun Quanfu

    2006-01-01

    Objective: To examine the pulmonary tuberculosis mortality risk of the residents in high background radiation area (HBRA), Yangjiang, China. Methods: A cohort including 89 694 persons in HBRA and 35 385 persons in control area (CA) has been established since 1979. Person-year tables based on classified variables including sex, attained age, follow-up calendar year, and dose-rate group (high, intermediate, and low in HBRA, and control group) were tabulated using DATAB in EPICURE. Poisson regression analysis was used to estimate the relative risks (RR) of infectious and parasitic disease especially for pulmonary tuberculosis. Cumulative dose for each cohort member was obtained. Results: Two million person-years were accumulated by follow-up and 612 cases of pulmonary tuberculosis ascertained. Compared with risk in the control area, statistically significant lower risk of pulmonary tuberculosis was observed in HBRA among those who aged 60 years and over; markedly decreased risk occurred among males; no significant difference was found among the 6 follow-up stages, two subregions in the HBRA, or different diagnostic facilities. A statistically significantly negative dose-response was observed (P<0.001), the higher accumulative dose, the lower dose the pulmonary tuberculosis mortality risk. Its excess relative risk (ERR/Sv) was estimated to be -1.09 (95% CI: -1.34, -0.85). No established risk factors could explain this lower risk. Conclusions: The mortality of puhnonary tuberculosis among residents in HBRA who were chronically exposed to low-dose radiation was statistically significantly lower than that in the control area, and a significant dose-response relationship was observed, which probably resulted from the immunoenhancement of low dose radiation. (authors)

  13. 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 competence-in-practice as an alternative approach to Competence Development within Human Resource Management....

  14. The effect of leadership, organizational culture, and competency on teachers' performance in Ibu Kartini vocational high school Semarang

    Science.gov (United States)

    Toha, Mohamad; Katoningsih, Sri

    2018-03-01

    The low performance of teachers in organization is influenced many factors. Organizational culture could be the key of organization success; hence many researches were done to identify the value and the attitude norm that gave big contribution for organization success. Competency is a part of employee they perform during work as kind of behavior. Competency depends on the aspects process of teachers' performance. The purpose of this research is to know the effect of leadership, organizational culture and competency on teachers' performance. The objects of this research are leadership, organizational culture, competency and teachers' performance in Ibu Kartini vocational high school. This research is quantitative. To collect the data, questionnaire was used. Then, the data were analyzed by using Path analysis in SPPS 16. The result of this research showed that leadership, organizational culture, competency and performance run well and had significant effect on teachers' performance.

  15. Motherhood during residency training: challenges and strategies.

    Science.gov (United States)

    Walsh, Allyn; Gold, Michelle; Jensen, Phyllis; Jedrzkiewicz, Michelle

    2005-07-01

    To determine what factors enable or impede women in a Canadian family medicine residency program from combining motherhood with residency training. To determine how policies can support these women, given that in recent decades the number of female family medicine residents has increased. Qualitative study using in-person interviews. McMaster University Family Medicine Residency Program. Twenty-one of 27 family medicine residents taking maternity leave between 1994 and 1999. Semistructured interviews. The research team reviewed transcripts of audiotaped interviews for emerging themes; consensus was reached on content and meaning. NVIVO software was used for data analysis. Long hours, unpredictable work demands, guilt because absences from work increase workload for colleagues, and residents' high expectations of themselves cause pregnant residents severe stress. This stress continues upon return to work; finding adequate child care is an added stress. Residents report receiving less support from colleagues and supervisors upon return to work; they associate this with no longer being visibly pregnant. Physically demanding training rotations put additional strain on pregnant residents and those newly returned to work. Flexibility in scheduling rotations can help accommodate needs at home. Providing breaks, privacy, and refrigerators at work can help maintain breastfeeding. Allowing residents to remain involved in academic and clinical work during maternity leave helps maintain clinical skills, build new knowledge, and promote peer support. Pregnancy during residency training is common and becoming more common. Training programs can successfully enhance the experience of motherhood during residency by providing flexibility at work to facilitate a healthy balance among the competing demands of family, work, and student life.

  16. 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,

  17. 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

  18. 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.

  19. High incidence of micronuclei in lymphocytes from residents of the area near the Semipalatinsk nuclear explosion test site

    International Nuclear Information System (INIS)

    Tanaka, Kimio; Hoshi, Masaharu; Kamada, Nanao; Tchaijunusova, N.J.; Takatsuji, Toshihiro; Gusev, B.I.; Sakerbaev, A.K.H.

    2000-01-01

    The Semipalatinsk area is highly contaminated with radioactive fallout from 40 years of continuous nuclear testing. The biological effects on human health in this area have not been studied. Significant remaining radioactivities include long-lived radioisotopes of 238, 239, 400 Pu, 137 Cs and 90 Sr. To evaluate the long-term biological effects of the radioactive fallout, the incidence of micronuclei in lymphocytes from residents of the area was observed. Blood was obtained from 10 residents (5 females and 5 males, aged 47 to 55 years old) from each of the 3 areas of Znamenka, Dolon and Semipalatinsk, which are about 50-150 km from the nuclear explosion test site. For micronucleus assay. PHA-stimulated lymphocytes were cultured for 72 h and cytochalasin B was added at 44 h for detecting binuclear lymphocytes. Five thousand binuclear lymphocytes in each resident were scored. The means of micronucleus counts in 1,000 lymphocytes in residents of Semipalatinsk, Dolon and Znamenka were 16.3, 12.6, and 7.80, respectively, which were higher than those of the normal Japanese persons (4.66). These values were equivalent to the results obtained from 0.187-0.47 Gy of chronic exposure to γ-rays at a dose rate of 0.02 cGy/min. The high incidence of micronuclei in residents of the Semipalatinsk nuclear test site area was mainly caused by internal exposure rather than external exposure received for the past 40 years. (author)

  20. 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 Behavior. Published by Elsevier Inc. All rights reserved.

  1. Designing faculty development to support the evaluation of resident competency in the intrinsic CanMEDS roles: practical outcomes of an assessment of program director needs.

    Science.gov (United States)

    Puddester, Derek; MacDonald, Colla J; Clements, Debbie; Gaffney, Jane; Wiesenfeld, Lorne

    2015-06-05

    The Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada mandate that faculty members demonstrate they are evaluating residents on all CanMEDS (Canadian Medical Education Directions for Specialists) roles as part of the accreditation process. Postgraduate Medical Education at the University of Ottawa initiated a 5-year project to develop and implement a comprehensive system to assess the full spectrum of CanMEDS roles. This paper presents the findings from a needs assessment with Program Directors, in order to determine how postgraduate medical faculty can be motivated and supported to evaluate residents on the intrinsic CanMEDS roles. Semi-structured individual interviews were conducted with 60 Postgraduate Program Directors in the Faculty of Medicine. Transcribed interviews were analyzed using qualitative analysis. Once the researchers were satisfied the identified themes reflected the views of the participants, the data was assigned to categories to provide rich, detailed, and comprehensive information that would indicate what faculty need in order to effectively evaluate their residents on the intrinsic roles. Findings indicated faculty members need faculty development and shared point of care resources to support them with how to not only evaluate, but also teach, the intrinsic roles. Program Directors expressed the need to collaborate and share resources across departments and national specialty programs. Based on our findings, we designed and delivered workshops with companion eBooks to teach and evaluate residents at the point of care (Developing the Professional, Health Advocate and Scholar). Identifying stakeholder needs is essential for designing effective faculty development. By sharing resources, faculties can prevent 'reinventing the wheel' and collaborate to meet the Colleges' accreditation requirements more efficiently.

  2. On-site storage of high level nuclear waste: Attitudes and perceptions of local residents

    International Nuclear Information System (INIS)

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

    1996-01-01

    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 countries 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. 24 refs., 7 figs., 5 tabs

  3. Review of epidemiological and cytogenetic studies on high background radiation area residents

    International Nuclear Information System (INIS)

    Iwasaki, Toshiyasu

    2008-01-01

    Emerging scientific knowledge in the field of radiation biology has put into question the generic use of a simple linear extrapolation of radiation effects from high to low dose or dose rate. Though the direct information of biological effects at low dose or low dose rate has been accumulated, it is still immature to mention health effects as the consequence of biological effects. As epidemiological data have been the main sources of direct information on human health effects, studies of the health of population exposed by low dose or low dose rate ionizing radiation will help to improve our understanding. In this meaning, the epidemiological studies of residents in high background radiation areas (HBRA), which are supported by us, will provide important direct information on the biological and health effects of chronic low dose rate ionizing radiation. The epidemiological results in HBRA in China showed there are no significant increases of cancer risks caused by the high background levels of ionizing radiation. From the results which come from cytogeneticl studies, the frequencies of unstable chromosomal aberrations have shown good correlation with cumulative doses in their lifetimes, which indicated it is a sensitive and informative biomarker. On the other hand, the frequencies of stable chromosomal aberrations have shown no significant difference and the frequency was much higher than that of unstable type aberrations. It suggests that mutagenic factors other than radiation contribute more than the elevated level of radiation to the induction of DNA rearrangements which could lead to the increase of cancer risk in HBRA in China. (author)

  4. Establishment of immortalized B lymphoblastoid cell lines of old residents in high background radiation area in Guangdong, China

    International Nuclear Information System (INIS)

    Lu Xue; Feng Jiangbing; Chen Deqing; Liu Qingjie; Cha Yongru; Zou Jianming

    2008-01-01

    Objective: To establish the immortalized cell lines of peripheral blood lymphocytes for old male residents in high background radiation area (HBRA) in Guangdong, China, in order to preserve the specific genomic resources of residents in HBRA for the further genetic and molecular biological study on HBRA. Methods: The peripheral blood samples of 20 old male residents in HBRA were collected after informed consent. The immortalized B lymphoblastoid cell lines, 2 fox each resident, were established with Epstein-Barr virus. After being frozen and recovered, the cell viability, the contamination of bacterium and mycoplasma were analyzed. The stabilization of cell lines was decided by comparing the karyotypes of the peripheral blood lymphocytes and the cell lines. Results: 40 cell lines for 20 residents in HBRA were successfully established.. The recovery rate of cell lines after being frozen was 100% . All the cell viablity after recovery was higher than 90%, and no contamination of bacteria and mycoplasma occurred. The karyotypes of the 20th generation cell lines were not change. Conclusion: The immortalized cell lines established in this study could provide biological resources for further study on genetics and molecular biology in HBRA. (authors)

  5. 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.

  6. Diversity in Dermatology Residency Programs.

    Science.gov (United States)

    Van Voorhees, Abby S; Enos, Clinton W

    2017-10-01

    Given the change in our population to one that is more racially and ethnically diverse, the topic of diversity in dermatology residency programs has gained attention. In a field that has become highly competitive, diversity is lagging behind. What are the reasons for this? The existing diversity among medical school matriculants is reflective of the applicant pool, and although modest, there has been an increase in applications and acceptances from minority populations. However, these proportions do not carry through to the population applying to dermatology residency. Making sense of this and planning how to recruit a more diverse applicant pool will improve the quality and cultural competency of future dermatologists. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  7. 'It depends': medical residents' perspectives on working with nurses.

    Science.gov (United States)

    Weinberg, Dana B; Miner, Dianne Cooney; Rivlin, Leetal

    2009-07-01

    Using the theory of relational coordination, which holds that in high-pressure settings such as hospitals, high-quality communication and strong relationships are necessary for coordinated action, we sought to determine the quality of the nurse-physician relationship by examining the communication and interaction between nurses and residents from the residents' perspective. A sample of 20 medical and surgical residents, selected by a snowball sampling technique, were interviewed about the quality of their communication and relationships with nurses in the workplace. Residents' responses were influenced by their perceptions of nurses' cooperativeness and competence, and their impressions of nurses' professional preparation and demeanor varied widely. Although 19 of 20 residents reported instances of poor communication or problematic relationships with nurses, most believed that this posed no significant threat to patient care because the nurses' role, as they saw it, was one of simply following orders. Given the strong doubts some residents expressed about nurses' cooperativeness and competence, the nursing profession should consider strengthening nursing education and clearly delineating nurses' roles and competencies.

  8. Competency champions in the clinical competency committee: a successful strategy to implement milestone evaluations and competency coaching.

    Science.gov (United States)

    Ketteler, Erika R; Auyang, Edward D; Beard, Kathy E; McBride, Erica L; McKee, Rohini; Russell, John C; Szoka, Nova L; Nelson, M Timothy

    2014-01-01

    To create a clinical competency committee (CCC) that (1) centers on the competency-based milestones, (2) is simple to implement, (3) creates competency expertise, and (4) guides remediation and coaching of residents who are not progressing in milestone performance evaluations. We created a CCC that meets monthly and at each meeting reviews a resident class for milestone performance, a competency (by a faculty competency champion), a resident rotation service, and any other resident or issue of concern. University surgical residency program. The CCC members include the program director, associate program directors, director of surgical curriculum, competency champions, departmental chair, 2 at-large faculty members, and the administrative chief residents. Seven residents were placed on remediation (later renamed as coaching) during the academic year after falling behind on milestone progression in one or more competencies. An additional 4 residents voluntarily placed themselves on remediation for medical knowledge after receiving in-training examination scores that the residents (not the CCC membership) considered substandard. All but 2 of the remediated/coached residents successfully completed all area milestone performance but some chose to stay on the medical knowledge competency strategy. Monthly meetings of the CCC make milestone evaluation less burdensome. In addition, the expectations of the residents are clearer and more tangible. "Competency champions" who are familiar with the milestones allow effective coaching strategies and documentation of clear performance improvements in competencies for successful completion of residency training. Residents who do not reach appropriate milestone performance can then be placed in remediation for more formal performance evaluation. The function of our CCC has also allowed us opportunity to evaluate the required rotations to ensure that they offer experiences that help residents achieve competency performance necessary

  9. Social competence intervention for youth with Asperger Syndrome and high-functioning autism: an initial investigation.

    Science.gov (United States)

    Stichter, Janine P; Herzog, Melissa J; Visovsky, Karen; Schmidt, Carla; Randolph, Jena; Schultz, Tia; Gage, Nicholas

    2010-09-01

    Individuals with high functioning autism (HFA) or Asperger Syndrome (AS) exhibit difficulties in the knowledge or correct performance of social skills. This subgroup's social difficulties appear to be associated with deficits in three social cognition processes: theory of mind, emotion recognition and executive functioning. The current study outlines the development and initial administration of the group-based Social Competence Intervention (SCI), which targeted these deficits using cognitive behavioral principles. Across 27 students age 11-14 with a HFA/AS diagnosis, results indicated significant improvement on parent reports of social skills and executive functioning. Participants evidenced significant growth on direct assessments measuring facial expression recognition, theory of mind and problem solving. SCI appears promising, however, larger samples and application in naturalistic settings are warranted.

  10. 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

    Objective To explore potential differences in food shopping behaviors and healthy food availability perceptions between residents living in areas with low and high food access. Design A cross-sectional telephone survey to assess food shopping behaviors and perceptions. Data from an eight-county food environment field census used to define the CDC (Centers for Disease Control and Prevention) healthier food retail tract and USDA ERS (United States Department of Agriculture Economic Research Service) food desert measure. Participants 968 residents in eight South Carolina counties. Main Outcome Measures Residents’ food shopping behaviors and healthy food availability perceptions. Analysis Linear and logistic regression. Results Compared to residents in high food access areas, residents in low food access areas traveled further to their primary food store (USDA ERS: 8.8 vs. 7.1 miles, p=0.03; CDC: 9.2 vs. 6.1 miles, pshopping miles per week; CDC 28.0 vs. 15.4 miles, pshopping access (p<0.001). Conclusions and Implications These findings lend support to ongoing community and policy interventions aimed at reducing food access disparities. PMID:24560861

  11. Effect of Performance Deficiencies on Graduation and Board Certification Rates: A 10-yr Multicenter Study of Anesthesiology Residents.

    Science.gov (United States)

    Turner, Judi A; Fitzsimons, Michael G; Pardo, Manuel C; Hawkins, Joy L; Huang, Yue Ming; Rudolph, Maria D D; Keyes, Mary A; Howard-Quijano, Kimberly J; Naim, Natale Z; Buckley, Jack C; Grogan, Tristan R; Steadman, Randolph H

    2016-07-01

    This multicenter, retrospective study was conducted to determine how resident performance deficiencies affect graduation and board certification. Primary documents pertaining to resident performance were examined over a 10-yr period at four academic anesthesiology residencies. Residents entering training between 2000 and 2009 were included, with follow-up through February 2016. Residents receiving actions by the programs' Clinical Competency Committee were categorized by the area of deficiency and compared to peers without deficiencies. A total of 865 residents were studied (range: 127 to 275 per program). Of these, 215 residents received a total of 405 actions from their respective Clinical Competency Committee. Among those who received an action compared to those who did not, the proportion graduating differed (93 vs. 99%, respectively, P graduating dropped to 55%. When more than three Accreditation Council for Graduate Medical Education Core Competencies were deficient, the proportion graduating also dropped significantly. Overall graduation and board certification rates were consistently high in residents with no, or isolated, deficiencies. Residents deficient in an Essential Attribute, or multiple competencies, are at high risk of not graduating or achieving board certification. More research is needed on the effectiveness and selective deployment of remediation efforts, particularly for high-risk groups.

  12. Effect of Performance Deficiencies on Graduation and Board Certification Rates: A 10-Year Multicenter Study of Anesthesiology Residents

    Science.gov (United States)

    Turner, Judi A.; Fitzsimons, Michael G.; Pardo, Manuel C.; Hawkins, Joy L.; Huang, Yue Ming; Rudolph, Maria D. D.; Keyes, Mary A.; Howard-Quijano, Kimberly J.; Naim, Natale Z.; Buckley, Jack C.; Grogan, Tristan R.; Steadman, Randolph H.

    2016-01-01

    Background This multi-center, retrospective study was conducted to determine how resident performance deficiencies affect graduation and board certification. Methods Primary documents pertaining to resident performance were examined over a 10-year period at four academic anesthesiology residencies. Residents entering training between 2000 and 2009 were included, with follow-up through February 2016. Residents receiving actions by the programs’ Clinical Competency Committee were categorized by the area of deficiency and compared to peers without deficiencies. Results A total of 865 residents were studied (range: 127–275 per program). Of these, 215 residents received a total of 405 actions from their respective Clinical Competency Committee. Among those who received an action compared to those who did not, the proportion graduating differed (93% versus 99%, respectively, Pgraduating dropped to 55%. When more than three Accreditation Council for Graduate Medical Education core competencies were deficient, the proportion graduating also dropped significantly. Conclusions Overall graduation and board certification rates were consistently high in residents with no, or isolated, deficiencies. Residents deficient in an Essential Attribute, or multiple competencies, are at high risk of not graduating or achieving board certification. More research is needed on the effectiveness and selective deployment of remediation efforts, particularly for high-risk groups. PMID:27119434

  13. Fear of failure, psychological stress, and burnout among adolescent athletes competing in high level sport.

    Science.gov (United States)

    Gustafsson, H; Sagar, S S; Stenling, A

    2017-12-01

    The purpose of this study was to investigate fear of failure in highly competitive junior athletes and the association with psychological stress and burnout. In total 258 athletes (152 males and 108 females) ranged in age from 15 to 19 years (M = 17.4 years, SD = 1.08) participated. Athletes competed in variety of sports including both team and individual sports. Results showed in a variable-oriented approach using regression analyses that one dimension, fear of experiencing shame and embarrassment had a statistically significant effect on perceived psychological stress and one dimension of burnout, reduced sense of accomplishment. However, adopting a person-oriented approach using latent class analysis, we found that athletes with high levels of fear failure on all dimensions scored high on burnout. We also found another class with high scores on burnout. These athletes had high scores on the individual-oriented dimensions of fear of failure and low scores on the other oriented fear of failure dimensions. The findings indicate that fear of failure is related to burnout and psychological stress in athletes and that this association is mainly associated with the individual-oriented dimensions of fear of failure. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. 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.

  15. The State of Evaluation in Internal Medicine Residency

    Science.gov (United States)

    Holmboe, Eric; Beasley, Brent W.

    2008-01-01

    Background There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations. Objective To describe evaluation methods used by our nation’s internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation. Design Nationwide survey. Participants All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM). Measurements Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods. Results The response rate was 70%. Programs were using an average of 4.2–6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)’s “most desirable” methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods. Conclusions Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high. PMID:18612734

  16. 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

  17. Is computer-assisted instruction more effective than other educational methods in achieving ECG competence among medical students and residents? Protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Viljoen, Charle André; Scott Millar, Rob; Engel, Mark E; Shelton, Mary; Burch, Vanessa

    2017-12-26

    Although ECG interpretation is an essential skill in clinical medicine, medical students and residents often lack ECG competence. Novel teaching methods are increasingly being implemented and investigated to improve ECG training. Computer-assisted instruction is one such method under investigation; however, its efficacy in achieving better ECG competence among medical students and residents remains uncertain. This article describes the protocol for a systematic review and meta-analysis that will compare the effectiveness of computer-assisted instruction with other teaching methods used for the ECG training of medical students and residents. Only studies with a comparative research design will be considered. Articles will be searched for in electronic databases (PubMed, Scopus, Web of Science, Academic Search Premier, CINAHL, PsycINFO, Education Resources Information Center, Africa-Wide Information and Teacher Reference Center). In addition, we will review citation indexes and conduct a grey literature search. Data extraction will be done on articles that met the predefined eligibility criteria. A descriptive analysis of the different teaching modalities will be provided and their educational impact will be assessed in terms of effect size and the modified version of Kirkpatrick framework for the evaluation of educational interventions. This systematic review aims to provide evidence as to whether computer-assisted instruction is an effective teaching modality for ECG training. It is hoped that the information garnered from this systematic review will assist in future curricular development and improve ECG training. As this research is a systematic review of published literature, ethical approval is not required. The results will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement and will be submitted to a peer-reviewed journal. The protocol and systematic review will be included in a PhD dissertation. CRD

  18. A national survey of residents in combined Internal Medicine and Dermatology residency programs: educational experience and future plans.

    Science.gov (United States)

    Mostaghimi, Arash; Wanat, Karolyn; Crotty, Bradley H; Rosenbach, Misha

    2015-10-16

    In response to a perceived erosion of medical dermatology, combined internal medicine and dermatology programs (med/derm) programs have been developed that aim to train dermatologists who take care of medically complex patients. Despite the investment in these programs, there is currently no data with regards to the potential impact of these trainees on the dermatology workforce. To determine the experiences, motivations, and future plans of residents in combined med/derm residency programs. We surveyed residents at all United States institutions with both categorical and combined training programs in spring of 2012. Respondents used visual analog scales to rate clinical interests, self-assessed competency, career plans, and challenges. The primary study outcomes were comfort in taking care of patients with complex disease, future practice plans, and experience during residency. Twenty-eight of 31 med/derm residents (87.5%) and 28 of 91 (31%) categorical residents responded (overall response rate 46%). No significant differences were seen in self-assessed dermatology competency, or comfort in performing inpatient consultations, cosmetic procedures, or prescribing systemic agents. A trend toward less comfort in general dermatology was seen among med/derm residents. Med/derm residents were more likely to indicate career preferences for performing inpatient consultation and taking care of medically complex patients. Categorical residents rated their programs and experiences more highly. Med/derm residents have stronger interests in serving medically complex patients. Categorical residents are more likely to have a positive experience during residency. Future work will be needed to ascertain career choices among graduates once data are available.

  19. 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…

  20. Residents in a high radon potential geographic area: Their risk perception and attitude toward testing and mitigation

    International Nuclear Information System (INIS)

    Ferng, S.F.; Lawson, J.K.

    1996-01-01

    Boone County, Indiana was identified by the EPA as one of the high radon potential geographic areas. Health education campaigns are needed to prevent resident's unnecessary radon exposure. In order to design suitable programs, a questionnaire mail survey was conducted to measure socio-demographic characteristics of County resident's knowledge about radon, attitude toward radon testing and mitigation, support of education campaigns, and the best media to deliver radon education campaigns. A stratified random sampling method was applied for a total of 400 samples. The number of samples from each township/city was a proportion of their taxable parcels. The survey return rate was 39.8%. The data were analyzed by Epi Info and SPSS. The statistical significant level was set at α = 0.05. The results showed that resident's knowledge about radon was at a relatively superficial level. There was no association identified between the knowledge of radon and gender, age, family income, or education, except that females more frequently believed in false effects caused by radon. A significant correlation between radon knowledge and home radon tests was observed. Also found in this study was that respondents with better knowledge about diseases caused by radon had more confidence in radon mitigation actions. Newspaper was chosen by respondents as the most favorite media to deliver radon health education campaigns. Health education campaigns for the residents of Boone County might be conducted by local governments and/or other organizations

  1. 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.

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

    Science.gov (United States)

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

    2016-12-01

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

  3. Transferable Competences of Young People with a High Dropout Risk in Vocational Training in Germany

    Science.gov (United States)

    Frey, Andreas; Balzer, Lars; Ruppert, Jean-Jacques

    2014-01-01

    This paper examines whether the subjective beliefs on their competences of 409 trainees in machinery, sales, and logistics constitute a reliable and valid way to measure transferable competences. The analysis of results attributes satisfactory to good reliability values to the assessment procedure. Furthermore, it could be shown that young people…

  4. Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.

    Science.gov (United States)

    Bartel, Billie J

    2014-08-01

    This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. © The Author(s) 2013.

  5. 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 

  6. Metacognitive Ability Relationship with Test Result of Senior High School of Biology Teacher Competence in Sijunjung District

    Science.gov (United States)

    Ardi, A.; Fadilah, M.; Ichsani, W.

    2018-04-01

    This research aimed to reveal how the relationship between metacognitive ability and the test result of biology teacher competence in Sijunjung District. The population of this descriptive research were all high school biology teachers in Sijunjung District, and sample is all teachers who are members of the population, which is 23 biology teachers. The instrument used in this research are a questionnaire of research on teacher's metacognitive ability and document about teacher competence test result. The questionnaire was validated first by two lecturers of biology and one lecturer of English. Data analysis using Pearson Product Moment's. Based on the results of research and discussion that have been described, it can generally be concluded that there is a low relationship between metacognitive ability with competence test results of high school biology teachers in Sijunjung District. Partially, the relationship of metacognitive ability with the test result of professional competence of biology teacher showed significant result, with correlation coefficient 0,46 and t table 1,72 while titung 2,37. The contribution of metacognitive ability to the competence test result of the teacher is 21.6%, while the other 78.4% have not been revealed in this research.

  7. 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.

  8. 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. Copyright © 2016. Published by Elsevier Ltd.

  9. Devolatilization kinetics of woody biomass at short residence times and high heating rates and peak temperatures

    DEFF Research Database (Denmark)

    Johansen, Joakim M.; Gadsbøll, Rasmus; Thomsen, Jesper

    2016-01-01

    This work combines experimental and computational fluid dynamics (CFD) results to derive global kinetics for biomass (pine wood) devolatilization during heating rates on the order of 105Ks-1, bulk flow peak temperatures between 1405 and 1667K, and particle residence times below 0.1s. Experiments......Jmol-1. The accuracy of the derived global kinetics was supported by comparing predictions to experimental results from a 15kW furnace. The work emphasizes the importance of characterizing the temperature history of the biomass particles when deriving pyrolysis kinetics. The present results indicate...

  10. The Effect of the Entrepreneurial Learning Design on Students' Entrepreneurial Competence in Vocational High Schools in Makassar

    Science.gov (United States)

    Muhe, Arniati; Tawe, Amiruddin

    2016-01-01

    This study aims at determining to what extent the entrepreneurial learning design influences students' entrepreneurial competence in the Vocational High School in the Makassar. To achieve that goal, then some data collection techniques were used namely documentation and questionnaires. The data were analyzed using several techniques namely…

  11. 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…

  12. The Development of a Competency Based Food Preparations Curriculum for High School Special Needs Students in New Castle County, Delaware.

    Science.gov (United States)

    Stewart, Richard Lee

    A competency-based culinary arts food preparation curriculum for Delaware high school students with special needs was developed during a project that included the following activities: review of the state's existing culinary arts curriculum for regular education students; incumbent worker survey administered to 24 restaurant…

  13. 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.

  14. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  15. 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.

  16. Asymptomatic dogs are highly competent to transmit Leishmania (Leishmania) infantum chagasi to the natural vector.

    Science.gov (United States)

    Laurenti, Márcia Dalastra; Rossi, Claudio Nazaretian; da Matta, Vânia Lúcia Ribeiro; Tomokane, Thaise Yumie; Corbett, Carlos Eduardo Pereira; Secundino, Nágila Francinete Costa; Pimenta, Paulo Filemon Paulocci; Marcondes, Mary

    2013-09-23

    levels (p=0.0379). Age and gender did not influence the transmissibility. Our data show that asymptomatic dogs are highly infective and competent for establishing sand fly infection, indicating their role in maintaining L. (L.) infantum chagasi cycle as well as their involvement in VL spreading in endemic areas. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Validation of the high performance leadership competencies as measured by an assessment centre in-basket

    Directory of Open Access Journals (Sweden)

    H. H. Spangenberg

    2003-10-01

    Full Text Available The purpose of this study was to validate Schroder’s High Performance Leadership Competencies (HPLCs, measured by a specially designed In-basket, against multiple criteria. These consisted of six measures of managerial success, representing managerial advancement and salary progress criteria, and a newly developed comprehensive measure of work unit performance, the Performance Index. An environmental dynamism and complexity questionnaire served as moderator variable. Results indicated disappointing predictive validity quotients for the HPLCs as measured by an In-basket, in contrast to satisfactory predictive and construct validity obtained in previous studies by means of a full assessment centre. The implications of the findings are discussed and suggestions are made for improving the validity of the In-basket. Opsomming Die doel van hierdie studie was die validering van Schroder se Hoëvlak Leierskapsbevoegdhede, gemeet deur ‘n spesiaal ontwerpte Posmandjie, teen veelvoudige kriteria. Dit behels ses metings van bestuursukses wat bestuursbevorderings- en salarisvorderingskriteria insluit, sowel as ‘n nuutontwikkelde, omvattende meting van werkeenheidsprestasie, die Prestasie indeks. ‘n Vraelys wat die dinamika en kompleksiteit van die omgewing meet, het as moderator veranderlike gedien. Resultate dui op teleurstellende geldigheidskwosiënte vir die Hoëvlak Leierskapsbevoegdhede soos gemeet deur ‘n posmandjie, in teenstelling met bevredigende voorspellings- en konstrukgeldigheid wat in vorige studies deur middel van ‘n volle takseersentrum verkry is. Die bevindinge word bespreek en voorstelle word gemaak om die geldigheidskwosiënte te verbeter.

  18. Ultrasensitive direct competitive FLISA using highly luminescent quantum dot beads for tuning affinity of competing antigens to antibodies

    Energy Technology Data Exchange (ETDEWEB)

    Xiong, Sicheng; Zhou, Yaofeng; Huang, Xiaolin [State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047 (China); Yu, Ruijin [College of Science, Northwest A& F University, Yangling, Shaanxi 712100 (China); Lai, Weihua [State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047 (China); Xiong, Yonghua, E-mail: yhxiongchen@163.com [State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047 (China)

    2017-06-15

    Herein, for the first time we report a novel direct competitive fluorescence-linked immunosorbent assay (dcFLISA) for the ultrasensitive detection of ochratoxin A (OTA) by introducing a large size polymer beads loaded with quantum dots (QBs) as carrier of competing antigen for decreasing binding affinity to antibody and enhancing the fluorescent signal intensity. When using 255 nm QBs as carrier of competing antigen, the equilibrium dissociation constant of QB based competing antigen to antibodies can be tuned to 100 times higher than that of the horseradish peroxidase (HRP) based competing antigen by controlling labeled amounts of antigen on the surface of QBs. Various parameters that influenced the sensitivity of dcFLISA were investigated and optimized. Under optimum detection parameters, the dynamic linear range of developed dcFLISA for detecting OTA was established at 0.05 pg/mL to 1.56 pg/mL with a half maximal inhibitory concentration at 0.14 ± 0.04 pg/mL (n = 5), which is three orders of magnitude lower than that of conventional HRP-based dcELISA (0.24 ng/mL). The developed FLISA is also highly accurate, reliable, and shows no cross reaction to other mycotoxins. In summary, the proposed method offers a straightforward approach to improve the sensitivity of direct competitive immunoassay for trace small chemical molecule detection in food quality control, environmental monitoring, and clinical diagnosis. - Highlights: • Highly luminescent QBs were used as a carrier of competing antigen for ultrasensitive detection of OTA. • It is the first time to use a large size QBs as a carrier for tuning affinity of competing antigen to antibodies. • IC{sub 50} value of QB-based dcFLISA is three orders of magnitude lower than that of HRP-based dcELISA.

  19. Ultrasensitive direct competitive FLISA using highly luminescent quantum dot beads for tuning affinity of competing antigens to antibodies

    International Nuclear Information System (INIS)

    Xiong, Sicheng; Zhou, Yaofeng; Huang, Xiaolin; Yu, Ruijin; Lai, Weihua; Xiong, Yonghua

    2017-01-01

    Herein, for the first time we report a novel direct competitive fluorescence-linked immunosorbent assay (dcFLISA) for the ultrasensitive detection of ochratoxin A (OTA) by introducing a large size polymer beads loaded with quantum dots (QBs) as carrier of competing antigen for decreasing binding affinity to antibody and enhancing the fluorescent signal intensity. When using 255 nm QBs as carrier of competing antigen, the equilibrium dissociation constant of QB based competing antigen to antibodies can be tuned to 100 times higher than that of the horseradish peroxidase (HRP) based competing antigen by controlling labeled amounts of antigen on the surface of QBs. Various parameters that influenced the sensitivity of dcFLISA were investigated and optimized. Under optimum detection parameters, the dynamic linear range of developed dcFLISA for detecting OTA was established at 0.05 pg/mL to 1.56 pg/mL with a half maximal inhibitory concentration at 0.14 ± 0.04 pg/mL (n = 5), which is three orders of magnitude lower than that of conventional HRP-based dcELISA (0.24 ng/mL). The developed FLISA is also highly accurate, reliable, and shows no cross reaction to other mycotoxins. In summary, the proposed method offers a straightforward approach to improve the sensitivity of direct competitive immunoassay for trace small chemical molecule detection in food quality control, environmental monitoring, and clinical diagnosis. - Highlights: • Highly luminescent QBs were used as a carrier of competing antigen for ultrasensitive detection of OTA. • It is the first time to use a large size QBs as a carrier for tuning affinity of competing antigen to antibodies. • IC_5_0 value of QB-based dcFLISA is three orders of magnitude lower than that of HRP-based dcELISA.

  20. Local Attitudes Towards AN International Project: a Study of Residents' Attitudes Towards a Future High Speed Rail Line in General and Towards Annoyance in Particular

    Science.gov (United States)

    Schaap, D.

    1996-05-01

    Plans for a high speed rail line in Holland generate concerns about the impact on the living environment. Residents living near the planned track have an extremely negative attitude towards the high speed rail line. Most of them do not see the need for the line and they expect a great deal of noise annoyance. There is a disparity between the expectations of the residents and those of the government: the residents expect much more noise that the government does, on the basis of scientific research. The image that residents have of the noise of a high speed train is probably too negative. Therefore the government should supply the residents with better and more detailed information about the noise and the possible annoyance. Furthermore, for a positive attitude, it is important that residents not only recognize the disadvantages of the rail line, but that they recognize some local advantages too. For instances, the government can guarantee compensation for the affected green space, or that other noise sources will be removed. Finally, the residents have the feeling they cannot influence the decision-making process. To reduce this feeling of powerlessness, the government can involve the residents; for example, in the decision-making about the local plans for the high speed rail line.

  1. An investigation into the knowledge and attitudes towards radon testing among residents in a high radon area

    International Nuclear Information System (INIS)

    Clifford, Susan; Menezes, Gerard; Hevey, David

    2012-01-01

    The aim of this study was to investigate the knowledge and attitudes of residents in the Castleisland area to radon. Castleisland in Co. Kerry was described as a high radon area following the discovery of a house in the area with radon levels 245 times that of the national reference level. Residents in this area were then asked to measure their homes for radon in the Castleisland radon survey. The uptake of this measurement was 17%. In order to investigate this response rate further, a questionnaire was designed and distributed to residents in the Castleisland area. This questionnaire measured the testing history of the participants, the reasons for testing/not testing, the factors important to them when considering having their home tested, radon knowledge and finally intentions to measure their home for radon. It was found that the main reason people do not test their home for radon is that they believe their home does not have a problem. Optimistic bias was thought to play a role here. The subjective norm component of the theory of planned behaviour was found to have a significant independent contribution in the variation in intentions to measure one’s home for radon and this in turn could be targeted to increase uptake of radon measurement in the future. (note)

  2. 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.

    2015-01-01

    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. PMID:26161136

  3. 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.

  4. Las competencias profesionales adquiridas en medicina familiar y comunitaria: Una mirada desde tutores y residentes Professional competencies acquired in family and community medicine: An overwiew from tutors and residents

    Directory of Open Access Journals (Sweden)

    Eulalia Ros Martrat

    2004-12-01

    Full Text Available El estudio tenía como objetivo analizar y contrastar las percepciones de tutores y de sus respectivos residentes en la especialidad de Medicina Familiar y Comunitaria sobre las competencias profesionales adquiridas al finalizar la formación de postgrado. Para ello se combinó información cuantitativa y cualitativa. Primero se utilizó un cuestionario para recoger una primera opinión de dos poblaciones: los residentes (R3 de Cataluña de esta especialidad (N=240 y sus respectivos tutores (N=240. Después se organizaron grupos de discusión para analizar y clarificar los datos obtenidos en el cuestionario. Este proceso se realizó en paralelo con ambos colectivos. Los resultados mostraron que estadísticamente la percepción de los tutores sobre el grado de capacitación obtenido al finalizar el periodo de residencia es o muy similar o superior a la de los propios residentes y en general bastante positiva. Las áreas más valoradas son las habilidades clínicas básicas, habilidades de manejo, comunicación y preventiva; las menos valoradas, docencia, investigación y comunitaria quedando las otras áreas (técnicas instrumentales, aspectos organizativos y familia en una posición intermedia. Sin embargo, los datos narrativos ofrecen una visión más compleja de la realidad. Los resultados apuntan que la formación del especialista sigue poniendo más énfasis en la atención al individuo que en áreas vinculadas a un enfoque integral de la salud.This study analyses and contrasts the perceptions of tutors and their respective residents in the Family and Community Medicine speciality regarding the professional competencies acquired by the end of their postgraduate training. The study combined quantitative and qualitative data. Firstly, a questionnaire was used to collect a first opinion from two populations: residents (R3 in this speciality in Catalan hospitals (N=240 and their tutors (N=240. Discussion groups were then organised in order to

  5. Competing orbital ordering in RVO3 compounds: High-resolution x-ray diffraction and thermal expansion

    International Nuclear Information System (INIS)

    Sage, M. H.; Blake, G. R.; Palstra, T. T. M.; Marquina, C.

    2007-01-01

    We report evidence for the phase coexistence of orbital orderings of different symmetry in RVO 3 compounds with intermediate-size rare earths. Through a study by high-resolution x-ray powder diffraction and thermal expansion, we show that the competing orbital orderings are associated with the magnitude of the VO 6 octahedral tilting and magnetic exchange striction in these compounds and that the phase-separated state is stabilized by lattice strains

  6. 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

  7. [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.

  8. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    Science.gov (United States)

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

    2017-01-01

    Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  9. 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.

  10. Pediatric Integrative Medicine in Residency Program: Relationship between Lifestyle Behaviors and Burnout and Wellbeing Measures in First-Year Residents.

    Science.gov (United States)

    McClafferty, Hilary; Brooks, Audrey J; Chen, Mei-Kuang; Brenner, Michelle; Brown, Melanie; Esparham, Anna; Gerstbacher, Dana; Golianu, Brenda; Mark, John; Weydert, Joy; Yeh, Ann Ming; Maizes, Victoria

    2018-04-23

    It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME) core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR) curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents ( N = 203), and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.

  11. Pediatric Integrative Medicine in Residency Program: Relationship between Lifestyle Behaviors and Burnout and Wellbeing Measures in First-Year Residents

    Directory of Open Access Journals (Sweden)

    Hilary McClafferty

    2018-04-01

    Full Text Available It is widely recognized that burnout is prevalent in medical culture and begins early in training. Studies show pediatricians and pediatric trainees experience burnout rates comparable to other specialties. Newly developed Accreditation Council for Graduate Medical Education (ACGME core competencies in professionalism and personal development recognize the unacceptably high resident burnout rates and present an important opportunity for programs to improve residents experience throughout training. These competencies encourage healthy lifestyle practices and cultivation of self-awareness, self-regulation, empathy, mindfulness, and compassion—a paradigm shift from traditional medical training underpinned by a culture of unrealistic endurance and self-sacrifice. To date, few successful and sustainable programs in resident burnout prevention and wellness promotion have been described. The University of Arizona Center for Integrative Medicine Pediatric Integrative Medicine in Residency (PIMR curriculum, developed in 2011, was designed in part to help pediatric programs meet new resident wellbeing requirements. The purpose of this paper is to detail levels of lifestyle behaviors, burnout, and wellbeing for the PIMR program’s first-year residents (N = 203, and to examine the impact of lifestyle behaviors on burnout and wellbeing. The potential of the PIMR to provide interventions addressing gaps in lifestyle behaviors with recognized association to burnout is discussed.

  12. Magnetic fields and cancer in people residing near Swedish high voltage power lines

    Energy Technology Data Exchange (ETDEWEB)

    Feychting, M; Ahlbom, A

    1992-01-01

    The study was designed as a case-control study, based on the population comprised of everyone who have lived on a property located within 300 meters from any of the 220 and 400 kV power lines in Sweden during the period from 1960 through 1985. For adults it was required that the duration of residence was at least one year. The corridor was chosen to be wide enough to ensure that it included both exposed and unexposed homes. The cases were all instances of cancer diagnosed between 1960-85. For children, all types of cancer were included, while for adults the study was restricted to leukemia and brain tumors. The controls were matched to the cases on time of diagnosis, age, sex, parish, and power line. Exposure was assessed in several different ways. First, spot measurements were performed in the homes of the subjects. Second, the magnetic fields generated by the power lines were calculated by means of a computer program taking distance, line configuration, and load into account. For childhood leukemia and with cut off points at 0.1 and 0.2 [mu]T, the relative risk (RR) increased over the two exposure levels and was estimated at 2.7 (95% c.l.: 1.0-6,3) for 0.2 [mu]T and over. The test for trend gave a p-value of 0.02. When the upper cut off point was shifted to 0.3 [mu]T the RR was instead 3.8 (1.4-9.3) and the corresponding trend test gave a p-value of 0.005. In adults and for magnetic fields of 0.2 [mu]T and over, the RR for acute myeloid (AML) and chronic myeloid leukemia (CML) were estimated at 1.7 (0.8-3.5) and 1.7 (0.7-3.8), respectively. This result persisted in most analyses. For brain tumours no association was seen. The results provide support for the hypothesis that exposure to magnetic fields increase the risk of cancer. This is most evident in childhood leukemia. What aspect of the fields that might be involved remains unclear. (6 figs., 82 tabs., 16 refs.).

  13. Magnetic fields and cancer in people residing near Swedish high voltage power lines

    Energy Technology Data Exchange (ETDEWEB)

    Feychting, M; Ahlbom, A

    1993-12-31

    The study was designed as a case-control study, based on the population comprised of everyone who have lived on a property located within 300 meters from any of the 220 and 400 kV power lines in Sweden during the period from 1960 through 1985. For adults it was required that the duration of residence was at least one year. The corridor was chosen to be wide enough to ensure that it included both exposed and unexposed homes. The cases were all instances of cancer diagnosed between 1960-85. For children, all types of cancer were included, while for adults the study was restricted to leukemia and brain tumors. The controls were matched to the cases on time of diagnosis, age, sex, parish, and power line. Exposure was assessed in several different ways. First, spot measurements were performed in the homes of the subjects. Second, the magnetic fields generated by the power lines were calculated by means of a computer program taking distance, line configuration, and load into account. For childhood leukemia and with cut off points at 0.1 and 0.2 {mu}T, the relative risk (RR) increased over the two exposure levels and was estimated at 2.7 (95% c.l.: 1.0-6,3) for 0.2 {mu}T and over. The test for trend gave a p-value of 0.02. When the upper cut off point was shifted to 0.3 {mu}T the RR was instead 3.8 (1.4-9.3) and the corresponding trend test gave a p-value of 0.005. In adults and for magnetic fields of 0.2 {mu}T and over, the RR for acute myeloid (AML) and chronic myeloid leukemia (CML) were estimated at 1.7 (0.8-3.5) and 1.7 (0.7-3.8), respectively. This result persisted in most analyses. For brain tumours no association was seen. The results provide support for the hypothesis that exposure to magnetic fields increase the risk of cancer. This is most evident in childhood leukemia. What aspect of the fields that might be involved remains unclear. (6 figs., 82 tabs., 16 refs.).

  14. Readiness for Residency: A Survey to Evaluate Undergraduate Medical Education Programs.

    Science.gov (United States)

    Peterson, Linda N; Rusticus, Shayna A; Wilson, Derek A; Eva, Kevin W; Lovato, Chris Y

    2015-11-01

    Health professions programs continue to search for meaningful and efficient ways to evaluate the quality of education they provide and support ongoing program improvement. Despite flaws inherent in self-assessment, recent research suggests that aggregated self-assessments reliably rank aspects of competence attained during preclerkship MD training. Given the novelty of those observations, the purpose of this study was to test their generalizability by evaluating an MD program as a whole. The Readiness for Residency Survey (RfR) was developed and aligned with the published Readiness for Clerkship Survey (RfC), but focused on the competencies expected to be achieved at graduation. The RfC and RfR were administered electronically four months after the start of clerkship and six months after the start of residency, respectively. Generalizability and decision studies examined the extent to which specific competencies were achieved relative to one another. The reliability of scores assigned by a single resident was G = 0.32. However, a reliability of G = 0.80 could be obtained by averaging over as few as nine residents. Whereas highly rated competencies in the RfC resided within the CanMEDS domains of professional, communicator, and collaborator, five additional medical expert competencies emerged as strengths when the program was evaluated after completion by residents. Aggregated resident self-assessments obtained using the RfR reliably differentiate aspects of competence attained over four years of undergraduate training. The RfR and RfC together can be used as evaluation tools to identify areas of strength and weakness in an undergraduate medical education program.

  15. Postoperative electrolyte management: Current practice patterns of surgeons and residents.

    Science.gov (United States)

    Angarita, Fernando A; Dueck, Andrew D; Azouz, Solomon M

    2015-07-01

    Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents. An online survey was distributed among attending surgeons and surgical residents at the University of Toronto. The survey was designed according to a systematic approach for formulating self-administered questionnaires. Questions addressed workload, decision making in hypothetical clinical scenarios, and improvement strategies. Of 232 surveys distributed, 156 were completed (response rate: 67%). The majority stated that junior residents were responsible for managing electrolytes at 13 University of Toronto-affiliated hospitals. Supervision was carried out predominately by senior residents (75%). Thirteen percent reported management went unsupervised. Approximately 59% of residents were unaware how often attending surgeons assessed patients' electrolytes. Despite the majority of residents (53.7%) reporting they were never given tools or trained in electrolyte replacement, they considered themselves moderately or extremely confident. The management of hypothetical clinical scenarios differed between residents and attending surgeons. The majority (50.5%) of respondents considered that an electrolyte replacement protocol is the most appropriate improvement strategy. Electrolyte replacement represents an important component of surgeons' workload. Despite reporting that formal training in electrolyte management is limited, residents consider themselves competent; however, their practice is highly variable and often differs from pharmacologic-directed recommendations. Optimizing how postoperative electrolytes are managed in surgical wards requires building a framework that improves knowledge, training, and limits unnecessary interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The Role of Challenge in Students' Engagement and Competence in High School Science Classrooms: Hispanic and Non-Hispanic Whites Compared

    Science.gov (United States)

    Schmidt, Jennifer A.; Kackar-Cam, Hayal Z.; Strati, Anna D.; Shumow, Lee

    2015-01-01

    This study explores the associations of ethnicity and perceived challenge with high-school students' academic engagement and perceived competence in science. Data were collected through a variant of the Experience Sampling Method in which participants reported on their levels of engagement, perceived competence, and challenge while in science…

  17. Nutritional Value and Utilization of Yams (Dioscorea steriscus by Residents of Bindura Town High Density Suburbs, Zimbabwe

    Directory of Open Access Journals (Sweden)

    S. Washaya

    2016-01-01

    Full Text Available The objective of this study was to assess utilization levels, availability, nutritional value, and magnitude of sales by vendors of Dioscorea steriscus by residents of Bindura. A multistage sampling procedure was used to select respondents. Data were subjected to Chi-square, logistic regression, and correlation to determine the effects of demographic determinants on utilization of D. steriscus. Questionnaires were used to collect data. Results show that education status and period of stay significantly affect the consumption of D. steriscus (P<0.05. It was also observed that consumption is frequent between lunch and supper (47% compared to breakfast. D. steriscus has high iron (6.8%, ash (2.06%, and CF (16.8% contents but it is low in protein (0.83%. Irrespective of gender of respondent, suburb of residence, size of family, period of stay, education level, employment status, and source of income, respondents will grow D. steriscus for use as food supplement (odds ratio = 0.475. The period of stay (r=0.08 and education level (r=0.08 positively affect the growing of D. steriscus. D. steriscus can be used as source of energy and can also be used possibly for medicinal purposes. Further study is required on possibility of phytochemicals and cytotoxic components to justify its use.

  18. Hemoglobin correction factors for estimating the prevalence of iron deficiency anemia in pregnant women residing at high altitudes in Bolivia

    Directory of Open Access Journals (Sweden)

    Jennifer Hadary Cohen

    1999-12-01

    Full Text Available This study had two primary objectives: 1 to derive a method to determine hemoglobin cutoffs that could be used to better estimate the prevalence of iron deficiency anemia in pregnancy at high altitudes and 2 to estimate the prevalence of anemia in a sample of pregnant women residing in two cities in Bolivia, La Paz (3 600 meters and El Alto (4 000 meters. We derived a hemoglobin-altitude curve from previously published data on the mean hemoglobin concentrations of nonanemic women of childbearing age at various altitudes. In addition, we abstracted data on hemoglobin concentration during pregnancy from medical records of women from La Paz and El Alto who had given birth at a maternity hospital in La Paz between January and June of 1996. Using our approach and two other previously published, currently used methods, we calculated and compared prevalences of iron deficiency anemia in this population using hemoglobin cutoffs determined from a hemoglobin-altitude curve corrected for pregnancy. The hemoglobin-altitude curve derived in this study provided a better fit to data for women of childbearing age than the two other models. Those models used cutoffs based on non-iron-replete populations of children or men, both of which were residing below 4 000 m, and then extrapolated to women and higher altitudes. The estimated prevalences of iron deficiency anemia in pregnancy using the hemoglobin cutoffs determined in this study were higher than those estimated by the two other approaches.

  19. How socio-emotional competences work on students with high abilitie

    Directory of Open Access Journals (Sweden)

    Marta SAINZ GÓMEZ

    2015-10-01

    Full Text Available The aim of this paper is to study social-emotional competences of a group of talented students. For this purpose 1237 secondary school students have participated, in which 231 students a 8.3% were identified as figurative talents, a 2.7% as academical talents and a 7.6% as combined talents (figurative and academical, where 145 (62.6% were boys. All of them are studying in different education centres in Spain both public and private. Identification was made according to the criteria developed by Castelló & Battle (1998. The students ages range from 11 to 17 years old (M = 13.91; DT = 1.182. The instrument used to measure social-emotional competences was the Emotional Quotient Inventory: Youth Version, EQ-i:YV (Bar-On & Parker, 2000. The Bar-On EQ-i:YV is a 60-item self-report inventory which assesses emotional intelligence (EI in youths aged from 7 to 18 years old. The results indicate that figurative talented students show a higher stress management; while the combinated talents (figurative and academical talent show higher intrapersonal and adaptability competences.

  20. 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...... present study. The pressure tolerance and optimal duration of recovery after HHP treatment were determined. Oocytes were treated with either 20 or 40 MPa (200 and 400 times greater than atmospheric pressure) for 60 min, with an interval of 10, 70, and 130 min between pressure treatment and subsequent...... vitrification under each pressure parameter. Oocytes from all vitrification groups had much lower developmental competence than fresh oocytes (Ppressure, with either 70...

  1. 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

  2. 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.

  3. Indoor Air Quality in 24 California Residences Designed as High Performance Green Homes

    OpenAIRE

    Less, Brennan

    2012-01-01

    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 IAQ cannot be fully determined by past efforts.  This research assessed IAQ in 24 new or deeply retrofitted homes designed to be high performance green buildings in California using pollutant measurements, home inspections, diagnostic testing and occupant surveys.  Measurements included six-day passive samples of nitrogen oxi...

  4. 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.

  5. 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.

  6. Prevalence of sun protection behaviors in Hispanic youth residing in a high ultraviolet light environment.

    Science.gov (United States)

    Altieri, Lisa; Miller, Kimberly A; Huh, Jimi; Peng, David H; Unger, Jennifer B; Richardson, Jean L; Allen, Martin W; Cockburn, Myles

    2018-01-01

    Although rates of late-stage melanoma are rising in Hispanics, particularly those living in high ultraviolet light environments, little is known about the prevalence of sun protective behaviors in Hispanic children. We analyzed baseline data including frequency of sunburn, sun protective behaviors, level of U.S. acculturation, and skin phototype from a cross-sectional survey of 2003 Hispanic elementary school children in Los Angeles, California, who participated in a skin cancer prevention intervention. Although the Hispanic children reported frequently engaging in some sun protective behaviors, they also had a high rate of sunburn (59%) that exceeded previous national estimates for non-Hispanic white children (43%). Fewer U.S.-acculturated children reported more frequent shade-seeking at home (P = .02), along with less shade-seeking at school (P = .001) and more sunscreen use at school (P = .02). The surprisingly high rate of sunburn in Hispanic children suggests that the way in which they are practicing sun protection is not preventing sunburns. Sun safety interventions should be targeted toward Hispanic youth to provide them with practical methods of effective sun protection, in addition to education on the risks of high sun exposure. © 2017 Wiley Periodicals, Inc.

  7. High-fat diet-induced brain region-specific phenotypic spectrum of CNS resident microglia.

    Science.gov (United States)

    Baufeld, Caroline; Osterloh, Anja; Prokop, Stefan; Miller, Kelly R; Heppner, Frank L

    2016-09-01

    Diets high in fat (HFD) are known to cause an immune response in the periphery as well as the central nervous system. In peripheral adipose tissue, this immune response is primarily mediated by macrophages that are recruited to the tissue. Similarly, reactivity of microglia, the innate immune cells of the brain, has been shown to occur in the hypothalamus of mice fed a high-fat diet. To characterize the nature of the microglial response to diets high in fat in a temporal fashion, we studied the phenotypic spectrum of hypothalamic microglia of mice fed high-fat diet for 3 days and 8 weeks by assessing their tissue reaction and inflammatory signature. While we observed a significant increase in Iba1+ myeloid cells and a reaction of GFAP+ astrocytes in the hypothalamus after 8 weeks of HFD feeding, we found the hypothalamic myeloid cell reaction to be limited to endogenous microglia and not mediated by infiltrating myeloid cells. Moreover, obese humans were found to present with signs of hypothalamic gliosis and exacerbated microglia dystrophy, suggesting a targeted microglia response to diet in humans as well. Notably, the glial reaction occurring in the mouse hypothalamus was not accompanied by an increase in pro-inflammatory cytokines, but rather by an anti-inflammatory reaction. Gene expression analyses of isolated microglia not only confirmed this observation, but also revealed a downregulation of microglia genes important for sensing signals in the microenvironment. Finally, we demonstrate that long-term exposure of microglia to HFD in vivo does not impair the cell's ability to respond to additional stimuli, like lipopolysaccharide. Taken together, our findings support the notion that microglia react to diets high in fat in a region-specific manner in rodents as well as in humans; however, this response changes over time as it is not exclusively pro-inflammatory nor does exposure to HFD prime microglia in the hypothalamus.

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

    Directory of Open Access Journals (Sweden)

    Graziela Sapienza

    2009-01-01

    Full Text Available 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.

  9. 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.

  10. Cytogenetic study of stable chromosome aberrations in residents of a high background radiation area in China

    International Nuclear Information System (INIS)

    Zhang Wei; Wang Chunyan; Chen Deqing; Wei Lvxin

    2004-01-01

    Objective: To investigate the effect of high background radiation on the induction of stable chromosome aberrations. Methods: By fluorescence in situ hybridization (FISH) technique chromosome Nos. 1, 2 and 4 were painted using specific biotin-labeled whole chromosome painting probes. Peripheral blood specimens were taken from 31 individuals living in the high background radiation area (HRBA) and 29 individuals in the control area. Results: No significant difference was found in the frequencies of translocations between HBRA and the control (P>0.05, Mann-Whitney U test) for both children and elderly individuals. On the other hand, correlation between age and translocation frequencies was significant at the 1% level (r s =0.388 with 56DF). Conclusion: There are no differences in the frequencies of translocations between HBRA and the control area. The present result indicates that the contribution of an elevated level of natural radiation in HBRA in China to the induction rate of stable type aberrations (translocations) dose not have a significant effect compared with the contributions from all other sources such as chemical mutagens and(or) metabolic factors. (authors)

  11. 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

  12. Biological effects of high level natural background radiation on human population residing in Kerala coast, South West India

    International Nuclear Information System (INIS)

    Seshadri, M.

    2010-01-01

    The populations residing in Kerala coast are exposed to elevated natural background radiation since many generations. Extensive studies conducted by Bio-Medical group, Bhabha Atomic Research Center have generated wealth of data from this area dealing with epidemiology, monitoring the newborns for malformations, Health Audit Survey, Dosimetry and biological studies using cytogenetic and molecular biology techniques. Our studies on congenital malformations and chromosomal anomalies in children born to parents residing in High Level Natural Radiation Areas in Kerala have not shown any significant difference from normal radiation areas. Screening of over 1,25,000 consecutively born children showed an incidence rate which is comparable in both areas. Other factors such as consanguinity, maternal age and gravida status are more significant contributors than radiation dose to the risk for having malformation in child. Radiation prevalent in the HLNRA is in the dose range of above 1.5 to about 50 mGy per year which translates to doses in the range of nGy per hour. This clearly indicate the number of cells exposed to radiations will be one in few thousand or ten thousands. This throws up challenges in our capability to investigate the effects of radiation on cells. It has become imperative to develop and exploit techniques which will detect responses in single cells and would be able screen large number of cells at a time. Developments in cell biology and molecular biology are now giving us these capabilities. Use of flowcytometer and next generation sequencing would enable us to address many of these questions and provide meaningful approaches to understand the effects of such low dose radiation

  13. High-fidelity simulation of lung isolation with double-lumen endotracheal tubes and bronchial blockers in anesthesiology resident training.

    Science.gov (United States)

    Failor, Erin; Bowdle, Andrew; Jelacic, Srdjan; Togashi, Kei

    2014-08-01

    Demonstrate the feasibility of using the AirSim Bronchi airway simulator to teach residents how to manage lung isolation with double-lumen endotracheal tubes and bronchial blockers and evaluate their performance with a detailed checklist. Prospective observational study. University anesthesiology residency training program. Anesthesiology residents taking a cardiothoracic anesthesiology rotation. Residents were instructed in 7 tasks using the AirSim Bronchi: The use of the fiberoptic bronchoscope, methods for placing left and right double-lumen endotracheal tubes and 3 bronchial blockers (Univent, Arndt, and Cohen), and application of continuous positive airway pressure (CPAP) to the unventilated lung. Two to 3 weeks later, checklists and a detailed scoring system were used to assess performance. Residents rated the curriculum and their own confidence in performing the tasks using a 5-point Likert scale. Thirteen residents completed the curriculum. Their median Likert scale ratings of the curriculum based on a questionnaire with 6 items ranged from 4 to 5 of 5. Resident confidence scores for each lung isolation technique improved after the simulation training, with the median gain ranging from 0.5 to 1.5 Likert levels depending on the task. The largest improvement occurred with the bronchial blockers (psimulator in a novel simulation curriculum to teach lung-isolation techniques to anesthesiology residents and evaluated performance using a detailed checklist scoring system. This curriculum is a promising educational tool. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Germline mutation rates in families residing in high level natural radiation areas of Kerala coast in southwest India

    International Nuclear Information System (INIS)

    Das, Birajalaxmi; Ghosh, Anu; Ahmad, Shazia; Saini, DivyaIakshmi; Chauhan, P.S.; Seshadri, M.

    2010-01-01

    For this study, 200 nuclear families have been analyzed using over 40 mini- and microsatellite markers. Cord blood samples for the child and peripheral blood samples for the parent(s) were collected in EDTA vacuutainers from the hospital units located in High Level Natural Radiation Areas (HLNRA) and Normal Level Natural Radiation Areas (NLNRA). Both the parents of the newborn were exposed to the background dose. The families were grouped into four distinct dose groups - NLNRA group 5.00 mGy/year. An overall mutation rate of 2.08 X 10 -3 per cell per generation was observed for NLNRA and 2.12 X 10 -3 per cell per generation for HLNRA families. No radiation induced dose response was observed for the stratified groups. Thus, this study shows that mutation rates at mini- and microsatellites in the off springs of the parents living in the high background radiation areas of Kerala does not vary with radiation exposure. This is the first report to understand germline mutation rates at hypervariable loci in families residing in high level natural radiation areas of the world

  15. The Competence Readiness of the Electrical Engineering Vocational High School Teachers in Manado towards the ASEAN Economic Community Blueprint in 2025

    OpenAIRE

    Fid Jantje Tasiam; Djoko Kustono; Purnomo Purnomo; Hakkun Elmunsyah

    2017-01-01

    This paper presents the competence readiness of the electrical engineering vocational high school teachers in Manado towards ASEAN Economic Community blueprint in 2025. The objective of this study is to get the competencies readiness description of the electrical engineering vocational high school teachers in Manado towards ASEAN Economic Community blueprint in 2025. Method used quantitative and qualitative approach which the statistical analysis in quantitative and the inductive analysis use...

  16. 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.

  17. High-fidelity simulation-based team training in urology: evaluation of technical and nontechnical skills of urology residents during laparoscopic partial nephrectomy.

    Science.gov (United States)

    Abdelshehid, Corollos S; Quach, Stephen; Nelson, Corey; Graversen, Joseph; Lusch, Achim; Zarraga, Jerome; Alipanah, Reza; Landman, Jaime; McDougall, Elspeth M

    2013-01-01

    The use of low-risk simulation training for resident education is rapidly expanding as teaching centers integrate simulation-based team training (SBTT) sessions into their education curriculum. SBTT is a valuable tool in technical and communication skills training and assessment for residents. We created a unique SBTT scenario for urology residents involving a laparoscopic partial nephrectomy procedure. Urology residents were randomly paired with a certified registered nurse anesthetists or an anesthesia resident. The scenario incorporated a laparoscopic right partial nephrectomy utilizing a unique polyvinyl alcohol kidney model with an embedded 3cm lower pole exophytic tumor and the high-fidelity SimMan3G mannequin. The Urology residents were instructed to pay particular attention to the patient's identifying information provided at the beginning of the case. Two scripted events occurred, the patient had an anaphylactic reaction to a drug and, after tumor specimen was sent for a frozen section, the confederate pathologist called into the operating room (OR) twice, first with the wrong patient name and subsequently with the wrong specimen. After the scenario was complete, technical performance and nontechnical performance were evaluated and assessed. A debriefing session followed the scenario to discuss and assess technical performance and interdisciplinary nontechnical communication between the team. All Urology residents (n = 9) rated the SBTT scenario as a useful tool in developing communication skills among the OR team and 88% rated the model as useful for technical skills training. Despite cuing to note patient identification, only 3 of 9 (33%) participants identified that the wrong patient information was presented when the confederate "pathologist" called in to report pathology results. All urology residents rated SBTT sessions as useful for the development of communication skills between different team members and making residents aware of unlikely but

  18. Teacher competencies

    OpenAIRE

    Svatošová, Kateřina

    2012-01-01

    This diploma thesis deals with adult teacher competencies. It describes current situation in adult education and it focuses on measuring quality level of teacher competencies. There is given the main overview of adult education specifics. These are the prerequisites for defining adult teacher competencies. There is given specific adult teacher competencies and related roles which are generally based on teacher's activities during educational courses. Next part describes present conception of ...

  19. 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.

  20. AAOHN Competencies.

    Science.gov (United States)

    2015-11-01

    The AAOHN Competency document is one of the core documents that define occupational health nursing practice. This article provides a description of the process used to update the competencies, as well as a description of the new competencies. © 2015 The Author(s).

  1. Evaluation of the Vocational Competence of the Cookery Students: A Study on the Students of Hotels and Vocational High Schools

    Directory of Open Access Journals (Sweden)

    Yüksel Öztürk

    2011-06-01

    Full Text Available The trend of globalization affects the frame of tourism education. The rising competition conditions make the quality of tourism services more important. One of the most important elements of the quality of tourism services is the theorical and practical competence of labor. From the other point of view, cookery education has an important value in tourism education. Since the school year of 2005-2006, the moduler vocational education system has been followed and the cookery education has been given within the frame of National Cookery Vocational Qualification with the support of the EU in Türkiye. The objective of this study is to find out the theorical and practical competence levels of the cookery students within the frame of National Cookery Vocational Qualification. To serve this purpose, a questionnaire survey was conducted for 1014 cookery students of Hotels and Vocational High Schools in Türkiye and the theorical and practical competence levels of the students have been analyzed. According to the findings of the study, the students are more competenced on; “self care, self preparation for work, cooking kinds of pasta, cooking kinds of pilafs, preparing kinds of salads, preparing vegetable garnishes, cooking kinds of soups” subjects than the other subjects. From the other point of view, the students are less competenced on; “designating of daily portion quantities of food groups, cooking special kinds of international soups, cooking offal food particular to Turkish cuisine, preparing stewed fruit particular to Turkish cuisine and preparing seafood” than the other subjects.

  2. Personal finances of urology residents in Canada.

    Science.gov (United States)

    Teichman, J M; Tongco, W; MacNeily, A E; Smart, M

    2000-12-01

    We examined how Urology residents in Canada manage their personal finances. A survey instrument was designed to elicit information on demographics, expenses, savings and incomes. The questionnaire was completed by 40 Urology residents attending the 2000 Queen's Urology Exam Skills Training (QUEST) program. Twenty-eight residents (70%) had educational debt (median debt $50 000). Seventeen residents (45%) paid credit card interest charges within the last year. Four residents (10%) maintained an unpaid credit card balance > $7500 at 17% annual interest rate. Twenty-six residents (67%) contributed to Registered Retirement Savings Program (RRSP) accounts. Seventeen residents (44%) contributed to non-RRSP retirement accounts. Nineteen residents (50%) budgeted expenses. Median resident income was $45 000. Thirteen residents (34%) had cash reserves < $250. Many residents save little, and incur substantial debt over and above educational loans. Many residents would benefit from instruction concerning prudent financial management. Residents should be informed of the consequences of low saving and high debt.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Real time curriculum map for internal medicine residency

    Directory of Open Access Journals (Sweden)

    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.

  5. Feeding the world's largest fish: highly variable whale shark residency patterns at a provisioning site in the Philippines.

    Science.gov (United States)

    Thomson, Jordan A; Araujo, Gonzalo; Labaja, Jessica; McCoy, Emer; Murray, Ryan; Ponzo, Alessandro

    2017-09-01

    Provisioning wildlife for tourism is a controversial yet widespread practice. We analysed the residency patterns of juvenile whale sharks ( Rhincodon typus ) in Oslob, Philippines, where provisioning has facilitated a large shark-watching operation since 2011. We identified 208 individual sharks over three years, with an average of 18.6 (s.d. = 7.8, range = 6-43) individuals sighted per week. Weekly shark abundance varied seasonally and peak-season abundance (approx. May-November) increased across years. Whale sharks displayed diverse individual site visitation patterns ranging from a single visit to sporadic visits, seasonal residency and year-round residency. Nine individuals became year-round residents, which represents a clear response to provisioning. The timing of the seasonal peak at Oslob did not align with known non-provisioned seasonal aggregations elsewhere in the Philippines, which could suggest that seasonal residents at Oslob exploit this food source when prey availability at alternative sites is low. Since prolonged residency equates to less time foraging naturally, provisioning could influence foraging success, alter distributions and lead to dependency in later life stages. Such impacts must be carefully weighed against the benefits of provisioning (i.e. tourism revenue in a remote community) to facilitate informed management decisions.

  6. 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.

    Directory of Open Access Journals (Sweden)

    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

  7. 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.

  8. 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.

  9. The Quality of Written Feedback by Attendings of Internal Medicine Residents.

    Science.gov (United States)

    Jackson, Jeffrey L; Kay, Cynthia; Jackson, Wilkins C; Frank, Michael

    2015-07-01

    Attending evaluations are commonly used to evaluate residents. Evaluate the quality of written feedback of internal medicine residents. Retrospective. Internal medicine residents and faculty at the Medical College of Wisconsin from 2004 to 2012. From monthly evaluations of residents by attendings, a randomly selected sample of 500 written comments by attendings were qualitatively coded and rated as high-, moderate-, or low-quality feedback by two independent coders with good inter-rater reliability (kappa: 0.94). Small group exercises with residents and attendings also coded the utterances as high, moderate, or low quality and developed criteria for this categorization. In-service examination scores were correlated with written feedback. There were 228 internal medicine residents who had 6,603 evaluations by 334 attendings. Among 500 randomly selected written comments, there were 2,056 unique utterances: 29% were coded as nonspecific statements, 20% were comments about resident personality, 16% about patient care, 14% interpersonal communication, 7% medical knowledge, 6% professionalism, and 4% each on practice-based learning and systems-based practice. Based on criteria developed by group exercises, the majority of written comments were rated as moderate quality (65%); 22% were rated as high quality and 13% as low quality. Attendings who provided high-quality feedback rated residents significantly lower in all six of the Accreditation Council for Graduate Medical Education (ACGME) competencies (p service examination scores. Most attending written evaluation was of moderate or low quality. Attendings who provided high-quality feedback appeared to be more discriminating, providing significantly lower ratings of residents in all six ACGME core competencies, and across a greater range. Attendings' negative written comments on medical knowledge correlated with lower in-service training scores.

  10. Competences required for the delivery of high and low-intensity cognitive behavioural interventions for chronic fatigue, chronic fatigue syndrome/ME and irritable bowel syndrome.

    Science.gov (United States)

    Rimes, Katharine A; Wingrove, Janet; Moss-Morris, Rona; Chalder, Trudie

    2014-11-01

    Cognitive behavioural interventions are effective in the treatment of chronic fatigue, chronic fatigue syndrome (sometimes known as ME or CFS/ME) and irritable bowel syndrome (IBS). Such interventions are increasingly being provided not only in specialist settings but in primary care settings such as Improving Access to Psychological Therapies (IAPT) services. There are no existing competences for the delivery of "low-intensity" or "high-intensity" cognitive behavioural interventions for these conditions. To develop "high-intensity" and "low-intensity" competences for cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS. The initial draft drew on a variety of sources including treatment manuals and other information from randomized controlled trials. Therapists with experience in providing cognitive behavioural interventions for CF, CFS/ME and IBS in research and clinical settings were consulted on the initial draft competences and their suggestions for minor amendments were incorporated into the final versions. Feedback from experienced therapists was positive. Therapists providing low intensity interventions reported that the competences were also helpful in highlighting training needs. These sets of competences should facilitate the training and supervision of therapists providing cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS. The competences are available online (see table of contents for this issue: http://journals.cambridge.org/jid_BCP) or on request from the first author.

  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; De La Fuente, Leonardo

    2016-09-01

    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. 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 vectors. This bacterium

  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. A Required Rotation in Clinical Laboratory Management for Pathology Residents

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

  15. 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 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.

  16. Emotional intelligence in orthopedic surgery residents.

    Science.gov (United States)

    Chan, Kevin; Petrisor, Brad; Bhandari, Mohit

    2014-04-01

    Emotional intelligence (EI) is the ability to understand and manage emotions in oneself and others. It was originally popularized in the business literature as a key attribute for success that was distinct from cognitive intelligence. Increasing focus is being placed on EI in medicine to improve clinical and academic performance. Despite the proposed benefits, to our knowledge, there have been no previous studies on the role of EI in orthopedic surgery. We evaluated baseline data on EI in a cohort of orthopedic surgery residents. We asked all orthopedic surgery residents at a single institution to complete an electronic version of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). We used completed questionnaires to calculate total EI scores and 4 branch scores. Data were analyzed according to a priori cutoff values to determine the proportion of residents who were considered competent on the test. Data were also analyzed for possible associations with age, sex, race and level of training. Thirty-nine residents (100%) completed the MSCEIT. The mean total EI score was 86 (maximum score 145). Only 4 (10%) respondents demonstrated competence in EI. Junior residents (p = 0.026), Caucasian residents (p = 0.009) and those younger than 30 years (p = 0.008) had significantly higher EI scores. Our findings suggest that orthopedic residents score low on EI based on the MSCEIT. Optimizing resident competency in noncognitive skills may be enhanced by dedicated EI education, training and testing.

  17. Timespacing competence

    DEFF Research Database (Denmark)

    Laursen, Helle Pia; Mogensen, Naja Dahlstrup

    2016-01-01

    -generated activity My linguistic world 2014, they are invited to map and talk about their lived experiences as multiple language users seen in the light of place and movement. By demythifying themselves and their linguistic worlds, the children also raise important questions about the notion of linguistic competence....... 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. PNEUMONIA IN NURSING HOME RESIDENTS

    Directory of Open Access Journals (Sweden)

    Renato Eržen

    2002-10-01

    Full Text Available Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%, tachypnea, cough (67% and confusion (47% dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%, have leucocytosis (63%, electrolyte disturbances and elevated urea (67%. According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high

  19. 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

  20. 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…

  1. Reanalysis of noncancer deaths (1987-1995) among residents in high background radiation area of Yangjiang, China

    International Nuclear Information System (INIS)

    Zou Jianming; Zha Yongru; Sun Quanfu; Liu Yusheng; Li Jia; Tao Zufan; Wei Lvxin

    2004-01-01

    Objective: To further analyze non-cancer mortality rates and relevant influencing factors among the residents in high background radiation area(HBRA) and its control area (CA). Methods: The data for the period 1987-1995 were obtained from a fixed cohort by prospective survey. The mortality investigation on the spot consisted of two steps, i.e. the follow-up of the cohort members and the ascertainment of causes of death. On the basis of the hamlet-specific average of annual external dose, the cohort members were classified into four groups for internal comparison: high, medial and low dose groups in HBRA and control group in CA. Relative risk (RR), excess relative risk(ERR/Sv) and its 95% confidence interval (CI) were estimated using AMFIT program in Epicure. Results: During the period 1987-1995, the noncancer mortality in HBRA increased by 9% compared with that in the control group, and the relative risk of noncancer diseases was 1.09 (P=0.01), indicating a statistically significant excess mortality in the HBRA. The significantly increased noncancer death was caused by diseases of digestive system, with a RR of 1.46(P=0.006); the relative risk of chronic liver diseases including cirrhosis was 1.98(P=0.004). The significantly decreased noncancer death rates were observed for the infectious and parasitic diseases, the RR being 0.81(P=0.04); for pulmonary tuberculosis, RR 0.58(P<0.001). The homogeneity tests of risks across the four dose-groups revealed that the RRs for diseases of digestive system and for liver cirrhosis were significantly different, P values being 0.01 and 0.04, respectively. The ERR(95% CI)/Sv for diseases of digestive system and liver cirrhosis were 2.18(0.22, 7.64) and 10.94(1.34, NA), respectively. Conclusion: The death rates from diseases of digestive system, especially chronic liver diseases and cirrhosis were statistically significantly higher, and that from pulmonary tuberculosis was significantly lower in the HBRA than those in the control

  2. Effect of high-fidelity shoulder dystocia simulation on emergency obstetric skills and crew resource management skills among residents.

    Science.gov (United States)

    Mannella, Paolo; Palla, Giulia; Cuttano, Armando; Boldrini, Antonio; Simoncini, Tommaso

    2016-12-01

    To determine the effect of a simulation training program for residents in obstetrics and gynecology in terms of technical and nontechnical skills for the management of shoulder dystocia. A prospective study was performed at a center in Italy in April-May 2015. Thirty-two obstetrics and gynecology residents were divided into two groups. Residents in the control group were immediately exposed to an emergency shoulder dystocia scenario, whereas those in the simulation group completed a 2-hour training session with the simulator before being exposed to the scenario. After 8weeks, the residents were again exposed to the shoulder dystocia scenario and reassessed. Participants were scored on their demonstration of technical and nontechnical skills. In the first set of scenarios, the mean score was higher in the simulation group than the control group in terms of both technical skills (P=0.008) and nontechnical skills (Pdystocia. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Self vs. Other Focus: Predicting Professionalism Remediation of Emergency Medicine Residents.

    Science.gov (United States)

    Thaxton, Robert E; Jones, Woodson S; Hafferty, Fred W; April, Carolyn W; April, Michael D

    2018-01-01

    Unprofessionalism is a major reason for resident dismissal from training. Because of the high stakes involved, residents and educators alike would benefit from information predicting whether they might experience challenges related to this competency. Our objective was to correlate the outcome of professionalism-related remedial actions during residency with the predictor variable of resident response to a standardized interview question: "Why is Medicine important to you?" We conducted a professional development quality improvement (QI) initiative to improve resident education and mentorship by achieving a better understanding of each resident's reasons for valuing a career in medicine. This initiative entailed an interview administered to each resident beginning emergency medicine training at San Antonio Military Medical Center during 2006-2013. The interviews uniformly began with the standardized question "Why is Medicine important to you?" The residency program director documented a free-text summary of each response to this question, the accuracy of which was confirmed by the resident. We analyzed the text of each resident's response after a review of the QI data suggested an association between responses and professionalism actions (retrospective cohort design). Two associate investigators blinded to all interview data, remedial actions, and resident identities categorized each text response as either self-focused (e.g., "I enjoy the challenge") or other-focused (e.g., "I enjoy helping patients"). Additional de-identified data collected included demographics, and expressed personal importance of politics and religion. The primary outcome was a Clinical Competency Committee professionalism remedial action. Of 114 physicians starting residency during 2006-2013, 106 (93.0%) completed the interview. There was good inter-rater reliability in associate investigator categorization of resident responses as either self-focused or other-focused (kappa coefficient 0

  4. Needs Assessment for Incoming PGY-1 Residents in Neurosurgical Residency.

    Science.gov (United States)

    Brandman, David M; Haji, Faizal A; Matte, Marie C; Clarke, David B

    2015-01-01

    Residents must develop a diverse range of skills in order to practice neurosurgery safely and effectively. The purpose of this study was to identify the foundational skills required for neurosurgical trainees as they transition from medical school to residency. Based on the CanMEDS competency framework, a web-based survey was distributed to all Canadian academic neurosurgical centers, targeting incoming and current PGY-1 neurosurgical residents as well as program directors. Using Likert scale and free-text responses, respondents rated the importance of various cognitive (e.g. management of raised intracranial pressure), technical (e.g. performing a lumbar puncture) and behavioral skills (e.g. obtaining informed consent) required for a PGY-1 neurosurgical resident. Of 52 individuals contacted, 38 responses were received. Of these, 10 were from program directors (71%), 11 from current PGY-1 residents (58%) and 17 from incoming PGY-1 residents (89%). Respondents emphasized operative skills such as proper sterile technique and patient positioning; clinical skills such as lesion localization and interpreting neuro-imaging; management skills for common scenarios such as raised intracranial pressure and status epilepticus; and technical skills such as lumbar puncture and external ventricular drain placement. Free text answers were concordant with the Likert scale results. We surveyed Canadian neurosurgical program directors and PGY-1 residents to identify areas perceived as foundational to neurosurgical residency education and training. This information is valuable for evaluating the appropriateness of a training program's goals and objectives, as well as for generating a national educational curriculum for incoming PGY-1 residents.

  5. Adjudicative Competence

    Science.gov (United States)

    Dawes, Sharron E.; Palmer, Barton W.; Jeste, Dilip V.

    2008-01-01

    Purpose of review Although the basic standards of adjudicative competence were specified by the U.S. Supreme Court in 1960, there remain a number of complex conceptual and practical issues in interpreting and applying these standards. In this report we provide a brief overview regarding the general concept of adjudicative competence and its assessment, as well as some highlights of recent empirical studies on this topic. Findings Most adjudicative competence assessments are conducted by psychiatrists or psychologists. There are no universal certification requirements, but some states are moving toward required certification of forensic expertise for those conducting such assessments. Recent data indicate inconsistencies in application of the existing standards even among forensic experts, but the recent publication of consensus guidelines may foster improvements in this arena. There are also ongoing efforts to develop and validate structured instruments to aid competency evaluations. Telemedicine-based competency interviews may facilitate evaluation by those with specific expertise for evaluation of complex cases. There is also interest in empirical development of educational methods to enhance adjudicative competence. Summary Adjudicative competence may be difficult to measure accurately, but the assessments and tools available are advancing. More research is needed on methods of enhancing decisional capacity among those with impaired competence. PMID:18650693

  6. 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

  7. FRAMING OF JOURNALISM DISCOURSE TO IMPROVE DISCOURSE COMPETENCE OF SENIOR HIGH SCHOOL STUDENTS

    Directory of Open Access Journals (Sweden)

    Dadang S. Anshori

    2017-12-01

    Full Text Available This study aims to describe the analysis model of framing on journalism discourse in Indonesian textbooks in Senior High School to be used in language learning. This research used qualitative method with framing theory from Pan and Kosicki as an tool of analysis. The research data is journalism discourse in textbook amounted to 30 pieces of discourse taken from 10 text books of class X, XI, and XII in Senior High School. The results show the following: (1 The discourse of journalism has received acceptance in the world of education, especially in textbooks. The use of journalism discourse in 10 textbooks is very high and very diverse in terms of number, topic, source, and usage. (2 The journalism discourse in the textbook meets the criteria of reporting value, even if not all reporting value is fulfilled. (3 The frame construction of the journalism discourse in Indonesian textbooks is packaged in different angles according to news topics and facts. (4 The analysis model of journalism discourse framing is developed by focusing on the structural analysis of category, syntax, script, thematic, diction/phrase, and rhetoric.

  8. Competence Building

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    The main question that guides this paper is how governments are focusing (and must focus) on competence building (education and training) when designing and implementing innovation policies. With this approach, the paper aims at filling the gap between the existing literature on competences...... 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...

  9. 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)

  10. The interplay of race, socioeconomic status and neighborhood residence upon birth outcomes in a high black infant mortality community

    Directory of Open Access Journals (Sweden)

    Catherine L. Kothari

    2016-12-01

    Full Text Available This study examined the interrelationship of race and socioeconomic status (SES upon infant birthweight at the individual and neighborhood levels within a Midwestern US county marked by high Black infant mortality. The study conducted a multi-level analysis utilizing individual birth records and census tract datasets from 2010, linked through a spatial join with ArcGIS 10.0. The maternal population of 2861 Black and White women delivering infants in 2010, residing in 57 census tracts within the county, constituted the study samples. The main outcome was infant birthweight. The predictors, race and SES were dichotomized into Black and White, low-SES and higher-SES, at both the individual and census tract levels. A two-part Bayesian model demonstrated that individual-level race and SES were more influential birthweight predictors than community-level factors. Specifically, Black women had 1.6 higher odds of delivering a low birthweight (LBW infant than White women, and low-SES women had 1.7 higher odds of delivering a LBW infant than higher-SES women. Moderate support was found for a three-way interaction between individual-level race, SES and community-level race, such that Black women achieved equity with White women (4.0% Black LBW and 4.1% White LBW when they each had higher-SES and lived in a racially congruous neighborhood (e.g., Black women lived in disproportionately Black neighborhood and White women lived in disproportionately White neighborhood. In sharp contrast, Black women with higher-SES who lived in a racially incongruous neighborhood (e.g., disproportionately White had the worst outcomes (14.5% LBW. Demonstrating the layered influence of personal and community circumstances upon health, in a community with substantial racial disparities, personal race and SES independently contribute to birth outcomes, while environmental context, specifically neighborhood racial congruity, is associated with mitigated health risk. Keywords: Birth

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  12. 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.

  13. 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

    2016-11-08

    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.

  14. 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.

  15. 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.

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

    Science.gov (United States)

    Bambini, Deborah; Emery, Matthew; de Voest, Margaret; Meny, Lisa; Shoemaker, Michael J

    2016-10-25

    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.

  17. 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

  18. 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.

  19. [Encouragement and training of ethical competence in geriatric nursing. A pre-condition of high quality in professional caring process].

    Science.gov (United States)

    Dettmann, Ulf

    2006-02-01

    The article makes a case for the necessity of more intensive training in the ethics of geriatric care. It confronts the bias against too much ethical behaviour in daily practice, while also arguing for the liberating and enriching aspects of giving ethical care to the aged. Based on a differentiation between morals and ethics, the essay recognizes the endeavors to achieve moral behaviour in geriatric care, but questions whether in every case the caregivers have sufficient ethical core competence to determine either the appropriateness or the righteousness of their moral actions. The essay discusses what should be understood under "ethical competence" and how ethical competence can be acquired and advanced by schooling.

  20. 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

  1. Cost Benefit Analyses of Developing a Legislation to Attract Non-Resident High Net Worth Individuals to Use Estonian Private Foundation Platform

    Directory of Open Access Journals (Sweden)

    Urmas Kaarlep

    2017-05-01

    Full Text Available On a global level, the high net worth population is expanding, and the wealth of high net worth individuals (HNWI is increasing rapidly. For various reasons, high net worth families and individuals are searching for vehicles to assist them in safeguarding and conveniently managing their wealth. Private foundations represent one useful avenue for achieving this end, and the use of private foundations has become increasingly popular in recent years, particularly in European countries. Many countries have laws which regulate private foundations and several are looking for adjusting or introducing legislation. In this article, authors analysing benefits for a country like Estonia in case the country increases the attractiveness of its jurisdiction for non-residents who are looking for establishment of a private foundation. The article comes to the conclusion that to be competitive, a country cannot collect tax revenues from private foundations established by non-residents except from income originated in the very same country. However, the country can earn benefits from revenues received by companies rendering services to non-residents and their private foundations. The article demonstrates that service fees a country earns and taxes collected from these fees would be substantial enough to make necessary changes to legislation beneficial for a country.

  2. A Research Study Using the Delphi Method to Define Essential Competencies for a High School Game Art and Design Course Framework at the National Level

    Science.gov (United States)

    Mack, Nayo Corenus-Geneva

    2011-01-01

    This research study reports the findings of a Delphi study conducted to determine the essential competencies and objectives for a high school Game Art and Design course framework at the national level. The Delphi panel consisted of gaming, industry and educational experts from all over the world who were members of the International Game…

  3. "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…

  4. The Use of Peer-Mediated Interventions to Promote the Generalization of Social Competence for Adolescents with High-Functioning Autism and Asperger's Syndrome

    Science.gov (United States)

    Schmidt, Carla; Stichter, Janine P.

    2012-01-01

    Impairments in social competence are core deficits for individuals with high-functioning autism and Asperger's Syndrome (HFA/AS). As the incidence rate for these disorders continues to increase so does the urgency to identify evidence-based interventions that can remediate core deficits in order to provide these individuals with independence as…

  5. 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.

  6. Operative Landscape at Canadian Neurosurgery Residency Programs.

    Science.gov (United States)

    Tso, Michael K; Dakson, Ayoub; Ahmed, Syed Uzair; Bigder, Mark; Elliott, Cameron; Guha, Daipayan; Iorio-Morin, Christian; Kameda-Smith, Michelle; Lavergne, Pascal; Makarenko, Serge; Taccone, Michael S; Wang, Bill; Winkler-Schwartz, Alexander; Sankar, Tejas; Christie, Sean D

    2017-07-01

    Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures. A number of prespecified subspecialty procedures were recorded. We defined the resident case index as the ratio of the total number of operations to the total number of neurosurgery residents in that program. Resident number included both Canadian medical and international medical graduates, and included residents on the neurosurgery service, off-service, or on leave for research or other personal reasons. Overall, there was an average of 1845 operative cases per neurosurgery residency program. The mean numbers of cranial, spine, peripheral nerve, and miscellaneous procedures were 725, 466, 48, and 193, respectively. The nationwide mean resident case indices for cranial, spine, peripheral nerve, and total procedures were 90, 58, 5, and 196, respectively. There was some variation in the resident case indices for specific subspecialty procedures, with some training programs not performing carotid endarterectomy or endoscopic transsphenoidal procedures. This study presents the breadth of neurosurgical training within Canadian neurosurgery residency programs. These results may help inform the implementation of neurosurgery training as the Royal College of Physicians and Surgeons residency training transitions to a competence-by-design curriculum.

  7. Fun, influence and competence-a mixed methods study of prerequisites for high school students' participation in physical education.

    Science.gov (United States)

    Abildsnes, Eirik; Rohde, Gudrun; Berntsen, Sveinung; Stea, Tonje H

    2017-03-10

    Many adolescents do not reach the recommended levels of physical activity (PA), and students attending vocational studies are less committed to take part in physical education (PE) than other students. The purpose of the present study was twofold: 1) to examine differences in physical activity, diet, smoking habits, sleep and screen time among Norwegian vocational high school students who selected either a PE model focusing on PA skills, technique and improvement of physical performance ("Sports enjoyment") or more on health, play and having fun when participating in PE lessons ("Motion enjoyment"), and 2) to explore the students' experiences with PE programs. In this mixed methods study 181 out of 220 invited students (82%) comprising 141 (78%) girls and 40 (22%) boys attending vocational studies of Restaurant and Food Processing (24%), Design, Arts and Crafts (27%) or Healthcare, Childhood and Youth Development (49%) were recruited for participation in the new PE program. PA level, sedentary time and sleep were objectively recorded using the SenseWear Armband Mini. A self-report questionnaire was used to assess dietary habits, smoking and snuffing habits, use of alcohol, screen use and active transportation. Four focus group interviews with 23 students (12 boys) were conducted to explore how the students experienced the new PE program. Students attending "Motion enjoyment" accrued less steps/day compared to the "Sports enjoyment" group (6661 (5514, 7808) vs.9167 (7945, 10390) steps/day) and reported higher screen use (mean, 3.1; 95% CI, 2.8, 3.5) vs. 2.4 (2.0, 2.9) hours/day). Compared to those attending "Sports enjoyment", a higher number of students attending "Motion enjoyment" reported an irregular meal pattern (adjusted odds ratio, 5.40; 95% confidence interval (CI), 2.28, 12.78), and being a current smoker (12.22 (1.62, 107.95)). The students participating in the focus group interviews emphasized the importance of having competent and engaging teachers

  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. Residents' perceptions of an integrated longitudinal curriculum: a qualitative study.

    Science.gov (United States)

    Lubitz, Rebecca; Lee, Joseph; Hillier, Loretta M

    2015-01-01

    The purpose of this study was to explore family medicine residents' perceptions of a newly restructured integrated longitudinal curriculum. A purposeful sample of 16 family medicine residents participated in focus group interviews conducted from a grounded theory perspective to identify the characteristics of this training model that contribute to and that challenge learning. Eight key themes were identified: continuity of care, relevance to family medicine, autonomy, program-focused preparation, professional development as facilitated by role modeling, patient volume, clarity of expectations for learners, and logistics. Positive learning experiences were marked by high levels of autonomy, continuity, and relevance to family medicine. Less favorable learning experiences were characterized by limited opportunities for continuity of care, limited relevance to family medicine practice and unclear expectations for the resident's role. Family physician-led learning experiences contributed to residents' understanding of the full scope of family medicine practice, more so than specialist-led experiences. The logistics of implementing the integrated block were challenging and negatively impacted continuity and learning. This study suggests that an integrated longitudinalized family medicine block training model has the potential to support the principles of a longitudinal integrated competency-based curriculum to effectively prepare residents for family medicine practice.

  11. Challenges of pediatric residency training in Taiwan.

    Science.gov (United States)

    Tsai, Tsuen-Chiuan; Harasym, Peter H

    2006-01-01

    A crisis in pediatric residency training today has raised serious concerns about the healthcare quality for children in Taiwan. The purpose of this study was to document the problems and to propose possible solutions for improvement. The problems include: 1) manpower shortage due to the difficulty of recruiting pediatric residents; 2) heavy workload that hinders learning; 3) lack of assessment and poor program planning; and 4) inadequate institutional and financial support. As a result, physicians' competencies are not guaranteed at the end of residency training, even with the pediatric board certification. Possible solutions may include: 1) conducting research on physician manpower statistics, work hours and environment; 2) establishing a Residency Program Review Committee and provision of standards for accreditation; 3) defining the competencies mandated as a general pediatrician and developing a set of measurable qualitative standards; 4) encouraging new programs with flexibility (e.g., primary care); and 5) pursuing adequate institutional and financial supports.

  12. 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

  13. Assessment of indoor and outdoor PM species at schools and residences in a high-altitude Ecuadorian urban center.

    Science.gov (United States)

    Raysoni, Amit U; Armijos, Rodrigo X; Weigel, M Margaret; Montoya, Teresa; Eschanique, Patricia; Racines, Marcia; Li, Wen-Whai

    2016-07-01

    An air monitoring campaign to assess children's environmental exposures in schools and residences, both indoors and outdoors, was conducted in 2010 in three low-income neighborhoods in Z1 (north), Z2 (central), and Z3 (southeast) zones of Quito, Ecuador - a major urban center of 2.2 million inhabitants situated 2850 m above sea level in a narrow mountainous basin. Z1 zone, located in northern Quito, historically experienced emissions from quarries and moderate traffic. Z2 zone was influenced by heavy traffic in contrast to Z3 zone which experienced low traffic densities. Weekly averages of PM samples were collected at schools (one in each zone) and residences (Z1 = 47, Z2 = 45, and Z3 = 41) every month, over a twelve-month period at the three zones. Indoor PM2.5 concentrations ranged from 10.6 ± 4.9 μg/m(3) (Z1 school) to 29.0 ± 30.5 μg/m(3) (Z1 residences) and outdoor PM2.5 concentrations varied from 10.9 ± 3.2 μg/m(3) (Z1 school) to 14.3 ± 10.1 μg/m(3) (Z2 residences), across the three zones. The lowest values for PM10-2.5 for indoor and outdoor microenvironments were recorded at Z2 school, 5.7 ± 2.8 μg/m(3) and 7.9 ± 2.2 μg/m(3), respectively. Outdoor school PM concentrations exhibited stronger associations with corresponding indoor values making them robust proxies for indoor exposures in naturally ventilated Quito public schools. Correlation analysis between the school and residential PM size fractions and the various pollutant and meteorological parameters from central ambient monitoring (CAM) sites suggested varying degrees of temporal relationship. Strong positive correlation was observed for outdoor PM2.5 at Z2 school and its corresponding CAM site (r = 0.77) suggesting common traffic related emissions. Spatial heterogeneity in PM2.5 concentrations between CAM network and sampled sites was assessed using Coefficient of Divergence (COD) analysis. COD values were lower when CAM sites were paired with outdoor

  14. A theory-informed, process-oriented Resident Scholarship Program.

    Science.gov (United States)

    Thammasitboon, Satid; Darby, John B; Hair, Amy B; Rose, Karen M; Ward, Mark A; Turner, Teri L; Balmer, Dorene F

    2016-01-01

    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. 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. 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. 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.

  15. 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.

  16. Family members' expectations regarding nurses' competence in care homes: a qualitative interview study.

    Science.gov (United States)

    Kiljunen, Outi; Kankkunen, Päivi; Partanen, Pirjo; Välimäki, Tarja

    2017-11-22

    Structural and cultural changes in the care of older people have influenced nursing practice, creating a need to identify current competency requirements for nurses working in care homes. Family members have an important role in ensuring the well-being of older people living in care homes, and family members' can provide valuable information about competence requirements. To explore the expectations of the care home residents' family members regarding the competence of nurses in care homes for older people. A qualitative descriptive design was used. Semi-structured interviews were conducted with 18 care home residents' family members between March and September 2016. Participants were recruited with help from regional associations and member associations of The Central Association of Carers in Finland and from regional associations of The Alzheimer's Society of Finland. The snowball technique was also used. The data were analysed using inductive content analysis. Ethics committee approval was obtained from the university committee on research ethics, and written informed consent was obtained from participants. The care home residents' family members expected that nurses would be able to interact with and treat people respectfully. Reflective collaboration between the nurse and a family member was also emphasised. Family members expected nurses to provide high-quality basic care and nursing and support residents' well-being individually and holistically. Family members' expectations reflect the need for ethical and interactional competence in the care home. In addition, evidence-based practice competencies are required to provide high-quality care. Nurses' ability to provide person-centred, individual and holistic care is vital to ensure care home residents' well-being. © 2017 Nordic College of Caring Science.

  17. Can One Portfolio Measure the Six ACGME General Competencies?

    Science.gov (United States)

    Jarvis, Robert M.; O'Sullivan, Patricia S.; McClain, Tina; Clardy, James A.

    2004-01-01

    Objective: To determine that portfolios, useable by any program, can provide needed evidence of resident performance within the ACGME general competencies. Methods: Eighteen residents constructed portfolios with selected entries from thirteen psychiatric skills. Two raters assessed whether entries reflected resident performance within the general…

  18. Self vs. Other Focus: Predicting Professionalism Remediation of Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Robert E. Thaxton

    2017-12-01

    Full Text Available Introduction Unprofessionalism is a major reason for resident dismissal from training. Because of the high stakes involved, residents and educators alike would benefit from information predicting whether they might experience challenges related to this competency. Our objective was to correlate the outcome of professionalism-related remedial actions during residency with the predictor variable of resident response to a standardized interview question: “Why is Medicine important to you?” Methods We conducted a professional development quality improvement (QI initiative to improve resident education and mentorship by achieving a better understanding of each resident’s reasons for valuing a career in medicine. This initiative entailed an interview administered to each resident beginning emergency medicine training at San Antonio Military Medical Center during 2006–2013. The interviews uniformly began with the standardized question “Why is Medicine important to you?” The residency program director documented a free-text summary of each response to this question, the accuracy of which was confirmed by the resident. We analyzed the text of each resident’s response after a review of the QI data suggested an association between responses and professionalism actions (retrospective cohort design. Two associate investigators blinded to all interview data, remedial actions, and resident identities categorized each text response as either self-focused (e.g., “I enjoy the challenge” or other-focused (e.g., “I enjoy helping patients”. Additional de-identified data collected included demographics, and expressed personal importance of politics and religion. The primary outcome was a Clinical Competency Committee professionalism remedial action. Results Of 114 physicians starting residency during 2006–2013, 106 (93.0% completed the interview. There was good inter-rater reliability in associate investigator categorization of resident

  19. The relationship between faculty performance assessment and results on the in-training examination for residents in an emergency medicine training program.

    Science.gov (United States)

    Ryan, James G; Barlas, David; Pollack, Simcha

    2013-12-01

    Medical knowledge (MK) in residents is commonly assessed by the in-training examination (ITE) and faculty evaluations of resident performance. We assessed the reliability of clinical evaluations of residents by faculty and the relationship between faculty assessments of resident performance and ITE scores. We conducted a cross-sectional, observational study at an academic emergency department with a postgraduate year (PGY)-1 to PGY-3 emergency medicine residency program, comparing summative, quarterly, faculty evaluation data for MK and overall clinical competency (OC) with annual ITE scores, accounting for PGY level. We also assessed the reliability of faculty evaluations using a random effects, intraclass correlation analysis. We analyzed data for 59 emergency medicine residents during a 6-year period. Faculty evaluations of MK and OC were highly reliable (κ  =  0.99) and remained reliable after stratification by year of training (mean κ  =  0.68-0.84). Assessments of resident performance (MK and OC) and the ITE increased with PGY level. The MK and OC results had high correlations with PGY level, and ITE scores correlated moderately with PGY. The OC and MK results had a moderate correlation with ITE score. When residents were grouped by PGY level, there was no significant correlation between MK as assessed by the faculty and the ITE score. Resident clinical performance and ITE scores both increase with resident PGY level, but ITE scores do not predict resident clinical performance compared with peers at their PGY level.

  20. Are 2 Years Enough? Exploring Technical Skills Acquisition Among General Surgery Residents in Brazil.

    Science.gov (United States)

    Santos, Elizabeth G; Salles, Gil F

    2016-01-01

    Phenomenon: Recent studies have shown that up to 40% of the General Surgery (GS) residents are not confident with their surgical skills. There is concern that residents are at risk of receiving inadequate training due to the low number of operations they perform. In Brazil, although all GS residents receive by law the Board Certification at the end of their programs, the assessment of their technical skills is not mandatory in Medical Residency programs' training. Consequently, our concern was that current GS medical residency format might be insufficient to create competent and autonomous general surgery residents after 2 years of regular training. Hence, the aim was to assess GS residents' surgical skills in their final months of training to evaluate the present format of GS residency programs in Brazil. Trained surgical faculty members directly observed 11 operations of varying difficulty performed by 2nd-year regular GS residents and by 4th-year residents in the optional Advanced Program in General Surgery. Participants were located at 3 university and 3 nonuniversity hospitals in Rio de Janeiro and Sao Paulo (Brazil's largest cities). Surgical skills were assessed using an internally developed observation checklist reviewed by subject matter experts. Sixty residents (46 regular 2nd-year trainees and 14 advanced 4th-year trainees) were assessed on performing 499 operations. Only 10 residents (17%), all advanced 4th-year residents, satisfactorily performed all operations and were considered eligible for the Board Certification. Even after excluding the 2 operations of greatest difficulty, only 24 regular 2nd-year residents (52%) satisfactorily performed the other 9 operations. Residents from hospitals with open Emergency Departments performed better than those from hospitals without Emergency Departments. Insights: The results of this pilot study suggest that residents with 2 years of training are not prepared for independent high-level surgical practice. The

  1. Ovarian cancer survival population differences: a "high resolution study" comparing Philippine residents, and Filipino-Americans and Caucasians living in the US.

    Science.gov (United States)

    Redaniel, Maria Theresa M; Laudico, Adriano; Mirasol-Lumague, Maria Rica; Gondos, Adam; Uy, Gemma Leonora; Toral, Jean Ann; Benavides, Doris; Brenner, Hermann

    2009-09-24

    In contrast to most other forms of cancer, data from some developing and developed countries show surprisingly similar survival rates for ovarian cancer. We aimed to compare ovarian cancer survival in Philippine residents, Filipino-Americans and Caucasians living in the US, using a high resolution approach, taking potential differences in prognostic factors into account. Using databases from the SEER 13 and from the Manila and Rizal Cancer Registries, age-adjusted five-year absolute and relative survival estimates were computed using the period analysis method and compared between Filipino-American ovarian cancer patients with cancer patients from the Philippines and Caucasians in the US. Cox proportional hazards modelling was used to determine factors affecting survival differences. Despite more favorable distribution of age and cancer morphology and similar stage distribution, 5-year absolute and relative survival were lower in Philippine residents (Absolute survival, AS, 44%, Standard Error, SE, 2.9 and Relative survival, RS, 49.7%, SE, 3.7) than in Filipino-Americans (AS, 51.3%, SE, 3.1 and RS, 54.1%, SE, 3.4). After adjustment for these and additional covariates, strong excess risk of death for Philippine residents was found (Relative Risk, RR, 2.45, 95% confidence interval, 95% CI, 1.99-3.01). In contrast, no significant differences were found between Filipino-Americans and Caucasians living in the US. Multivariate analyses disclosed strong survival disadvantages of Philippine residents compared to Filipino-American patients, for which differences in access to health care might have played an important role. Survival is no worse among Filipino-Americans than among Caucasians living in the US.

  2. 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…

  3. Global Warming in Schools: An Inquiry about the Competing Conceptions of High School Social Studies and Science Curricula and Teachers

    Science.gov (United States)

    Meehan, Casey R.

    Despite the scientific consensus supporting the theory of anthropogenic (human-induced) global warming, whether global warming is a serious problem, whether human activity is the primary cause of it, and whether scientific consensus exists at all are controversial questions among the U.S. lay-public. The cultural theory of risk perception (Schwarz and Thompson, 1990) serves as the theoretical framework for this qualitative analysis in which I ask the question how do U.S. secondary school curricula and teachers deal with the disparity between the overwhelming scientific consensus and the lay-public's skepticism regarding global warming? I analyzed nine widely used social studies and science textbooks, eight sets of supplemental materials about global warming produced by a range of not-for-profit and governmental organizations, and interviewed fourteen high school teachers who had experience teaching formal lessons about global warming in their content area. Findings suggest: 1) the range of global warming content within social studies and science textbooks and supplemental curricula reflects the spectrum of conceptualizations found among members of the U.S. public; 2) global warming curricula communicate only a narrow range of strategies for dealing with global warming and its associated threats; and 3) social studies and science teachers report taking a range of stances about global warming in their classroom, but sometimes the stance they put forth to their students does not align with their personal beliefs about global warming. The findings pose a troubling conundrum. Some of the global warming curricula treat the cause of global warming--a question that is not scientifically controversial--as a question with multiple and competing "right" answers. At the same time, much of curricula position how we should address global warming--a question that is legitimately controversial--as a question with one correct answer despite there being many reasonable responses

  4. Perceived Competence of Juvenile Delinquents and Nondelinquents.

    Science.gov (United States)

    Cole, Peter G.; And Others

    1989-01-01

    Thirty male juvenile delinquents and 90 male high achievers, low achievers, and students with behavior problems were compared using an adapted version of Harter's Perceived Competence Scale for Children. The Australian students (aged 12-15) were compared on 4 different domains of perceived competence--cognitive competence, social competence,…

  5. Online database for documenting clinical pathology resident education.

    Science.gov (United States)

    Hoofnagle, Andrew N; Chou, David; Astion, Michael L

    2007-01-01

    Training of clinical pathologists is evolving and must now address the 6 core competencies described by the Accreditation Council for Graduate Medical Education (ACGME), which include patient care. A substantial portion of the patient care performed by the clinical pathology resident takes place while the resident is on call for the laboratory, a practice that provides the resident with clinical experience and assists the laboratory in providing quality service to clinicians in the hospital and surrounding community. Documenting the educational value of these on-call experiences and providing evidence of competence is difficult for residency directors. An online database of these calls, entered by residents and reviewed by faculty, would provide a mechanism for documenting and improving the education of clinical pathology residents. With Microsoft Access we developed an online database that uses active server pages and secure sockets layer encryption to document calls to the clinical pathology resident. Using the data collected, we evaluated the efficacy of 3 interventions aimed at improving resident education. The database facilitated the documentation of more than 4 700 calls in the first 21 months it was online, provided archived resident-generated data to assist in serving clients, and demonstrated that 2 interventions aimed at improving resident education were successful. We have developed a secure online database, accessible from any computer with Internet access, that can be used to easily document clinical pathology resident education and competency.

  6. Assessing Technical Competence in Surgical Trainees: A Systematic Review.

    Science.gov (United States)

    Szasz, Peter; Louridas, Marisa; Harris, Kenneth A; Aggarwal, Rajesh; Grantcharov, Teodor P

    2015-06-01

    To systematically examine the literature describing the methods by which technical competence is assessed in surgical trainees. The last decade has witnessed an evolution away from time-based surgical education. In response, governing bodies worldwide have implemented competency-based education paradigms. The definition of competence, however, remains elusive, and the impact of these education initiatives in terms of assessment methods remains unclear. A systematic review examining the methods by which technical competence is assessed was conducted by searching MEDLINE, EMBASE, PsychINFO, and the Cochrane database of systematic reviews. Abstracts of retrieved studies were reviewed and those meeting inclusion criteria were selected for full review. Data were retrieved in a systematic manner, the validity and reliability of the assessment methods was evaluated, and quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation classification. Of the 6814 studies identified, 85 studies involving 2369 surgical residents were included in this review. The methods used to assess technical competence were categorized into 5 groups; Likert scales (37), benchmarks (31), binary outcomes (11), novel tools (4), and surrogate outcomes (2). Their validity and reliability were mostly previously established. The overall Grading of Recommendations Assessment, Development and Evaluation for randomized controlled trials was high and low for the observational studies. The definition of technical competence continues to be debated within the medical literature. The methods used to evaluate technical competence predominantly include instruments that were originally created to assess technical skill. Very few studies identify standard setting approaches that differentiate competent versus noncompetent performers; subsequently, this has been identified as an area with great research potential.

  7. 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.

  8. Teaching and Assessing Professionalism in Ophthalmology Residency Training Programs

    NARCIS (Netherlands)

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

    2007-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) has mandated that all residency training programs teach and assess new competencies including professionalism. This article reviews the literature on medical professionalism, describes good practices gleaned from published works, and

  9. Emotional Intelligence and the ACGME Competencies.

    Science.gov (United States)

    Webb, Anita R; Young, Richard A; Baumer, Joane G

    2010-12-01

    Residency programs desire assessment tools for teaching and measuring resident attainment of the Accreditation Council for Graduate Medical Education competencies, including interpersonal and communication skills. We sought to evaluate the use of emotional intelligence (EI) assessment and training tools in assessing and enhancing interpersonal and communication skills. We used a quasi-experimental design, with an intervention and control group composed of 1 class each of family medicine residents. The intervention was EI coaching. The assessment used the Emotional and Social Competence Inventory, a 360-degree EI survey consisting of self and other (colleague) ratings for 12 EI competencies. There were 21 participants in each of the 3 assessments (test, posttest, and control). Our EI coaching intervention had very limited participation due to a lack of protected time for EI coaching and residents' competing obligations. Return rates for self surveys were 86% to 91% and 66% to 68% for others. On all 3 trials, ratings by others were significantly higher than self ratings for every competence (range, P competencies. None of the intervention group self ratings increased significantly on posttesting, whereas ratings by others increased significantly for coach/mentor (P coaching intervention was unsuccessful, the effects of coaching on interpersonal and communication skills could not be assessed.

  10. Social economical and psychological considerations in conveying potential radiation risks from high level natural background radiation to the residents of Ramsar, Iran

    International Nuclear Information System (INIS)

    Mortazavi, S. M. J.; Ghiassi-nejad, M.

    2003-01-01

    X-rays and radioactivity were discovered more than 100 years ago but the need for protection against very low doses of ionizing radiation and especially different levels of natural radiation is still among the most controversial matters in radiobiology and radiation protection. According to formal reports, some areas in Ramsar, a city in northern Iran, are the inhabited areas with the highest levels of natural radiation studied so far. A population of about 2000 is exposed to average annual radiation levels of 10.2 mGy y''-1 and the highest recorded external gamma dose rates are about 130 mGy y''-1. We have previously shown that in high background radiation areas (HBRAs), cultured human lymphocytes of the inhabitants whose cumulative radiation doses were as much as 170 times more than those of a control area when subjected to 1.5 Gy challenge dose,were significantly more radioresistant compared to the residents of the control area (Mortazavi et al. 2002a,b, Mortazavi and Karam 2002, Ghiassi-Najed et al. 2002). The people who live in these areas are usually unaware of the high levels of natural radiation in their environment. Studies performed on the residents of these areas have indicated that the effective dose of the inhabitants, in some cases, is much higher than the dose limits for occupational irradiation. Considering recent policies of ICRP regarding suggesting dose limits for exposure to natural sources of ionizing including radon, it seems that the inhabitants should become familiar with the possible risks of the exposure to high levels of ionizing radiation. They should also realize that studies performed over the past years have indicated no detrimental effect. On the other hand, according to ICRP suggestions and considering the experiences in other countries, especially evacuation of the residents of contaminated areas after Chernobyl accident, setting any radiation protection regulation for the inhabitants without considering social, economic and

  11. 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

  12. Do Mathematics and Reading Competencies Integrated into Career and Technical Education Courses Improve High School Student State Assessment Scores?

    Science.gov (United States)

    Pierce, Kristin B.; Hernandez, Victor M.

    2015-01-01

    A quasi experimental study tested a contextual teaching and learning model for integrating reading and mathematics competencies through 13 introductory career and technical education (CTE) courses. The treatment group consisted of students in the 13 introductory courses taught by the CTE teachers who designed the units and the control group…

  13. 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.

  14. The Competence Readiness of the Electrical Engineering Vocational High School Teachers in Manado towards the ASEAN Economic Community Blueprint in 2025

    Directory of Open Access Journals (Sweden)

    Fid Jantje Tasiam

    2017-08-01

    Full Text Available This paper presents the competence readiness of the electrical engineering vocational high school teachers in Manado towards ASEAN Economic Community blueprint in 2025. The objective of this study is to get the competencies readiness description of the electrical engineering vocational high school teachers in Manado towards ASEAN Economic Community blueprint in 2025. Method used quantitative and qualitative approach which the statistical analysis in quantitative and the inductive analysis used in qualitative. There were 46 teachers of the electrical engineering vocational high school in Manado observed. The results have shown that the competencies readiness of the electrical engineering vocational high school teachers in Manado such as: pedagogical, professional, personality, and social were 13.04%, 19.56%, 19.56%, and 19.56% respectively. The results were still far from the focus of the ASEAN economic community blueprint in 2025, so they need to be improved through in-house training, internship programs, school partnerships, distance learning, tiered training and special training, short courses in educational institutions, internal coaching by schools, discussion of educational issues, workshops, research and community service, textbook writing, learning media making, and the creation of technology and art.

  15. Radiology residents' experience with intussusception reduction

    International Nuclear Information System (INIS)

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

    2011-01-01

    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 < 0.0001), and 336 (62.2%) thought they would benefit from a computer-assisted training model simulating intussusception reduction (P < 0.0001). 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. (orig.)

  16. Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

    Science.gov (United States)

    Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

    2015-01-01

    Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

  17. National Undergraduate Medical Core Curriculum in Turkey: Evaluation of Residents

    Directory of Open Access Journals (Sweden)

    Işıl İrem Budakoğlu

    2014-03-01

    Full Text Available Background: There is very little information available on self-perceived competence levels of junior medical doctors with regard to definitions by the National Core Curriculum (NCC for Undergraduate Medical Education. Aims: This study aims to determine the perceived level of competence of residents during undergraduate medical education within the context of the NCC. Study Design: Descriptive study. Methods: The survey was conducted between February 2010 and December 2011; the study population comprised 450 residents. Of this group, 318 (71% participated in the study. Self-assessment questionnaires on competencies were distributed and residents were asked to assess their own competence in different domains by scoring them on a scale of 1 to 10. Results: Nearly half of the residents reported insufficient experience of putting clinical skills into practice when they graduated. In the theoretical part of NCC, the lowest competency score was reported for health-care administration, while the determination of level of chlorine in water, delivering babies, and conducting forensic examinations had the lowest perceived levels of competency in the clinical skills domain. Conclusion: Residents reported low levels of perceived competency in skills they rarely performed outside the university hospital. They were much more confident in skills they performed during their medical education.

  18. "The Actualized Neurosurgeon": A Proposed Model of Surgical Resident Development.

    Science.gov (United States)

    Lipsman, Nir; Khan, Osaama; Kulkarni, Abhaya V

    2017-03-01

    Modern neurosurgical training is both physically and emotionally demanding, posing significant challenges, new and old, to residents as well as programs attempting to train safe, competent surgeons. Models to describe resident development, such as the Accreditation Council for Graduate Medical Education competencies and milestones, address the acquisition of specific skills but largely ignore the stresses and pressures unique to each stage of resident training. We propose an alternative model of resident development adapted from the developmental psychology literature. Our model identifies the challenges that must be met at each stage of junior, intermediate, and senior and chief residency, leading ultimately to an "actualized" neurosurgeon (i.e., one who has maximized his or her potential). Failure to overcome any 1 of these challenges can lead to specific long-lasting consequences, including regret, identity crisis, incompetence, and bitterness. In contrast, the actualized surgeon is one who has successfully acquired the virtues of hope, will, purpose, fidelity, productivity, leadership, competence, and wisdom. The actualized surgeon not only functions safely, confidently, and professionally, but also successfully navigates the challenges of residency and emerges from them having fulfilled his or her maximal potential. This developmental perspective provides an individualized description of healthy surgical development. Our model allows programs to identify the basis for residents who fail to progress, counsel residents during their training, and perhaps help identify resident candidates who are better prepared to meet the developmental challenges of residency training. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Validation of a method for assessing resident physicians' quality improvement proposals.

    Science.gov (United States)

    Leenstra, James L; Beckman, Thomas J; Reed, Darcy A; Mundell, William C; Thomas, Kris G; Krajicek, Bryan J; Cha, Stephen S; Kolars, Joseph C; McDonald, Furman S

    2007-09-01

    Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking. We developed an instrument for assessing resident QI proposals--the Quality Improvement Proposal Assessment Tool (QIPAT-7)-and determined its validity and reliability. QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised. Seven raters used the instrument to assess 45 resident QI proposals. Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach's alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively. QIPAT-7 items comprised a single factor (eigenvalue = 3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach's alpha = 0.87) were high. This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes.

  20. 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...

  1. Supporting At-Risk Youth and Their Families to Manage and Prevent Diabetes: Developing a National Partnership of Medical Residency Programs and High Schools.

    Science.gov (United States)

    Gefter, Liana; Morioka-Douglas, Nancy; Srivastava, Ashini; Rodriguez, Eunice

    2016-01-01

    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 (pknowledge 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 promise to empower these youth with health literacy and encourage them to adopt healthy behaviors.

  2. Inconsistency of residents' communication performance in challenging consultations.

    Science.gov (United States)

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

    2013-12-01

    Communication performance inconsistency between consultations is usually regarded as a measurement error that jeopardizes the reliability of assessments. However, inconsistency is an important phenomenon, since it indicates that physicians' communication may be below standard in some consultations. Fifty residents performed two challenging consultations. Residents' communication competency was assessed with the CELI instrument. Residents' background in communication skills training (CST) was also established. We used multilevel analysis to explore communication performance inconsistency between the two consultations. We also established the relationships between inconsistency and average performance quality, the type of consultation, and CST background. Inconsistency accounted for 45.5% of variance in residents' communication performance. Inconsistency was dependent on the type of consultation. The effect of CST background training on performance quality was case specific. Inconsistency and average performance quality were related for those consultation combinations dissimilar in goals, structure, and required skills. CST background had no effect on inconsistency. Physician communication performance should be of high quality, but also consistent regardless of the type and complexity of the consultation. In order to improve performance quality and reduce performance inconsistency, communication education should offer ample opportunities to practice a wide variety of challenging consultations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. 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

  4. 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

    2015-01-29

    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.

  5. Efforts to Improve Mathematics Teacher Competency Through Training Program on Design Olympiad Mathematics Problems Based on Higher Order Thinking Skills in The Junior High School

    Science.gov (United States)

    Arnellis, A.; Jamaan, E. Z.; Amalita, N.

    2018-04-01

    The goal to analyse a improvement of teacher competence after being trained in preparing high-order math olympicad based on high order thinking skills in junior high school teachers in Pesisir Selatan Regency. The sample of these activities are teachers at the MGMP junior high school in Pesisir Selatan District. Evaluation of the implementation is done by giving a pre test and post test, which will measure the success rate of the implementation of this activities. The existence of the devotion activities is expected to understand the enrichment of mathematics olympiad material and training in the preparation of math olympiad questions for the teachers of South Pesisir district junior high school, motivating and raising the interest of the participants in order to follow the mathematics olympiad with the enrichment of mathematics materials and the training of problem solving about mathematics olympiad for junior high school teachers, the participants gain experience and gain insight, as well as the ins and outs of junior mathematics olympiad and implement to teachers and students in olympic competitions. The result of that the post-test is better than the result of pretest in the training of mathematics teacher competence improvement in composing the mathematics olympiad problem based on high order thinking skills of junior high school (SMP) in Pesisir Selatan District, West Sumatra, Indonesia.

  6. 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.

  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. The Implementation of Integrated Natural Science Textbook of Junior High School be Charged on Character-based Shared Models to Improve the Competence of Learners' Knowledge

    Science.gov (United States)

    Rahmiwati, S.; Ratnawulan; Yohandri

    2018-04-01

    The process of science learning can take place if there is an attempt to create an active learning atmosphere and can improve the knowledge competence of learners. One of the efforts made is to use learning resources. Textbooks are a learning resource used by learners. This study aims to describe the increase of knowledge’s competence of learners with integrated Natural Science (IPA) textbook of Junior High School (SMP) be charged on character-based shared model. The method used pre-test, post-test design with one group using the class as a research subject. Pre-test was given before treatment to measure student’s initial understanding of the problem, while the post-test was given to measure student’s final understanding.The subject of this research is students of class VII SMP N 13 Padang. Result of gain score is 0,73. The result showed competence student’s knowledge increased significantly and high categorized.

  9. Preparing Psychiatric Residents for the "Real World": A Practice Management Curriculum

    Science.gov (United States)

    Wichman, Christina L.; Netzel, Pamela J.; Menaker, Ronald

    2009-01-01

    Objective: The authors describe a course designed for residents to develop the knowledge and skills necessary to collaborate and successfully compete in today's complex health care environment and to achieve competency in systems-based practice. Methods: Postgraduation surveys demonstrated a need for improvement in preparing residents for practice…

  10. The effect of the Accreditation Council for Graduate Medical Education Duty Hours Policy on plastic surgery resident education and patient care: an outcomes study.

    Science.gov (United States)

    Basu, Chandrasekhar Bob; Chen, Li-Mei; Hollier, Larry H; Shenaq, Saleh M

    2004-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) Work-Hours Duty Policy became effective on July 1, 2003, mandating the reduction of resident duty work hours. The Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program instituted a resident duty work-hours policy on July 1, 2002 (1 year ahead of the national mandate). Outcomes data are needed to facilitate continuous improvements in plastic surgical residency training while maintaining high-quality patient care. To assess the effect of this policy intervention on plastic surgery resident education as measured through the six core competencies and patient/resident safety, the investigators surveyed all categorical plastic surgery residents 6 months after implementation of the policy. This work represents the first empiric study investigating the effect of duty hours reduction on plastic surgery training and education. The categorical plastic surgery residents at the Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program completed a 68-item survey on a five-point Likert scale (1 = strongly disagree to 5 = strongly agree). Residents were asked to rate multiple parameters based on the ACGME six core competencies, including statements on patient care and clinical/operative duties, resident education, resident quality of life, and resident perceptions on this policy. All surveys were completed anonymously. The sample size was n = 12 (program year 3 through program year 6), with a 100 percent response rate. Univariate and bivariate statistical analysis was conducted with SPSS version 10.0 statistical software. Specifically, interquartile deviations were used to find consensus among resident responses to each statement. Descriptive statistics indicated higher percentages of agreement on a majority of statements in three categories, including patient care and clinical/operative duties, academic duties, and resident quality of life. Using interquartile

  11. High-speed mapping of water isotopes and residence time in Cache Slough Complex, San Francisco Bay Delta, CA

    Data.gov (United States)

    Department of the Interior — Real-time, high frequency (1-second sample interval) GPS location, water quality, and water isotope (δ2H, δ18O) data was collected in the Cache Slough Complex (CSC),...

  12. Psychosocial and career outcomes of peer mentorship in medical resident education: a systematic review protocol.

    Science.gov (United States)

    Pethrick, Helen; Nowell, Lorelli; Oddone Paolucci, Elizabeth; Lorenzetti, Liza; Jacobsen, Michele; Clancy, Tracey; Lorenzetti, Diane L

    2017-08-31

    Many medical residents lack ready access to social and emotional supports that enable them to successfully cope with the challenges associated with medical residency. This absence of support has been shown to lead to high levels of burnout, decreased mental wellbeing, and difficulty mastering professional competencies in this population. While there is emerging evidence that peer mentoring can be an important source of psychosocial and career-related support for many individuals, the extent of the evidence regarding the benefits of peer mentorship in medical residency education has not yet been established. We describe a protocol for a systematic review to assess the effects of peer mentoring on medical residents' mental wellbeing, social connectedness, and professional competencies. Studies included in this review will be those that report on peer-mentoring relationships among medical residents. Quantitative, qualitative, and mixed-methods studies will be eligible for inclusion. No date or language limits will be applied. We will search EMBASE, MEDLINE, PsychINFO, Web of Science, Scopus, ERIC, Education Research Complete, and Academic Research Complete databases to identify relevant studies. Two authors will independently assess all abstracts and full-text studies for inclusion and study quality and extract study data in duplicate. This is the first systematic review to explicitly explore the role of peer mentoring in the context of medical residency education. We anticipate that the findings from this review will raise awareness of the benefits and challenges associated with peer-mentoring relationships, further the development and implementation of formal peer-mentoring programs for medical residents, and, through identifying gaps in the existing literature, inform future research efforts. This protocol has not been registered in PROSPERO or any other publicly accessible registry.

  13. Models for Evaluating and Improving Architecture Competence

    National Research Council Canada - National Science Library

    Bass, Len; Clements, Paul; Kazman, Rick; Klein, Mark

    2008-01-01

    ... producing high-quality architectures. This report lays out the basic concepts of software architecture competence and describes four models for explaining, measuring, and improving the architecture competence of an individual...

  14. First-Year Residents Outperform Third-Year Residents after Simulation-Based Education in Critical Care Medicine

    Science.gov (United States)

    Singer, Benjamin D.; Corbridge, Thomas C.; Schroedl, Clara J.; Wilcox, Jane E.; Cohen, Elaine R.; McGaghie, William C.; Wayne, Diane B.

    2012-01-01

    Introduction Prior research shows that gaps exist in internal medicine residents’ critical care knowledge and skills. The purpose of this study was to compare the bedside critical care competency of first-year residents who received a simulation-based educational intervention plus clinical training to third-year residents who received clinical training alone. Methods During their first three months of residency, a group of first-year residents completed a simulation-based educational intervention. A group of traditionally-trained third-year residents who did not receive simulation-based training served as a comparison group. Both groups were evaluated using a 20-item clinical skills assessment at the bedside of a patient receiving mechanical ventilation at the end of their medical intensive care unit rotation. Scores on the skills assessment were compared between groups. Results Simulator-trained first-year residents (n=40) scored significantly higher compared to traditionally-trained third-year residents (n=27) on the bedside assessment, 91.3% (95% CI 88.2% to 94.3%) vs. 80.9% (95% CI 76.8% to 85.0%), P = simulation-based educational intervention demonstrated higher clinical competency than third-year residents who did not undergo simulation training. Critical care competency cannot be assumed after clinical ICU rotations; simulation-based curricula can help ensure residents are proficient to care for critically ill patients. PMID:23222546

  15. Competencies required for occupational health nurses.

    Science.gov (United States)

    Kono, Keiko; Goto, Yuki; Hatanaka, Junko; Yoshikawa, Etsuko

    2017-11-25

    For occupational health (OH) nurses to perform activities effectively, not only skills and knowledge but also competencies proposed by Dr. McClelland are indispensable. This study aimed to identify competencies required for OH nurses and to show their structure diagram. Qualitative descriptive research was conducted from October 2010 to August 2011. Eight high-performing OH nurses participated, and data were collected from semi-structured interviews held for each nurse. Data were qualitatively and inductively analyzed using the KJ method. Seven competencies were identified: "self-growth competency," "OH nursing essence perpetuation competency," "strategic planning and duty fulfillment competency," "coordination competency," "client growth support competency," "team empowerment competency," and "creative competency." A structure diagram of the seven competencies was clarified. As the definitions of the competencies were different, the findings of competencies for OH nursing in the United States of America (USA) could not simply be compared with the findings of our study; however, all seven competencies were compatible with those in AAOHN model 1 and AAOHN model 2 in the USA. Our seven competencies are essential for OH nurses to perform activities that meet the expectations of employees and the employer.

  16. The Competence Promoting by NNSA for Keeping High Level Nuclear Safety: The Corner Stone of the Nuclear Safety Regulation Edifice

    International Nuclear Information System (INIS)

    Hu, L.

    2016-01-01

    Facing the fast development of the nuclear power industry and the application of radioactive sources, The MEP(NNSA) is endeavoured to promoting its competency, including: complementing the law system, training and recruiting staff to keep a capable team, constructing the R&D base to keep the basic capability, promoting safety culture both for the industry and the regulator. After the Fukushima nuclear accident, the MEP(NNSA) planned to construct R&D base, in which the Platform Nuclear Safety Monitoring and Emergency Responding, the Platform of Safety Technology of PWR Testing, the Laboratory of Safety Management Technology of Nuclear Waste Verification, the Laboratory of Environmental Radiation Monitoring and the Center of International Cooperation are included. On the other hand, the MEP(NNSA) issued Chinese nuclear safety culture policy declaration in 2014, and carried out a large scale Specialized Action for Nuclear Safety Promotion to promote the nuclear safety culture both for the industry and herself. For the nuclear regulator, It is essential to conduct the competence promoting by both “hardware” and “software”, the former is the material foundation of regulation authority, which will be effectively functioning under the facilitating of the latter. (author)

  17. Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

    Science.gov (United States)

    Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

    2016-04-01

    goal in analyzing these data was to provide residency programs at large a sense of which criteria may be "high yield" in ranking applicants by analyzing data from within our own pool of residents. Similar studies across a broader scope of programs are warranted to confirm applicability of our findings. The continually emerging complexities of the field of orthopaedic surgery lend increasing importance to future work on the appropriate selection and training of orthopaedic residents.

  18. Reproductive Psychiatry Residency Training: A Survey of Psychiatric Residency Program Directors.

    Science.gov (United States)

    Osborne, Lauren M; MacLean, Joanna V; Barzilay, Erin Murphy; Meltzer-Brody, Samantha; Miller, Laura; Yang, Sarah Nagle

    2018-04-01

    The reproductive life cycle has unique influences on the phenotypic expression of mental illness in women. Didactic and clinical training focused on these sex-specific influences should be a vital component of the education of future psychiatrists. The authors sought to determine the current state of and attitudes toward reproductive psychiatry in resident education. The authors administered a web-based survey to psychiatry residency training directors. They assessed the availability of both mandated and optional didactic and clinical training experiences in reproductive psychiatry. Fifty residency program directors answered the survey, for a response rate of 28%. More than half of residency program directors (59%) reported requiring some training in reproductive psychiatry. Both the breadth and depth of topics covered varied greatly among programs. Lack of time (48%) and lack of qualified faculty (26%) were the most frequently cited barriers to more training. Only 40% of residency directors surveyed agreed that all residents should be competent in reproductive psychiatry. These findings suggest that specific training in reproductive psychiatry is inconsistent in US residency programs, and that training that does exist varies considerably in clinical time and content. Given that women comprise more than 50% of all psychiatric patients and most women will menstruate, give birth, and undergo menopause, future psychiatrists would benefit from more systematic instruction in this area. The authors propose the development of a national, standardized reproductive psychiatry curriculum to address this gap and aid in producing psychiatrists competent to treat women at all stages of life.

  19. 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.

  20. "I Feel Trapped": The Tension Between Personal and Structural Factors of Social Isolation and the Desire for Social Integration Among Older Residents of a High-Crime Neighborhood.

    Science.gov (United States)

    Portacolone, Elena; Perissinotto, Carla; Yeh, Jarmin Christine; Greysen, S Ryan

    2018-01-18

    The aim of this study was to examine the factors contributing to the social isolation of older residents of a high-crime neighborhood through the in-depth examination of their lived experiences. A deeper understanding of factors contributing to social isolation can allow policymakers and health care providers to create policies and programs to alleviate the social isolation of these vulnerable and understudied individuals. Participants were recruited through the support of the Housing Authority and Police and Fire Departments of Richmond, California, a town with a high-crime rate. Fifty-nine ethnographic interviews were conducted with 20 individuals of 58-95 years of age. Transcripts and fieldnotes were analyzed with a focus on the specific factors contributing the social isolation of participants. An overarching theme of tension between personal and structural factors of social isolation and desire for social integration emerged from qualitative content analysis. A tension emerged between a longing to participate in society and the immersion in a reality so dense with obstacles that made participation in society difficult to attain. Four specific themes also emerged. Three themes demonstrated underlying factors of social isolation stemming from the personal sphere and the physical and social environment. The fourth theme illustrated participants' desire for social integration. Findings demonstrate the salience of interventions and programs to make neighborhoods safe and accessible to older residents. Findings also suggest a need to reframe the conceptual framework for social isolation to better measure and alleviate this public health problem. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. A theory-informed, process-oriented Resident Scholarship Program

    Science.gov (United States)

    Thammasitboon, Satid; Darby, John B.; Hair, Amy B.; Rose, Karen M.; Ward, Mark A.; Turner, Teri L.; Balmer, Dorene F.

    2016-01-01

    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. PMID:27306995

  2. 國民核心素養與高中課程發展The Development of Integration of Key Competence into the Senior High School Curriculum

    Directory of Open Access Journals (Sweden)

    林永豐 Yung-Feng Lin

    2013-03-01

    Full Text Available 本研究旨在說明如何依據後期中等教育階段之核心素養,融入普通高中各學科 課程綱要,進而建構各學科課程之核心素養指標,以達成「K-12年級一貫課程綱要」的「核心素養」之「垂直銜接」與「水平統整」,並做為進一步擬訂「十二年一貫課程體系指引」之基礎。本研究透過文件分析與德懷術探討現行普通高中課程各學科與核心素養之對應關係,以瞭解如何將核心素養融入各學科課程中,達至學科課程與核心素養之課程統整。本研究結論有三,包括:一、普通高中各學科與核心素養的相關性高,應強化核心素養的培養與精進;二、普通高中各學科課綱中所列之核心能力與國民核心素養九個項目有對應之處,亦有不足之處;三、普通高中教育向來重視學科知能的教學,應調整為內容與能力兼具的課程取向。本研究建議:一、依據核心素養的理念,建議重新檢討並修正各科之課程目標與核心能力;二、宜進一步針對尚未分析之六科進行核心素養之分析;三、納入更多各學科專家與實務教師,討論並修正各科之核心素養等。This paper aims to elaborate how can the key competences for upper secondary education stage be integrated into the curriculum of senior high schools. Moreover, it is hoped that indicators of key competences in different subjects can be built up so that key competences for the K-12 grades curriculum could be established being both vertically coherent in different grades and horizontally integrated with other academic subjects. This study adopt document analysis and the Delphi technique as main research methods with particular focus on the relationship between key competences and main subjects in the senior high school curriculum. Three main conclusions are summarized as follows. First, there is a strong relationship between the key

  3. Emergency Medicine Resident Perceptions of Medical Professionalism.

    Science.gov (United States)

    Jauregui, Joshua; Gatewood, Medley O; Ilgen, Jonathan S; Schaninger, Caitlin; Strote, Jared

    2016-05-01

    Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees' perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the "respect for others" and "honor and integrity" valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the "duty and service" domain (p<0.05). Among different residencies, significant differences were found with attributes within the "altruism" and "duty and service" domains (p<0.05). Residents perceive differences in the relative importance of traditionally defined professional attributes and this may

  4. 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.

  5. Burnout is Associated With Emotional Intelligence but not Traditional Job Performance Measurements in Surgical Residents.

    Science.gov (United States)

    Cofer, Kevin D; Hollis, Robert H; Goss, Lauren; Morris, Melanie S; Porterfield, John R; Chu, Daniel I

    2018-02-23

    To evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. General surgery residents at a single institution were surveyed using the Maslach Burnout Inventory (MBI) and trait EI questionnaire (TEIQ-SF). Burnout was defined as scoring in 2 of the 3 following domains; Emotional Exhaustion (high), Depersonalization (high), and Personal Accomplishment (low). Job performance was evaluated using faculty evaluations of clinical competency-based surgical milestones and standardized test scores including the American Board of Surgery In-Training Exam (ABSITE) and the United States Medical Licensing Examination (USMLE) Step 3. USMLE Step 1 and USMLE Step 2, which were taken prior to residency training, were included to examine possible associations of burnout with USMLE examinations. Statistical comparison was made using Pearson correlation and simple linear regression adjusting for PGY level. This study was conducted at the University of Alabama at Birmingham (UAB) general surgery residency program. All current and incoming general surgery residents at UAB were invited to participate in this study. Forty residents participated in the survey (response rate 77%). Ten residents, evenly distributed from incoming residents to PGY-4, had burnout (25%). Mean global EI was lower in residents with burnout versus those without burnout (3.71 vs 3.9, p = 0.02). Of the 4 facets of EI, mean self-control values were lower in residents with burnout versus those without burnout (3.3 vs 4.06, p burnout was associated with global EI, with the strongest correlation being with personal accomplishment (r = 0.64; p burnout did not have significantly different mean scores for USMLE Step 1 (229 vs 237, p = 0.12), Step 2 (248 vs 251, p = 0.56), Step 3 (223 vs 222, p = 0.97), or ABSITE percentile (44.6 vs 58, p = 0.33) compared to residents without burnout. Personal accomplishment was associated with ABSITE percentile scores (r = 0.35; p = 0

  6. 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.

  7. Assessment of indoor radiation dose received by the residents of natural high background radiation areas of coastal villages of Kanyakumari district, Tamil Nadu, India

    International Nuclear Information System (INIS)

    Deva Jayanthi, D.; Maniyan, C.G.; Perumal, S.

    2011-01-01

    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: → 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. → The high dose indicates higher concentration of radioactive nuclides like Thorium and Uranium in the soil. → 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. → Contribution from vegetables, fruits, fish and other non vegetarian items are also being examined. → These results along with other socio-economic factors can throw considerable light on the epidemiological impacts due to low levels of chronic exposure.

  8. Implementation of full patient simulation training in surgical residency.

    Science.gov (United States)

    Fernandez, Gladys L; Lee, Patrick C; Page, David W; D'Amour, Elizabeth M; Wait, Richard B; Seymour, Neal E

    2010-01-01

    Simulated patient care has gained acceptance as a medical education tool but is underused in surgical training. To improve resident clinical management in critical situations relevant to the surgical patient, high-fidelity full patient simulation training was instituted at Baystate Medical Center in 2005 and developed during successive years. We define surgical patient simulation as clinical management performed in a high fidelity environment using a manikin simulator. This technique is intended to be specifically modeled experiential learning related to the knowledge, skills, and behaviors that are fundamental to patient care. We report 3 academic years' use of a patient simulation curriculum. Learners were PGY 1-3 residents; 26 simulated patient care experiences were developed based on (1) designation as a critical management problem that would otherwise be difficult to practice, (2) ability to represent the specific problem in simulation, (3) relevance to the American Board of Surgery (ABS) certifying examination, and/or (4) relevance to institutional quality or morbidity and mortality reports. Although training started in 2005, data are drawn from the period of systematic and mandatory training spanning from July 2006 to June 2009. Training occurred during 1-hour sessions using a computer-driven manikin simulator (METI, Sarasota, Florida). Educational content was provided either before or during presimulation briefing sessions. Scenario areas included shock states, trauma and critical care case management, preoperative processes, and postoperative conditions and complications. All sessions were followed by facilitated debriefing. Likert scale-based multi-item assessments of core competency in medical knowledge, patient care, diagnosis, management, communication, and professionalism were used to generate a performance score for each resident for each simulation (percentage of best possible score). Performance was compared across PGYs by repeated

  9. Cultural transition of international medical graduate residents into family practice in Canada.

    Science.gov (United States)

    Triscott, Jean A C; Szafran, Olga; Waugh, Earle H; Torti, Jacqueline M I; Barton, Martina

    2016-05-04

    To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada's health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles. Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning.

  10. 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

    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. 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. 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. 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. This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction.

  11. 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.

  12. Variable Operative Experience in Hand Surgery for Plastic Surgery Residents.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Levin, Lawrence Scott; Chang, Benjamin

    Efforts to standardize hand surgery training during plastic surgery residency remain challenging. We analyze the variability of operative hand experience at U.S. plastic surgery residency programs. Operative case logs of chief residents in accredited U.S. plastic surgery residency programs were analyzed (2011-2015). Trends in fold differences of hand surgery case volume between the 10th and 90th percentiles of residents were assessed graphically. Percentile data were used to calculate the number of residents achieving case minimums in hand surgery for 2015. Case logs from 818 plastic surgery residents were analyzed of which a minority were from integrated (35.7%) versus independent/combined (64.3%) residents. Trend analysis of fold differences in case volume demonstrated decreasing variability among procedure categories over time. By 2015, fold differences for hand reconstruction, tendon cases, nerve cases, arthroplasty/arthrodesis, amputation, arterial repair, Dupuytren release, and neoplasm cases were below 10-fold. Congenital deformity cases among independent/combined residents was the sole category that exceeded 10-fold by 2015. Percentile data suggested that approximately 10% of independent/combined residents did not meet case minimums for arterial repair and congenital deformity in 2015. Variable operative experience during plastic surgery residency may limit adequate exposure to hand surgery for certain residents. Future studies should establish empiric case minimums for plastic surgery residents to ensure hand surgery competency upon graduation. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. The medical mission and modern cultural competency training.

    Science.gov (United States)

    Campbell, Alex; Sullivan, Maura; Sherman, Randy; Magee, William P

    2011-01-01

    Culture has increasingly appreciated clinical consequences on the patient-physician relationship, and governing bodies of medical education are widely expanding educational programs to train providers in culturally competent care. A recent study demonstrated the value an international surgical mission in modern surgical training, while fulfilling the mandate of educational growth through six core competencies. This report further examines the impact of international volunteerism on surgical residents, and demonstrates that such experiences are particularly suited to education in cultural competency. Twenty-one resident physicians who participated in the inaugural Operation Smile Regan Fellowship were surveyed one year after their experiences. One hundred percent strongly agreed that participation in an international surgical mission was a quality educational experience and 94.7% deemed the experience a valuable part of their residency training. In additional to education in each of the ACGME core competencies, results demonstrate valuable training in cultural competence. A properly structured and proctored experience for surgical residents in international volunteerism is an effective instruction tool in the modern competency-based residency curriculum. These endeavors provide a unique understanding of the global burden of surgical disease, a deeper appreciation for global public health issues, and increased cultural sensitivity. A surgical mission experience should be widely available to surgery residents. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Genotoxic differences by sex in nasal epithelium and blood leukocytes in subjects residing in a highly polluted area

    International Nuclear Information System (INIS)

    Fortoul, T.I.; Valverde, M.; Lopez, M.C.; Avila-Costa, M.R.; Avila-Casado, M.C.; Mussali-Galante, P.; Gonzalez-Villalva, A.; Rojas, E.; Ostrosky-Shejet, P.

    2004-01-01

    We describe differences by sex in genotoxic damage found in a population of medical students exposed to a highly oxidative atmosphere, compared with a control group, measured by the single-cell gel electrophoresis assay and histological changes in nasal epithelium smears. Cells were obtained from the nasal epithelium and blood leukocytes. Higher DNA damage in nasal cells and leukocytes was found in males compared to females and control subjects. The percentage of squamous metaplastic changes in the nasal epithelium was also higher in males compared with females and controls. The commutation of normal nasal epithelium by squamous cells might modify its protective function in the nose, increasing the risk of damage to the lower respiratory tract. Although, as medical students, males and females were exposed to the same environment and activity patterns, male genotoxicity damage was higher in control and exposed subjects. More research should be done in order to identify direct or indirect sexual hormone intervention

  15. 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

    2016-01-01

    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. PMID:27563486

  16. 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.

  17. Competency-based continuing professional development.

    Science.gov (United States)

    Campbell, Craig; Silver, Ivan; Sherbino, Jonathan; Cate, Olle Ten; Holmboe, Eric S

    2010-01-01

    Competence is traditionally viewed as the attainment of a static set of attributes rather than a dynamic process in which physicians continuously use their practice experiences to "progress in competence" toward the attainment of expertise. A competency-based continuing professional development (CPD) model is premised on a set of learning competencies that include the ability to (a) use practice information to identify learning priorities and to develop and monitor CPD plans; (b) access information sources for innovations in development and new evidence that may potentially be integrated into practice; (c) establish a personal knowledge management system to store and retrieve evidence and to select and manage learning projects; (d) construct questions, search for evidence, and record and track conclusions for practice; and (e) use tools and processes to measure competence and performance and develop action plans to enhance practice. Competency-based CPD emphasizes self-directed learning processes and promotes the role of assessment as a professional expectation and obligation. Various approaches to defining general competencies for practice require the creation of specific performance metrics to be meaningful and relevant to the lifelong learning strategies of physicians. This paper describes the assumptions, advantages, and challenges of establishing a CPD system focused on competencies that improve physician performance and the quality and safety of patient care. Implications for competency-based CPD are discussed from an individual and organizational perspective, and a model to bridge the transition from residency to practice is explored.

  18. FIRST robots compete

    Science.gov (United States)

    2000-01-01

    FIRST teams and their robots work to go through the right motions at the FIRST competition. Students from all over the country are at the KSC Visitor Complex for the FIRST (For Inspiration and Recognition of Science and Technology) Southeast Regional competition March 9-11 in the Rocket Garden. Teams of high school students are testing the limits of their imagination using robots they have designed, with the support of business and engineering professionals and corporate sponsors, to compete in a technological battle against other schools' robots. Of the 30 high school teams competing, 16 are Florida teams co-sponsored by NASA and KSC contractors. Local high schools participating are Astronaut, Bayside, Cocoa Beach, Eau Gallie, Melbourne, Melbourne Central Catholic, Palm Bay, Rockledge, Satellite, and Titusville.

  19. A questionnaire survey on sleeping thermal environment and bedroom air conditioning in high-rise residences in Hong Kong

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Z. [Institute of Heating, Ventilation, Air Conditioning and Gas Engineering, Tongji University, Shanghai (China); Deng, S. [Department of Building Services Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR (China)

    2006-07-01

    This paper reports on the results of a questionnaire survey on sleeping thermal environment and bedroom air conditioning in high-rise residential buildings in Hong Kong. The survey aimed at investigating the current situation of sleeping thermal environment and bedroom air conditioning, in order to gather relevant background information to develop strategies for bedroom air conditioning in the subtropics. It focused on the use patterns and types of bedroom air conditioning systems used, human factors such as the use of bedding and sleep wear during sleep, preference for indoor air temperature settings in bedrooms, ventilation control at nighttime with room air conditioner (RAC) turned on, etc. The results of the survey showed that most of the respondents would prefer a relatively low indoor air temperature at below 24 {sup o}C. Most of the respondents might however not be satisfied with the indoor air quality (IAQ) in bedrooms in Hong Kong. On the other hand, 68% of the respondents did not use any ventilation control intentionally during their sleep with their RACs turned on. A lack of knowledge of the ventilation control devices provided on window type room air conditioners (WRACs) indicated an urgent need for user education. (author)

  20. Women's willingness to experiment with condoms and lubricants: A study of women residing in a high HIV seroprevalence area.

    Science.gov (United States)

    Sanders, Stephanie A; Crosby, Richard A; Milhausen, Robin R; Graham, Cynthia A; Tirmizi, Amir; Yarber, William L; Beauchamps, Laura; Mena, Leandro

    2018-03-01

    The objective of this study was to investigate women's willingness to experiment with new condoms and lubricants, in order to inform condom promotion in a city with high rates of poverty and HIV. One hundred and seventy-three women (85.9% Black) sexually transmitted infection clinic attendees in Jackson, Mississippi, United States completed a questionnaire assessing willingness to experiment with condoms and lubricants and sexual pleasure and lubrication in relation to last condom use. Most women were willing to: (1) experiment with new types of condoms and lubricants to increase their sexual pleasure, (2) touch/handle these products in the absence of a partner, and (3) suggest experimenting with new condoms and lubricants to a sex partner. Previous positive sexual experiences with lubricant during condom use predicted willingness. The role women may play in male condom use should not be underestimated. Clinicians may benefit women by encouraging them to try new types of condoms and lubricants to find products consistent with sexual pleasure.

  1. Integrated and implicit : how residents learn CanMEDS roles by participating in practice

    NARCIS (Netherlands)

    Renting, Nienke; Raat, A N Janet; Dornan, Tim; Wenger-Trayner, Etienne; van der Wal, Martha A; Borleffs, Jan C C; Gans, Rijk O B; Jaarsma, A Debbie C

    CONTEXT: Learning outcomes for residency training are defined in competency frameworks such as the CanMEDS framework, which ultimately aim to better prepare residents for their future tasks. Although residents' training relies heavily on learning through participation in the workplace under the

  2. Improving Clinical Feedback to Anesthesia Residents by Using an Optical Scanner and a Microcomputer.

    Science.gov (United States)

    Albanese, Mark A.; And Others

    1989-01-01

    At the University of Iowa problems associated with managing evaluations of anesthesia residents led to a major backlog of unanalyzed evaluation forms. A system developed at the University that enables ongoing feedback to residents and provides a method to assess the clinical competence of residents is described. (Author/MLW)

  3. 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...

  4. 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.

  5. 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…

  6. Understanding Resident Performance, Mindfulness, and Communication in Critical Care Rotations.

    Science.gov (United States)

    Real, Kevin; Fields-Elswick, Katelyn; Bernard, Andrew C

    Evidence from the medical literature suggests that surgical trainees can benefit from mindful practices. Surgical educators are challenged with the need to address resident core competencies, some of which may be facilitated by higher levels of mindfulness. This study explores whether mindful residents perform better than their peers as members of the health care team. This study employed a multiphase, multimethod design to assess resident mindfulness, communication, and clinical performance. Academic, tertiary medical center. Residents (N = 51) working in an intensive care unit. In phase I, medical residents completed a self-report survey of mindfulness, communication, emotional affect, and clinical decision-making. In phase II, resident performance was assessed using independent ratings of mindfulness and clinical decision-making by attending physicians and registered nurses. In phase 1, a significant positive relationship was found between resident performance and mindfulness, positive affect (PA), and communication. In phase 2, attending physicians/registered nurses' perceptions of residents' mindfulness were positively correlated with communication and inversely related to negative affect (NA). The top quartile of residents for performance and mindfulness had the lowest NA. Higher-rated residents underestimated their performance/mindfulness, whereas those in the lowest quartile overestimated these factors. This study offers a number of implications for medical resident education. First, mindfulness was perceived to be a significant contributor to self-assessments of competency and performance. Second, both PA and NA were important to mindfulness and performance. Third, communication was associated with resident performance, mindfulness, and PA. These implications suggest that individual characteristics of mindfulness, communication, and affect, all potentially modifiable, influence care quality and safety. To improve low performers, surgical educators could

  7. Psychotherapy Training: Residents' Perceptions and Experiences.

    Science.gov (United States)

    Kovach, Jessica G; Dubin, William R; Combs, Christopher J

    2015-10-01

    This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more

  8. How do urology residents manage personal finances?

    Science.gov (United States)

    Teichman, J M; Bernheim, B D; Espinosa, E A; Cecconi, P P; Meyer, J; Pearle, M S; Preminger, G M; Leveillee, R J

    2001-05-01

    To examine personal financial management among residents to answer three research questions: do residents make reasonable financial choices; why do some residents not save; and what steps can be taken to improve residents' personal financial decisions. Portions of the Federal Reserve Board's Survey of Consumer Finances were modified and piloted to elicit demographic, expense, saving, and income data. The final questionnaire was completed by 151 urology residents at 20 programs. Comparing residents with the general population in the same age and income categories, the median debt/household income ratio was 2.38 versus 0.64. Residents had greater educational debt, greater noneducational debt, and lower savings. Resident participation in retirement accounts was 100% at institutions with employer-matching 401k or 403b plans, 63% at institutions with nonmatching 401k or 403b plans, and 48% at institutions without retirement plans for residents (P = 0.002). Fifty-nine percent of residents budgeted expenses, 27% had cash balances below $1000, 51% had paid interest charges on credit cards within the previous year, and 12% maintained unpaid credit card balances greater than $10,000. The median resident income was $38,400. A significant minority of residents appear not to make reasonable financial choices. Some residents save little because of a failure to budget, indebtedness, high projected income growth, or insufficient attention to personal financial management. Residents save more when they are eligible for tax-deferred retirement plans, particularly when their institution matches their contributions. Many residents would benefit from instruction concerning prudent financial management.

  9. Incidence of a didactic sequence, based on multiple representations, for the strengthening of argumentative competence in high school students

    Directory of Open Access Journals (Sweden)

    Gustavo Bonilla

    2018-01-01

    Full Text Available The present article; seeks to identify the way in which a didactic sequence, based on the implementation of multiple representations, can have an impact on the strengthening of the argumentative competence in basic secondary school students. The methodological foundation on which is based the research, taking into account the mixed approach as a perspective that properly oriented, the exercise of research in the field of education. In view of the above, it performs a process of pedagogical intervention related to the general law of ideal gases, through the implementation of the elements presented in the didactic cycle with a research approach and with the application of a pretest and posttest. The techniques to be used for the process of intervention are the participant observation, the discussion group and the survey. Specifically, as instruments for the collection of information; the interview focused, semi-structured interview and the questions guide. The unit of work corresponds to 36 students --240, six students per each group of 9°-- the basic secondary educational institutions belonging to the Citadel New West, located in the Commune 60 and The Heart, located in the commune 13; both in the city of Medellín.

  10. High throughput generation and characterization of replication-competent clade C transmitter-founder simian human immunodeficiency viruses.

    Directory of Open Access Journals (Sweden)

    Debashis Dutta

    Full Text Available Traditional restriction endonuclease-based cloning has been routinely used to generate replication-competent simian-human immunodeficiency viruses (SHIV and simian tropic HIV (stHIV. This approach requires the existence of suitable restriction sites or the introduction of nucleotide changes to create them. Here, using an In-Fusion cloning technique that involves homologous recombination, we generated SHIVs and stHIVs based on epidemiologically linked clade C transmitted/founder HIV molecular clones from Zambia. Replacing vif from these HIV molecular clones with vif of SIVmac239 resulted in chimeric genomes used to generate infectious stHIV viruses. Likewise, exchanging HIV env genes and introducing N375 mutations to enhance macaque CD4 binding site and cloned into a SHIVAD8-EO backbone. The generated SHIVs and stHIV were infectious in TZMbl and ZB5 cells, as well as macaque PBMCs. Therefore, this method can replace traditional methods and be a valuable tool for the rapid generation and testing of molecular clones of stHIV and SHIV based on primary clinical isolates will be valuable to generate rapid novel challenge viruses for HIV vaccine/cure studies.

  11. Early learning effect of residents for laparoscopic sigmoid resection.

    Science.gov (United States)

    Bosker, Robbert; Groen, Henk; Hoff, Christiaan; Totte, Eric; Ploeg, Rutger; Pierie, Jean-Pierre

    2013-01-01

    To evaluate the effect of learning the laparoscopic sigmoid resection procedure on resident surgeons; establish a minimum number of cases before a resident surgeon could be expected to achieve proficiency with the procedure; and examine if an analysis could be used to measure and support the clinical evaluation of the surgeon's competence with the procedure. Retrospective analysis of data which was prospective entered in the database. From 2003 to 2007 all patients who underwent a laparoscopic sigmoid resection carried out by senior residents, who completed the procedure as the primary surgeon proctored by an experienced surgeon, were included in the study. A cumulative sum control chart (CUSUM) analysis was used evaluate performance. The procedure was defined as a failure if major intra-operative complications occurred such as intra abdominal organ injury, bleeding, or anastomotic leakage; if an inadequate number of lymph nodes (<12 nodes) were removed; or if conversion to an open surgical procedure was required. Thirteen residents performed 169 laparoscopic sigmoid resections in the period evaluated. A significant majority of the resident surgeons were able to consistently perform the procedure without failure after 11 cases and determined to be competent. One resident was not determined to be competent and the CUSUM score supported these findings. We concluded that at least 11 cases are required for most residents to obtain necessary competence with the laparoscopic sigmoid resection procedure. Evaluation with the CUSUM analysis can be used to measure and support the clinical evaluation of the resident surgeon's competence with the procedure. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Advancing resident assessment in graduate medical education.

    Science.gov (United States)

    Swing, Susan R; Clyman, Stephen G; Holmboe, Eric S; Williams, Reed G

    2009-12-01

    The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007-2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008.

  13. Competency-based education and training in internal medicine.

    Science.gov (United States)

    Weinberger, Steven E; Pereira, Anne G; Iobst, William F; Mechaber, Alex J; Bronze, Michael S

    2010-12-07

    Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.

  14. Afraid of being "witchy with a 'b'": a qualitative study of how gender influences residents' experiences leading cardiopulmonary resuscitation.

    Science.gov (United States)

    Kolehmainen, Christine; Brennan, Meghan; Filut, Amarette; Isaac, Carol; Carnes, Molly

    2014-09-01

    Ineffective leadership during cardiopulmonary resuscitation ("code") can negatively affect a patient's likelihood of survival. In most teaching hospitals, internal medicine residents lead codes. In this study, the authors explored internal medicine residents' experiences leading codes, with a particular focus on how gender influences the code leadership experience. The authors conducted individual, semistructured telephone or in-person interviews with 25 residents (May 2012 to February 2013) from 9 U.S. internal medicine residency programs. They audio recorded and transcribed the interviews and then thematically analyzed the transcribed text. Participants viewed a successful code as one with effective leadership. They agreed that the ideal code leader was an authoritative presence; spoke with a deep, loud voice; used clear, direct communication; and appeared calm. Although equally able to lead codes as their male colleagues, female participants described feeling stress from having to violate gender behavioral norms in the role of code leader. In response, some female participants adopted rituals to signal the suspension of gender norms while leading a code. Others apologized afterwards for their counternormative behavior. Ideal code leadership embodies highly agentic, stereotypical male behaviors. Female residents employed strategies to better integrate the competing identities of code leader and female gender. In the future, residency training should acknowledge how female gender stereotypes may conflict with the behaviors required to enact code leadership and offer some strategies, such as those used by the female residents in this study, to help women integrate these dual identities.

  15. 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.

  16. Implementation of a Novel Structured Social and Wellness Committee in a Surgical Residency Program: A Case Study.

    Science.gov (United States)

    Van Orden, Kathryn E; Talutis, Stephanie D; Ng-Glazier, Joanna H; Richman, Aaron P; Pennington, Elliot C; Janeway, Megan G; Kauffman, Douglas F; Dechert, Tracey A

    2017-01-01

    This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness.

  17. Changes in motor skill and fitness measures among children with high and low motor competence: a five-year longitudinal study.

    Science.gov (United States)

    Hands, Beth

    2008-04-01

    Children with low motor competence (LMC) are less able to participate fully in many sports and recreational activities typically enjoyed by their well-coordinated peers. Poor fitness outcomes have been reported for these children, although previous studies have not tracked these outcomes over time. In this study, 19 children (8 girls and 11 boys) with LMC aged between 5 and 7years were matched by age and gender with 19 children with high motor competence (HMC). Six fitness (body composition and cardiovascular endurance) and motor skill (sprint run, standing broad jump and balance) measures were repeated for each group once a year for five years. For each year of the study, the LMC groups performed less well on all measures than the HMC groups. Changes over time were significantly different between groups for cardiovascular endurance, 50-m run and balance, but not for body composition, overhand throw or standing broad jump. Between the two groups, performances were significantly different for all measures, except body composition. These findings confirm the impact of LMC on fitness measures and skill performances over time.

  18. A Time Study of Plastic Surgery Residents.

    Science.gov (United States)

    Lau, Frank H; Sinha, Indranil; Jiang, Wei; Lipsitz, Stuart R; Eriksson, Elof

    2016-05-01

    Resident work hours are under scrutiny and have been subject to multiple restrictions. The studies supporting these changes have not included data on surgical residents. We studied the workday of a team of plastic surgery residents to establish prospective time-study data of plastic surgery (PRS) residents at a single tertiary-care academic medical center. Five trained research assistants observed all residents (n = 8) on a PRS service for 10 weeks and produced minute-by-minute activity logs. Data collection began when the team first met in the morning and continued until the resident being followed completed all non-call activities. We analyzed our data from 3 perspectives: 1) time spent in direct patient care (DPC), indirect patient care, and didactic activities; 2) time spent in high education-value activities (HEAs) versus low education-value activities; and 3) resident efficiency. We defined HEAs as activities that surgeons must master; other activities were LEAs. We quantified resident efficiency in terms of time fragmentation and time spent waiting. A total of 642.4 hours of data across 50 workdays were collected. Excluding call, residents worked an average of 64.2 hours per week. Approximately 50.7% of surgical resident time was allotted to DPC, with surgery accounting for the largest segment of this time (34.8%). Time spent on HEAs demonstrated trended upward with higher resident level (P = 0.086). Time in spent in surgery was significantly associated with higher resident levels (P time study of PRS residents, we found that compared with medicine trainees, surgical residents spent 3.23 times more time on DPC. High education-value activities comprised most of our residents' workdays. Surgery was the leading component of both DPC and HEAs. Our residents were highly efficient and fragmented, with the majority of all activities requiring 4 minutes or less. Residents spent a large portion of their time waiting for other services. In light of these data, we

  19. [Part-time residency training in Israel].

    Science.gov (United States)

    Fishbain, Dana; Levi, Baruch; Borow, Malke; Ashkenazi, Shai; Lindner, Arie

    2012-08-01

    Full-time work has long been perceived as a cornerstone of medical residency, the consensus being that a resident must apply the bulk of his time and attention to his professional training. Demographic and cultural changes that have taken place over the last several years, specifically the rise in the number of female doctors and the importance of leisure time to the younger generation, have intensified the need to find new and innovative ways to deal with the plight of the resident population. One idea, already in effect in many Western countries, is the institution of part-time residency programs. The possibility of fulfilling residency requirements on a part-time basis is intended to assist medical residents in integrating their professional development with their personal and family life, without compromising the quality of their training. A number of research studies conducted over the last several years in countries that allow part-time residency, among them the United States, England and Switzerland, aimed to examine the quality of part-time training. The various studies evinced a high level of satisfaction from the program both by the residents themselves and their supervisors, and in many aspects those doing residency part-time received higher appraisals than their full-time colleagues. Some of the residents polled noted that they would have totally foregone the practice of medicine had there not been an option to complete residency part-time. In light of the experience throughout the world and the changing landscape in Israel, the Scientific Council of the Israeli Medical Association decided to examine the issue and its various aspects, and weighed all the considerations in favor and against part-time residency. Recently, the Scientific Council approved the launch of a pilot program to allow part-time residency in several fields that were carefully selected according to specific criteria. Once the Ministry of Health completes the LegisLation process, part

  20. 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

    International Nuclear Information System (INIS)

    Krannich, R.S.; Little, R.L.; Mushkatel, A.; Pijawka, K.D.; Jones, P.

    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

  1. Cerebrospinal Fluid Biomarkers in Highly Exposed PM2.5 Urbanites: The Risk of Alzheimer's and Parkinson's Diseases in Young Mexico City Residents.

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Avila-Ramírez, José; Calderón-Garcidueñas, Ana; González-Heredia, Tonatiuh; Acuña-Ayala, Hilda; Chao, Chih-Kai; Thompson, Charles; Ruiz-Ramos, Rubén; Cortés-González, Victor; Martínez-Martínez, Luz; García-Pérez, Mario Alberto; Reis, Jacques; Mukherjee, Partha S; Torres-Jardón, Ricardo; Lachmann, Ingolf

    2016-09-06

    Exposure to fine particulate matter (PM2.5) and ozone (O3) above US EPA standards is associated with Alzheimer's disease (AD) risk, while Mn toxicity induces parkinsonism. Mexico City Metropolitan Area (MCMA) children have pre- and postnatal sustained and high exposures to PM2.5, O3, polycyclic aromatic hydrocarbons, and metals. Young MCMA residents exhibit frontal tau hyperphosphorylation and amyloid-β (Aβ)1 - 42 diffuse plaques, and aggregated and hyperphosphorylated α-synuclein in olfactory nerves and key brainstem nuclei. We measured total prion protein (TPrP), total tau (T-tau), tau phosphorylated at threonine 181 (P-Tau), Aβ1-42, α-synuclein (t-α-syn and d-α-synuclein), BDNF, insulin, leptin, and/or inflammatory mediators, in 129 normal CSF samples from MCMA and clean air controls. Aβ1-42 and BDNF concentrations were significantly lower in MCMA children versus controls (p = 0.005 and 0.02, respectively). TPrP increased with cumulative PM2.5 up to 5 μg/m3 and then decreased, regardless of cumulative value or age (R2 = 0.56). TPrP strongly correlated with T-Tau and P-Tau, while d-α-synuclein showed a significant correlation with TNFα, IL10, and IL6 in MCMA children. Total synuclein showed an increment in childhood years related to cumulated PM2.5, followed by a decrease after age 12 years (R2 = 0.47), while d-α-synuclein exhibited a tendency to increase with cumulated PM2.5 (R2 = 0.30). CSF Aβ1-42, BDNF, α-synuclein, and TPrP changes are evolving in young MCMA urbanites historically showing underperformance in cognitive processes, odor identification deficits, downregulation of frontal cellular PrP, and neuropathological AD and PD hallmarks. Neuroprotection of young MCMA residents ought to be a public health priority.

  2. 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.

  3. Social Workers as Workplace-Based Instructors of Alcohol and Drug Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Emergency Medicine Residents.

    Science.gov (United States)

    Duong, David K; O'Sullivan, Patricia S; Satre, Derek D; Soskin, Philippa; Satterfield, Jason

    2016-01-01

    Residency education is challenged by a shortage of personnel and time, particularly for teaching behavioral interventions such as screening, brief intervention, and referral to treatment (SBIRT) to reduce hazardous drinking and drug use. However, social workers may be well placed to teach SBIRT in clinical training settings. We describe a curriculum with social workers as SBIRT trainers of emergency medicine (EM) residents during actual clinical shifts in an EM residency training program. The curriculum required 1 EM faculty member working with social workers and 1 additional hour of formal residency conference teaching time. We implemented the curriculum at both a university tertiary care hospital emergency department and a county trauma center. We trained 8 social workers at both sites as SBIRT superusers to teach and assess EM resident SBIRT performance with actual patients. We measured the length and number of sessions to attain SBIRT competence, residents' satisfaction, and resident comments (coded by authors). Five of the 8 social workers trained residents between June 2013 and May 2014, 31 EM residents trained to a level indicating SBIRT competence with 114 patients. Each patient interaction averaged 8.8 minutes and residents averaged 3.13 patients. Twenty-four (77%) residents gave ratings of 1.58 (SD = .58) for the quality of teaching, 2.33 (SD = .87) for recommending the training to a colleague, 1.38 (SD = .49) for superusers' knowledge, 1.88 (SD = .95) for usefulness of instruction, 1.54 (SD = .72) for workplace learning, and 1.58 (SD = .78) for valuing learning from social workers (on a scale of 1 [very satisfied/strongly agree] to 5 [very dissatisfied/strongly disagree]). Residents preferred learning SBIRT during the 1st and 2nd training years and in the workplace. Social work colleagues can be effective in teaching SBIRT to residents in the workplace, and our residents highly valued learning from social workers, who all had prior training in

  4. In the eyes of residents good supervisors need to be more than engaged physicians: the relevance of teacher work engagement in residency training

    NARCIS (Netherlands)

    Scheepers, Renée A.; Arah, Onyebuchi A.; Heineman, Maas Jan; Lombarts, Kiki M. J. M. H.

    2015-01-01

    During their development into competent medical specialists, residents benefit from their attending physicians' excellence in teaching and role modelling. Work engagement increases overall job performance, but it is unknown whether this also applies to attending physicians' teaching performance and

  5. Pediatric dermatology training survey of United States dermatology residency programs.

    Science.gov (United States)

    Nijhawan, Rajiv I; Mazza, Joni M; Silverberg, Nanette B

    2014-01-01

    Variability exists in pediatric dermatology education for dermatology residents. We sought to formally assess the pediatric dermatology curriculum and experience in a dermatology residency program. Three unique surveys were developed for dermatology residents, residency program directors, and pediatric dermatology fellowship program directors. The surveys consisted of questions pertaining to residency program characteristics. Sixty-three graduating third-year residents, 51 residency program directors, and 18 pediatric dermatology fellowship program directors responded. Residents in programs with one or more full-time pediatric dermatologist were more likely to feel very competent treating children and were more likely to be somewhat or extremely satisfied with their pediatric curriculums than residents in programs with no full-time pediatric dermatologist (50.0% vs 5.9%, p = 0.002, and 85.3% vs 52.9%, p dermatology fellowships were much more likely to report being extremely satisfied than residents in programs without a pediatric dermatology fellowship (83.3% vs 21.2%; p dermatology residency programs to continue to strengthen their pediatric dermatology curriculums, especially through the recruitment of full-time pediatric dermatologists. © 2013 Wiley Periodicals, Inc.

  6. 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

  7. 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.

  8. Performance of Vascular Exposure and Fasciotomy Among Surgical Residents Before and After Training Compared With Experts.

    Science.gov (United States)

    Mackenzie, Colin F; Garofalo, Evan; Puche, Adam; Chen, Hegang; Pugh, Kristy; Shackelford, Stacy; Tisherman, Samuel; Henry, Sharon; Bowyer, Mark W

    2017-06-01

    ] and vs 64 [6] 14 months later [P = .002]). Critical errors that might lead to patient death were identified by pretraining IPS decile of less than 0.5. At follow-up, frequency of resident critical errors was no different from experts. The IPSs ranged from 31.6% to 76.9% among residents for core trauma competency procedures. Modeling revealed that interval experience, rather than time since training, affected skill retention up to 18 months later. Only 4 experts and 16 residents (40%) adequately decompressed and confirmed entry into all 4 lower extremity compartments. This study found that ASSET training improved resident procedural skills for up to 18 months. Performance was highly variable. Interval experience after training affected performance. Pretraining skill identified competency of residents vs experts. Extremity vascular and fasciotomy performance evaluations suggest the need for specific anatomical training interventions in residents with IPS deciles less than 0.5.

  9. 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.

  10. Competency-based education: programme design and challenges to implementation.

    Science.gov (United States)

    Gruppen, Larry D; Burkhardt, John C; Fitzgerald, James T; Funnell, Martha; Haftel, Hilary M; Lypson, Monica L; Mullan, Patricia B; Santen, Sally A; Sheets, Kent J; Stalburg, Caren M; Vasquez, John A

    2016-05-01

    Competency-based education (CBE) has been widely cited as an educational framework for medical students and residents, and provides a framework for designing educational programmes that reflect four critical features: a focus on outcomes, an emphasis on abilities, a reduction of emphasis on time-based training, and promotion of learner centredness. Each of these features has implications and potential challenges for implementing CBE. As an experiment in CBE programme design and implementation, the University of Michigan Master of Health Professions Education (UM-MHPE) degree programme was examined for lessons to be learned when putting CBE into practice. The UM-MHPE identifies 12 educational competencies and 20 educational entrustable professional activities (EPAs) that serve as the vehicle for both learning and assessment. The programme also defines distinct roles of faculty members as assessors, mentors and subject-matter experts focused on highly individualised learning plans adapted to each learner. Early experience with implementing the UM-MHPE indicates that EPAs and competencies can provide a viable alternative to traditional courses and a vehicle for rigorous assessment. A high level of individualisation is feasible but carries with it significant costs and makes intentional community building essential. Most significantly, abandoning a time-based framework is a difficult innovation to implement in a university structure that is predicated on time-based education. © 2016 John Wiley & Sons Ltd.

  11. 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.

  12. 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.

  13. Evaluating Dermatology Residency Program Websites.

    Science.gov (United States)

    Ashack, Kurt A; Burton, Kyle A; Soh, Jonathan M; Lanoue, Julien; Boyd, Anne H; Milford, Emily E; Dunnick, Cory; Dellavalle, Robert P

    2016-03-16

    Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms

  14. Teaching and Assessing Professionalism in Radiology Resident Education.

    Science.gov (United States)

    Kelly, Aine Marie; Gruppen, Larry D; Mullan, Patricia B

    2017-05-01

    Radiologists in teaching hospitals and in practices with residents rotating through are involved in the education of their residents. The Accreditation Council for Graduate Medical Education requires evidence that trainees are taught and demonstrate competency not only in medical knowledge and in patient care-the historic focus of radiology education-but also in the so-called non-interpretative core competencies, which include professionalism and interpersonal skills. In addition to accreditation agencies, the prominent assessment practices represented by the American Board of Radiology core and certifying examinations for trainees, as well as Maintenance of Certification for practitioners, are planning to feature more non-interpretative competency assessment, including professionalism to a greater extent. Because professionalism was incorporated as a required competency in medical education as a whole, more clarity about the justification and expected content for teaching about competence in professionalism, as well as greater understanding and evidence about appropriate and effective teaching and assessment methods, have emerged. This article summarizes justifications and expectations for teaching and assessing professionalism in radiology residents and best practices on how to teach and evaluate professionalism that can be used by busy radiology faculty in their everyday practice supervising radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  15. Redfield Ratios in Inland Waters: Higher Biological Control of C:N:P Ratios in Tropical Semi-arid High Water Residence Time Lakes

    Directory of Open Access Journals (Sweden)

    Ng H. They

    2017-08-01

    Full Text Available The canonical Redfield C:N:P ratio for algal biomass is often not achieved in inland waters due to higher C and N content and more variability when compared to the oceans. This has been attributed to much lower residence times and higher contributions of the watershed to the total organic matter pool of continental ecosystems. In this study we examined the effect of water residence times in low latitude lakes (in a gradient from humid to a semi-arid region on seston elemental ratios in different size fractions. We used lake water specific conductivity as a proxy for residence time in a region of Eastern Brazil where there is a strong precipitation gradient. The C:P ratios decreased in the seston and bacterial size-fractions and increased in the dissolved fraction with increasing water retention time, suggesting uptake of N and P from the dissolved pool. Bacterial abundance, production and respiration increased in response to increased residence time and intracellular nutrient availability in agreement with the growth rate hypothesis. Our results reinforce the role of microorganisms in shaping the chemical environment in aquatic systems particularly at long water residence times and highlights the importance of this factor in influencing ecological stoichiometry in all aquatic ecosystems.

  16. [Life project of residents and institutional approach in nursing homes].

    Science.gov (United States)

    Chanut, Corinne

    The life project in a nursing home involves all the players concerned: first of all, the resident, then the caregivers, the families and the institution. This unifying tool, organised around the elderly, helps to develop collective competencies, favours the integration of new residents and reassures families. This article presents a nursing home's experience of setting up a life project. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. 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.

  18. How Entrustment Is Informed by Holistic Judgments Across Time in a Family Medicine Residency Program: An Ethnographic Nonparticipant Observational Study.

    Science.gov (United States)

    Sagasser, Margaretha H; Fluit, Cornelia R M G; van Weel, Chris; van der Vleuten, Cees P M; Kramer, Anneke W M

    2017-06-01

    Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands. Seven supervisor-resident pairs participated. During two days, one researcher observed first-year residents' patient encounters, debriefing sessions, and supervisor-resident educational meetings and interviewed them separately afterwards. Data were collected and analyzed using iterative, phenomenological inductive research methodology. The entrustment process developed over three phases. Supervisors based their initial entrustment on prior knowledge about the resident. In the ensuing two weeks, entrustment decisions regarding independent patient care were derived from residents' observed general competencies necessary for a range of health problems (clinical reasoning, decision making, relating to patients); medical knowledge and skills; and supervisors' intuition. Supervisors provided supervision during and after encounters. Once residents performed independently, supervisors kept reevaluating their decisions, informed by residents' overall growth in competencies rather than by adhering to a predefined set of tasks. Supervisors in family medicine residency training took a holistic approach to trust, based on general competencies, knowledge, skills, and intuition. Entrustment started before training and developed over time. Building trust is a mutual process between supervisor and resident, requiring a good working relationship.

  19. Effects of chronic low level radiation in the population residing in the high level natural radiation area in Kerala, India: employing heritable DNA mutation studies.

    Science.gov (United States)

    Ahmad, Shazia; Koya, P K M; Seshadri, M

    2013-03-18

    To study the effect of chronic low level radiation, 4040 meiosis were screened at eight microsatellite and five minisatellite (2485 and 1555 meiosis respectively) marker loci in people residing in high and normal level natural radiation areas of Kerala. Variants in the repeat length of allele were considered as mutants. Mutation rates (expressed as the number of mutations observed in the total number of meiosis) were 6.4×10(-3) (16/2485) and 2.6×10(-3) (4/1555) at microsatellite and minisatellite respectively. The germline microsatellite mutation frequency of father was 1.78 times higher at 7.52×10(-3) (8/1064) compared to 4.22×10(-3) (6/1421) of mother (P=0.292, Fisher's Exact two-sided test). The paternal and maternal mutation rates at minisatellite loci were more or less similar at 2.78×10(-3) (2/719) and 2.39×10(-3) (2/836), respectively (P=1.0, Fisher's Exact two-sided test). Higher but statistically non-significant microsatellite mutation frequency was observed in HLNRA compared to NLNRA (7.25×10(-3) vs 3.64×10(-3); P=0.547). The apparent increase in the mutation rate of microsatellite loci with the increase in radiation dose was also not statistically significant. All the four minisatellite mutation observed were from HLNRA (1198 meiosis) and no mutation was observed among 357 meiosis screened from NLNRA families. All the markers used in the present study were in the non-coding region and hence mutations in these regions may not cause adverse health effects, but the study is important in understanding the effect of chronic low level radiation. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. UBC-Nepal expedition: markedly lower cerebral blood flow in high-altitude Sherpa children compared with children residing at sea level.

    Science.gov (United States)

    Flück, Daniela; Morris, Laura E; Niroula, Shailesh; Tallon, Christine M; Sherpa, Kami T; Stembridge, Mike; Ainslie, Philip N; McManus, Ali M

    2017-10-01

    Developmental cerebral hemodynamic adaptations to chronic high-altitude exposure, such as in the Sherpa population, are largely unknown. To examine hemodynamic adaptations in the developing human brain, we assessed common carotid (CCA), internal carotid (ICA), and vertebral artery (VA) flow and middle cerebral artery (MCA) velocity in 25 (9.6 ± 1.0 yr old, 129 ± 9 cm, 27 ± 8 kg, 14 girls) Sherpa children (3,800 m, Nepal) and 25 (9.9 ± 0.7 yr old, 143 ± 7 cm, 34 ± 6 kg, 14 girls) age-matched sea level children (344 m, Canada) during supine rest. Resting gas exchange, blood pressure, oxygen saturation and heart rate were assessed. Despite comparable age, height and weight were lower (both P sea level children. Mean arterial pressure, heart rate, and ventilation were similar, whereas oxygen saturation (95 ± 2 vs. 99 ± 1%, P sea level children. This was reflected in a lower ICA flow (283 ± 108 vs. 333 ± 56 ml/min, P = 0.05), VA flow (78 ± 26 vs. 118 ± 35 ml/min, P sea level children (425 ± 92 vs. 441 ± 81 ml/min, P = 0.52). Scaling flow and oxygen uptake for differences in vessel diameter and body size, respectively, led to the same findings. A lower cerebral blood flow in Sherpa children may reflect specific cerebral hemodynamic adaptations to chronic hypoxia. NEW & NOTEWORTHY Cerebral blood flow is lower in Sherpa children compared with children residing at sea level; this may reflect a cerebral hemodynamic pattern, potentially due to adaptation to a hypoxic environment. Copyright © 2017 the American Physiological Society.

  1. Assessment of radioactivity and estimation of effective dose received by villagers residing at natural high background areas of coastal regions of Tamil Nadu

    International Nuclear Information System (INIS)

    Esaiselvan, K.; Rajagopal, R.; Sreekumar, K.; Harikumar, M.; AllenGnanaraj, G.

    2010-01-01

    Radiation exposure and effective dose received by villagers residing at seven villages belonging to Natural High Background Radiation Areas (NHBRA) of coastal regions of Tamil Nadu were studied; five houses in each village were selected. The NHBRA villages were Chinnavilai, Periavilai, Kottilpadu, Puthoor Colachel, Kodimunai and Midalam. The houses were of similar construction pattern (brick wall-tiled roof, cement flooring). Measurements of radon ( 222 Rn), thoron ( 220 Rn) and their progeny, produced by the decay of naturally occurring radioisotopes uranium and thorium in dwellings are the largest contributor to the average internal effective dose received by human beings. Internal doses due to radon/thoron and their progeny were estimated using, Solid State Nuclear Track Detectors (SSNTD), LR-115, as the detector. External doses were estimated by gamma measurement using scintillometer and Thermo Luminescent Dosimeter (TLD). TLDs were exposed for one year, on a quarterly basis, inside the house at a height of 3 meters and about 1 meter away from the walls. The SSNTD cups were exposed adjacent to the TLDS, and the exposure was for a period of three months each. The SSNTDs were developed by standard procedures (10% NaOH, etching for 90 min at 60 deg C) and counted in a spark counter. Earlier the SSNTDs were calibrated using U and Th sources and calibration factors were obtained. Inhalation dose due to 232 Th and Th (B) in mWL were estimated by collecting air samples from each house, for one hour each, during the replacement time of TLD and SSNTD Cups. For inhalation dose estimation the occupancy factor was assumed to be 0.8. The soil samples were also collected from each sampling point. (author)

  2. Developing students' worksheets applying soft skill-based scientific approach for improving building engineering students' competencies in vocational high schools

    Science.gov (United States)

    Suparno, Sudomo, Rahardjo, Boedi

    2017-09-01

    Experts and practitioners agree that the quality of vocational high schools needs to be greatly improved. Many construction services have voiced their dissatisfaction with today's low-quality vocational high school graduates. The low quality of graduates is closely related to the quality of the teaching and learning process, particularly teaching materials. In their efforts to improve the quality of vocational high school education, the government have implemented Curriculum 2013 (K13) and supplied teaching materials. However, the results of monitoring and evaluation done by the Directorate of Vocational High School, Directorate General of Secondary Education (2014), the provision of tasks for students in the teaching materials was totally inadequate. Therefore, to enhance the quality and the result of the instructional process, there should be provided students' worksheets that can stimulate and improve students' problem-solving skills and soft skills. In order to develop worksheets that can meet the academic requirements, the development needs to be in accordance with an innovative learning approach, which is the soft skill-based scientific approach.

  3. 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.

  4. Tracing genomic variations in two highly virulent Yersinia enterocolitica strains with unequal ability to compete for host colonization

    OpenAIRE

    Garzetti, Debora; Bouabe, Hicham; Heesemann, Juergen; Rakin, Alexander

    2012-01-01

    Abstract Background Yersinia enterocolitica is a gastrointestinal foodborne pathogen found worldwide and which especially affects infants and young children. While different bioserotypes have been associated with varying pathogenicity, research on Y. enterocolitica is mainly conducted on the highly virulent mouse-lethal strains of biotype 1B and serotype O:8. We demonstrate here that two Y. enterocolitica bioserotype 1B/O:8 strains, 8081 and WA-314, display different virulence and fitness pro...

  5. 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…

  6. Enhancing residents’ neonatal resuscitation competency through unannounced simulation-based training

    Science.gov (United States)

    Surcouf, Jeffrey W.; Chauvin, Sheila W.; Ferry, Jenelle; Yang, Tong; Barkemeyer, Brian

    2013-01-01

    Background Almost half of pediatric third-year residents surveyed in 2000 had never led a resuscitation event. With increasing restrictions on residency work hours and a decline in patient volume in some hospitals, there is potential for fewer opportunities. Purpose Our primary purpose was to test the hypothesis that an unannounced mock resuscitation in a high-fidelity in-situ simulation training program would improve both residents’ self-confidence and observed performance of adopted best practices in neonatal resuscitation. Methods Each pediatric and medicine–pediatric resident in one pediatric residency program responded to an unannounced scenario that required resuscitation of the high fidelity infant simulator. Structured debriefing followed in the same setting, and a second cycle of scenario response and debriefing occurred before ending the 1-hour training experience. Measures included pre- and post-program confidence questionnaires and trained observer assessments of live and videotaped performances. Results Statistically significant pre–post gains for self-confidence were observed for 8 of the 14 NRP critical behaviors (p=0.00–0.03) reflecting knowledge, technical, and non-technical (teamwork) skills. The pre–post gain in overall confidence score was statistically significant (p=0.00). With a maximum possible assessment score of 41, the average pre–post gain was 8.28 and statistically significant (psimulation-based training and significant positive gains in confidence and observed competency-related abilities. Results support the potential for other applications in residency and continuing education. PMID:23522399

  7. [Needs assessment of a core curriculum for residency training].

    Science.gov (United States)

    Kwon, Hyo-Jin; Lee, Young-Mee; Chang, Hyung-Joo; Kim, Ae-Ri

    2015-09-01

    The core curriculum in graduate medical education (GME) is an educational program that covers the minimum body of knowledge and skills that is required of all residents, regardless of their specialty. This study examined the opinions of stakeholders in GME regarding the core curriculum. A questionnaire was administered at three tertiary hospitals that were affiliated with one university; 192 residents and 61 faculty members and attending physicians participated in the survey. The questionnaire comprised six items on physician competency and the needs for a core curriculum. Questions on subjects or topics and adequate training years for each topics were asked only to residents. Most residents (78.6%) and faculty members (86.9%) chose "medical expertise" as the "doctor's role in the 21st century." In contrast, communicator, manager, and collaborator were recognized by less than 30% of all participants. Most residents (74.1%) responded that a core curriculum is "necessary but not feasible," whereas 68.3% of faculty members answered that it is "absolutely needed." Regarding subjects that should be included in the core curriculum, residents and faculty members had disparate preferences- residents preferred more "management of a private clinic" and "financial management," whereas faculty members desired "medical ethics" and "communication skills." Residents and faculty members agree that residents should develop a wide range of competencies in their training. However, the perception of the feasibility and opinions on the contents of the core curriculum differed between groups. Further studies with larger samples should be conducted to define the roles and professional competencies of physicians and the needs for a core curriculum in GME.

  8. 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.

  9. Resident away rotations allow adaptive neurosurgical training.

    Science.gov (United States)

    Gephart, Melanie Hayden; Derstine, Pamela; Oyesiku, Nelson M; Grady, M Sean; Burchiel, Kim; Batjer, H Hunt; Popp, A John; Barbaro, Nicholas M

    2015-04-01

    Subspecialization of physicians and regional centers concentrate the volume of certain rare cases into fewer hospitals. Consequently, the primary institution of a neurological surgery training program may not have sufficient case volume to meet the current Residency Review Committee case minimum requirements in some areas. To ensure the competency of graduating residents through a comprehensive neurosurgical education, programs may need for residents to travel to outside institutions for exposure to cases that are either less common or more regionally focused. We sought to evaluate off-site rotations to better understand the changing demographics and needs of resident education. This would also allow prospective monitoring of modifications to the neurosurgery training landscape. We completed a survey of neurosurgery program directors and query of data from the Accreditation Council of Graduate Medical Education to characterize the current use of away rotations in neurosurgical education of residents. We found that 20% of programs have mandatory away rotations, most commonly for exposure to pediatric, functional, peripheral nerve, or trauma cases. Most of these rotations are done during postgraduate year 3 to 6, lasting 1 to 15 months. Twenty-six programs have 2 to 3 participating sites and 41 have 4 to 6 sites distinct from the host program. Programs frequently offset potential financial harm to residents rotating at a distant site by support of housing and transportation costs. As medical systems experience fluctuating treatment paradigms and demographics, over time, more residency programs may adapt to meet the Accreditation Council of Graduate Medical Education case minimum requirements through the implementation of away rotations.

  10. 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.

  11. 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. © The Author(s) 2014.

  12. SAP Nuclear Competence Centre

    International Nuclear Information System (INIS)

    Andrlova, Z.

    2009-01-01

    In this issue we continue and introduce the SAP Nuclear Competence Centre and its head Mr. Igor Dzama. SAP Nuclear Competence Centrum is one of the fi rst competence centres outside ENEL headquarters. It should operate in Slovakia and should have competencies within the whole Enel group. We are currently dealing with the issues of organisation and funding. We are trying to balance the accountability to the NPP directors and to the management of the competence centres at Enel headquarters; we are looking at the relations between the competence centres within the group and defining the services that we will provide for the NPPs. author)

  13. Assessment of Innovation Competency

    DEFF Research Database (Denmark)

    Nielsen, Jan Alexis

    2015-01-01

    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...... 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...

  14. Emergency Medicine Resident Perceptions of Medical Professionalism

    Directory of Open Access Journals (Sweden)

    Joshua Jauregui

    2016-05-01

    Full Text Available Introduction: Medical professionalism is a core competency for emergency medicine (EM trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods: We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results: Of the 114 residents eligible, 100 (88% completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001. Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05. Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05. Conclusion: Residents perceive differences in