A National Survey to Evaluate Graduate Medical Education in Disparities and Limited English Proficiency: A Report From the AAIM Diversity and Inclusion Committee.

Science.gov (United States)

Cardinal, Lucien J; Maldonado, Maria; Fried, Ethan D

2016-01-01

This article presents the results of a national survey addressing issues related to patients with limited English proficiency. We disseminated a national confidential survey to 391 program directors of Internal Medicine residency programs accredited by the Accreditation Council for Graduate Medical Education. Seventy percent of program directors indicated that their residents cared for a patient population that was composed of more than 10% limited-English-proficiency patients. Nineteen percent of residency programs provided no education on caring for patients with limited English proficiency. Thirty percent of program directors felt that their faculty could not adequately evaluate residents on their ability to practice culturally competent care, and 68% cited lack of faculty expertise as a significant barrier to implementing a curriculum in cultural competency. Yet only 24% indicated that they had faculty development relevant to cultural competency and health care disparities. Internal Medicine residents care for many patients with limited English proficiency. While it seems clear that an effective training curriculum is necessary, such a curriculum was not found to be uniformly present. Additionally, the lack of faculty expertise and faculty development in cultural competency and health care disparities is a significant barrier to the correction of this problem. Copyright © 2016 Alliance for Academic Internal Medicine. Published by Elsevier Inc. All rights reserved.

Educating doctors in the clinical workplace: unraveling the process of teaching and learning in the medical resident as teacher.

Science.gov (United States)

Busari, J O; Arnold, Aer

2009-01-01

In recent years, higher medical education has witnessed major changes in the structure and content of postgraduate medical training. Seven professional competencies have been described that address the medical doctors' ability to effectively communicate and transfer medical information, interact effectively and professionally, and demonstrate a good grasp of clinical knowledge and skills. Proficiency in didactic skills, however, is an important competency that has not received prominent attention. In the clinical setting, attending-physicians and medical residents are responsible for teaching. Consequently, several medical institutions have proposed the need for teacher training programs to improve the teaching skills of attending doctors and medical residents. The supporters of these programs believe that through teaching, medical doctors improve their individual professional and clinical problem-solving abilities. Hence, it is logical to assume that didactic skills' training would contribute to the professional development of doctors. In this paper, we re-examine the underlying theory of the didactic proficiency, how it relates to the clinical setting, and why it may be beneficial for the professional training of medical residents.

Educating doctors in the clinical workplace: Unraveling the process of teaching and learning in the medical resident as teacher

Directory of Open Access Journals (Sweden)

Busari J

2009-01-01

Full Text Available In recent years, higher medical education has witnessed major changes in the structure and content of postgraduate medical training. Seven professional competencies have been described that address the medical doctors′ ability to effectively communicate and transfer medical information, interact effectively and professionally, and demonstrate a good grasp of clinical knowledge and skills. Proficiency in didactic skills, however, is an important competency that has not received prominent attention. In the clinical setting, attending-physicians and medical residents are responsible for teaching. Consequently, several medical institutions have proposed the need for teacher training programs to improve the teaching skills of attending doctors and medical residents. The supporters of these programs believe that through teaching, medical doctors improve their individual professional and clinical problem-solving abilities. Hence, it is logical to assume that didactic skills′ training would contribute to the professional development of doctors. In this paper, we re-examine the underlying theory of the didactic proficiency, how it relates to the clinical setting, and why it may be beneficial for the professional training of medical residents.

Combining clinical microsystems and an experiential quality improvement curriculum to improve residency education in internal medicine.

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Tess, Anjala V; Yang, Julius J; Smith, C Christopher; Fawcett, Caitlin M; Bates, Carol K; Reynolds, Eileen E

2009-03-01

Beth Israel Deaconess Medical Center's internal medicine residency program was admitted to the new Education Innovation Project accreditation pathway of the Accreditation Council of Graduate Medical Education to begin in July 2006. The authors restructured the inpatient medical service to create clinical microsystems in which residents practice throughout residency. Program leadership then mandated an active curriculum in quality improvement based in those microsystems. To provide the experience to every graduating resident, a core faculty in patient safety was trained in the basics of quality improvement. The authors hypothesized that such changes would increase the number of residents participating in quality improvement projects, improve house officer engagement in quality improvement work, enhance the culture of safety the residents perceive in their training environment, improve work flow on the general medicine ward rotations, and improve the overall educational experience for the residents on ward rotations.The authors describe the first 18 months of the intervention (July 2006 to January 2008). The authors assessed attitudes and the educational experience with surveys and evaluation forms. After the intervention, the authors documented residents' participation in projects that overlapped with hospital priorities. More residents reported roles in designing and implementing quality improvement changes. Residents also noted greater satisfaction with the quality of care they deliver. Fewer residents agreed or strongly agreed that the new admitting system interfered with communication. Ongoing residency program assessment showed an improved perception of workload, and educational ratings of rotations improved. The changes required few resources and can be transported to other settings.

Improvement in Student Science Proficiency Through InSciEd Out

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Sonju, James D.; Leicester, Jean E.; Hoody, Maggie; LaBounty, Thomas J.; Frimannsdottir, Katrin R.; Ekker, Stephen C.

2012-01-01

Abstract Integrated Science Education Outreach (InSciEd Out) is a collaboration formed between Mayo Clinic, Winona State University, and Rochester Public Schools (MN) with the shared vision of achieving excellence in science education. InSciEd Out employs an equitable partnership model between scientists, teachers, education researchers, and the community. Teams of teachers from all disciplines within a single school experience cutting-edge science using the zebrafish model system, as well as current pedagogical methods, during a summer internship at the Mayo Clinic. Within the internship, the teachers produce new curriculum that directly addresses opportunities for science education improvement at their own school. Zebrafish are introduced within the new curriculum to support a living model of the practice of science. Following partnership with the InSciEd Out program and 2 years of implementation in the classroom, teacher-interns from a K–8 public school reported access to local scientific technology and expertise they had not previously recognized. Teachers also reported improved integration of other disciplines into the scientific curriculum and a flow of concepts vertically from K through 8. Students more than doubled selection of an Honors science track in high school to nearly 90%. 98% of students who took the Minnesota Comprehensive Assessments in their 5th and 8th grade year (a span that includes 2 years of InSciEd Out) showed medium or high growth in science proficiency. These metrics indicate that cooperation between educators and scientists can result in positive change in student science proficiency and demonstrate that a higher expectation in science education can be achieved in US public schools. PMID:23244687

Use of Proficiency Testing as a Tool to Improve Quality in Microbiology Laboratories

OpenAIRE

Stang, Heather L.; Anderson, Nancy L.

2013-01-01

Proficiency testing (PT) is a valuable tool for assessing laboratory performance and verifying the accuracy and reliability of test results. Participation is required by the Clinical Laboratory Improvement Amendments (CLIA) of 1988 for each of the microbiology subspecialties (bacteriology, mycobacteriology, mycology, parasitology, and virology), and the regulations include specific PT requirements for each subspecialty. To determine the use and perceived value of PT beyond meeting CLIA requir...

Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum.

Science.gov (United States)

Potts, Stacy; Shields, Sara; Upshur, Carole

2016-06-01

The Accreditation Council for Graduate Medical Education (ACGME) has recognized the importance of quality improvement (QI) training and requires that accredited residencies in all specialties demonstrate that residents are "integrated and actively participate in interdisciplinary clinical quality improvement and patient safety activities." However, competing demands in residency training may make this difficult to accomplish. The study's objective is to develop and evaluate a longitudinal curriculum that meets the ACGME requirement for QI and patient safety training and links to patient-centered medical home (PCMH) practices. Residents in the Worcester Family Medicine Residency (WFMR) participated in a faculty-developed quality improvement curriculum that included web-based tutorials, quality improvement projects, and small-group sessions across all 3 years of residency. They completed self-evaluations of knowledge and use of curricular activities annually and at graduation, and comparisons were made between two graduating classes, as well as comparison of end of PGY2 to end of PGY3 for one class. Graduating residents who completed the full 3 years of the curriculum rated themselves as significantly more skilled in nine of 15 areas assessed at end of residency compared to after PGY2 and reported confidence in providing future leadership in a focus group. Five areas were also rated significantly higher than prior-year residents. Involving family medicine residents in a longitudinal curriculum with hands-on practice in implementing QI, patient safety, and chronic illness management activities that are inclusive of PCMH goals increased their self-perceived skills and leadership ability to implement these new and emerging evidence-based practices in primary care.

Determinants of Second Language Proficiency among Refugees in the Netherlands

Science.gov (United States)

van Tubergen, Frank

2010-01-01

Little is known about the language acquisition of refugees in Western countries. This study examines how pre- and post-migration characteristics of refugees are related to their second language proficiency. Data are from a survey of 3,500 refugees, who were born in Afghanistan, Iran, Iraq, former Yugoslavia and Somalia, and who resided in the…

National radon measurement-proficiency program: Individual proficiency report

International Nuclear Information System (INIS)

1992-05-01

In February 1986, the U.S. Environmental Protection Agency (EPA) established the Radon Measurement Proficiency (RMP) Program to assist the public in identifying organizations capable of providing reliable radon measurement services. In December 1991, EPA announced the new individual proficiency listing category in the RMP Program. Individuals applying for this new listing status must demonstrate knowledge of radon measurement fundamentals by passing a written proficiency examination, maintain affiliation with an RMP listed organization, and meet other program requirements. This report lists those individuals who have met the requirements of the RMP Program as of April 30, 1992. These requirements are designed to provide minimum proficiency criteria for individuals who provide radon measurement services on-site in a residential environment

National Radon Contractor Proficiency Program. Proficiency report: Supplement

International Nuclear Information System (INIS)

1991-02-01

The report, a supplement to the RCP Proficiency Report, will further assist governmental officials in providing advice to the public on the selection of proficient radon mitigation contractors. These reports list 1,123 contractors who have met the requirements of the RCP Program as of December 15, 1990. The Proficiency Report provides information on each contractor's name, RCP identification number, company name, address, phone number, and geographic service area. The report provides two additional tables, indexed by company name and by RCP identification number. The report is intended to help users quickly identify a proficient contractor if only the company name is known, or to verify which contractor is associated with a particular ID number

Impact of Intervention to Improve Nursing Home Resident-Staff Interactions and Engagement.

Science.gov (United States)

Hartmann, Christine W; Mills, Whitney L; Pimentel, Camilla B; Palmer, Jennifer A; Allen, Rebecca S; Zhao, Shibei; Wewiorski, Nancy J; Sullivan, Jennifer L; Dillon, Kristen; Clark, Valerie; Berlowitz, Dan R; Snow, Andrea Lynn

2018-04-30

For nursing home residents, positive interactions with staff and engagement in daily life contribute meaningfully to quality of life. We sought to improve these aspects of person-centered care in an opportunistic snowball sample of six Veterans Health Administration nursing homes (e.g., Community Living Centers-CLCs) using an intervention that targeted staff behavior change, focusing on improving interactions between residents and staff and thereby ultimately aiming to improve resident engagement. We grounded this mixed-methods study in the Capability, Opportunity, Motivation, Behavior (COM-B) model of behavior change. We implemented the intervention by (a) using a set of evidence-based practices for implementing quality improvement and (b) combining primarily CLC-based staff facilitation with some researcher-led facilitation. Validated resident and staff surveys and structured observations collected pre and post intervention, as well as semi-structured staff interviews conducted post intervention, helped assess intervention success. Sixty-two CLC residents and 308 staff members responded to the surveys. Researchers conducted 1,490 discrete observations. Intervention implementation was associated with increased staff communication with residents during the provision of direct care and decreased negative staff interactions with residents. In the 66 interviews, staff consistently credited the intervention with helping them (a) develop awareness of the importance of identifying opportunities for engagement and (b) act to improve the quality of interactions between residents and staff. The intervention proved feasible and influenced staff to make simple enhancements to their behaviors that improved resident-staff interactions and staff-assessed resident engagement.

Teaching wound care to family medicine residents on a wound care service

Directory of Open Access Journals (Sweden)

Little SH

2013-08-01

Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

Verb-Noun Collocation Proficiency and Academic Years

Directory of Open Access Journals (Sweden)

Fatemeh Ebrahimi-Bazzaz

2014-01-01

Full Text Available Generally vocabulary and collocations in particular have significant roles in language proficiency. A collocation includes two words that are frequently joined concurrently in the memory of native speakers. There have been many linguistic studies trying to define, to describe, and to categorise English collocations. It contains grammatical collocations and lexical collocations which include nouns, adjectives, verbs, and adverb. In the context of a foreign language environment such as Iran, collocational proficiency can be useful because it helps the students improve their language proficiency. This paper investigates the possible relationship between verb-noun collocation proficiency among students from one academic year to the next. To reach this goal, a test of verb-noun collocations was administered to Iranian learners. The participants in the study were 212 Iranian students in an Iranian university. They were selected from the second term of freshman, sophomore, junior, and senior years. The students’ age ranged from 18 to 35.The results of ANOVA showed there was variability in the verb-noun collocations proficiency within each academic year and between the four academic years. The results of a post hoc multiple comparison tests demonstrated that the means are significantly different between the first year and the third and fourth years, and between the third and the fourth academic year; however, students require at least two years to show significant development in verb-noun collocation proficiency. These findings provided a vital implication that lexical collocations are learnt and developed through four academic years of university, but requires at least two years showing significant development in the language proficiency.

Quality Improvement in Skilled Nursing Facilities for Residents With Alzheimer's Disease.

Science.gov (United States)

Farlow, Martin R; Borson, Soo; Connor, Stephen R; Grossberg, George T; Mittelman, Mary S

2016-03-01

This report describes a quality improvement continuing medical education activity designed to enhance the recognition and treatment of residents with Alzheimer's disease (AD) or other dementias in skilled-nursing facilities (SNFs). Charts were compared in 6 areas prior to and following (stages A and C) a live, faculty-led workshop (stage B). Four SNFs completed stages A (n = 67 residents) and B, and 3 SNFs completed stage C (n = 52 residents). All charts came from residents with AD or a diagnosis of dementia or dementia-like symptoms. The SNFs had >95% baseline performance in both the frequency of cognitive assessments and documented medication reviews. The percentage of residents who received a quality-of-life assessment and those who had a mental health care plan in place represent areas for improvement. As part of this activity, a toolkit was developed to help guide facilities and clinicians in instituting care improvements for residents with AD/dementia. © The Author(s) 2015.

Peer-Assisted Analysis of Resident Feedback Improves Clinical Teaching: A Case Report.

Science.gov (United States)

Mai, Christine L; Baker, Keith

2017-07-01

Anesthesiologists play an important role in educating future clinicians. Yet few residency programs incorporate teaching skills into faculty development. Consequently, many anesthesiologists have limited training to supervise and educate residents. In turn, these attendings may receive negative feedback and poor evaluations from residents without a means to effectively improve. Peer-assisted teaching between faculty members may serve as a strategy to improve teaching skills. We report a case of peer-assisted analysis of resident feedback to identify specific areas of concern that were targeted for improvement. This approach resulted in improved teaching scores and feedback for the faculty member.

Computer proficiency questionnaire: assessing low and high computer proficient seniors.

Science.gov (United States)

Boot, Walter R; Charness, Neil; Czaja, Sara J; Sharit, Joseph; Rogers, Wendy A; Fisk, Arthur D; Mitzner, Tracy; Lee, Chin Chin; Nair, Sankaran

2015-06-01

Computers and the Internet have the potential to enrich the lives of seniors and aid in the performance of important tasks required for independent living. A prerequisite for reaping these benefits is having the skills needed to use these systems, which is highly dependent on proper training. One prerequisite for efficient and effective training is being able to gauge current levels of proficiency. We developed a new measure (the Computer Proficiency Questionnaire, or CPQ) to measure computer proficiency in the domains of computer basics, printing, communication, Internet, calendaring software, and multimedia use. Our aim was to develop a measure appropriate for individuals with a wide range of proficiencies from noncomputer users to extremely skilled users. To assess the reliability and validity of the CPQ, a diverse sample of older adults, including 276 older adults with no or minimal computer experience, was recruited and asked to complete the CPQ. The CPQ demonstrated excellent reliability (Cronbach's α = .98), with subscale reliabilities ranging from .86 to .97. Age, computer use, and general technology use all predicted CPQ scores. Factor analysis revealed three main factors of proficiency related to Internet and e-mail use; communication and calendaring; and computer basics. Based on our findings, we also developed a short-form CPQ (CPQ-12) with similar properties but 21 fewer questions. The CPQ and CPQ-12 are useful tools to gauge computer proficiency for training and research purposes, even among low computer proficient older adults. © The Author 2013. 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.

Not Just Numbers: Creating a Partnership Climate to Improve Math Proficiency in Schools

Science.gov (United States)

Sheldon, Steven B.; Epstein, Joyce L.; Galindo, Claudia L.

2009-01-01

Although we know that family involvement is associated with stronger math performance, little is known about what educators are doing to effectively involve families and community members, and whether this measurably improves math achievement at their schools. This study used data from 39 schools to assess the effects of family and community involvement activities on school levels of math achievement. The study found that better implementation of math-related practices of family and community involvement predicted stronger support from parents for schools’ partnership programs, which, in turn, helped estimate the percentage of students scoring proficient on math achievement tests. PMID:20200592

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.

What factors influence attending surgeon decisions about resident autonomy in the operating room?

Science.gov (United States)

Williams, Reed G; George, Brian C; Meyerson, Shari L; Bohnen, Jordan D; Dunnington, Gary L; Schuller, Mary C; Torbeck, Laura; Mullen, John T; Auyang, Edward; Chipman, Jeffrey G; Choi, Jennifer; Choti, Michael; Endean, Eric; Foley, Eugene F; Mandell, Samuel; Meier, Andreas; Smink, Douglas S; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Joseph B; Lillemoe, Keith D; Fryer, Jonathan P

2017-12-01

Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents. We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs. The primary outcome measure was supervising surgeon autonomy granted to the resident during the operative procedure. Predictor variables included resident performance on that case, supervising surgeon history with granting autonomy, resident training level, and case difficulty. Resident performance was the strongest predictor of autonomy granted. Typical autonomy by supervising surgeon was the second most important predictor. Each additional factor led to a smaller but still significant improvement in ability to predict the supervising surgeon's autonomy decision. The 4 factors together accounted for 54% of decision variance (r = 0.74). Residents' operative performance in each case was the strongest predictor of how much autonomy was allowed in that case. Typical autonomy granted by the supervising surgeon, the second most important predictor, is unrelated to resident proficiency and warrants efforts to ensure that residents perform each procedure with many different supervisors. Copyright © 2017 Elsevier Inc. All rights reserved.

Improving Gram stain proficiency in hospital and satellite laboratories that do not have microbiology.

Science.gov (United States)

Guarner, Jeannette; Street, Cassandra; Matlock, Margaret; Cole, Lisa; Brierre, Francoise

2017-03-01

Consolidation of laboratories has left many hospitals and satellite laboratories with minimal microbiologic testing. In many hospitals and satellite laboratories, Gram stains on primary specimens are still performed despite difficultly in maintaining proficiency. To maintain Gram stain proficiency at a community 450-bed hospital with an active emergency room we designed bimonthly challenges that require reporting Gram staining and morphology of different organisms. The challenges consist of five specimens prepared by the reference microbiology laboratory from cultures and primary specimens. Twenty to 23 medical laboratory scientists participate reading the challenges. Results from the challenges are discussed with each medical laboratory scientists. In addition, printed images from the challenges are presented at huddle to add microbiology knowledge. On the first three challenges, Gram staining was read correctly in 71%-77% of the time while morphology 53%-66%. In the last six challenges correct answers for Gram stain were 77%-99% while morphology 73%-96%. We observed statistically significant improvement when reading Gram stains by providing frequent challenges to medical laboratory scientists. The clinical importance of Gram stain results is emphasized during huddle presentations increasing knowledge and motivation to perform the test for patients.

Residency factors that influence pediatric in-training examination score improvement.

Science.gov (United States)

Chase, Lindsay H; Highbaugh-Battle, Angela P; Buchter, Susie

2012-10-01

The goal of this study was to determine which measurable factors of resident training experience contribute to improvement of in-training examination (ITE) and certifying examination (CE) scores. This is a descriptive retrospective study analyzing data from July 2003 through June 2006 at a large academic pediatric training program. Pediatric categorical residents beginning residency in July 2003 were included. Regression analyses were used to determine if the number of admissions performed, core lectures attended, acute care topics heard, grand rounds attended, continuity clinic patients encountered, or procedures performed correlated with improvement of ITE scores. These factors were then analyzed in relation to CE scores. Seventeen residents were included in this study. The number of general pediatric admissions was the only factor found to correlate with an increase in ITE score (P = .04). Scores for the ITE at pediatric levels 1 and 3 were predictive of CE scores. No other factors measured were found to influence CE scores. Although all experiences of pediatric residents likely contribute to professional competence, some experiences may have more effect on ITE and CE scores. In this study, only general pediatric admissions correlated significantly with an improvement in ITE scores from year 1 to year 3. Further study is needed to identify which elements of the residency experience contribute most to CE success. This would be helpful in optimizing residency program structure and curriculum within the limitations of duty hour regulations.

Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project.

Science.gov (United States)

Jones, Kyle Bradford; Gren, Lisa H; Backman, Richard

2014-09-01

Increased emphasis is being placed on the continuous quality improvement (CQI) education of residents of all specialties. This article describes a resident-led continuous quality improvement (CQI) project, based on a novel curriculum, to improve the immunization rates of children under 2 years old at the Madsen Family Health Center (MHC). All third-year residents were trained in the FOCUS-PDSA CQI methodology through concurrent didactic lectures and experience leading the CQI team. The CQI team included clinical staff led by a third-year family medicine resident and mentored by a member of the family medicine faculty. Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic as the intervention. Compliance with the intervention (process measure), as well as immunization rates at 2 and 5 months post-intervention (outcome measure), were monitored. Immunization records were printed on 84% of clinic days from October 24, 2011 to March 31, 2012. The percentage of patients immunized at baseline was 66%. The percentage immunized as of December 31, 2011 was 96% and was 91% as of March 31, 2012. An important educational experience was organized for third-year family medicine residents through learning CQI skills, leading a CQI team, and directing a CQI project to completion. Significant improvement in the percentage of patients under 2 years old immunized at the MHC was achieved by presenting provider-medical assistant teamlets with immunization records of all pediatric patients on the daily clinic schedule.

Core stability exercise is as effective as task-oriented motor training in improving motor proficiency in children with developmental coordination disorder: a randomized controlled pilot study.

Science.gov (United States)

Au, Mei K; Chan, Wai M; Lee, Lin; Chen, Tracy Mk; Chau, Rosanna Mw; Pang, Marco Yc

2014-10-01

To compare the effectiveness of a core stability program with a task-oriented motor training program in improving motor proficiency in children with developmental coordination disorder (DCD). Randomized controlled pilot trial. Outpatient unit in a hospital. Twenty-two children diagnosed with DCD aged 6-9 years were randomly allocated to the core stability program or the task-oriented motor program. Both groups underwent their respective face-to-face training session once per week for eight consecutive weeks. They were also instructed to carry out home exercises on a daily basis during the intervention period. Short Form of the Bruininks-Oseretsky Test of Motor Proficiency (Second Edition) and Sensory Organization Test at pre- and post-intervention. Intention-to-treat analysis revealed no significant between-group difference in the change of motor proficiency standard score (P=0.717), and composite equilibrium score derived from the Sensory Organization Test (P=0.100). Further analysis showed significant improvement in motor proficiency in both the core stability (mean change (SD)=6.3(5.4); p=0.008) and task-oriented training groups (mean change(SD)=5.1(4.0); P=0.007). The composite equilibrium score was significantly increased in the task-oriented training group (mean change (SD)=6.0(5.5); P=0.009), but not in the core stability group (mean change(SD) =0.0(9.6); P=0.812). In the task-oriented training group, compliance with the home program was positively correlated with change in motor proficiency (ρ=0.680, P=0.030) and composite equilibrium score (ρ=0.638, P=0.047). The core stability exercise program is as effective as task-oriented training in improving motor proficiency among children with DCD. © The Author(s) 2014.

The Effects of an Extensive Reading Program on Improving English as Foreign Language Proficiency in University Level Education

Science.gov (United States)

Alzu'bi, Mohammad Akram

2014-01-01

This study aimed at investigating the impact of extensive reading on improving reading proficiency. The study tried to find the effect of ER on EFL student's reading, vocabulary and grammar. The researcher designed two instruments; a program based on the extensive reading strategy and general test. Forty-one university students who study English…

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

residents' proficiency as demonstrated by the evaluation after implementation of the standardized educational module positively correlated to an increase in resident SAE scores in EDX compared with resident scores before implementation of the educational module. Resident proficiency in EDX medicine skills and knowledge was objectively verified after completion of the standardized educational module. Validation of the assessment tools is evidenced by collected data correlating with significantly improved SAE scores and American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) exam scores, as outlined in the result section. In addition, the clinical development tool (procedure checklist) was validated by residents being individually observed performing skills and deemed competent by an AANEM-certified physician. The standardized educational module and evaluation methodology provide a potential framework for the definition of baseline competency in the clinical skill area of EDX.

Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey.

Science.gov (United States)

Shetty, Shohan; Zevin, Boris; Grantcharov, Teodor P; Roberts, Kurt E; Duffy, Andrew J

2014-01-01

Simulation training for surgical residents can shorten learning curves, improve technical skills, and expedite competency. Several studies have shown that skills learned in the simulated environment are transferable to the operating room. Residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room. Despite the availability and proven utility of surgical simulators and simulation laboratories, they are still widely underutilized by surgical trainees. Studies have shown that voluntary use leads to minimal participation in a training curriculum. Although there are several simulation tools, there is no clear evidence of the superiority of one tool over the other in skill acquisition. The purpose of this study was to explore resident perceptions, training experiences, and preferences regarding laparoscopic simulation training. Our goal was to profile resident participation in surgical skills simulation, recognize potential barriers to voluntary simulator use, and identify simulation tools and tasks preferred by residents. Furthermore, this study may help to inform whether mandatory/protected training time, as part of the residents' curriculum is essential to enhance participation in the simulation laboratory. A cross-sectional study on general surgery residents (postgraduate years 1-5) at Yale University School of Medicine and the University of Toronto via an online questionnaire was conducted. Overall, 67 residents completed the survey. The institutional review board approved the methods of the study. Overall, 95.5% of the participants believed that simulation training improved their laparoscopic skills. Most respondents (92.5%) perceived that skills learned during simulation training were transferrable to the operating room. Overall, 56.7% of participants agreed that proficiency in a simulation curriculum should be mandatory before operating room experience. The

National Radon Contractor Proficiency Program. Proficiency report, October 1990

International Nuclear Information System (INIS)

1990-10-01

The report lists those individual contractors in the United States who have met the requirements of the Radon Contractor Proficiency (RCP) Program as of August 18, 1990. These requirements are designed to provide minimum proficiency criteria for individuals who design and supervise the installation of radon mitigation systems in buildings. (Some States have more stringent requirements as part of their radon certification programs. The States should be consulted directly for details on their programs; see Section 5 for a list of State radon contacts). The RCP Program measures the proficiency of an individual contractor, not their company. Therefore, users of the report who select a mitigation firm should ensure that the services are provided by the listed contractor. The National RCP Program does not accredit mitigation contractors, nor does it certify, recommend, or endorse participating companies. Only the listed contractor, not their company of affilation, are deemed proficient. The inclusion of a contractor in the report should not be interpreted as a certification or accreditation of the individual or affiliated company

National Radon Contractor Proficiency (RCP) Program. Proficiency report, June 1991

International Nuclear Information System (INIS)

1991-06-01

The primary objective of the U.S. Environmental Protection Agency's (EPA) efforts to address the indoor radon problem is to reduce radon levels in buildings throughout the country. Achieving the objective requires a nationwide supply of capable radon mitigation contractors. In the Indoor Radon Abatement Act of 1988, Congress authorized EPA to establish a program to evaluate radon mitigation contractors and to provide the information to the public in cooperation with the States. The Radon Contractor Proficiency (RCP) Program was developed to assist States, EPA Regions, local government officials, and the public in selecting contractors who have demonstrated their proficiency in reducing indoor radon levels. The program is managed by the EPA Office of Radiation Programs' Radon Division. Under the voluntary program, radon contractors demonstrate their proficiency by meeting specific Program requirements. Individual contractors who meet these requirements are then listed in periodic RCP Proficiency Reports

A strategic approach to quality improvement and patient safety education and resident integration in a general surgery residency.

Science.gov (United States)

O'Heron, Colette T; Jarman, Benjamin T

2014-01-01

To outline a structured approach for general surgery resident integration into institutional quality improvement and patient safety education and development. A strategic plan to address Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review assessments for resident integration into Quality Improvement and Patient Safety initiatives is described. Gundersen Lutheran Medical Foundation is an independent academic medical center graduating three categorical residents per year within an integrated multi-specialty health system serving 19 counties over 3 states. The quality improvement and patient safety education program includes a formal lecture series, online didactic sessions, mandatory quality improvement or patient safety projects, institutional committee membership, an opportunity to serve as a designated American College of Surgeons National Surgical Quality Improvement Project and Quality in Training representative, mandatory morbidity and mortality conference attendance and clinical electives in rural surgery and international settings. Structured education regarding and participation in quality improvement and patient safety programs are able to be accomplished during general surgery residency. The long-term outcomes and benefits of these strategies are unknown at this time and will be difficult to measure with objective data. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

A didactic and hands-on module enhances resident microsurgical knowledge and technical skill.

Science.gov (United States)

El Ahmadieh, Tarek Y; Aoun, Salah G; El Tecle, Najib E; Nanney, Allan D; Daou, Marc R; Harrop, James; Batjer, Hunt H; Bendok, Bernard R

2013-10-01

Simulation has been adopted as a powerful training tool in many areas of health care. However, it has not yet been systematically embraced in neurosurgery because of the absence of validated tools, assessment scales, and curricula. To use our validated microanastomosis module and scale to evaluate the effects of an educational intervention on the performance of neurosurgery residents at the 2012 Congress of Neurological Surgeons Annual Meeting. The module consisted of an end-to-end microanastomosis of a 3-mm vessel and was divided into 3 phases: (1) a cognitive and microsuture prelecture testing phase, (2) a didactic lecture, and (3) a cognitive and microsuture postlecture testing phase. We compared resident knowledge and technical proficiency from the pretesting and posttesting phases. One neurosurgeon and 7 neurosurgery residents participated in the study. None had previous experience in microsurgery. The average score on the microsuture prelecture and postlecture tests, as measured by our assessment scale, was 32.50 and 39.75, respectively (P = .001). The number of completed sutures at the end of each procedure was higher for 75% of participants in the postlecture testing phase (P = .03). The average score on the cognitive postlecture test (12.75) was significantly better than that of the cognitive prelecture test (8.38; P = .001). Simulation has the potential to enhance resident education and to elevate proficiency levels. Our data suggest that a focused microsurgical module that incorporates a didactic component and a technical component can enhance resident knowledge and technical proficiency in microsurgical anastomosis.

Simulation-based education with mastery learning improves residents' lumbar puncture skills

Science.gov (United States)

Cohen, Elaine R.; Caprio, Timothy; McGaghie, William C.; Simuni, Tanya; Wayne, Diane B.

2012-01-01

Objective: To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods: This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulator-trained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores. Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p < 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p < 0.001) and only 6% met the MPS. Conclusions: Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. PMID:22675080

An Accounting Writing Proficiency Survey

Science.gov (United States)

Firch, Tim; Campbell, Annhenrie; Filling, Steven; Lindsay, David H.

2011-01-01

Although there has been much discussion about improving college student writing with college-level courses, little is known about how accounting programs, in particular, are addressing the writing proficiency challenge. This study surveys the 852 accounting programs in the United States to identify the frequency and types of accounting writing…

Training Psychiatry Residents in Quality Improvement: An Integrated, Year-Long Curriculum

Science.gov (United States)

Arbuckle, Melissa R.; Weinberg, Michael; Cabaniss, Deborah L.; Kistler; Susan C.; Isaacs, Abby J.; Sederer, Lloyd I.; Essock, Susan M.

2013-01-01

Objective: The authors describe a curriculum for psychiatry residents in Quality Improvement (QI) methodology. Methods: All PGY3 residents (N=12) participated in a QI curriculum that included a year-long group project. Knowledge and attitudes were assessed before and after the curriculum, using a modified Quality Improvement Knowledge Assessment…

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

Early tracking would improve the operative experience of general surgery residents.

Science.gov (United States)

Stain, Steven C; Biester, Thomas W; Hanks, John B; Ashley, Stanley W; Valentine, R James; Bass, Barbara L; Buyske, Jo

2010-09-01

High surgical complexity and individual career goals has led most general surgery (GS) residents to pursue fellowship training, resulting in a shortage of surgeons who practice broad-based general surgery. We hypothesize that early tracking of residents would improve operative experience of residents planning to be general surgeons, and could foster greater interest and confidence in this career path. Surgical Operative Log data from GS and fellowship bound residents (FB) applying for the 2008 American Board of Surgery Qualifying Examination (QE) were used to construct a hypothetical training model with 6 months of early specialization (ESP) for FB residents in 4 specialties (cardiac, vascular, colorectal, pediatric); and presumed these cases would be available to GS residents within the same program. A total of 142 training programs had both FB residents (n = 237) and GS residents (n = 402), and represented 70% of all 2008 QE applicants. The mean numbers of operations by FB and GS residents were 1131 and 1091, respectively. There were a mean of 252 cases by FB residents in the chief year, theoretically making 126 cases available for each GS resident. In 9 defined categories, the hypothetical model would result in an increase in the 5-year operative experience of GS residents (mastectomy 6.5%; colectomy 22.8%; gastrectomy 23.4%; antireflux procedures 23.4%; pancreatic resection 37.4%; liver resection 29.3%; endocrine procedures 19.6%; trauma operations 13.3%; GI endoscopy 6.5%). The ESP model improves operative experience of GS residents, particularly for complex gastrointestinal procedures. The expansion of subspecialty ESP should be considered.

Jack Barney award: the effect of fatigue on cognitive and psychomotor skills of trauma residents and attending surgeons.

Science.gov (United States)

Gerdes, Jodi; Kahol, Kanav; Smith, Marshall; Leyba, Mario J; Ferrara, John J

2008-12-01

Fatigue and sleep deprivation and their effects on surgical proficiency have been actively researched areas. Past studies that have focused solely on residents have provided an important insight into how fatigue affects residents' ability to perform. This study aims to quantify the effect of fatigue on attending surgeons. To quantify the effect of fatigue on psychomotor and cognitive skills of surgical residents and attending surgeons, visiohaptic simulations were created to mimic realistic interactions. Both groups showed a significant decrement in proficiency measures postcall. When tasks were separated based on psychomotor versus cognitive-dominated skills, attending surgeons made 25% fewer (P Psychomotor skills were equally affected in both groups. Call-associated fatigue is associated with increased error rates in the cognitive skill domain, although less so in attending surgeons compared with their resident counterparts.

Proficiency tests, Evaluating

NARCIS (Netherlands)

Cofino, W.P.; Molenaar, J.; Torfs, P.J.J.F.

2017-01-01

Marine monitoring programs provide data that are essential for marine management. The reliability of such data is underpinned by proficiency tests. In the context of Quasimeme, a proficiency testing program for the marine environment, a statistical model has been developed in 2000 to evaluate data

The Moderating Role of English Proficiency in the Association Between Immigrant Chinese Mothers' Authoritative Parenting and Children's Outcomes.

Science.gov (United States)

Yu, Wei; Cheah, Charissa S L; Sun, Shuyan

2015-01-01

The authors' objective was to investigate the association between Chinese immigrant mothers' authoritative parenting and their children's socioemotional and behavioral difficulties. Participants were 136 first-generation Chinese immigrant mothers with 3-5-year-old children residing in the United States. Authoritative parenting was associated with lower socioemotional and behavioral difficulties in children as reported by preschool teachers. Further moderation analyses revealed that immigrant mothers' English proficiency moderated the association between authoritative parenting and children's difficulties. Specifically, authoritative parenting was significantly associated with fewer total difficulties only for children with mothers who reported higher English proficiency.

A stress management workshop improves residents' coping skills.

Science.gov (United States)

McCue, J D; Sachs, C L

1991-11-01

We describe the effectiveness of a stress management workshop designed for physicians. Of the 64 medicine, pediatrics, and medicine-pediatrics residents who agreed to participate in the workshop, the 43 who could be freed from clinical responsibilities constituted the intervention group; the 21 residents who could not be freed from clinical responsibilities were asked to be the nonintervention group. The ESSI Stress Systems Instrument and Maslach Burnout Inventory were administered to control subjects and workshop participants 2 weeks before and 6 weeks after the workshop. The half-day workshops taught management of the stresses of medical practice through: (1) learning and practicing interpersonal skills that increase the availability of social support; (2) prioritization of personal, work, and educational demands; (3) techniques to increase stamina and attend to self-care needs; (4) recognition and avoidance of maladaptive responses; and (5) positive outlook skills. Overall, the ESSI Stress Systems Instrument test scores for the workshop participants improved (+1.27), while the nonintervention group's mean scores declined (-0.65). All 21 individual ESSI Stress Systems Instrument scale items improved for the workshop, compared with eight of 21 items for the nonintervention group. The workshop group improved in the Maslach Burnout Inventory emotional exhaustion scale and deteriorated less than the nonintervention group in the depersonalization scale. We conclude that a modest, inexpensive stress management workshop was received positively, and can lead to significant short-term improvement in stress and burnout test scores for medicine and pediatrics residents.

Attitudes of Jordanian University Students towards Using Online Chat Discourse with Native Speakers of English for Improving Their Language Proficiency

Science.gov (United States)

Mahfouz, Safi M.; Ihmeideh, Fathi M.

2009-01-01

This study aims to investigate Jordanian university students' attitudes towards using video and text chat discourse with anonymous native speakers of English to improve their English proficiency. To achieve this aim, a questionnaire was designed. The study sample consisted of 320 university students enrolled in two Jordanian universities. Results…

Resident simulation training in endoscopic endonasal surgery utilizing haptic feedback technology.

Science.gov (United States)

Thawani, Jayesh P; Ramayya, Ashwin G; Abdullah, Kalil G; Hudgins, Eric; Vaughan, Kerry; Piazza, Matthew; Madsen, Peter J; Buch, Vivek; Sean Grady, M

2016-12-01

Simulated practice may improve resident performance in endoscopic endonasal surgery. Using the NeuroTouch haptic simulation platform, we evaluated resident performance and assessed the effect of simulation training on performance in the operating room. First- (N=3) and second- (N=3) year residents were assessed using six measures of proficiency. Using a visual analog scale, the senior author scored subjects. After the first session, subjects with lower scores were provided with simulation training. A second simulation served as a task-learning control. Residents were evaluated in the operating room over six months by the senior author-who was blinded to the trained/untrained identities-using the same parameters. A nonparametric bootstrap testing method was used for the analysis (Matlab v. 2014a). Simulation training was associated with an increase in performance scores in the operating room averaged over all measures (p=0.0045). This is the first study to evaluate the training utility of an endoscopic endonasal surgical task using a virtual reality haptic simulator. The data suggest that haptic simulation training in endoscopic neurosurgery may contribute to improvements in operative performance. Limitations include a small number of subjects and adjudication bias-although the trained/untrained identity of subjects was blinded. Further study using the proposed methods may better describe the relationship between simulated training and operative performance in endoscopic Neurosurgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training

DEFF Research Database (Denmark)

Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi

2017-01-01

PURPOSE: To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. DESIGN: Multicenter masked clinical trial. PARTICIPANTS: Eighteen cataract...... surgeons with different levels of experience. METHODS: Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. MAIN OUTCOME MEASURES: Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated...... task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. RESULTS: Novices (non...

Resident duty hour modification affects perceptions in medical education, general wellness, and ability to provide patient care.

Science.gov (United States)

Moeller, Andrew; Webber, Jordan; Epstein, Ian

2016-07-13

Resident duty hours have recently been under criticism, with concerns for resident and patient well-being. Historically, call shifts have been long, and some residency training programs have now restricted shift lengths. Data and opinions about the effects of such restrictions are conflicting. The Internal Medicine Residency Program at Dalhousie University recently moved from a traditional call structure to a day float/night float system. This study evaluated how this change in duty hours affected resident perceptions in several key domains. Senior residents from an internal medicine training program in Canada responded to an anonymous online survey immediately before and 6 months after the implementation of duty hour reform. The survey contained questions relating to three major domains: resident wellness, ability to deliver quality health care, and medical education experience. Mean pre- and post-intervention scores were compared using the t-test for paired samples. Twenty-three of 27 (85 %) senior residents completed both pre- and post-reform surveys. Residents perceived significant changes in many domains with duty hour reform. These included improved general wellness, less exposure to personal harm, fewer feelings of isolation, less potential for error, improvement in clinical skills expertise, increased work efficiency, more successful teaching, increased proficiency in medical skills, more successful learning, and fewer rotation disruptions. Senior residents in a Canadian internal medicine training program perceived significant benefits in medical education experience, ability to deliver healthcare, and resident wellness after implementation of duty hour reform.

Improving Surgical Skills of OBGYN Residents through Partnership ...

African Journals Online (AJOL)

Improving Surgical Skills of OBGYN Residents through Partnership with Rural Hospitals: Experience from Southeast Nigeria. Odidika Ugochukwu Joannes Umeora, Azubuike Kanario Onyebuchi, Nkechi Bridget Emma-Echiegu, Justus Ndulue Eze, Paul Olisaemeka Ezeonu ...

Improving Reliability of a Residency Interview Process

Science.gov (United States)

Serres, Michelle L.; Gundrum, Todd E.

2013-01-01

Objective. To improve the reliability and discrimination of a pharmacy resident interview evaluation form, and thereby improve the reliability of the interview process. Methods. In phase 1 of the study, authors used a Many-Facet Rasch Measurement model to optimize an existing evaluation form for reliability and discrimination. In phase 2, interviewer pairs used the modified evaluation form within 4 separate interview stations. In phase 3, 8 interviewers individually-evaluated each candidate in one-on-one interviews. Results. In phase 1, the evaluation form had a reliability of 0.98 with person separation of 6.56; reproducibly, the form separated applicants into 6 distinct groups. Using that form in phase 2 and 3, our largest variation source was candidates, while content specificity was the next largest variation source. The phase 2 g-coefficient was 0.787, while confirmatory phase 3 was 0.922. Process reliability improved with more stations despite fewer interviewers per station—impact of content specificity was greatly reduced with more interview stations. Conclusion. A more reliable, discriminating evaluation form was developed to evaluate candidates during resident interviews, and a process was designed that reduced the impact from content specificity. PMID:24159209

Improving reliability of a residency interview process.

Science.gov (United States)

Peeters, Michael J; Serres, Michelle L; Gundrum, Todd E

2013-10-14

To improve the reliability and discrimination of a pharmacy resident interview evaluation form, and thereby improve the reliability of the interview process. In phase 1 of the study, authors used a Many-Facet Rasch Measurement model to optimize an existing evaluation form for reliability and discrimination. In phase 2, interviewer pairs used the modified evaluation form within 4 separate interview stations. In phase 3, 8 interviewers individually-evaluated each candidate in one-on-one interviews. In phase 1, the evaluation form had a reliability of 0.98 with person separation of 6.56; reproducibly, the form separated applicants into 6 distinct groups. Using that form in phase 2 and 3, our largest variation source was candidates, while content specificity was the next largest variation source. The phase 2 g-coefficient was 0.787, while confirmatory phase 3 was 0.922. Process reliability improved with more stations despite fewer interviewers per station-impact of content specificity was greatly reduced with more interview stations. A more reliable, discriminating evaluation form was developed to evaluate candidates during resident interviews, and a process was designed that reduced the impact from content specificity.

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

Improving shoulder dystocia management among resident and attending physicians using simulations.

Science.gov (United States)

Goffman, Dena; Heo, Hye; Pardanani, Setul; Merkatz, Irwin R; Bernstein, Peter S

2008-09-01

The objective of the study was to determine whether a simulation-based educational program would improve residents' and attending physicians' performance in a simulated shoulder dystocia. Seventy-one obstetricians participated in an unanticipated simulated shoulder dystocia, an educational debriefing session, and a subsequent shoulder dystocia simulation. Each simulation was scored, based on standardized checklists for 4 technical maneuvers and 6 communication tasks, by 2 physician observers. Paired Student t tests were used for analysis. Forty-three attendings and 28 residents participated. Residents showed significant improvement in mean maneuver (3.3 +/- 0.9 vs 3.9 +/- 0.4, P = .001) and communication (3.5 +/- 1.2 vs 4.9 +/- 1.0, P < .0001) scores after simulation training. Attending physicians' communication (3.6 +/- 1.6 vs 4.9 +/- 1.1, P < .0001) scores were significantly improved after training. Our program improved physician performance in the management of simulated shoulder dystocia deliveries. Obstetric emergency simulation training can improve physicians' communication skills, at all levels of training, and should be incorporated into labor and delivery quality improvement measures.

Improving applicant selection: identifying qualities of the unsuccessful otolaryngology resident.

Science.gov (United States)

Badran, Karam W; Kelley, Kanwar; Conderman, Christian; Mahboubi, Hossein; Armstrong, William B; Bhandarkar, Naveen D

2015-04-01

To identify the prevalence and management of problematic residents. Additionally, we hope to identify the factors associated with successful remediation of unsuccessful otolaryngology residents. Self-reported Internet and paper-based survey. An anonymous survey was distributed to 152 current and former program directors (PDs) in 2012. The factors associated with unsuccessful otolaryngology residents and those associated with the successful remediation of problematic residents were investigated. An unsuccessful resident is defined as one who quit or was removed from the program for any reason, or one whose actions resulted in criminal action or citation against their medical license after graduation from residency. Remediation is defined as an individualized program implemented to correct documented weaknesses. The overall response rate was 26% (40 PDs). Seventy-three unsuccessful or problematic residents were identified. Sixty-six problematic or unsuccessful residents were identified during residency, with 58 of 66 (88%) undergoing remediation. Thirty-one (47%) residents did not graduate. The most commonly identified factors of an unsuccessful resident were: change in specialty (21.5%), interpersonal and communication skills with health professionals (13.9%), and clinical judgment (10.1%). Characteristics of those residents who underwent successful remediation include: poor performance on in-training examination (17%, P otolaryngology PDs in this sample identified at least one unsuccessful resident. Improved methods of applicant screening may assist in optimizing otolaryngology resident selection. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Proficiency training on a virtual reality robotic surgical skills curriculum.

Science.gov (United States)

Bric, Justin; Connolly, Michael; Kastenmeier, Andrew; Goldblatt, Matthew; Gould, Jon C

2014-12-01

The clinical application of robotic surgery is increasing. The skills necessary to perform robotic surgery are unique from those required in open and laparoscopic surgery. A validated laparoscopic surgical skills curriculum (Fundamentals of Laparoscopic Surgery or FLS™) has transformed the way surgeons acquire laparoscopic skills. There is a need for a similar skills training and assessment tool for robotic surgery. Our research group previously developed and validated a robotic training curriculum in a virtual reality (VR) simulator. We hypothesized that novice robotic surgeons could achieve proficiency levels defined by more experienced robotic surgeons on the VR robotic curriculum, and that this would result in improved performance on the actual daVinci Surgical System™. 25 medical students with no prior robotic surgery experience were recruited. Prior to VR training, subjects performed 2 FLS tasks 3 times each (Peg Transfer, Intracorporeal Knot Tying) using the daVinci Surgical System™ docked to a video trainer box. Task performance for the FLS tasks was scored objectively. Subjects then practiced on the VR simulator (daVinci Skills Simulator) until proficiency levels on all 5 tasks were achieved before completing a post-training assessment of the 2 FLS tasks on the daVinci Surgical System™ in the video trainer box. All subjects to complete the study (1 dropped out) reached proficiency levels on all VR tasks in an average of 71 (± 21.7) attempts, accumulating 164.3 (± 55.7) minutes of console training time. There was a significant improvement in performance on the robotic FLS tasks following completion of the VR training curriculum. Novice robotic surgeons are able to attain proficiency levels on a VR simulator. This leads to improved performance in the daVinci surgical platform on simulated tasks. Training to proficiency on a VR robotic surgery simulator is an efficient and viable method for acquiring robotic surgical skills.

Improving Resident Performance Through a Simulated Rapid Response Team: A Pilot Study.

Science.gov (United States)

Burke, Peter A; Vest, Michael T; Kher, Hemant; Deutsch, Joseph; Daya, Sneha

2015-07-01

The Joint Commission requires hospitals to develop systems in which a team of clinicians can rapidly recognize and respond to changes in a patient's condition. The rapid response team (RRT) concept has been widely adopted as the solution to this mandate. The role of house staff in RRTs and the impact on resident education has been controversial. At Christiana Care Health System, eligible residents in their second through final years lead the RRTs. To evaluate the use of a team-based, interdisciplinary RRT training program for educating and training first-year residents in an effort to improve global RRT performance before residents start their second year. This pilot study was administered in 3 phases. Phase 1 provided residents with classroom-based didactic sessions using case-based RRT scenarios. Multiple choice examinations were administered, as well as a confidence survey based on a Likert scale before and after phase 1 of the program. Phase 2 involved experiential training in which residents engaged as mentored participants in actual RRT calls. A qualitative survey was used to measure perceived program effectiveness after phase 2. In phase 3, led by senior residents, simulated RRTs using medical mannequins were conducted. Participants were divided into 5 teams, in which each resident would rotate in the roles of leader, nurse, and respiratory therapist. This phase measured resident performance with regard to medical decision making, data gathering, and team behaviors during the simulated RRT scenarios. Performance was scored by an attending and a senior resident. A total of 18 residents were eligible (N=18) for participation. The average multiple choice test score improved by 20% after didactic training. The average confidence survey score before training was 3.44 out of 5 (69%) and after training was 4.13 (83%), indicating a 14% improvement. High-quality team behaviors correlated with medical decision making (0.92) more closely than did high-quality data

Building bridges: engaging medical residents in quality improvement and medical leadership.

Science.gov (United States)

Voogt, Judith J; van Rensen, Elizabeth L J; van der Schaaf, Marieke F; Noordegraaf, Mirko; Schneider, Margriet Me

2016-12-01

To develop an educational intervention that targets residents' beliefs and attitudes to quality Improvement (QI) and leadership in order to demonstrate proactive behaviour. Theory-driven, mixed methods study including document analysis, interviews, observations and open-ended questionnaires. Six Dutch teaching hospitals. Using expertise from medicine, psychology, organizational and educational sciences we developed a situated learning programme named Ponder and IMProve (PIMP). The acronym PIMP reflects the original upbeat name in Dutch, Verwonder & Verbeter. It has a modern, positive meaning that relates to improving your current circumstances. In quarterly 1-h sessions residents are challenged to identify daily workplace frustrations and translate them into small-scale QI activities. Organizational awareness, beliefs and attitudes to QI and organizational responsibilities, resident behaviour, barriers and facilitators to successful learning and the programme's potential impact on the organization. Overall, 19 PIMP meetings were held over a period of 3 years. Residents defined 119 PIMP goals, resolved 37 projects and are currently working on another 39 projects. Interviews show that PIMP sessions make residents more aware of the organizational aspects of their daily work. Moreover, residents feel empowered to take up the role of change agent. Facilitators for success include a positive cost-benefit trade-off, a valuable group process and a safe learning environment. This article demonstrates the added value of multidisciplinary theory-driven research for the design, development and evaluation of educational programmes. Residents can be encouraged to develop organizational awareness and reshape their daily frustrations in QI work. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The effect of acculturation on obesity among foreign-born Asians residing in the United States.

Science.gov (United States)

Nguyen, Hannah-Hanh D; Smith, Charlotte; Reynolds, Grace L; Freshman, Brenda

2015-04-01

This study examined the relationship between acculturation and obesity in foreign-born Asians residing in the United States, using the 2009 California Health Interview Survey secondary data (N = 2,871). Two series of proxies and/or behavioral variables were used to measure level of acculturation: (a) length of US residency (years and percent of life) and (b) English language use and proficiency. It was hypothesized that acculturation measured with both proxies would positively predict obesity among foreign-born Asian adults who live in the United States. Results did not support the relationship between obesity and residency length, and greater English use and proficiency seemed to predict lower obesity. However, additional exploratory analysis was performed for each Asian ethnicity and the results showed that the hypothesized links were partly supported for Filipino subgroup, but the links for Vietnamese subgroup were in the opposite direction of the hypotheses and inconsistent with previous literature.

A New Tool for Assessing Mobile Device Proficiency in Older Adults: The Mobile Device Proficiency Questionnaire.

Science.gov (United States)

Roque, Nelson A; Boot, Walter R

2018-02-01

Mobile device proficiency is increasingly required to participate in society. Unfortunately, there still exists a digital divide between younger and older adults, especially with respect to mobile devices (i.e., tablet computers and smartphones). Training is an important goal to ensure that older adults can reap the benefits of these devices. However, efficient/effective training depends on the ability to gauge current proficiency levels. We developed a new scale to accurately assess the mobile device proficiency of older adults: the Mobile Device Proficiency Questionnaire (MDPQ). We present and validate the MDPQ and a short 16-question version of the MDPQ (MDPQ-16). The MDPQ, its subscales, and the MDPQ-16 were found to be highly reliable and valid measures of mobile device proficiency in a large sample. We conclude that the MDPQ and MDPQ-16 may serve as useful tools for facilitating mobile device training of older adults and measuring mobile device proficiency for research purposes.

Improving English Listening Proficiency: The Application of ARCS Learning-Motivational Model

Science.gov (United States)

Zhang, Jianfeng

2015-01-01

Language learning motivation is one of vital factors which strongly correlates to the success in second language acquisition. Listening proficiency, as one of the basic language abilities, is paid much attention in English instruction, but presently the college English listening teaching is a weak link in English language teaching in China, which…

Significance of Objective Structured Clinical Examinations to Plastic Surgery Residency Training.

Science.gov (United States)

Simmons, Brian J; Zoghbi, Yasmina; Askari, Morad; Birnbach, David J; Shekhter, Ilya; Thaller, Seth R

2017-09-01

Objective structured clinical examinations (OSCEs) have proven to be a powerful tool. They possess more than a 30-year track record in assessing the competency of medical students, residents, and fellows. Objective structured clinical examinations have been used successfully in a variety of medical specialties, including surgery. They have recently found their way into the subspecialty of plastic surgery. This article uses a systematic review of the available literature on OSCEs and their recent use in plastic surgery. It incorporates survey results assessing program directors' views on the use of OSCEs. Approximately 40% of programs surveyed use OSCEs to assess the Accreditation Council for Graduate Medical Education core competencies. We found that 40% use OSCEs to evaluate specific plastic surgery milestones. Objective structured clinical examinations are usually performed annually. They cost anywhere between $100 and more than $1000 per resident. Four milestones giving residents the most difficulties on OSCEs were congenital anomalies, noncancer breast surgery, breast reconstruction, and practice-based learning and improvement. It was determined that challenges with milestones were due to lack of adequate general knowledge and surgical ward patient care, as well as deficits in professionalism and system-based problems. Programs were able to remediate weakness found by OSCEs using a variety of methods. Objective structured clinical examinations offer a unique tool to objectively assess the proficiency of residents in key areas of the Accreditation Council for Graduate Medical Education core competencies. In addition, they can be used to assess the specific milestones that plastic surgery residents must meet. This allows programs to identify and improve identified areas of weakness.

Development and participant assessment of a practical quality improvement educational initiative for surgical residents.

Science.gov (United States)

Sellers, Morgan M; Hanson, Kristi; Schuller, Mary; Sherman, Karen; Kelz, Rachel R; Fryer, Jonathan; DaRosa, Debra; Bilimoria, Karl Y

2013-06-01

As patient-safety and quality efforts spread throughout health care, the need for physician involvement is critical, yet structured training programs during surgical residency are still uncommon. Our objective was to develop an extended quality-improvement curriculum for surgical residents that included formal didactics and structured practical experience. Surgical trainees completed an 8-hour didactic program in quality-improvement methodology at the start of PGY3. Small teams developed practical quality-improvement projects based on needs identified during clinical experience. With the assistance of the hospital's process-improvement team and surgical faculty, residents worked through their selected projects during the following year. Residents were anonymously surveyed after their participation to assess the experience. During the first 3 years of the program, 17 residents participated, with 100% survey completion. Seven quality-improvement projects were developed, with 57% completing all DMAIC (Define, Measure, Analyze, Improve, Control) phases. Initial projects involved issues of clinical efficiency and later projects increasingly focused on clinical care questions. Residents found the experience educationally important (65%) and believed they were well equipped to lead similar initiatives in the future (70%). Based on feedback, the timeline was expanded from 12 to 24 months and changed to start in PGY2. Developing an extended curriculum using both didactic sessions and applied projects to teach residents the theory and implementation of quality improvement is possible and effective. It addresses the ACGME competencies of practice-based improvement and learning and systems-based practice. Our iterative experience during the past 3 years can serve as a guide for other programs. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

General surgery residents improve efficiency but not outcome of trauma care.

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Offner, Patrick J; Hawkes, Allison; Madayag, Robert; Seale, Fred; Maines, Charles

2003-07-01

Current American College of Surgeons Level I trauma center verification requires the presence of a residency program in which trauma care is an integral part of the training. The rationale for this requirement remains unclear, with no scientific evidence that resident participation improves the quality of trauma care. The purpose of this study was to determine whether quality or efficiency of trauma care is influenced by general surgery residents. Our urban Level I trauma center has traditionally used 24-hour in-house postgraduate year-4 general surgery residents in conjunction with at-home trauma attending backup to provide trauma care. As of July 1, 2000, general surgery residents no longer participated in trauma patient care, leaving sole responsibility to an in-house trauma attending. Data regarding patient outcome and resource use with and without surgery resident participation were tabulated and analyzed. Continuous data were compared using Student's t test if normally distributed and the Mann-Whitney U test if nonparametric. Categorical data were compared using chi2 analysis or Fisher's exact test as appropriate. During the 5-month period with resident participation, 555 trauma patients were admitted. In the identical time period without residents, 516 trauma patients were admitted. During the period without housestaff, patients were older and more severely injured. Mechanism was not different during the two time periods. Mortality was not affected; however, time in the emergency department and hospital lengths of stay were significantly shorter with residents. Multiple regression confirmed these findings while controlling for age, mechanism, and Injury Severity Score. Although resident participation in trauma care at a Level I trauma center does not affect outcome, it does significantly improve the efficiency of trauma care delivery.

Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship

Science.gov (United States)

Ford, Bradley A.; Klutts, J. Stacey; Jensen, Chris S.; Briggs, Angela S.; Robinson, Robert A.; Bruch, Leslie A.; Karandikar, Nitin J.

2017-01-01

Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output. PMID:28913416

Using Focused Laboratory Management and Quality Improvement Projects to Enhance Resident Training and Foster Scholarship.

Science.gov (United States)

Krasowski, Matthew D; Ford, Bradley A; Klutts, J Stacey; Jensen, Chris S; Briggs, Angela S; Robinson, Robert A; Bruch, Leslie A; Karandikar, Nitin J

2017-01-01

Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement. In this report, we present our experience at a pathology residency program (University of Iowa) in engaging pathology residents in projects related to practical issues of laboratory management, process improvement, and informatics. In this program, at least 1 management/quality improvement project, typically performed during a clinical chemistry/management rotation, was required and ideally resulted in a journal publication. The residency program also initiated a monthly management/informatics series for pathology externs, residents, and fellows that covers a wide range of topics. Since 2010, all pathology residents at the University of Iowa have completed at least 1 management/quality improvement project. Many of the projects involved aspects of laboratory test utilization, with some projects focused on other areas such as human resources, informatics, or process improvement. Since 2012, 31 peer-reviewed journal articles involving effort from 26 residents have been published. Multiple projects resulted in changes in ongoing practice, particularly within the hospital electronic health record. Focused management/quality improvement projects involving pathology residents can result in both meaningful quality improvement and scholarly output.

National Radon Contractor Proficiency (RCP) program. Proficiency report, September 1991

International Nuclear Information System (INIS)

1991-09-01

The primary objective of the U.S. Environmental Protection Agency's (EPA) efforts to address the indoor radon problem is to reduce radon levels in buildings throughout the country. Achieving this objective requires a nationwide supply of capable radon mitigation contractors. In the Indoor Radon Abatement Act of 1988, Congress authorized EPA to establish a program to evaluate radon mitigation contractors and to provide this information to the public in cooperation with the States. The Radon Contractor Proficiency (RCP) Program was developed to assist States, EPA Regions, local government officials, and the public in selecting contractors who have demonstrated their proficiency in reducing indoor radon levels. The program is managed by the EPA Office of Radiation Programs' Radon Division. Under this voluntary program, radon contractors demonstrate their proficiency by meeting specific Program requirements. Individual contractors who meet these requirements are then listed in the Report

National Radon Contractor Proficiency (RCP) Program. Proficiency report, January 1992

International Nuclear Information System (INIS)

1992-01-01

The primary objective of the U.S. Environmental Protection Agency's (EPA) efforts to address the indoor radon problem is to reduce radon levels in buildings throughout the country. Achieving the objective requires a nationwide supply of capable radon mitigation contractors. In the Indoor Radon Abatement Act of 1988, Congress authorized EPA to establish a program to evaluate radon mitigation contractors and to provide the information to the public in cooperation with the States. The Radon Contractor Proficiency (RCP) Program was developed to assist States, EPA Regions, local government officials, and the public in selecting contractors who have demonstrated their proficiency in reducing indoor radon levels. The program is managed by the EPA Office of Radiation Programs' Radon Division. Under the voluntary program, radon contractors demonstrate their proficiency by meeting specific Program requirements. Individual contractors who meet these requirements are then listed in the Report

The relationship between spoken English proficiency and participation in higher education, employment and income from two Australian censuses.

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Blake, Helen L; Mcleod, Sharynne; Verdon, Sarah; Fuller, Gail

2018-04-01

Proficiency in the language of the country of residence has implications for an individual's level of education, employability, income and social integration. This paper explores the relationship between the spoken English proficiency of residents of Australia on census day and their educational level, employment and income to provide insight into multilingual speakers' ability to participate in Australia as an English-dominant society. Data presented are derived from two Australian censuses i.e. 2006 and 2011 of over 19 million people. The proportion of Australians who reported speaking a language other than English at home was 21.5% in the 2006 census and 23.2% in the 2011 census. Multilingual speakers who also spoke English very well were more likely to have post-graduate qualifications, full-time employment and high income than monolingual English-speaking Australians. However, multilingual speakers who reported speaking English not well were much less likely to have post-graduate qualifications or full-time employment than monolingual English-speaking Australians. These findings provide insight into the socioeconomic and educational profiles of multilingual speakers, which will inform the understanding of people such as speech-language pathologists who provide them with support. The results indicate spoken English proficiency may impact participation in Australian society. These findings challenge the "monolingual mindset" by demonstrating that outcomes for multilingual speakers in education, employment and income are higher than for monolingual speakers.

Documentation of quality improvement exposure by internal medicine residency applicants.

Science.gov (United States)

Kolade, Victor O; Sethi, Anuradha

2016-01-01

Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

Neurosurgical Skills Assessment: Measuring Technical Proficiency in Neurosurgery Residents Through Intraoperative Video Evaluations.

Science.gov (United States)

Sarkiss, Christopher A; Philemond, Steven; Lee, James; Sobotka, Stanislaw; Holloway, Terrell D; Moore, Maximillian M; Costa, Anthony B; Gordon, Errol L; Bederson, Joshua B

2016-05-01

Although technical skills are fundamental in neurosurgery, there is little agreement on how to describe, measure, or compare skills among surgeons. The primary goal of this study was to develop a quantitative grading scale for technical surgical performance that distinguishes operator skill when graded by domain experts (residents, attendings, and nonsurgeons). Scores provided by raters should be highly reliable with respect to scores from other observers. Neurosurgery residents were fitted with a head-mounted video camera while performing craniotomies under attending supervision. Seven videos, 1 from each postgraduate year (PGY) level (1-7), were anonymized and scored by 16 attendings, 8 residents, and 7 nonsurgeons using a grading scale. Seven skills were graded: incision, efficiency of instrument use, cauterization, tissue handling, drilling/craniotomy, confidence, and training level. A strong correlation was found between skills score and PGY year (P Technical skills of neurosurgery residents recorded during craniotomy can be measured with high interrater reliability. Surgeons and nonsurgeons alike readily distinguish different skill levels. This type of assessment could be used to coach residents, to track performance over time, and potentially to compare skill levels. Developing an objective tool to evaluate surgical performance would be useful in several areas of neurosurgery education. Copyright © 2016 Elsevier Inc. All rights reserved.

Improving resident well-being and clinical learning environment through academic initiatives.

Science.gov (United States)

Lee, Nathaniel; Appelbaum, Nital; Amendola, Michael; Dodson, Kelley; Kaplan, Brian

2017-07-01

Organizational effects on job satisfaction, burnout, work-life balance, and perceived support have not been studied in the context of the clinical learning environment. We evaluated the relationship between academic resources and resident well-being, the clinical learning environment, and in-service examination performance of surgical residents. Residents of general surgery and surgical specialty programs were recruited from March 2016 through June 2016 across the Southeast, Mid-Atlantic, and Northeast regions. Program directors were asked to allow distribution of a paper survey or to forward an electronic survey link onto residents. Five dichotomous questions were asked regarding access to academic resources. Validated measures were obtained assessing resident well-being and perceived clinical learning environment. Data were analyzed through t-tests and chi-squared test of independence. We received 276 respondents across 50 programs. Residents perceiving adequate support to succeed had less burnout (P = 0.008), better resilience (P = 0.009), better job satisfaction (P workplace climate (P < 0.001), better organizational support (P < 0.001), and were more likely to have high performance on the in-service examination (P = 0.001). Specific resources including educational stipends, review questions, in-service board prep, and support for poor performers correlated with improved well-being and perceived clinical learning environment. Provision of academic resources has implications beyond in-service examination performance, correlating with improved resident well-being and perceptions of the clinical learning environment. Copyright © 2017 Elsevier Inc. All rights reserved.

The Oral Proficiency Interview: A Research Agenda

Science.gov (United States)

Chalhoub-Deville, Micheline; Fulcher, Glenn

2003-01-01

Many researchers and practitioners maintain that ACTFL's efforts to improve instructional practices and promote proficiency assessments tied to descriptors of what learners can do in real life have contributed significantly to second language teaching and testing. Similar endeavors in the area of research, however, are critically needed. Focusing…

A Case for Improved Reading Instruction for Academic English Reading Proficiency

Directory of Open Access Journals (Sweden)

Glenn Ole Hellekjær

2008-06-01

Full Text Available This article presents a study of the academic reading proficiency in English of 217 senior level Norwegian upper secondary school students who upon graduation are considered qualified for higher education. Testing with an International English Language Testing System (IELTS Academic Reading Module revealed that two thirds of the 178 respondents with ordinary EFL courses did not achieve the equivalent of the IELTS Band 6 score minimum that is usually required for admission to British and Australian universities. In comparison, two thirds of a sample of 39 respondents with a single, sheltered Content and Language Integrated Learning (CLIL subject achieved a Band 6 score or better. Closer analysis indicates that the poor test scores can be attributed to weaknesses in current English as a Foreign Language (EFL instruction where reading is neglected, where students do not learn to adjust how they read to reading purpose, and where they do not learn how to handle unfamiliar words to avoid disrupting the reading process. The article ends with suggestions on how to improve EFL instruction, in Norway and elsewhere.

More Proficient vs. Less Proficient EFL Learners’ Perceptions of Teachers ‘Motivation Raising Strategies

Directory of Open Access Journals (Sweden)

Nasrin Yousefi

2022-09-01

Full Text Available Motivation raising strategies are frequently used in English as a Foreign Language (EFL classes; nevertheless, learners’ perceptions of such strategies used by language teachers have not sufficiently been explored. Also, there are not enough studies on differences and similarities between more and less proficient EFL learners regarding this issue. To scrutinize this topic, a groups of more (No=50 and less proficient EFL learners (No=50 participated in this study by completing to a validated, researcher-made questionnaire with a five-point Likert type format. Non-parametric Mann-Whiteny U test was run in the SPSS ver. 23 to check the differences between the two groups. The results of the study verified that, regardless of each individual scale in the utilized questionnaire, overall, the more proficient ones manifested significantly less perceptions on teachers’ motivation raising strategies based on the total estimated mean ranks compared with the less proficient learners.  However, within the surveyed scales, only in the classroom atmosphere scale, the results showed that the less proficient learners were more mindful of teacher strategies for motivation raising. The findings from this study have implications for motivation raising strategy instructions for a language classroom.

Pediatrics Residents' Confidence and Performance Following a Longitudinal Quality Improvement Curriculum.

Science.gov (United States)

Courtlandt, Cheryl; Noonan, Laura; Koricke, Maureen Walsh; Zeskind, Philip Sanford; Mabus, Sarah; Feld, Leonard

2016-02-01

Quality improvement (QI) training is an integral part of residents' education. Understanding the educational value of a QI curriculum facilitates understanding of its impact. The purpose of this study was to evaluate the effects of a longitudinal QI curriculum on pediatrics residents' confidence and competence in the acquisition and application of QI knowledge and skills. Three successive cohorts of pediatrics residents (N = 36) participated in a longitudinal curriculum designed to increase resident confidence in QI knowledge and skills. Key components were a succession of progressive experiential projects, QI coaching, and resident team membership culminating in leadership of the project. Residents completed precurricular and postcurricular surveys and demonstrated QI competence by performance on the pediatric QI assessment scenario. Residents participating in the Center for Advancing Pediatric Excellence QI curriculum showed significant increases in pre-post measures of confidence in QI knowledge and skills. Coaching and team leadership were ranked by resident participants as having the most educational value among curriculum components. A pediatric QI assessment scenario, which correlated with resident-perceived confidence in acquisition of QI skills but not QI knowledge, is a tool available to test pediatrics residents' QI knowledge. A 3-year longitudinal, multimodal, experiential QI curriculum increased pediatrics residents' confidence in QI knowledge and skills, was feasible with faculty support, and was well-accepted by residents.

Summary of microsatellite instability test results from laboratories participating in proficiency surveys: proficiency survey results from 2005 to 2012.

Science.gov (United States)

Boyle, Theresa A; Bridge, Julia A; Sabatini, Linda M; Nowak, Jan A; Vasalos, Patricia; Jennings, Lawrence J; Halling, Kevin C

2014-03-01

The College of American Pathologists surveys are the largest laboratory peer comparison programs in the world. These programs allow laboratories to regularly evaluate their performance and improve the accuracy of the patient test results they provide. Proficiency testing is offered twice a year to laboratories performing microsatellite instability testing. These surveys are designed to emulate clinical practice, and some surveys have more challenging cases to encourage the refinement of laboratory practices. This report summarizes the results and trends in microsatellite instability proficiency testing from participating laboratories from the inception of the program in 2005 through 2012. We compiled and analyzed data for 16 surveys of microsatellite instability proficiency testing during 2005 to 2012. The number of laboratories participating in the microsatellite instability survey has more than doubled from 42 to 104 during the 8 years analyzed. An average of 95.4% of the laboratories correctly classified each of the survey test samples from the 2005A through 2012B proficiency challenges. In the 2011B survey, a lower percentage of laboratories (78.4%) correctly classified the specimen, possibly because of overlooking subtle changes of microsatellite instability and/or failing to enrich the tumor content of the specimen to meet the limit of detection of their assay. In general, laboratories performed well in microsatellite instability testing. This testing will continue to be important in screening patients with colorectal and other cancers for Lynch syndrome and guiding the management of patients with sporadic colorectal cancer.

Fundamental movement skills proficiency in children with developmental coordination disorder: does physical self-concept matter?

Science.gov (United States)

Yu, Jie; Sit, Cindy H P; Capio, Catherine M; Burnett, Angus; Ha, Amy S C; Huang, Wendy Y J

2016-01-01

The purpose of this study was to (1) examine differences in fundamental movement skills (FMS) proficiency, physical self-concept, and physical activity in children with and without developmental coordination disorder (DCD), and (2) determine the association of FMS proficiency with physical self-concept while considering key confounding factors. Participants included 43 children with DCD and 87 age-matched typically developing (TD) children. FMS proficiency was assessed using the Test of Gross Motor Development - second edition. Physical self-concept and physical activity were assessed using self-report questionnaires. A two-way (group by gender) ANCOVA was used to determine whether between-group differences existed in FMS proficiency, physical self-concept, and physical activity after controlling for age and BMI. Partial correlations and hierarchical multiple regression models were used to examine the relationship between FMS proficiency and physical self-concept. Compared with their TD peers, children with DCD displayed less proficiency in various components of FMS and viewed themselves as being less competent in physical coordination, sporting ability, and physical health. Physical coordination was a significant predictor of ability in object control skills. DCD status and gender were significant predictors of FMS proficiency. Future FMS interventions should target children with DCD and girls, and should emphasize improving object control skills proficiency and physical coordination. Children with DCD tend to have not only lower FMS proficiency than age-matched typically developing children but also lower physical self-concept. Self-perceptions of physical coordination by children with DCD are likely to be valuable contributors to development of object control skills. This may then help to develop their confidence in performing motor skills. Children with DCD need supportive programs that facilitate the development of object control skills. Efficacy of training

Use of Proficiency Testing as a Tool to Improve Quality in Microbiology Laboratories.

Science.gov (United States)

Stang, Heather L; Anderson, Nancy L

2013-09-15

Proficiency testing (PT) is a valuable tool for assessing laboratory performance and verifying the accuracy and reliability of test results. Participation is required by the Clinical Laboratory Improvement Amendments (CLIA) of 1988 for each of the microbiology subspecialties (bacteriology, mycobacteriology, mycology, parasitology, and virology), and the regulations include specific PT requirements for each subspecialty. To determine the use and perceived value of PT beyond meeting CLIA requirements, the Centers for Disease Control and Prevention funded a cooperative agreement with the Association of Public Health Laboratories to convene a series of focus groups to query laboratory professionals responsible for PT. The seven focus groups were comprised of 60 laboratory professionals representing large and small clinical laboratories, microbiology subspecialties, and public health. While participants acknowledged the need to perform PT to meet regulatory requirements, many also cited benefits and challenges beyond regulatory compliance.

A pilot study of orthopaedic resident self-assessment using a milestones' survey just prior to milestones implementation.

Science.gov (United States)

Bradley, Kendall E; Andolsek, Kathryn M

2016-01-11

To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education. In June 2012, an email was sent to Program Directors and administrative coordinators of the 154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible. Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents' rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones. Milestone self-assessment may be a useful tool as one component of a program's overall performance assessment strategy.

A pilot study of orthopaedic resident self-assessment using a milestones’ survey just prior to milestones implementation

Science.gov (United States)

Bradley, Kendall E.

2016-01-01

Objectives To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education.  Methods In June 2012, an email was sent to Program Directors and administrative coordinators of the154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. Results Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible.  Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. Conclusions Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents’ rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones.  Milestone self-assessment may be a useful tool as one component of a program’s overall performance assessment strategy. PMID:26752012

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

Science.gov (United States)

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

2017-02-22

Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation. In Fiscal Year (FY) 2014 and 2015, an additional faculty member was added to the SCM rotation. In FY 2014, the faculty member was a staff physician, and in FY 2015, the faculty member was an APP.. Resident workload was assessed using billing data. We measured residents' perceptions of the rotation using an anonymous electronic survey tool. We compared FY2014-2015 data to the baseline FY2013. The number of patients seen per resident per day decreased from 8.0(SD 3.3) in FY2013 to 5.0(SD 1.9) in FY2014 (p value of the rotation (40.0%, 72.2%, 72.6% in FY2013, 2014, 2015 respectively, p perceived educational value and clinical experience of a medical consultation rotation.

Assessment of Preschoolers' Gross Motor Proficiency: Revisiting Bruininks-Oseretsky Test of Motor Proficiency

Science.gov (United States)

Lam, Hazel Mei Yung

2011-01-01

Literature reveals that there are very few validated motor proficiency tests for young children. According to Gallahue and Ozmun, the Bruininks-Oseretsky Test of Motor Proficiency is a valid test. However, manipulative skills, which are classified as gross motor skills by most motor development specialists, are only tested in the Upper Limb…

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.

Online education improves pediatric residents' understanding of atopic dermatitis.

Science.gov (United States)

Craddock, Megan F; Blondin, Heather M; Youssef, Molly J; Tollefson, Megha M; Hill, Lauren F; Hanson, Janice L; Bruckner, Anna L

2018-01-01

Pediatricians manage skin conditions such as atopic dermatitis (AD) but report that their dermatologic training is inadequate. Online modules may enhance medical education when sufficient didactic or clinical teaching experiences are lacking. We assessed whether an online module about AD improved pediatric residents' knowledge and changed their clinical management of AD. Target and control cohorts of pediatric residents from two institutions were recruited. Target subjects took a 30-question test about AD early in their residency, reviewed the online module, and repeated the test 6 months and 1 year later. The control subjects, who had 1 year of clinical experience but had not reviewed the online module, also took the test. The mean percentage of correct answers was calculated and compared using two-sided, two-sample independent t tests and repeated-measures analysis of variance. For a subset of participants, clinical documentation from AD encounters was reviewed and 13 practice behaviors were compared using the Fisher exact test. Twenty-five subjects in the target cohort and 29 subjects in the control cohort completed the study. The target cohort improved from 18.0 ± 3.2 to 23.4 ± 3.4 correctly answered questions over 1 year (P online module about AD demonstrated statistically significant improvement in disease-specific knowledge over time and had statistically significantly higher scores than controls. Online dermatology education may effectively supplement traditional clinical teaching. © 2017 Wiley Periodicals, Inc.

Proficiency performance benchmarks for removal of simulated brain tumors using a virtual reality simulator NeuroTouch.

Science.gov (United States)

AlZhrani, Gmaan; Alotaibi, Fahad; Azarnoush, Hamed; Winkler-Schwartz, Alexander; Sabbagh, Abdulrahman; Bajunaid, Khalid; Lajoie, Susanne P; Del Maestro, Rolando F

2015-01-01

Assessment of neurosurgical technical skills involved in the resection of cerebral tumors in operative environments is complex. Educators emphasize the need to develop and use objective and meaningful assessment tools that are reliable and valid for assessing trainees' progress in acquiring surgical skills. The purpose of this study was to develop proficiency performance benchmarks for a newly proposed set of objective measures (metrics) of neurosurgical technical skills performance during simulated brain tumor resection using a new virtual reality simulator (NeuroTouch). Each participant performed the resection of 18 simulated brain tumors of different complexity using the NeuroTouch platform. Surgical performance was computed using Tier 1 and Tier 2 metrics derived from NeuroTouch simulator data consisting of (1) safety metrics, including (a) volume of surrounding simulated normal brain tissue removed, (b) sum of forces utilized, and (c) maximum force applied during tumor resection; (2) quality of operation metric, which involved the percentage of tumor removed; and (3) efficiency metrics, including (a) instrument total tip path lengths and (b) frequency of pedal activation. All studies were conducted in the Neurosurgical Simulation Research Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada. A total of 33 participants were recruited, including 17 experts (board-certified neurosurgeons) and 16 novices (7 senior and 9 junior neurosurgery residents). The results demonstrated that "expert" neurosurgeons resected less surrounding simulated normal brain tissue and less tumor tissue than residents. These data are consistent with the concept that "experts" focused more on safety of the surgical procedure compared with novices. By analyzing experts' neurosurgical technical skills performance on these different metrics, we were able to establish benchmarks for goal proficiency performance training of neurosurgery residents. This

Improving Otolaryngology Residency Selection Using Principles from Personnel Psychology.

Science.gov (United States)

Bowe, Sarah N; Laury, Adrienne M; Gray, Stacey T

2017-06-01

There has been a heightened focus on improving the resident selection process, particularly within highly competitive specialties. Previous research, however, has generally lacked a theoretical background, leading to inconsistent and biased results. Our recently published systematic review examining applicant characteristics and performance in residency can provide historical insight into the predictors (ie, constructs) and outcomes (ie, criteria) previously deemed pertinent by the otolaryngology community. Personnel psychology uses evidence-based practices to identify the most qualified candidates for employment using a variety of selection methods. Extensive research in this discipline has shown that integrity tests, structured interviews, work samples, and conscientiousness offer the greatest increase in validity when combined with general cognitive ability. Blending past research knowledge with the principles of personnel selection can provide the necessary foundation with which to engage in theory-driven, longitudinal studies on otolaryngology resident selection moving forward.

Effect of repetitive feedback on residents' communication skills improvement.

Directory of Open Access Journals (Sweden)

Ali Labaf

2014-07-01

Full Text Available To evaluate the effect of frequent feedback on residents' communication skills as measured by a standardized checklist. Five medical students were recruited in order to assess twelve emergency medicine residents' communication skills during a one-year period. Students employed a modified checklist based on Calgary-Cambridge observation guide. The checklist was designed by faculty members of Tehran University of Medical Science, used for assessment of students' communication skills. 24 items from 71 items of observational guide were selected, considering study setting and objects. Every two months an expert faculty, based on descriptive results of observation, gave structured feedback to each resident during a 15-minute private session. Total mean score for baseline observation standing at 20.58 was increased significantly to 28.75 after feedbacks. Results markedly improved on "gathering information" (T1=5.5, T6=8.33, P=0.001, "building relationship" (T1=1.5, T6=4.25, P<0.001 and "closing the session" (T1=0.75, T6=2.5, P=0.001 and it mildly dropped on "understanding patients view" (T1=3, T6=2.33, P=0.007 and "providing structure" (T1=4.17, T6=4.00, P=0.034. Changes in result of "initiating the session" and "explanation and planning" dimensions are not statically significant (P=0.159, P=0.415 respectively. Frequent feedback provided by faculty member can improve residents' communication skills. Feedback can affect communication skills educational programs, and it can be more effective if it is combined with other educational methods.

Effect of repetitive feedback on residents' communication skills improvement.

Science.gov (United States)

Labaf, Ali; Jamali, Kazem; Jalili, Mohammad; Baradaran, Hamid R; Eizadi, Parisa

2014-01-01

To evaluate the effect of frequent feedback on residents' communication skills as measured by a standardized checklist. Five medical students were recruited in order to assess twelve emergency medicine residents' communication skills during a one-year period. Students employed a modified checklist based on Calgary-Cambridge observation guide. The checklist was designed by faculty members of Tehran University of Medical Science, used for assessment of students' communication skills. 24 items from 71 items of observational guide were selected, considering study setting and objects. Every two months an expert faculty, based on descriptive results of observation, gave structured feedback to each resident during a 15-minute private session. Total mean score for baseline observation standing at 20.58 was increased significantly to 28.75 after feedbacks. Results markedly improved on "gathering information" (T1=5.5, T6=8.33, P=0.001), "building relationship" (T1=1.5, T6=4.25, P<0.001) and "closing the session" (T1=0.75, T6=2.5, P=0.001) and it mildly dropped on "understanding patients view" (T1=3, T6=2.33, P=0.007) and "providing structure" (T1=4.17, T6=4.00, P=0.034). Changes in result of "initiating the session" and "explanation and planning" dimensions are not statically significant (P=0.159, P=0.415 respectively). Frequent feedback provided by faculty member can improve residents' communication skills. Feedback can affect communication skills educational programs, and it can be more effective if it is combined with other educational methods.

Development of a PROficiency-Based StePwise Endovascular Curricular Training (PROSPECT) Program.

Science.gov (United States)

Maertens, Heidi; Aggarwal, Rajesh; Desender, Liesbeth; Vermassen, Frank; Van Herzeele, Isabelle

2016-01-01

Focus on patient safety, work-hour limitations, and cost-effective education is putting pressure to improve curricula to acquire minimally invasive techniques during surgical training. This study aimed to design a structured training program for endovascular skills and validate its assessment methods. A PROficiency-based StePwise Endovascular Curricular Training (PROSPECT) program was developed, consisting of e-learning and hands-on simulation modules, focusing on iliac and superficial femoral artery atherosclerotic disease. Construct validity was investigated. Performances were assessed using multiple-choice questionnaires, valid simulation parameters, global rating scorings, and examiner checklists. Feasibility was assessed by passage of 2 final-year medical students through this PROSPECT program. Ghent University Hospital, a tertiary clinical care and academic center in Belgium with general surgery residency program. Senior-year medical students were recruited at Ghent University Hospital. Vascular surgeons were invited to participate during conferences and meetings if they had performed at least 100 endovascular procedures as the primary operator during the last 2 years. Overall, 29 medical students and 20 vascular surgeons participated. Vascular surgeons obtained higher multiple-choice questionnaire scores (median: 24.5-22.0 vs. 15.0-12.0; p train cognitive, technical, and nontechnical endovascular skills was developed. A structured, stepwise, proficiency-based valid endovascular program to train cognitive, technical, and human factor skills has been developed and proven to be feasible. A randomized controlled trial has been initiated to investigate its effect on performances in real life, patient outcomes, and cost-effectiveness. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Improving residents' handovers through just-in-time training for structured communication.

Science.gov (United States)

Rourke, Liam; Amin, Aditi; Boyington, Curtiss; Ao, Peter; Frolova, Natalia

2016-01-01

In a recent quality assurance project we learned that nearly half of the handovers we examined were characterized as unsatisfactory by our residents, who provided examples in which their anxiety had been piqued and patient care had been affected. These reports substantiated a growing body of literature on the relationship between the quality of handover and the quality of patient care, so we sought to improve the quality and consistency of the in-hosptial handovers undertaken by our internal medicine residents. Senior residents attended morning report for three consecutive month long blocks and evaluated the quality of the handovers using an observational protocol comprised of 16 aspects of effective handover. During the first block, the resident observed a median of eight of the 16 practices occurring across the 46 handovers, and a large amount of variability. At the beginning of the subsequent block we presented a concise introduction to a structured handover procedure (SBARR). The median quality of the subsequent 33 handovers rose to 11, and the variability decreased considerably. In the next block we refined the SBARR orientation to focus on the errors observed in the previous blocks, and the improvement in the quality and variability was sustained. The minor change, which requires few resources to sustain, had a favourable impact on the quality of our residents' in-hospital handovers.

Evaluation of Mycology Laboratory Proficiency Testing

OpenAIRE

Reilly, Andrew A.; Salkin, Ira F.; McGinnis, Michael R.; Gromadzki, Sally; Pasarell, Lester; Kemna, Maggi; Higgins, Nancy; Salfinger, Max

1999-01-01

Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient te...

Quality Improvement in Otolaryngology Residency: Survey of Program Directors.

Science.gov (United States)

Bowe, Sarah N

2016-02-01

The Clinical Learning Environment Review focuses on the responsibility of the sponsoring institution for quality and patient safety. Very little information is known regarding the status of quality improvement (QI) education during otolaryngology training. The purpose of this survey is to evaluate the extent of resident and faculty participation in QI and identify opportunities for both resident curriculum and faculty development. Cross-sectional survey A 15-item survey was distributed to all 106 otolaryngology program directors. The survey was developed after an informal review of the literature regarding education in QI and patient safety. Questions were directed at the format and content of the QI curriculum, as well as barriers to implementation. There was a 39% response rate. Ninety percent of responding program directors considered education in QI important or very important to a resident's future success. Only 23% of responding programs contained an educational curriculum in QI, and only 33% monitored residents' individual outcome measures. Barriers to implementation of a QI program included inadequate number of faculty with expertise in QI (75%) and competing resident educational demands (90%). Every program director considered morbidity and mortality conferences as an integral component in QI education. Program directors recognize the importance of QI in otolaryngology practice. Unfortunately, this survey identifies a distinct lack of resources in support of these educational goals. The results highlight the need to generate a comprehensive and stepwise approach to QI for faculty development and resident instruction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Southeast Asian Languages Proficiency Examinations.

Science.gov (United States)

Brown, James Dean; And Others

The design, administration, revision, and validation of the Southeast Asian Summer Studies Institute proficiency examinations are reported. The examinations were created as parallel language proficiency tests in each of five languages: Indonesian, Khmer, Tagalog, Thai, and Vietnamese. Four tests were developed in each language: multiple-choice…

Clinical Wisdom among Proficient Nurses

DEFF Research Database (Denmark)

Uhrenfeldt, Lisbeth; Hall, Elisabeth

2007-01-01

This paperexamines clinical wisdom which has emerged from a broader study anout nurse managers´influence on proficient registered nurse turnover and retention. The purpose of the study was to increase understanding of proficient nurses´experience and clinical practice by giving voice to the nurses...

34 CFR 300.27 - Limited English proficient.

Science.gov (United States)

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Limited English proficient. 300.27 Section 300.27... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.27 Limited English proficient. Limited English proficient has the meaning given the term in section 9101(25) of the ESEA. (Authority: 20...

Emergency Medicine Residency Boot Camp Curriculum: A Pilot Study

Directory of Open Access Journals (Sweden)

Ataya, Ramsey

2015-03-01

Full Text Available Introduction: Establishing a boot camp curriculum is pertinent for emergency medicine (EM residents in order to develop proficiency in a large scope of procedures and leadership skills.  In this article, we describe our program’s EM boot camp curriculum as well as measure the confidence levels of resident physicians through a pre- and post-boot camp survey. Methods: We designed a one-month boot camp curriculum with the intention of improving the confidence, procedural performance, leadership, communication and resource management of EM interns. Our curriculum consisted of 12 hours of initial training and culminated in a two-day boot camp. The initial day consisted of clinical skill training and the second day included code drill scenarios followed by interprofessional debriefing.   Results: Twelve EM interns entered residency with an overall confidence score of 3.2 (1-5 scale across all surveyed skills. Interns reported the highest pre-survey confidence scores in suturing (4.3 and genitourinary exams (3.9. The lowest pre-survey confidence score was in thoracostomy (2.4. Following the capstone experience, overall confidence scores increased to 4.0. Confidence increased the most in defibrillation and thoracostomy. Additionally, all interns reported post-survey confidence scores of at least 3.0 in all skills, representing an internal anchor of “moderately confident/need guidance at times to perform procedure.” Conclusion: At the completion of the boot camp curriculum, EM interns had improvement in self-reported confidence across all surveyed skills and procedures. The described EM boot camp curriculum was effective, feasible and provided a foundation to our trainees during their first month of residency. [West J Emerg Med. 2015;16(2:356–361.

Unique Contributions of Maternal Reading Proficiency to Predicting Children's Preschool Receptive Vocabulary and Reading Proficiency

Science.gov (United States)

Phillips, Linda M.; Norris, Stephen P.; Hayward, Denyse V.; Lovell, Meridith A.

2017-01-01

This study investigated whether mothers' measured reading proficiency and their educational level predict, over and above each other, their children's receptive vocabulary and reading proficiency when confounding factors of speaking a minority language, ethnicity, number of children in the family, and marital and employment status are controlled.…

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.

Measuring receptive collocational competence across proficiency levels

Directory of Open Access Journals (Sweden)

Déogratias Nizonkiza

2015-12-01

Full Text Available The present study investigates, (i English as Foreign Language (EFL learners’ receptive collocational knowledge growth in relation to their linguistic proficiency level; (ii how much receptive collocational knowledge is acquired as proficiency develops; and (iii the extent to which receptive knowledge of collocations of EFL learners varies across word frequency bands. A proficiency measure and a collocation test were administered to English majors at the University of Burundi. Results of the study suggest that receptive collocational competence develops alongside EFL learners’ linguistic proficiency; which lends empirical support to Gyllstad (2007, 2009 and Author (2011 among others, who reported similar findings. Furthermore, EFL learners’ collocations growth seems to be quantifiable wherein both linguistic proficiency level and word frequency occupy a crucial role. While more gains in terms of collocations that EFL learners could potentially add as a result of change in proficiency are found at lower levels of proficiency; collocations of words from more frequent word bands seem to be mastered first, and more gains are found at more frequent word bands. These results confirm earlier findings on the non-linearity nature of vocabulary growth (cf. Meara 1996 and the fundamental role played by frequency in word knowledge for vocabulary in general (Nation 1983, 1990, Nation and Beglar 2007, which are extended here to collocations knowledge.

Organization of Proficiency Testing for Dairy Laboratories in Croatia, Bosnia and Herzegovina and Macedonia in Order to Improve Quality Assurance

Directory of Open Access Journals (Sweden)

Nataša Mikulec

2009-06-01

Full Text Available Participation in proficiency testing is not only an obligation for all analytical laboratories which tend to be credible, but also an opportunity to check how the results agree with the reference or assign value. The Reference Laboratory for Milk and Dairy Products of the Dairy Science Department, Faculty of Agriculture University of Zagreb, is itself incorporated in the proficiency testing organized by dairy laboratories from Germany, Italy, France, Switzerland and Slovenia. The aim is to find out its own accuracy and reliability in particular milk and dairy products analyses. On the basis of seven years experience of participating in proficiency testing, five years ago the Reference Laboratory started organizing its own proficiency testing for dairy laboratories in Croatia, Bosnia and Herzegovina and Macedonia for milk components such as milk fat, protein, lactose and somatic cells count. The results of the analyses have been statistically analyzed and, on the basis of Z-score, the successful measurements have been estimated. The aim of this paper is to demonstrate the organisation and data processing of proficiency testing for milk fat, protein, lactose and somatic cells count in milk for the involved dairy laboratories.

Using an Inpatient Quality Improvement Curriculum for Internal Medicine Residents to Improve Pneumococcal Conjugate Vaccine Administration Rates.

Science.gov (United States)

Jolin, Jonathan; van Aalst, Robertus; Volpp, Bryan; Taylor, Thomas; Cohen, Emily

2018-06-01

Pneumococcal infections are an important source of morbidity and mortality in older adults and persons with compromised immune systems. New recommendations from the Advisory Committee on Immunization Practices (ACIP) became available September 2014, which included recommendations for the use of the 13-valent pneumococcal conjugate vaccine (PCV13). A study was conducted to increase the PCV13 vaccination rates of hospitalized patients at the White River Junction Veterans Affairs Medical Center (White River Junction, Vermont) through the use of a resident-driven quality improvement (QI) project. From December 2014 through April 2016, 16 internal medicine inpatient residents addressed inpatient PCV13 vaccination rates by participating in the facility's QI curriculum. Eight Plan-Do-Study-Act cycles were used, including discharge template editing, electronic reminders, and the discovery of a vaccination administration documentation error in the record through data validation. The measure was the monthly percentage of patients who received PCV13 vaccination (vaccination completion rate) of those discharged from the hospital medicine service who were due for PCV13 vaccination. The percentage of veterans discharged with an up-to-date PCV13 vaccination on discharge increased from approximately 30% to 87% and was sustained. Despite being driven by many different residents, this project demonstrates that continuous improvement can be achieved through a structured and iterative process while providing active learning of core QI concepts to residents. It also displays a method in which new guidelines can be incorporated into practice in an effective manner. Finally, this project is an example of how resident-driven data validation can lead to further improvement. Published by Elsevier Inc.

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.

Interactive case-based learning improves resident knowledge and confidence in reproductive endocrinology and infertility.

Science.gov (United States)

Goldman, Kara N; Tiegs, Ashley W; Uquillas, Kristen; Nachtigall, Margaret; Fino, M Elizabeth; Winkel, Abigail F; Lerner, Veronica

2017-06-01

Resident physicians' scores on the REI section of the CREOG exam are traditionally low, and nearly 40% of house staff nation-wide perceive their REI knowledge to be poor. We aimed to assess whether an interactive case-based group-learning curriculum would narrow the REI knowledge gap by improving understanding and retention of core REI concepts under the time constraints affecting residents. A three-hour case-based workshop was developed to address four primary CREOG objectives. A multiple-choice test was administered immediately before and after the intervention and 7 weeks post-workshop, to evaluate both knowledge and confidence. Following the intervention, residents self-reported increased confidence with counseling and treatment of PCOS, ovulation induction cycle monitoring, counseling and treatment of POI, and breaking bad news related to infertility (p < 0.05). The multiple-choice exam was re-administered 7 weeks post-intervention, and scores remained significantly improved compared to pre-workshop scores (p < 0.05). At that time, all residents either strongly agreed (91.7%) or agreed (8.3%) that the case-based interactive format was preferable to traditional lecture-based teaching. In conclusion, a nontraditional curriculum aimed at teaching core REI concepts to residents through interactive case-based learning can be successfully integrated into a residency curriculum, and significantly improves knowledge and confidence of critical concepts in REI.

A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates.

Science.gov (United States)

Singh, Mamta K; Einstadter, Douglas; Lawrence, Renee

2010-10-01

Multiple resident-related factors contribute to 'missed opportunities' in providing comprehensive preventive care for female patients, including comfort level, knowledge and experience--all of which are compounded by resident turnover rates. Of particular concern among Internal Medicine (IM) residents is their knowledge and comfort level in performing pelvic exams. To evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening. The WPHC, a multidisciplinary weekly clinic, focused on preventive services for women with chronic conditions. The alternating didactic and clinic sessions emphasised women's preventive health topics for IM residents. Sixty-three IM residents participated in WPHC between 2002 and 2005. Pre- and post-test design was used to assess resident knowledge and comfort levels. Cervical cancer screening rates of residents' patients were assessed pre- and post-WPHC initiation. There was a significant improvement in general knowledge (64% correct at pretest vs 73% at post-test, p=0.0002), resident comfort level in discussing women's health topics and performing gynaecological exams (p<0.0002). Cervical cancer screening rates among IM residents' patients improved from 54% (pre-WPHC initiation) to 65% (post-WPHC initiation period). The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.

Knowledge Management and Organizational Proficiency with NPP

International Nuclear Information System (INIS)

Marler, M.

2016-01-01

Full text: The pace of new NPP construction, startup, and operation is straining the supply of proficient operators, technicians, and engineers. This technical brief explains an approach implemented by a US nuclear utility to capture and transfer knowledge possessed by proficient workers to new workers using the VISION learning content management system. This approach could also be used to accelerate worker proficiency in new NPP organizations. (author

The Rating of Direct and Semi-Direct Oral Proficiency Interviews: Comparing Performance at Lower Proficiency Levels.

Science.gov (United States)

Kenyon, Dorry M.; Tschirner, Erwin

2000-01-01

Reports on a study comparing student performances and test reliabilities for the German Speaking Test, a semi-direct tape-mediated oral proficiency test (GST) developed by the Center for Applied Linguistics, and the American Council on the Teaching of Foreign Languages Oral Proficiency Interviews. (Author/VWL)

Fine motor skill proficiency in typically developing children: On or off the maturation track?

Science.gov (United States)

Gaul, David; Issartel, Johann

2016-04-01

Fine motor skill proficiency is an essential component of numerous daily living activities such as dressing, feeding or playing. Poor fine motor skills can lead to difficulties in academic achievement, increased anxiety and poor self-esteem. Recent findings have shown that children's gross motor skill proficiency tends to fall below established developmental norms. A question remains: do fine motor skill proficiency levels also fall below developmental norms? The aim of this study was to examine the current level of fine motor skill in Irish children. Children (N=253) from 2nd, 4th and 6th grades (mean age=7.12, 9.11 and 11.02 respectively) completed the Fine Motor Composite of the Bruininks Oseretsky Test of Motor Proficiency 2nd Edition (BOT-2). Analysis revealed that only 2nd grade children met the expected level of fine motor skill proficiency. It was also found that despite children's raw scores improving with age, children's fine motor skill proficiency was not progressing at the expected rate given by normative data. This leads us to question the role and impact of modern society on fine motor skills development over the past number of decades. Copyright © 2015 Elsevier B.V. All rights reserved.

Developing Autonomous Learning for Oral Proficiency Using Digital Storytelling

Science.gov (United States)

Kim, SoHee

2014-01-01

Since online educational technology can support a ubiquitous language learning environment, there are many ways to develop English learners' autonomy through self-access learning. This study investigates whether English as a second language (ESL) learners can improve their oral proficiency through independent study by using online self-study…

Statistical analysis of nematode counts from interlaboratory proficiency tests

NARCIS (Netherlands)

Berg, van den W.; Hartsema, O.; Nijs, Den J.M.F.

2014-01-01

A series of proficiency tests on potato cyst nematode (PCN; n=29) and free-living stages of Meloidogyne and Pratylenchus (n=23) were investigated to determine the accuracy and precision of the nematode counts and to gain insights into possible trends and potential improvements. In each test, each

Language proficiency and nursing registration.

Science.gov (United States)

Müller, Amanda

2016-02-01

This discussion paper focuses on English proficiency standards for nursing registration in Australia, how Australia has dealt with the issue of language proficiency, and the factors which have led to the establishment of the current language standards. Also, this paper will provide a comparison of the two language tests that are currently accepted in Australia (OET and IELTS), including the appropriateness of these tests and the minimum standards used. The paper will also examine the use of educational background as an indicator of language proficiency. Finally, communication-based complaints in the post-registration environment will be explored, and some discussion will be provided about why pre-registration measures might have failed to prevent such problematic situations from occurring. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving prediction of fall risk among nursing home residents using electronic medical records.

Science.gov (United States)

Marier, Allison; Olsho, Lauren E W; Rhodes, William; Spector, William D

2016-03-01

Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls. The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data. In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification. Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Measuring receptive collocational competence across proficiency ...

African Journals Online (AJOL)

The present study investigates (i) English as Foreign Language (EFL) learners' receptive collocational knowledge growth in relation to their linguistic proficiency level; (ii) how much receptive collocational knowledge is acquired as linguistic proficiency develops; and (iii) the extent to which receptive knowledge of ...

Proficiency study for quinolones in egg

NARCIS (Netherlands)

Berendsen, B.J.A.; Stolker, A.A.M.

2008-01-01

The aim of this proficiency study was to give laboratories the possibility to evaluate or demonstrate their competence for the analysis of quinolones in egg. Furthermore the specificity of the applied methods is evaluated by including possibly interfering compounds in the proficiency study. This

Resident cross-cultural training, satisfaction, and preparedness.

Science.gov (United States)

Frintner, Mary Pat; Mendoza, Fernando S; Dreyer, Benard P; Cull, William L; Laraque, Danielle

2013-01-01

To describe the diversity of pediatric residents and examine relationships of cross-cultural training experiences with training satisfaction, perceived preparedness for providing culturally effective care, and attitudes surrounding care for underserved populations. A cross-sectional survey was conducted of a national random sample of graduating pediatric residents and an additional sample of minority residents. Using weighted analysis, we used multivariate regression to test for differences in satisfaction, preparedness, and attitudes between residents with more and less cross-cultural experiences during residency, controlling for residents' characteristics and experiences before training. The survey response rate was 57%. Eleven percent were Hispanic, 61% white, 21% Asian, 9% African American, 9% other racial/ethnic groups; 34% grew up in a bi- or multilingual family. Ninety-three percent of residents were satisfied with their residency training, 81% with the instruction they received on health and health care disparities, and 54% on global health issues. Ninety-six percent of residents felt they were prepared to care for patients from diverse backgrounds, but fewer felt prepared to care for families with beliefs at odds with Western medicine (49%) and families who receive alternative or complementary care (37%). Residents with more cross-cultural experiences during residency reported being better prepared than those with less experience to care for families with limited English proficiency (adjusted odds ratio [aOR] 2.11; 95% confidence interval [CI] 1.40-3.17), new immigrants (aOR 1.91; 95% CI 1.32-2.75), and with religious beliefs that might affect clinical care (aOR 1.62; 95% CI 1.13-2.32). Pediatric residents begin their training with diverse cross-cultural backgrounds and experiences. Residency experiences in cross-cultural care contribute to feelings of preparedness to care for diverse US children. Copyright © 2013 Academic Pediatric Association. Published

The relationship between fundamental movement skill proficiency and physical self-confidence among adolescents.

Science.gov (United States)

McGrane, Bronagh; Belton, Sarahjane; Powell, Danielle; Issartel, Johann

2017-09-01

This study aims to assess fundamental movement skill (FMS) proficiency, physical self-confidence levels, and the relationship between these variables and gender differences among adolescents. Three hundred and ninety five adolescents aged 13.78 years (SD = ±1.2) from 20 schools were involved in this study. The Test of Gross Motor Development-2nd Edition (TGMD), TGMD-2 and Victorian Skills Manual were used to assess 15 FMS. Participants' physical self-confidence was also assessed using a valid skill-specific scale. A significant correlation was observed between FMS proficiency and physical self-confidence for females only (r = 0.305, P < 0.001). Males rated themselves as having significantly higher physical self-confidence levels than females (P = 0.001). Males scored significantly higher than females in FMS proficiency (P < 0.05), and the lowest physical self-confidence group were significantly less proficient at FMS than the medium (P < 0.001) and high physical self-confidence groups (P < 0.05). This information not only highlights those in need of assistance to develop their FMS but will also facilitate in the development of an intervention which aims to improve physical self-confidence and FMS proficiency.

Discrepancies between perceptions of English proficiency and ...

African Journals Online (AJOL)

multilingual awareness pedagogy” embedded in Dörnyei's (2009) L2 Motivational Self System theory. Key words: self-reported perceptions, language proficiency, English proficiency, multilingualism, pedagogy, resilience, L2 Motivational Self System ...

Language proficiency: Current strategies, future remedies ...

African Journals Online (AJOL)

Language proficiency among young South Africans is low. This is true not only of mother tongue speakers of English and Afrikaans, but also, and especially, of non-mother tongue speakers of English, among whom language proficiency levels raise serious concern. Some examples are given to illustrate the importance of ...

Singing proficiency in the majority: normality and "phenotypes" of poor singing.

Science.gov (United States)

Dalla Bella, Simone; Berkowska, Magdalena

2009-07-01

Recent evidence indicates that the majority of occasional singers can carry a tune. For example, when asked to sing a well-known song (e.g., "Happy Birthday"), nonmusicians performing at a slow tempo are as proficient as professional singers. Yet, some occasional singers are poor singers, mostly in the pitch domain, and sometimes despite not having impoverished perception. Poor singing is not a monolithic deficit, but is likely to be characterized by a diversity of singing "phenotypes." Here we systematically examined singing proficiency in a group of occasional singers, with the goal of characterizing the different patterns of poor singing. Participants sang three well-known melodies (e.g., "Jingle Bells") at a natural tempo and at a slow tempo, as indicated by a metronome. For each rendition, we computed objective measures of pitch and time accuracy with an acoustical method. The results confirmed previous observations that the majority of occasional singers can sing in tune and in time. Moreover, singing at a slow tempo after the target melody to be imitated was presented with a metronome improved pitch and time accuracy. In general, poor singers were mostly impaired on the pitch dimension, although various patterns of impairment emerged. Pitch accuracy or time accuracy could be selectively impaired; moreover, absolute measures of singing proficiency (pitch or tempo transposition) dissociated from relative measures of proficiency (pitch intervals, relative duration). These patterns of dissociations point to a multicomponent system underlying proficient singing that fractionates as a result of a developmental anomaly.

ECG interpretation in Emergency Department residents: an update and e-learning as a resource to improve skills.

Science.gov (United States)

Barthelemy, Francois X; Segard, Julien; Fradin, Philippe; Hourdin, Nicolas; Batard, Eric; Pottier, Pierre; Potel, Gilles; Montassier, Emmanuel

2017-04-01

ECG interpretation is a pivotal skill to acquire during residency, especially for Emergency Department (ED) residents. Previous studies reported that ECG interpretation competency among residents was rather low. However, the optimal resource to improve ECG interpretation skills remains unclear. The aim of our study was to compare two teaching modalities to improve the ECG interpretation skills of ED residents: e-learning and lecture-based courses. The participants were first-year and second-year ED residents, assigned randomly to the two groups. The ED residents were evaluated by means of a precourse test at the beginning of the study and a postcourse test after the e-learning and lecture-based courses. These evaluations consisted of the interpretation of 10 different ECGs. We included 39 ED residents from four different hospitals. The precourse test showed that the overall average score of ECG interpretation was 40%. Nineteen participants were then assigned to the e-learning course and 20 to the lecture-based course. Globally, there was a significant improvement in ECG interpretation skills (accuracy score=55%, P=0.0002). However, this difference was not significant between the two groups (P=0.14). Our findings showed that the ECG interpretation was not optimal and that our e-learning program may be an effective tool for enhancing ECG interpretation skills among ED residents. A large European study should be carried out to evaluate ECG interpretation skills among ED residents before the implementation of ECG learning, including e-learning strategies, during ED residency.

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

Proficiency Testing for Determination of Water Content in Toluene of Chemical Reagents by iteration robust statistic technique

Science.gov (United States)

Wang, Hao; Wang, Qunwei; He, Ming

2018-05-01

In order to investigate and improve the level of detection technology of water content in liquid chemical reagents of domestic laboratories, proficiency testing provider PT0031 (CNAS) has organized proficiency testing program of water content in toluene, 48 laboratories from 18 provinces/cities/municipals took part in the PT. This paper introduces the implementation process of proficiency testing for determination of water content in toluene, including sample preparation, homogeneity and stability test, the results of statistics of iteration robust statistic technique and analysis, summarized and analyzed those of the different test standards which are widely used in the laboratories, put forward the technological suggestions for the improvement of the test quality of water content. Satisfactory results were obtained by 43 laboratories, amounting to 89.6% of the total participating laboratories.

A retrospective evaluation of proficiency testing, and rapid HIV test ...

African Journals Online (AJOL)

Background: Proficiency testing (PT) has been implemented as a form of External Quality Assurance (EQA) by the National HIV Reference Laboratory in Kenya since 2007 in order to monitor and improve on the quality of HIV testing and counselling HTC services. Objective: To compare concordance between National HIV ...

Building bridges : engaging medical residents in quality improvement and medical leadership

NARCIS (Netherlands)

Voogt, Judith J; van Rensen, Elizabeth L J; van der Schaaf, Marieke F; Noordegraaf, Mirko; Schneider, Margriet Me

2017-01-01

OBJECTIVE: To develop an educational intervention that targets residents' beliefs and attitudes to quality Improvement (QI) and leadership in order to demonstrate proactive behaviour. DESIGN: Theory-driven, mixed methods study including document analysis, interviews, observations and open-ended

A virtual reality endoscopic simulator augments general surgery resident cancer education as measured by performance improvement.

Science.gov (United States)

White, Ian; Buchberg, Brian; Tsikitis, V Liana; Herzig, Daniel O; Vetto, John T; Lu, Kim C

2014-06-01

Colorectal cancer is the second most common cause of death in the USA. The need for screening colonoscopies, and thus adequately trained endoscopists, particularly in rural areas, is on the rise. Recent increases in required endoscopic cases for surgical resident graduation by the Surgery Residency Review Committee (RRC) further emphasize the need for more effective endoscopic training during residency to determine if a virtual reality colonoscopy simulator enhances surgical resident endoscopic education by detecting improvement in colonoscopy skills before and after 6 weeks of formal clinical endoscopic training. We conducted a retrospective review of prospectively collected surgery resident data on an endoscopy simulator. Residents performed four different clinical scenarios on the endoscopic simulator before and after a 6-week endoscopic training course. Data were collected over a 5-year period from 94 different residents performing a total of 795 colonoscopic simulation scenarios. Main outcome measures included time to cecal intubation, "red out" time, and severity of simulated patient discomfort (mild, moderate, severe, extreme) during colonoscopy scenarios. Average time to intubation of the cecum was 6.8 min for those residents who had not undergone endoscopic training versus 4.4 min for those who had undergone endoscopic training (p Virtual reality endoscopic simulation is an effective tool for both augmenting surgical resident endoscopy cancer education and measuring improvement in resident performance after formal clinical endoscopic training.

Electrocardiographic interpretation skills of cardiology residents: are they competent?

Science.gov (United States)

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.

Role of WhatsApp-based discussions in improving residents' knowledge of post-operative pain management: a pilot study.

Science.gov (United States)

Bakshi, Sumitra G; Bhawalkar, Pranay

2017-10-01

To provide a platform for the dissemination of basic knowledge of pain management, a WhatsApp group was created by residents and consultants. Common clinical scenarios, resident queries, and important instructions to be followed by residents with respect to running the Acute Pain Service were discussed in the group. This study evaluates the benefits of this interaction. This study was approved by the hospital ethics board and was registered with the Clinical Trial Registry of India. Second- and third-year anesthesia residents were included in a WhatsApp group, along with consultants (board certified anesthesiologists with a special interest in pain). Pain knowledge assessment was performed pre- and post-discussion using a standard 22-point questionnaire. A feedback form, which included self-rated confidence scores (1-10, 10-most confident) and opinions about the 3-month WhatsApp discussion, was collected. Improvements in the documentation in clinical sheets post-discussion were also analyzed. A total of 38 residents were included in the WhatsApp group. An improvement in the percentage of correct answers from 69.1% (pre-discussion) to 73.6% (post-discussion) was observed (P = 0.031). Improvements in the self-rated residents' confidence levels were also noted (P WhatsApp-based discussion was useful. Documentation of the details of epidural blockade in clinical sheets improved from 30% to 100%. The WhatsApp discussion improved residents' knowledge and confidence levels, and also resulted in improved documentation of essential details in the clinical notes. This form of education is promising and should be explored in future studies.

The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.

Science.gov (United States)

Kalanithi, Lucy; Coffey, Charles E; Mourad, Michelle; Vidyarthi, Arpana R; Hollander, Harry; Ranji, Sumant R

2013-01-01

This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.

Tactical proficiency among table tennis players with and without intellectual disabilities.

Science.gov (United States)

Van Biesen, Debbie; Mactavish, Jennifer; Vanlandewijck, Yves

2014-01-01

The effect of intellectual impairment on sports performance has received limited attention by researchers. As a contribution to closing this gap, the purpose of the present investigation was to examine the differences in tactical proficiency between table tennis players with and without intellectual disabilities (ID). These groups were matched for training-volume and experience and consisted of 41 male (age = 27±8) and 30 female (age= 28±8) elite players with ID and a reference group of 12 male (age= 24±12) and 5 female (age= 20±9) players without ID. In two different test settings - one a World Championship and the other a training camp - the players in each group performed 60 semi-standardised rallies against the same opponent. Players were told that 12 sets of five identical services would be delivered, and their goal was to return the service with the intention of 'winning the point'. The test results were validated for this study, to compute tactical proficiency scores (maximal score of eight points) for each player. A two-way Analysis of Variance (ANOVA) revealed significantly lower proficiency scores for players with ID than for those without ID. Repeated-measures ANOVA revealed that within each series of five rallies, starting with identical services, all participants were able to significantly improve their tactical proficiency gradually, but players without ID scored 4.3±0.5 from the first ball on, and while athletes with ID only 3.3±0.7 after five balls. The results of this study indicate that ID is associated with decreased tactical proficiency in table tennis.

Improvement of Skills in Cardiopulmonary Resuscitation of Pediatric Residents by Recorded Video Feedbacks.

Science.gov (United States)

Anantasit, Nattachai; Vaewpanich, Jarin; Kuptanon, Teeradej; Kamalaporn, Haruitai; Khositseth, Anant

2016-11-01

To evaluate the pediatric residents' cardiopulmonary resuscitation (CPR) skills, and their improvements after recorded video feedbacks. Pediatric residents from a university hospital were enrolled. The authors surveyed the level of pediatric resuscitation skill confidence by a questionnaire. Eight psychomotor skills were evaluated individually, including airway, bag-mask ventilation, pulse check, prompt starting and technique of chest compression, high quality CPR, tracheal intubation, intraosseous, and defibrillation. The mock code skills were also evaluated as a team using a high-fidelity mannequin simulator. All the participants attended a concise Pediatric Advanced Life Support (PALS) lecture, and received video-recorded feedback for one hour. They were re-evaluated 6 wk later in the same manner. Thirty-eight residents were enrolled. All the participants had a moderate to high level of confidence in their CPR skills. Over 50 % of participants had passed psychomotor skills, except the bag-mask ventilation and intraosseous skills. There was poor correlation between their confidence and passing the psychomotor skills test. After course feedback, the percentage of high quality CPR skill in the second course test was significantly improved (46 % to 92 %, p = 0.008). The pediatric resuscitation course should still remain in the pediatric resident curriculum and should be re-evaluated frequently. Video-recorded feedback on the pitfalls during individual CPR skills and mock code case scenarios could improve short-term psychomotor CPR skills and lead to higher quality CPR performance.

What Is Lexical Proficiency? Some Answers from Computational Models of Speech Data

Science.gov (United States)

Crossley, Scott A.; Salsbury, Tom; McNamara, Danielle S.; Jarvis, Scott

2011-01-01

Lexical proficiency, as a cognitive construct, is poorly understood. However, lexical proficiency is an important element of language proficiency and fluency, especially for second language (L2) learners. Lexical proficiency is also an important attribute of L2 academic achievement. Generally speaking, lexical proficiency comprises breadth of…

Proficiency test for aflatoxin in pig feed

NARCIS (Netherlands)

Elbers, I.J.W.; Nijs, de W.C.M.

2015-01-01

Proficiency testing is conducted to provide laboratories with a powerful tool to evaluate and demonstrate the reliability of the data that are produced. Next to validation and accreditation, proficiency testing is an important requirement of the EU Additional Measures Directive 93/99/EEC [1] and is

Proficiency test for allergens in food 2014

NARCIS (Netherlands)

Bremer, M.G.E.G.; Alamenou, P.; Elbers, I.J.W.

2015-01-01

In the autumn of 2014 a proficiency test for allergens in baby cereal was organized by RIKILT, Wageningen UR. This PT-test enabled laboratories to evaluate their competence for the analysis of allergens in baby cereal. Both quantitative and qualitative methods were accepted. The proficiency test was

Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

Science.gov (United States)

Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

2016-10-01

Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

Influence of English proficiency on patient-provider communication and shared decision-making.

Science.gov (United States)

Paredes, Anghela Z; Idrees, Jay J; Beal, Eliza W; Chen, Qinyu; Cerier, Emily; Okunrintemi, Victor; Olsen, Griffin; Sun, Steven; Cloyd, Jordan M; Pawlik, Timothy M

2018-06-01

The number of patients in the United States (US) who speak a language other than English is increasing. We evaluated the impact of English proficiency on self-reported patient-provider communication and shared decision-making. The 2013-2014 Medical Expenditure Panel Survey database was utilized to identify respondents who spoke a language other than English. Patient-provider communication (PPC) and shared decision-making (SDM) scores from 4-12 were categorized as "poor" (4-7), "average" (8-11), and "optimal." The relationship between PPC, SDM, and English proficiency was analyzed. Among 13,880 respondents, most were white (n = 10,281, 75%), age 18-39 (n = 6,677, 48%), male (n = 7,275, 52%), middle income (n = 4,125, 30%), and born outside of the US (n = 9,125, 65%). English proficiency was rated as "very well" (n = 7,221, 52%), "well" (n = 2,378, 17%), "not well" (n = 2,820, 20%), or "not at all" (n = 1,463, 10%). On multivariable analysis, patients who rated their English as "well" (OR 1.73, 95% CI 1.37-2.18) or "not well" (OR 1.53, 95% CI 1.10-2.14) were more likely to report "poor" PPC (both P English proficiency as "not well" (OR 1.31, 95% CI 1.04-1.65, P = .02). Decreased English proficiency was associated with worse self-reported patient-provider communication and shared decision-making. Attention to patients' language needs is critical to patient satisfaction and improved perception of care. Copyright © 2018 Elsevier Inc. All rights reserved.

A novel online didactic curriculum helps improve knowledge acquisition among non-emergency medicine rotating residents.

Science.gov (United States)

Branzetti, Jeremy B; Aldeen, Amer Z; Foster, Andrew W; Courtney, D Mark

2011-01-01

Rotating residents represent a significant proportion of housestaff in academic emergency departments (EDs), yet they rarely receive targeted didactic education during their emergency medicine (EM) rotations. The goals of this study were: 1) to determine the effectiveness of an online didactic curriculum in improving EM knowledge among rotating residents and 2) to assess rotating resident satisfaction with this curriculum. The authors created an online lecture series of six EM subject areas targeted to rotating residents called the Northwestern University Rotating Resident Curriculum (NURRC). All rotating residents at the study site were eligible, written consent was obtained, and the study was approved by the institutional review board. Consenting participants were pretested with a 42-question multiple-choice examination and then randomized to two groups: one with access to the NURRC during the first 2 weeks of the rotation (experimental) and one without (control). Halfway through the rotation, all participants were post-tested with a different multiple-choice examination, and the controls were then granted NURRC access. The primary outcome was the difference between pretest and posttest scores (score delta). The t-test was used to compare mean scores, and a linear regression model was used to determine the association of NURRC access on score delta after adjustment for pretest type and resident type. A postintervention survey was administered at the end of the rotation to assess satisfaction with the NURRC and collect suggestions for improvement. Fifty-four rotating residents were enrolled: 29 in the experimental group and 25 in the control group. There was no significant difference in pretest scores between the two groups. Mean score delta was 17.3% in the experimental group and 1.6% in the control group, an absolute difference of 15.7% (95% confidence interval [CI]=10% to 22%). After adjustment for resident type and pretest type, the only variable positively

Improving the quality of life of aged care residents through the joy of food: The Lantern Project.

Science.gov (United States)

Hugo, Cherie; Dwonczyk, Marcia; Skinner, Jan; Isenring, Liz

2018-03-23

Mealtimes directly impact the quality of life of residents in aged care. The objective of The Lantern Project is to improve the dining experience of aged care residents to reduce malnutrition risk through improving dietary intake, meal. A transdisciplinary team of aged care professionals and resident advocates was formed as a collaboration collectively known as The Lantern Project. This paper outlines the journey and timeline of The Lantern Project collaboration since its inception and the interplay between the monthly stakeholder meetings and inter-related research projects demonstrating improved outcomes. Transdisciplinary collaboration offers well-grounded benefits and realistic strategies sensitive to the complexity of the aged care setting. © 2018 AJA Inc.

The Effectiveness of Diagnostic Assessment on the Development of Turkish Language Learners’ Narrative Skills as an Oral Proficiency Interview (OPI Task

Directory of Open Access Journals (Sweden)

Anjel Tozcu

2016-07-01

Full Text Available This study investigated the effectiveness of diagnostic assessment on improving students’ proficiency in narrating past events, an Oral Proficiency Interview (OPI Level 2 task. It found that students who were given a personalized learning plan subsequent to the diagnostic assessment interview significantly improved their proficiency in basic sentence structures than those in a control group. They used a significantly larger number of cohesive devices as compared to the control group and exhibited significantly increased accuracy in using cohesive devices than a control group. The students in the treatment group worked on the recommended activities based on the data gathered during the diagnostic assessment interview and the pre-interview questionnaires, i.e., the E & L, MBTI, and Barsch. The students in the control group spent the same amount of time reading narrations, doing comprehension exercise,s and following standard teacher feedback for improvement. Although both groups showed increases in accurate use of cohesive devices and proficiency in basic sentence structures, the treatment students showed significantly greater gains than the control students.

Proficiency and sentence constraint effects on second language word learning.

Science.gov (United States)

Ma, Tengfei; Chen, Baoguo; Lu, Chunming; Dunlap, Susan

2015-07-01

This paper presents an experiment that investigated the effects of L2 proficiency and sentence constraint on semantic processing of unknown L2 words (pseudowords). All participants were Chinese native speakers who learned English as a second language. In the experiment, we used a whole sentence presentation paradigm with a delayed semantic relatedness judgment task. Both higher and lower-proficiency L2 learners could make use of the high-constraint sentence context to judge the meaning of novel pseudowords, and higher-proficiency L2 learners outperformed lower-proficiency L2 learners in all conditions. These results demonstrate that both L2 proficiency and sentence constraint affect subsequent word learning among second language learners. We extended L2 word learning into a sentence context, replicated the sentence constraint effects previously found among native speakers, and found proficiency effects in L2 word learning. Copyright © 2015 Elsevier B.V. All rights reserved.

The modulatory role of second language proficiency on performance monitoring: evidence from a saccadic countermanding task in high and low proficient bilinguals.

Science.gov (United States)

Singh, Niharika; Mishra, Ramesh K

2014-01-01

We compared Hindi-English bilinguals differing in their L2 proficiency on a saccadic countermanding task which taps inhibitory control as well as monitoring. We particularly explored whether response inhibition and performance monitoring within the oculomotor domain are affected by language proficiency in bilinguals. There were two different oculomotor redirect tasks: Visually Guided Redirect (VGR) task (Experiment1) and Memory Guided Redirect (MGR) task (Experiment 2). In the redirect task, typically a target is presented and the subject is required to make a saccade (no-step trials), unless a new target appears on a different location after some delay from the first target onset (step trials). On such trials participants are required to inhibit and cancel the saccade to the first target and programme a saccade to the new target. Using trial switch reaction time (TSRT), the time taken to inhibit the initiated saccade to the first target as a measure of response inhibition and post-step slowing as a measure of performance monitoring. The results showed the high proficient bilinguals displayed more post-step slowing on the no-step trials as compared to the low proficient bilinguals for both VGR and MGR versions of the task. Secondly, both the high and low proficient bilinguals exhibited comparable TSRT in both VGR and MGR task, showing no modulatory effects of language proficiency on the response inhibition. These results suggest that language proficiency may have an effect on performance monitoring, but not the inhibitory control per se. Thus, we infer that higher proficiency may lead to superior cognitive flexibility and an ability to adjust behavior that facilitates the attainment of the cognitive goal. These findings are in consonance with other current studies that suggest a top-down effect of bilingualism on action control systems.

[Improve, but measure in moderation; quality management in specialty residency training].

Science.gov (United States)

Ter Braak, E W M T

2017-01-01

Intuitively, we believe we gain knowledge through taking measurements, and our appetite for quality measurement in general has grown spectacularly. However, this approach has to be qualified. Many aspects of quality are difficult to measure, yet are very important, and choosing what to measure may be heavily influenced by the availability bias of instruments. Moreover, a lot can be known without actually measuring. Quantitative results tend to offer false reassurance simply by their abundance, and results presented by means of Likert scales may obscure the crucial critique of a minority of respondents. Narrative comments in surveys are often much more meaningful as they can foster an open dialogue between residents and their clinical teachers, preferably led by a neutral chairperson. Contrary to what is often claimed, it is even possible to engage in improvement without prior measurement. I propose measuring only in moderation and instead devoting time and money to patient care and educating residents, and on the design and execution of improvement plans.

Improving Communication Skills: A Course for Academic Medical Center Surgery Residents and Faculty.

Science.gov (United States)

Raper, Steven E; Gupta, Meera; Okusanya, Olugbenga; Morris, Jon B

2015-01-01

To improve physician/patient communication and familiarize surgeons with contemporary skills for and metrics assessing communication, courses were developed to provide academic general surgery residents and faculty with a toolkit of information, behaviors, and specific techniques. If academic faculty are expected to mentor residents in communication and residents are expected to learn good communication skills, then both should have the necessary education to accomplish such a goal. Didactic lectures introduced current concepts of physician-patient communication including information on better patient care, fewer malpractice suits, and the move toward transparency of communication metrics. Next, course participants viewed and critiqued "Surgi-Drama" videos, with actors simulating "before" and "after" physician-patient communication scenarios. Finally, participants were provided with a "toolkit" of techniques for improving physician-patient communication including "2-3-4"-a semiscripted short communication tool residents and other physicians can use in patient encounters-and a number of other acronymic approaches. Each participant was asked to complete an anonymous evaluation to assess course content satisfaction. Overall, 86% of residents participated (68/79), with a 52% response rate (35/68) for the evaluation tool. Overall, 88% of faculty participated (84/96), with an 84% response rate (71/84). Residents voiced satisfaction with all domains. For faculty, satisfaction was quantitatively confirmed (Likert score 4 or 5) in 4 of 7 domains, with the highest satisfaction in "communication of goals" and "understanding of the HCAHPS metric." The percentage of "top box" Doctor Communication Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and national percentile ranking showed a sustained increase more than 1 and 2 years from the dates of the courses. The assessment of communication skills is increasing in importance in the practice of

Proverb Comprehension as a Function of Reading Proficiency in Preadolescents.

Science.gov (United States)

Nippold, Marilyn A.; Allen, Melissa M.; Kirsch, Dixon I.

2001-01-01

Proverb comprehension through reading was examined in 42 preadolescent students, 24 of whom were identified as "proficient readers," and 18 as "less proficient readers." Comprehension on both unfamiliar concrete and abstract proverbs was associated with reading proficiency, word knowledge, and analogical reasoning. (Contains references.)…

Does teaching crisis resource management skills improve resuscitation performance in pediatric residents?*.

Science.gov (United States)

Blackwood, Jaime; Duff, Jonathan P; Nettel-Aguirre, Alberto; Djogovic, Dennis; Joynt, Chloe

2014-05-01

The effect of teaching crisis resource management skills on the resuscitation performance of pediatric residents is unknown. The primary objective of this pilot study was to determine if teaching crisis resource management to residents leads to improved clinical and crisis resource management performance in simulated pediatric resuscitation scenarios. A prospective, randomized control pilot study. Simulation facility at tertiary pediatric hospital. Junior pediatric residents. Junior pediatric residents were randomized to 1 hour of crisis resource management instruction or no additional training. Time to predetermined resuscitation tasks was noted in simulated resuscitation scenarios immediately after intervention and again 3 months post intervention. Crisis resource management skills were evaluated using the Ottawa Global Rating Scale. Fifteen junior residents participated in the study, of which seven in the intervention group. The intervention crisis resource management group placed monitor leads 24.6 seconds earlier (p = 0.02), placed an IV 47.1 seconds sooner (p = 0.04), called for help 50.4 seconds faster (p = 0.03), and checked for a pulse after noticing a rhythm change 84.9 seconds quicker (p = 0.01). There was no statistically significant difference in time to initiation of cardiopulmonary resuscitation (p = 0.264). The intervention group had overall crisis resource management performance scores 1.15 points higher (Ottawa Global Rating Scale [out of 7]) (p = 0.02). Three months later, these differences between the groups persisted. A 1-hour crisis resource management teaching session improved time to critical initial steps of pediatric resuscitation and crisis resource management performance as measured by the Ottawa Global Rating Scale. The control group did not develop these crisis resource management skills over 3 months of standard training indicating that obtaining these skills requires specific education. Larger studies of crisis resource education are

A Contextualized Approach to Describing Oral Proficiency.

Science.gov (United States)

Chalhoub-Deville, Micheline

1995-01-01

Studies learners' second-language (L2) oral proficiency, incorporating an interview, a narration, and a read-aloud. Results show that the nature of the L2 oral construct is not constant. The article concludes that proficiency researchers should use dimensions empirically derived according to the specific elicitation task and audience. (53…

Language Learning Strategy Use across Proficiency Levels

Science.gov (United States)

Zarei, Abbas, Ali; Baharestani, Nooshin

2014-01-01

To investigate the use of language learning strategies (LLS) by Iranian EFL learners across proficiency levels, a total of 180 Iranian adult female EFL learners were selected and divided into three different proficiency level groups. To collect data, Oxford's (1990) Strategy Inventory for Language Learning (SILL) was used. One-way ANOVA procedures…

Beyond English Proficiency: Rethinking Immigrant Integration

Science.gov (United States)

Akresh, Ilana Redstone; Massey, Douglas S.; Frank, Reanne

2014-01-01

We develop and test a conceptual model of English language acquisition and the strength of the latter in predicting social and cultural assimilation. We present evidence that the path to English proficiency begins with exposure to English in the home country and on prior U.S. trips. English proficiency, then, has direct links to the intermediate migration outcomes of occupational status in the U.S., the amount of time in the U.S. since the most recent trip, and the co-ethnic residential context in the U.S. In turn, pre-migration characteristics and the intermediate characteristics work in tandem with English proficiency to determine social assimilation in the U.S., while cultural assimilation is primarily determined by pre-migration habits. A shift in focus to English use is desirable in studies of immigrant integration. PMID:24576636

Making Residents Part of the Safety Culture: Improving Error Reporting and Reducing Harms.

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Fox, Michael D; Bump, Gregory M; Butler, Gabriella A; Chen, Ling-Wan; Buchert, Andrew R

2017-01-30

Reporting medical errors is a focus of the patient safety movement. As frontline physicians, residents are optimally positioned to recognize errors and flaws in systems of care. Previous work highlights the difficulty of engaging residents in identification and/or reduction of medical errors and in integrating these trainees into their institutions' cultures of safety. The authors describe the implementation of a longitudinal, discipline-based, multifaceted curriculum to enhance the reporting of errors by pediatric residents at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center. The key elements of this curriculum included providing the necessary education to identify medical errors with an emphasis on systems-based causes, modeling of error reporting by faculty, and integrating error reporting and discussion into the residents' daily activities. The authors tracked monthly error reporting rates by residents and other health care professionals, in addition to serious harm event rates at the institution. The interventions resulted in significant increases in error reports filed by residents, from 3.6 to 37.8 per month over 4 years (P error reporting correlated with a decline in serious harm events, from 15.0 to 8.1 per month over 4 years (P = 0.01). Integrating patient safety into the everyday resident responsibilities encourages frequent reporting and discussion of medical errors and leads to improvements in patient care. Multiple simultaneous interventions are essential to making residents part of the safety culture of their training hospitals.

A Validation Study of the Student Oral Proficiency Assessment (SOPA).

Science.gov (United States)

Thompson, Lynn E.; Kenyon, Dorry M.; Rhodes, Nancy C.

This study validated the Student Oral Proficiency Assessment (SOPA), an oral proficiency instrument designed for students in elementary foreign language programs. Elementary students who were tested with the SOPA were also administered other instruments designed to measure proficiency. These instruments included the Stanford Foreign Language Oral…

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

Improving resident engagement in quality improvement and patient safety initiatives at the bedside: the Advocate for Clinical Education (ACE).

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Schleyer, Anneliese M; Best, Jennifer A; McIntyre, Lisa K; Ehrmantraut, Ross; Calver, Patty; Goss, J Richard

2013-01-01

Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment. In a pilot, the ACE observed 2862 physician-patient interactions and 178 physicians. Self-reported compliance often was greater than the behaviors observed. Following ACE implementation, observed professionalism behaviors trended toward improvement; infection control also improved. Physicians were highly satisfied with the program. The ACE initiative is one coaching/feedback model for engaging residents in QI/PS that may warrant further study.

Proficiency in Motivational Interviewing among Nurses in Child Health Services Following Workshop and Supervision with Systematic Feedback.

Directory of Open Access Journals (Sweden)

Johanna Enö Persson

Full Text Available Research on training in motivational interviewing (MI has shown eroding skills after workshops not followed by additional training input (supervision/coaching. There is a need for more research evaluating different types and lengths of post-workshop training with follow-up periods extending six months. This study is an extension of a previous evaluation of the level of proficiency in MI after workshop and four sessions of supervision among nurses in Swedish child health services.To explore the level of MI proficiency among nurses participating in an intervention to prevent childhood obesity (n = 33, after receiving five additional sessions of supervision including feedback on observed practice, as well as level of proficiency at follow-up.Level of proficiency was measured 4 and 12 months after completed supervision using recorded practice samples coded according to the Motivational Interviewing Treatment Integrity (MITI Code. Potential predictors of outcome were investigated.Proficiency remained on the same levels after nine sessions of supervision as after four sessions, and was generally low. The percentage of nurses reaching the proficiency level ranged from 18.2 to 54.5% across indicators. MI-spirit had increased significantly at follow-up, and the rest of the indicators remained on the same levels. No predictors of outcome were found.Comprehensive training programs with prolonged post-workshop supervision and feedback on observed practice may help to sustain but not improve participants' proficiency in MI. Potential explanations to the results and suggestions for future research are discussed.

Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare.

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Williams, Nathaniel J; Glisson, Charles

2013-11-01

High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures. The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2,346 youth aged 1.5- to 18-years-old and 1,544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18 month follow-up. The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency. To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.

Does a peer model's task proficiency influence children's solution choice and innovation?

Science.gov (United States)

Wood, Lara A; Kendal, Rachel L; Flynn, Emma G

2015-11-01

The current study investigated whether 4- to 6-year-old children's task solution choice was influenced by the past proficiency of familiar peer models and the children's personal prior task experience. Peer past proficiency was established through behavioral assessments of interactions with novel tasks alongside peer and teacher predictions of each child's proficiency. Based on these assessments, one peer model with high past proficiency and one age-, sex-, dominance-, and popularity-matched peer model with lower past proficiency were trained to remove a capsule using alternative solutions from a three-solution artificial fruit task. Video demonstrations of the models were shown to children after they had either a personal successful interaction or no interaction with the task. In general, there was not a strong bias toward the high past-proficiency model, perhaps due to a motivation to acquire multiple methods and the salience of other transmission biases. However, there was some evidence of a model-based past-proficiency bias; when the high past-proficiency peer matched the participants' original solution, there was increased use of that solution, whereas if the high past-proficiency peer demonstrated an alternative solution, there was increased use of the alternative social solution and novel solutions. Thus, model proficiency influenced innovation. Copyright © 2015 Elsevier Inc. All rights reserved.

Internal Medicine Residents' Perceptions of Cross-Cultural Training

Science.gov (United States)

Park, Elyse R; Betancourt, Joseph R; Miller, Elizabeth; Nathan, Michael; MacDonald, Ellie; Ananeh-Firempong, Owusu; Stone, Valerie E

2006-01-01

BACKGROUND Physicians increasingly face the challenge of managing clinical encounters with patients from a range of cultural backgrounds. Despite widespread interest in cross-cultural care, little is known about resident physicians' perceptions of what will best enable them to provide quality care to diverse patient populations. OBJECTIVES To assess medicine residents' (1) perceptions of cross-cultural care, (2) barriers to care, and (3) training experiences and recommendations. DESIGN, SETTING, AND PATIENTS Qualitative individual interviews were conducted with 26 third-year medicine residents at Massachusetts General Hospital in Boston (response rate = 87%). Interviews were recorded, transcribed, and analyzed. RESULTS Despite significant interest in cross-cultural care, almost all of the residents reported very little training during residency. Most had gained cross-cultural skills through informal learning. A few were skeptical about formal training, and some expressed concern that it is impossible to understand every culture. Challenges to the delivery of cross-cultural care included managing patients with limited English proficiency, who involve family in critical decision making, and who have beliefs about disease that vary from the biomedical model. Residents cited many implications to these barriers, ranging from negatively impacting the patient-physician relationship to compromised care. Training recommendations included making changes to the educational climate and informal and formal training mechanisms. CONCLUSIONS If cross-cultural education is to be successful, it must take into account residents' perspectives and be focused on overcoming residents' cited barriers. It is important to convey that cross-cultural education is a set of skills that can be taught and applied, in a time-efficient manner, rather than requiring an insurmountable knowledge base. PMID:16704391

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.

Is Fibre an Effective Strategy to Improve Laxation in Long-Term Care Residents?

Science.gov (United States)

Dahl, Wendy J; Mendoza, Daniela Rivero

2018-03-01

The high prevalence of constipation in long-term care (LTC) residents has been a long-standing issue for caregivers, attending health professionals, and the residents themselves. The traditional medical response has been to utilize pharmaceutical laxatives, enemas, and suppositories for treatment. The purpose of this review was to determine if fibre supplementation (including fibre added to foods) is effective in increasing stool frequency, improving stool consistency, and decreasing laxative use in LTC residents. A systematic search was conducted using PubMed and CINAHL databases, inclusive to March 2017. Search terms included: "long-term care" or "nursing home" AND "fiber (fibre)," "bran," "psyllium," "inulin," or "prebiotic." Intervention trials of fibre supplementation with ≥5 LTC residents were included. The search generated 456 articles following removal of duplicates; 8 studies met the inclusion criteria. Three additional trials were identified through a hand search of references of pertinent articles. Current evidence suggests that added fibre may be effective in increasing stool frequency and/or decreasing laxative use in LTC residents and, thus, may lessen the burden of constipation. However, randomized controlled trials are needed to clearly demonstrate the effects of adding fibre to foods, particularly insoluble and less fermentable sources, on constipation in LTC residents.

Educational technology improves ECG interpretation of acute myocardial infarction among medical students and emergency medicine residents.

Science.gov (United States)

Pourmand, Ali; Tanski, Mary; Davis, Steven; Shokoohi, Hamid; Lucas, Raymond; Zaver, Fareen

2015-01-01

Asynchronous online training has become an increasingly popular educational format in the new era of technology-based professional development. We sought to evaluate the impact of an online asynchronous training module on the ability of medical students and emergency medicine (EM) residents to detect electrocardiogram (ECG) abnormalities of an acute myocardial infarction (AMI). We developed an online ECG training and testing module on AMI, with emphasis on recognizing ST elevation myocardial infarction (MI) and early activation of cardiac catheterization resources. Study participants included senior medical students and EM residents at all post-graduate levels rotating in our emergency department (ED). Participants were given a baseline set of ECGs for interpretation. This was followed by a brief interactive online training module on normal ECGs as well as abnormal ECGs representing an acute MI. Participants then underwent a post-test with a set of ECGs in which they had to interpret and decide appropriate intervention including catheterization lab activation. 148 students and 35 EM residents participated in this training in the 2012-2013 academic year. Students and EM residents showed significant improvements in recognizing ECG abnormalities after taking the asynchronous online training module. The mean score on the testing module for students improved from 5.9 (95% CI [5.7-6.1]) to 7.3 (95% CI [7.1-7.5]), with a mean difference of 1.4 (95% CI [1.12-1.68]) (p<0.0001). The mean score for residents improved significantly from 6.5 (95% CI [6.2-6.9]) to 7.8 (95% CI [7.4-8.2]) (p<0.0001). An online interactive module of training improved the ability of medical students and EM residents to correctly recognize the ECG evidence of an acute MI.

Proficiency evaluation of maintenance personnel: Training equivalency determination

International Nuclear Information System (INIS)

Price, W.J.

1991-01-01

The nuclear industry has recognized the importance of safe, quality, productive maintenance practices and has taken a number of initiatives that have generally improved maintenance programs. Because proficient maintenance practices are critical to plant safety and reliability, most plants have also recognized the need for reliable, valid testing techniques that demonstrate and assure the competence of their maintenance personnel. Until now, resource demands were too great to develop in-plant testing programs. In the past, maintenance supervisors have exempted personnel from training, using informal judgment of the employees' previous training and experience and informal observation of the employee on the job. While this procedure may have some degree of validity, it fails to provide the documentation for training equivalency that is required to satisfy the US Nuclear Regulatory Commission (NRC) regulations and Institute of Nuclear Power Operations (INPO) guidelines. To assess and demonstrate the proficiency levels of personnel, Calvert Cliffs needed to establish an objective, reliable, time-saving, and valid system to evaluate the competency levels of personnel. This was done in a joint effort with the Electric Power Research Institute

Evaluation of cardiac auscultation skills in pediatric residents.

Science.gov (United States)

Kumar, Komal; Thompson, W Reid

2013-01-01

Auscultation skills are in decline, but few studies have shown which specific aspects are most difficult for trainees. We evaluated individual aspects of cardiac auscultation among pediatric residents using recorded heart sounds to determine which elements pose the most difficulty. Auscultation proficiency was assessed among 34 trainees following a pediatric cardiology rotation using an open-set format evaluation module, similar to the actual clinical auscultation description process. Diagnostic accuracy for distinguishing normal from abnormal cases was 73%. Findings most commonly correctly identified included pathological systolic and diastolic murmurs and widely split second heart sounds. Those least likely to be identified included continuous murmurs and clicks. Accuracy was low for identifying specific diagnoses. Given time constraints for clinical skills teaching, this suggests that focusing on distinguishing normal from abnormal heart sounds and murmurs instead of making specific diagnoses may be a more realistic goal for pediatric resident auscultation training.

Learning Strategies in Proficient and Less Proficient Readers in Medicine

Science.gov (United States)

Nemati, Majid; Nodoushan, Mohammad Ali Salmani; Ashrafzadeh, Anis

2010-01-01

The current study aimed to diagnose the probable significant differences in the use of language learning strategies among medical-text readers of opposite sex from different levels of proficiency. 120 (N = 120) participants were randomly selected from Azad Medical University of Mashhad: 60 medical students (age range 23-25; 30 = male and 30 =…

The relationship between English language learning strategies and proficiency of pre-university students: A study case of UMS

Science.gov (United States)

Kiram, Johannah Jamalul; Sulaiman, Jumat; Swanto, Suyansah; Din, Wardatul Akmam

2014-07-01

This paper seeks to investigate the relationship between language learning strategies and proficiency in English. Fifty-six pre-university students (22 males, 34 females) of University Malaysia Sabah participated in this study. Oxford's Strategy Inventory for Language Learning (SILL) self-report questionnaire was adopted to identify the students' language learning strategies, whereas their proficiencies were judged based on their Malaysian University English Test (MUET) Results. Pearson's correlation coefficient, Spearman's rank correlation coefficient and the t-test were utilized to make statistical interpretation about the relationship. The knowledge obtained from this study will be helpful for future studies on how to improve the quality of learning and proficiency in English.

Proficiency Test Program Involvement as a Tool for External Quality Control for Radiochemistry and Environmental Laboratory, Malaysian Nuclear Agency

International Nuclear Information System (INIS)

Nurrul Assyikeen Mohd Jaffary; Wo, Y.M.; Zal U'yun Wan Mahmood; Norfaizal Mohamed; Abdul Kadir Ishak; Noor Fadzilah Yusof; Jalal Sharib

2016-01-01

As the only Laboratory in Malaysia under the IAEA Analytical Laboratories for the Measurement of Environmental Radioactivity (ALMERA) Network, the Radiochemistry and Environmental Laboratory (RAS), Malaysian Nuclear Agency participates in the proficiency test programmes organised by ALMERA to achieve mutual acceptance of analytical data. The ALMERA has been providing quality support of proficiency tests using sets of different samples matrices and radionuclide levels typically encountered in environmental and food monitoring laboratories. The involvement of RAS laboratory in the IAEA proficiency tests gives opportunity to improve the laboratory capability and personnel skills in the field of radioactivity testing. (author)

Resident Physicians Improve Nontechnical Skills When on Operating Room Management and Leadership Rotation.

Science.gov (United States)

Cole, Devon C; Giordano, Christopher R; Vasilopoulos, Terrie; Fahy, Brenda G

2017-01-01

attending AOD and charge nurse assessments, resident performance of NTS improved from the beginning to the end of the rotation on 12 of the 14 NTS items (P leadership when completing a 2-week senior elective as an OR manager.

5 CFR 9901.364 - Foreign language proficiency pay.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Foreign language proficiency pay. 9901... NATIONAL SECURITY PERSONNEL SYSTEM (NSPS) Pay and Pay Administration Premium Pay § 9901.364 Foreign language proficiency pay. (a) General provisions. (1) This section applies to employees who may be paid...

Factors Affecting Teachers’ Perceived Proficiency in Using ICT in the Classroom

Directory of Open Access Journals (Sweden)

Prema Basargekar

2017-09-01

Full Text Available Effective implementation of Information and Communication Technologies (ICT plays an important role in school education, especially in a developing country like India, to improve the quality of education. School teachers’ lack of confidence and motivation for using ICT is one of the major barriers of its implementation in schools. These barriers can be either non-manipulative (i.e. which cannot be changed or manipulative (i.e. which can be changed with the help of school/government policies. This paper studies the impact of non-manipulative and manipulative teachers’ factors on their perceived proficiency in using ICT in the classrooms. It uses the primary data of 515 school teachers from the Maharashtra region of India teaching at high-school level (8th grade to 12th grade. The study concludes that both non-manipulative as well as manipulative teachers’ factors are important in affecting teachers’ perception regarding their own proficiency in using ICT in the classrooms. The study also provides some suggestions to improve the perception by changing some manipulative factors.

Comparing Examinee Attitudes Toward Computer-Assisted and Other Oral Proficiency Assessments.

Science.gov (United States)

Kenyon, Dorry M.; Malabonga, Valerie

2001-01-01

Examined attitudes toward taking different formats of oral proficiency assessments across three languages: Spanish, Arabic, and Chinese. Students were administered both the tape-mediated Simulated Oral Proficiency Interview (SOPI) and a new Computerized Oral Proficiency Instrument (COPI). Questionnaire responses showed examinees, particularly…

Specific Physician Orders Improve Pain Detection and Pain Reports in Nursing Home Residents: Preliminary Data.

Science.gov (United States)

Monroe, Todd B; Misra, Sumathi; Habermann, Ralf C; Dietrich, Mary S; Bruehl, Stephen P; Cowan, Ronald L; Newhouse, Paul A; Simmons, Sandra F

2015-10-01

Despite evidence that many nursing home residents' pain is poorly managed, reasons for this poor management remain unanswered. The aim of this study was to determine if specific order sets related to pain assessment would improve pain management in nursing home (NH) residents. Outcomes included observed nurse pain assessment queries and resident reports of pain. The pretest/post-test study was performed in a 240-bed for-profit nursing home in the mid-southern region of the United States and participants were 43 nursing home residents capable of self-consent. Medical chart abstraction was performed during a 2-week (14-day) period before the implementation of specific order sets for pain assessment (intervention) and a 2-week (14-day) period after the intervention. Trained research assistants observed medication administration passes and performed participant interviews after each medication pass. One month after intervention implementation, 1 additional day of observations was conducted to determine data reliability. Nurses were observed to ask residents about pain more frequently, and nurses continued to ask about pain at higher rates 1 month after the intervention was discontinued. The proportion of residents who reported pain also significantly increased in response to increased nurse queries (e.g., "Do you have any pain right now?"), which underscores the importance of nurses directly asking residents about pain. Notably 70% of this long-stay NH population only told the nurses about their pain symptoms when asked directly. Findings uncover that using specific pain order sets seems to improve the detection of pain, which should be a routine part of nursing assessment. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Worldwide Open Proficiency Test: Determination of Natural and Artificial Radionuclides in Moss-Soil and Water IAEA-CU-2009-03

International Nuclear Information System (INIS)

2012-01-01

Reliable determination of natural and artificial radionuclides in environmental samples is necessary to comply with radiation protection and environmental regulations. The IAEA assists Member State laboratories in maintaining and improving their readiness by producing reference materials, by developing standardized analytical methods, and by conducting interlaboratory comparisons and proficiency tests as tools for quality control. To fulfil this obligation and ensure a reliable, worldwide, rapid and consistent response, the IAEA Terrestrial Environment Laboratory in Seibersdorf, Austria, organizes interlaboratory comparisons and proficiency tests. This summary report presents the results of the worldwide proficiency test IAEA-CU-2009- 03 on the determination of natural and artificial radionuclides in moss-soil and spiked water. The methodologies, data evaluation approach, summary evaluation of each nuclide and individual evaluation reports for each laboratory are also described. This proficiency test was designed to identify analytical problems, to support Member State laboratories to improve the quality of their analytical results and maintain their accreditation, and to provide a regular forum for discussion and technology transfer in this area. The number of samples, their matrix interferences and the concentration levels of the analytes were designed in a way that enables identification of potential analytical problems.

Proficiency test for heavy metals in compound feed

NARCIS (Netherlands)

Pereboom, D.P.K.H.; Elbers, I.J.W.; Jong, de J.; Lee, van der M.K.; Nijs, de W.C.M.

2016-01-01

The here described proficiency test for heavy metals in compound feed was organised by RIKILT, Wageningen UR in accordance with ISO 17043. RIKILT Wageningen UR has an ISO/IEC 17043 accreditation for proficiency tests of residues in products of animal origin. However, this specific test is not part

Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module.

Science.gov (United States)

Boggan, Joel C; Swaminathan, Aparna; Thomas, Samantha; Simel, David L; Zaas, Aimee K; Bae, Jonathan G

2017-04-01

Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback. Residents performed audits of ambulatory patients requiring laboratory or radiologic testing by means of a shared online interface. The intervention consisted of an educational module viewed with initial audits, development of a personalized improvement plan after Phase 1, and repeated real-time feedback of individual relative performance compared at clinic and program levels. Outcomes included results communicated within 14 days and prespecified "significant" results communicated within 72 hours. A total of 76 of 86 eligible residents (88%) reviewed 1713 individual ambulatory patients' charts in Phase 1, and 73 residents (85%) reviewed 1509 charts in Phase 2. Follow-up rates were higher in Phase 2 than Phase 1 for communicating results within 14 days and significant results within 72 hours (85% versus 78%, P  Communication of "significant" results was more likely to occur via telephone, compared with communication of nonsignificant results. Participation in a shared audit and feedback quality improvement project can improve rates of resident follow-up and communication of results, although communication gaps remained.

Using Complementary Learning Clusters in Studying Literature to Enhance Students' Medical Humanities Literacy, Critical Thinking, and English Proficiency.

Science.gov (United States)

Liao, Hung-Chang; Wang, Ya-Huei

2016-04-01

This study examined whether students studying literature in complementary learning clusters would show more improvement in medical humanities literacy, critical thinking skills, and English proficiency compared to those in conventional learning clusters. Ninety-three students participated in the study (M age = 18.2 years, SD = 0.4; 36 men, 57 women). A quasi-experimental design was used over 16 weeks, with the control group (n = 47) working in conventional learning clusters and the experimental group (n = 46) working in complementary learning clusters. Complementary learning clusters were those in which individuals had complementary strengths enabling them to learn from and offer assistance to other cluster members, hypothetically facilitating the learning process. Measures included the Medical Humanities Literacy Scale, Critical Thinking Disposition Assessment, English proficiency tests, and Analytic Critical Thinking Scoring Rubric. The results showed that complementary learning clusters have the potential to improve students' medical humanities literacy, critical thinking skills, and English proficiency. © The Author(s) 2016.

The correlation between motor proficiency and physical activity in ...

African Journals Online (AJOL)

Lizl-Louise van Niekerk

eOseretsky Test of Motor Proficiency 2 (BOT-2) for motor proficiency, and the International. Physical Activity ... Pienaar, 2007; Malina, 2012). ..... sults of Hardy, Reinten-Reynolds, Espinel, Zask, and Okely .... Journal of Psychiatric and Mental.

Preoperative warm-up the key to improved resident technique: a randomized study.

Science.gov (United States)

Moran-Atkin, Erin; Abdalla, Gamal; Chen, Grace; Magnuson, Thomas H; Lidor, Anne O; Schweitzer, Michael A; Steele, Kimberley E

2015-05-01

The ACGME has required that a skills lab be incorporated into the surgical residency curriculum. While the value of warm-up is generally accepted in other areas requiring complex motor skills, there is little evidence to support the benefits of warm-up prior to performing surgery. We are conducting this study in an attempt to identify whether a warm-up period prior to operating impacts operative technique. All general surgery residents and MIS fellows were included in this IRB-approved randomized study. Participants were randomized to either warm-up or no warm-up groups. Participants randomized to the warm-up group completed a 10 min practice session in the simulation lab within 1 h of starting the case, using an FLS training box. At the conclusion of the operation, the participant was evaluated by the attending surgeon using the validated global rating scales of Reznick and Vassiliou. The attending surgeons were blinded to the use of pre-procedure warm-up. The results of the questionnaire were analyzed using student's t test with p warm-up (19) or no warm-up (21). There was a statistically significant improvement in depth perception (p = 0.02), bimanual dexterity (p = 0.01), and efficiency of movements (p = 0.03) for those randomized to warm-up. There was statistical improvement when we preformed a composite scoring of the attending evaluations for each of the Reznick (p = 0.008) and the Vassiliou (p = 0.01) global rating scales. Preoperative warm-up significantly improves depth perception, bimanual dexterity, and efficiency of movements, as well as improvement in composite scores as judged by the attending surgeon. The lack of self-perceived improvement by the residents may be a reflection of the high standards and intense self-critique that is common among surgical trainees. We believe that our findings, while preliminary, reflect that surgical performance can be enhanced through structured warm-up activities.

Exploring Senior Residents' Intraoperative Error Management Strategies: A Potential Measure of Performance Improvement.

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Law, Katherine E; Ray, Rebecca D; D'Angelo, Anne-Lise D; Cohen, Elaine R; DiMarco, Shannon M; Linsmeier, Elyse; Wiegmann, Douglas A; Pugh, Carla M

The study aim was to determine whether residents' error management strategies changed across 2 simulated laparoscopic ventral hernia (LVH) repair procedures after receiving feedback on their initial performance. We hypothesize that error detection and recovery strategies would improve during the second procedure without hands-on practice. Retrospective review of participant procedural performances of simulated laparoscopic ventral herniorrhaphy. A total of 3 investigators reviewed procedure videos to identify surgical errors. Errors were deconstructed. Error management events were noted, including error identification and recovery. Residents performed the simulated LVH procedures during a course on advanced laparoscopy. Participants had 30 minutes to complete a LVH procedure. After verbal and simulator feedback, residents returned 24 hours later to perform a different, more difficult simulated LVH repair. Senior (N = 7; postgraduate year 4-5) residents in attendance at the course participated in this study. In the first LVH procedure, residents committed 121 errors (M = 17.14, standard deviation = 4.38). Although the number of errors increased to 146 (M = 20.86, standard deviation = 6.15) during the second procedure, residents progressed further in the second procedure. There was no significant difference in the number of errors committed for both procedures, but errors shifted to the late stage of the second procedure. Residents changed the error types that they attempted to recover (χ 2 5 =24.96, perrors, but decreased for strategy errors. Residents also recovered the most errors in the late stage of the second procedure (p error management strategies changed between procedures following verbal feedback on their initial performance and feedback from the simulator. Errors and recovery attempts shifted to later steps during the second procedure. This may reflect residents' error management success in the earlier stages, which allowed further progression in the

Embedding patient simulation in a pediatric cardiology rotation: a unique opportunity for improving resident education.

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Mohan, Shaun; Follansbee, Christopher; Nwankwo, Ugonna; Hofkosh, Dena; Sherman, Frederick S; Hamilton, Melinda F

2015-01-01

High-fidelity patient simulation (HFPS) has been used in medical education to bridge gaps in medical knowledge and clinical skills. Few studies have analyzed the impact of HFPS in subspecialty rotations for pediatric residents. We hypothesized that pediatric residents exposed to HFPS with a structured content curriculum would perform better on a case quiz than residents without exposure to HFPS. Prospective randomized controlled Tertiary-care free standing children's hospital During a cardiology rotation, senior pediatric residents completed an online pediatric cardiology curriculum and a cardiology quiz. After randomization into two groups, the study group participated in a fully debriefed HFPS session. The control group had no HFPS. Both groups completed a case quiz. Confidence surveys pre- and postsimulation were completed. From October 2010 through March 2013, 55 residents who rotated through the pediatric cardiology rotation were used in the final analysis (30 control, 25 in the study group). There was no significant difference between groups on the initial cardiology quiz. The study group scored higher on the case quiz compared with the control group (P = .024). Based on pre- and postsimulation questionnaires, residents' confidence in approaching a pediatric cardiology patient improved from an average Likert score of 5.1 to 7.5 (on scale of 0-10) (P cardiology rotation was feasible and well received. Our study suggests that simulation promotes increased confidence and may modestly improve clinical reasoning compared to traditional educational techniques. Targeted simulation sessions may readily be incorporated into pediatric subspecialty rotations. © 2014 Wiley Periodicals, Inc.

Resident Workflow and Psychiatric Emergency Consultation: Identifying Factors for Quality Improvement in a Training Environment.

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Blair, Thomas; Wiener, Zev; Seroussi, Ariel; Tang, Lingqi; O'Hora, Jennifer; Cheung, Erick

2017-06-01

Quality improvement to optimize workflow has the potential to mitigate resident burnout and enhance patient care. This study applied mixed methods to identify factors that enhance or impede workflow for residents performing emergency psychiatric consultations. The study population consisted of all psychiatry program residents (55 eligible, 42 participating) at the Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles. The authors developed a survey through iterative piloting, surveyed all residents, and then conducted a focus group. The survey included elements hypothesized to enhance or impede workflow, and measures pertaining to self-rated efficiency and stress. Distributional and bivariate analyses were performed. Survey findings were clarified in focus group discussion. This study identified several factors subjectively associated with enhanced or impeded workflow, including difficulty with documentation, the value of personal organization systems, and struggles to communicate with patients' families. Implications for resident education are discussed.

Relationship between phonological awareness and spelling proficiency in first-grade students

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Nasibe Soltaninejad

2014-12-01

Full Text Available Background and Aim: Phonological awareness (consisting of phoneme, syllable and intra-syllable awareness is an important part of receptive and expressive language; it facilitates reading and writing skills through phonological re-coding. Multiple studies in several languages have studied the relationship between phonological awareness and dictation. This research is based on a study of the relationship between phonological skill and spelling score in first-grade Persian students.Methods: Four hundred first-grade students participated in the study, including 209 girls and 191 boys. A phonological awareness test was individually administered for each student and then a spelling exam was administered in groups. The correlation between the two tests was studied using a simple regression model. The comparison of mean scores of girls and boys was evaluated employing an independent t-test.Results: A correlation coefficient of 0.82 was obtained between phonological awareness and spelling proficiency (p<0.001. Phonological skill sub-tests also showed a significant correlation with spelling proficiency (highest for phoneme awareness r=0.34 and lowest for rhyme awareness r=0.12. The mean scores of girls and boys differed significantly (p<0.05.Conclusion: There is a strong positive association between phonological awareness and spelling proficiency. Therefore, if phonological skill is improved, spelling score can be enhanced.

Early learning effect of residents for laparoscopic sigmoid resection.

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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.

The proficiency testing of determination of dioxins in food

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Matsuda, R.; Tsutsumi, T.; Maitani, T. [National Institute of Health Sciences, Tokyo (Japan); Toyoda, M. [Jissen Womens Univ., Hino (Japan)

2004-09-15

Food intake is the main route of human dioxin exposure, making the determination of dioxins in food indispensable for risk assessment and risk management of dioxins. The uncertainty of analytical results, however, can be very great because of the low concentration of the analytes and complicated cleanup procedures. The risk assessment of dioxins based on analytical results also suffers from a similar degree of uncertainty. The Ministry of Health, Labor and Welfare of Japan has published ''Guideline for the Determination of Dioxins in Food'' to standardize the analytical procedures. The guideline contains the quality assurance procedures to obtain reliable analytical results and recommends participation in the relevant proficiency testing scheme. The proficiency testing provides the fair evaluation of the analytical results. The central science laboratory in England and the food and drug safety center in Japan offer the proficiency testing on food. The National Institute of Health Sciences of Japan (NIHS) also has carried out proficiency testing of dioxins in food since 1998 to assure the quality of analytical results for dioxins. In this presentation we will show the results of 5 rounds of proficiency testing.

THE BANGLADESHI EMPLOYMENT SECTOR: EMPLOYER PERSPECTIVES CONCERNING ENGLISH PROFICIENCY

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Rubina Khan

2012-07-01

Full Text Available Abstract: This paper presents a brief summary of a study which was carried out to investigate how employers representing major employment sectors in the Bangladeshi Industry view the skills and English proficiency level of the current employees. Opinions were also solicited on what skills are required for fresh recruits. Semi-structured interviews were conducted with 30 employers representing the major employment sectors in Bangladeshi Industry. Results revealed the importance of English as an indispensible means of communication in the Bangladeshi corporate sector and showed that the business enterprises use extensive amounts of English. It also highlighted that the existent English proficiency of the employees was far below the required proficiency level. Recommendations were made to address the gap and prepare the youth to meet the demands of the global market. Keywords: English proficiency, competency, employability skills, global literacy skills

Still under the microscope: can a surgical aptitude test predict otolaryngology resident performance?

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Moore, Eric J; Price, Daniel L; Van Abel, Kathryn M; Carlson, Matthew L

2015-02-01

Application to otolaryngology-head and neck surgery residency is highly competitive, and the interview process strives to select qualified applicants with a high aptitude for the specialty. Commonly employed criteria for applicant selection have failed to show correlation with proficiency during residency training. We evaluate the correlation between the results of a surgical aptitude test administered to otolaryngology resident applicants and their performance during residency. Retrospective study at an academic otolaryngology-head and neck surgery residency program. Between 2007 and 2013, 224 resident applicants participated in a previously described surgical aptitude test administered at a microvascular surgical station. The composite score and attitudinal scores for 24 consecutive residents who matched at our institution were recorded, and their residency performance was analyzed by faculty survey on a five-point scale. The composite and attitudinal scores were analyzed for correlation with residency performance score by regression analysis. Twenty-four residents were evaluated for overall quality as a clinician by eight faculty members who were blinded to the results of surgical aptitude testing. The results of these surveys showed good inter-rater reliability. Both the overall aptitude test scores and the subset attitudinal score showed reliability in predicting performance during residency training. The goal of the residency selection process is to evaluate the candidate's potential for success in residency and beyond. The results of this study suggest that a simple-to-administer clinical skills test may have predictive value for success in residency and clinician quality. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

INFLUENCE OF STUDENT ENGLISH UTILITY AND TEACHER EFFICACY ON ENGLISH PROFICIENCY OF HIGH SCHOOL STUDENTS

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Ruth A. ORTEGA-DELA CRUZ

2016-12-01

Full Text Available Learning second language considers a number of factors that influence the manner in which the language is taught. Understanding of the learners’ goals and motivation for learning is one. Using descriptive-correlational research design, this study determined the influence of student English utility and teacher efficacy on the students’ English proficiency. A total of 101 students from first year to fourth year level served as the respondents of the study. The study quantified the students’ perception towards English utility and their evaluation of English teacher efficacy which employed a researcher-made survey questionnaire. Results revealed high positive perceptions of students towards English utility. Analysis of variance revealed significant differences in the perceptions of high school students on the efficacy of their English teachers. Correlation coefficients indicated a positive linear relationship among the given variables. The p-value revealed significant relationship of teacher efficacy (r = .691, p-value = .000 and English utility (r = .467, p-value = .000 to students’ English proficiency. Results of regression statistics revealed that English utility has no significant influence on the student English proficiency. Therefore, the main factor that must still be considered then should be the teacher. Finally, there is an explicit indication that high level of teachers’ efficacy performing in teaching has much powerful influence on the English proficiency of high school students. Thus improving the methods of teaching English provides a better way of motivating students to achieve higher levels of proficiency in the future.

Childhood motor skill proficiency as a predictor of adolescent physical activity.

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Barnett, Lisa M; van Beurden, Eric; Morgan, Philip J; Brooks, Lyndon O; Beard, John R

2009-03-01

Cross-sectional evidence has demonstrated the importance of motor skill proficiency to physical activity participation, but it is unknown whether skill proficiency predicts subsequent physical activity. In 2000, children's proficiency in object control (kick, catch, throw) and locomotor (hop, side gallop, vertical jump) skills were assessed in a school intervention. In 2006/07, the physical activity of former participants was assessed using the Australian Physical Activity Recall Questionnaire. Linear regressions examined relationships between the reported time adolescents spent participating in moderate-to-vigorous or organized physical activity and their childhood skill proficiency, controlling for gender and school grade. A logistic regression examined the probability of participating in vigorous activity. Of 481 original participants located, 297 (62%) consented and 276 (57%) were surveyed. All were in secondary school with females comprising 52% (144). Adolescent time in moderate-to-vigorous and organized activity was positively associated with childhood object control proficiency. Respective models accounted for 12.7% (p = .001), and 18.2% of the variation (p = .003). Object control proficient children became adolescents with a 10% to 20% higher chance of vigorous activity participation. Object control proficient children were more likely to become active adolescents. Motor skill development should be a key strategy in childhood interventions aiming to promote long-term physical activity.

Language proficiency and metacognition as predictors of spontaneous rehearsal in children.

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Bebko, James M; McMorris, Carly A; Metcalfe, Alisa; Ricciuti, Christina; Goldstein, Gayle

2014-03-01

Despite decades of research on fundamental memory strategies such as verbal rehearsal, the potential underlying skills associated with the emergence of rehearsal are still not fully understood. Two studies examined the relative roles of language proficiency and metamemory in predicting rehearsal use, as well as the prediction of metamemory performance by language proficiency. In Study 1, 59 children, 5 to 8 years old, were administered a serial recall task, 2 language measures, a nonverbal cognitive measure, and a rapid automatized naming (RAN) task. Language proficiency, RAN, and age were significant individual predictors of rehearsal use. In hierarchical regression analyses, language proficiency mediated almost completely the age → rehearsal use relation. In addition, automatized naming was a strong but partial mediator of the contribution of language proficiency to rehearsal use. In Study 2, 54 children were administered a metamemory test, a language measure, and a serial recall task. Metamemory skills and, again, language proficiency significantly predicted rehearsal use in the task. The predictive strength of metamemory skills was mediated by the children's language proficiency. The mutually supportive roles of automatized naming, language, and metamemory in the emergence of spontaneous cumulative verbal rehearsal are discussed in the context of the resulting model, along with the minimal roles of age and aspects of intelligence.

Gender impacts on motor skill proficiency-physical activity relationship in children

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Diana Samara

2015-12-01

Full Text Available BACKGROUND Physical activity is the greatest contributor to achievement of adequate physical activity. Children performing adequate daily physical activity will get positive benefits from their activity. Several studies indicate a difference in motor skills between boys and girls. To understand the development of motor skill proficiency and physical activity in boys and girls, a study was conducted to determine the role of gender on motor skill proficiency and physical activity in children aged 6-12 years. METHODS A cross-sectional observational study was conducted and a total of 162 children were included at a primary school in the Grogol area, West Jakarta. Data collection was by questionnaire-based interviews, covering age, gender, and physical activity (watching TV, playing games, and outdoor play. Assessment of motor skills was performed using the Bruininks-Oseretsky Test–Second Edition (BOT-2. Data analysis was performed using SPSS for Windows release 17.0 and level of significance was set at 0.05. RESULTS Multiple linear regression results showed that in boys the strength subset was the most influential factor on TV watching activity, with the higher scores for strength indicating a lower TV watching activity (â=-0.125;p=0.021. Age was the most influential factor on outdoor playing activity in girls, with older girls having lower outdoor playing activity (â=-0.375;p=0.016. CONCLUSIONS This study revealed that gender difference impacts on motor skills and physical activity in children. Higher motor proficiency increases outdoor playing activity only in boys. Primary school pupils should be given opportunities for performing outdoor playing activities to improve their motor proficiency.

Gender impacts on motor skill proficiency-physical activity relationship in children

Directory of Open Access Journals (Sweden)

Diana Samara

2012-12-01

Full Text Available Background Physical activity is the greatest contributor to achievement of adequate physical activity. Children performing adequate daily physical activity will get positive benefits from their activity. Several studies indicate a difference in motor skills between boys and girls. To understand the development of motor skill proficiency and physical activity in boys and girls, a study was conducted to determine the role of gender on motor skill proficiency and physical activity in children aged 6-12 years. Methods A cross-sectional observational study was conducted and a total of 162 children were included at a primary school in the Grogol area, West Jakarta. Data collection was by questionnaire-based interviews, covering age, gender, and physical activity (watching TV, playing games, and outdoor play. Assessment of motor skills was performed using the Bruininks-Oseretsky Test–Second Edition (BOT-2. Data analysis was performed using SPSS for Windows release 17.0 and level of significance was set at 0.05. Results Multiple linear regression results showed that in boys the strength subset was the most influential factor on TV watching activity, with the higher scores for strength indicating a lower TV watching activity (â=-0.125;p=0.021. Age was the most influential factor on outdoor playing activity in girls, with older girls having lower outdoor playing activity (â=-0.375;p=0.016. Conclusions This study revealed that gender difference impacts on motor skills and physical activity in children. Higher motor proficiency increases outdoor playing activity only in boys. Primary school pupils should be given opportunities for performing outdoor playing activities to improve their motor proficiency.

STRATEGIES OF MAINTAINING PROFICIENCY BY TEACHERS OF ENGLISH IN INDONESIA

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Junaidi Mistar, Alfan Zuhairini

2011-10-01

Full Text Available The objectives of the present study are four-fold: (1 to identify the types of strategies to maintain proficiency used by teachers of English in Indonesia, (2 to know the intensity of use of the obtained strategy types, (3 to measure the inter-correlation in the use of the obtained strategy types, and (4 to investigate the effect of proficiency level on the use of maintaining strategies. The subjects were 93 teachers applying for S2 degree in 2010/2011 at the postgraduate program of the Islamic University of Malang. They were given two sets of instrument, a Likert-scale questionnaire of English proficiency maintaining strategies and a TOEFL test. Then, a factor analysis identified nine strategy categories, including language focusing, metacognitive and affective developing, reading and writing activating, language resource utilizing, cognitive processing, culture learning, social communicating, text analyzing, and radio listening strategies. These strategy types explained 63.84% of variances of maintaining strategies and they were used at high level of intensity. Moreover, the use of the nine strategy types were found to be inter-correlated with one another. Finally, no significant effect of proficiency level on strategy use was found, indicating that teachers with different level of proficiency reported using the same strategies of maintaining their proficiency.

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

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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

Teaching English through English: Proficiency, Pedagogy and Performance

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Richards, Jack C.

2017-01-01

Most of the world's English language teachers speak English as a second or third language rather than as their first language. For many, their level of proficiency in English may not reach benchmarks established by their employers, raising the issue that is the focus of this article, namely, what kind of proficiency in English is necessary to be…

The English Proficiency of the Academics of the Teacher Training and Education Institutions

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Ali Saukah

2016-02-01

Full Text Available The study is aimed at describing the general English proficiency level of the academics of Teacher Training and Education Institutions (LPTK's as indicated by their TOEFL scores. Specifically, the study is focused on finding out whether there is any difference among the academics' English proficiencies when they are grouped in terms of the geographic regions of their institutions and their fields of study. This study is also intended to reveal any possible relationship between the academics' English proficiency and their age. The results indicate that the English proficiency of the academics on the average is far below the average of that of the international students. The academics in West Java are the highest in their English proficiency, and the English group, as expected, has the best English proficiency. In addition, there is a negative correlation between English proficiency and age

Proficiency testing for sensory profile panels : measuring panel performance

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Mcewan, J.A.; Hunter, E.A.; Gemert, L.J. van; Lea, P.

2002-01-01

Proficiency testing in sensory analysis is an important step towards demonstrating that results from one sensory panel are consistent with the results of other sensory panels. The uniqueness of sensory analysis poses some specific problems for measuring the proficiency of the human instrument

Effect of WhatsApp on Critique Writing Proficiency and Perceptions toward Learning

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Awada, Ghada

2016-01-01

This article reports the results of an experimental study on the effectiveness of mobile technology (WhatsApp) in improving the critique writing skills of English as a Foreign Language learners and increasing their motivation for learning. The participants (n = 52) are Average-English proficient learners enrolled in two writing courses given at…

Creating Entrustable Professional Activities to Assess Internal Medicine Residents in Training: A Mixed-Methods Approach.

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Taylor, David R; Park, Yoon Soo; Smith, Christopher A; Karpinski, Jolanta; Coke, William; Tekian, Ara

2018-05-15

Competency-based medical education has not advanced residency training as much as many observers expected. Some medical educators now advocate reorienting competency-based approaches to focus on a resident's ability to do authentic clinical work. To develop descriptions of clinical work for which internal medicine residents must gain proficiency to deliver meaningful patient care (for example, "Admit and manage a medical inpatient with a new acute problem"). A modified Delphi process involving clinical experts followed by a conference of educational experts. The Royal College of Physicians and Surgeons of Canada. In phase 1 of the project, members of the Specialty Committee for Internal Medicine participated in a modified Delphi process to identify activities in internal medicine that represent the scope of the specialty. In phase 2 of the project, 5 experts who were scholars and leaders in competency-based medical education reviewed the results. Phase 1 identified important activities, revised descriptions to improve accuracy and avoid overlap, and assigned activities to stages of training. Phase 2 compared proposed activity descriptions with published guidelines for their development and application in medical education. The project identified 29 activities that qualify as entrustable professional activities. The project also produced a detailed description of each activity and guidelines for using them to assess residents. These activities reflect the practice patterns of the developers and may not fully represent internal medicine practice in Canada. Identification of these activities is expected to facilitate modification of training and assessment programs for medical residents so that programs focus less on isolated skills and more on integrated tasks. Southeastern Ontario Academic Medical Organization Endowed Scholarship and Education Fund and Queen's University Department of Medicine Innovation Fund.

Knowledge Management Impacts on Organizational Proficiency in a Changing Demographic Nuclear Industry

International Nuclear Information System (INIS)

Heler, D.; Marco, J. A.

2016-01-01

Full text: The US nuclear energy industry has focused on workforce development and planning efforts over the past decade in anticipation of a large number of retirements taking place. Efforts by the US nuclear industry to replace retiring workers with younger staff to close the knowledge gap and improve organizational proficiency have started. This is resulting in a bimodal workforce distribution, which means that the industry has two workforce peaks. The 2015 Nuclear Energy Institute (NEI) Workforce Pipeline Survey results illustrate a significant number of experienced and young professionals, with fewer employees in the mid-career age group. This workforce distribution can pose a challenge for US nuclear industry to ensure it has effectively implemented knowledge management elements (People, Process, and Technology) to improve organizational proficiency and maintain critical skill sets. This technical brief will examine how one US nuclear plant performance dropped, which in part was a result of a significant demographic shift in their organizations. In addition, the paper will explore the challenge organizations may have as they undergo demographic changes without proper knowledge management programmes in place. (author

Evaluation of Mycology Laboratory Proficiency Testing

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Reilly, Andrew A.; Salkin, Ira F.; McGinnis, Michael R.; Gromadzki, Sally; Pasarell, Lester; Kemna, Maggi; Higgins, Nancy; Salfinger, Max

1999-01-01

Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient testing. This study addresses this issue by evaluating medical mycology OPT and comparing its fungal specimen identification error rates to those obtained in a covert (blinded) proficiency testing (CPT) program. Identifications from 188 laboratories participating in the New York State mycology OPT from 1982 to 1994 were compared with the identifications of the same fungi recovered from patient specimens in 1989 and 1994 as part of the routine procedures of 88 of these laboratories. The consistency in the identification of OPT specimens was sufficient to make accurate predictions of OPT error rates. However, while the error rates in OPT and CPT were similar for Candida albicans, significantly higher error rates were found in CPT for Candida tropicalis, Candida glabrata, and other common pathogenic fungi. These differences may, in part, be due to OPT’s use of ideal organism representatives cultured under optimum growth conditions. This difference, as well as the organism-dependent error rate differences, reflects the limitations of OPT as a means of assessing the quality of routine laboratory performance in medical mycology. PMID:10364601

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators.

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Chang, Justues; Banaszek, Daniel C; Gambrel, Jason; Bardana, Davide

2016-04-01

Work-hour restrictions and fatigue management strategies in surgical training programs continue to evolve in an effort to improve the learning environment and promote safer patient care. In response, training programs must reevaluate how various teaching modalities such as simulation can augment the development of surgical competence in trainees. For surgical simulators to be most useful, it is important to determine whether surgical proficiency can be reliably differentiated using them. To our knowledge, performance on both virtual and benchtop arthroscopy simulators has not been concurrently assessed in the same subjects. (1) Do global rating scales and procedure time differentiate arthroscopic expertise in virtual and benchtop knee models? (2) Can commercially available built-in motion analysis metrics differentiate arthroscopic expertise? (3) How well are performance measures on virtual and benchtop simulators correlated? (4) Are these metrics sensitive enough to differentiate by year of training? A cross-sectional study of 19 subjects (four medical students, 12 residents, and three staff) were recruited and divided into 11 novice arthroscopists (student to Postgraduate Year [PGY] 3) and eight proficient arthroscopists (PGY 4 to staff) who completed a diagnostic arthroscopy and loose-body retrieval in both virtual and benchtop knee models. Global rating scales (GRS), procedure times, and motion analysis metrics were used to evaluate performance. The proficient group scored higher on virtual (14 ± 6 [95% confidence interval {CI}, 10-18] versus 36 ± 5 [95% CI, 32-40], p virtual scope (579 ±169 [95% CI, 466-692] versus 358 ± 178 [95% CI, 210-507] seconds, p = 0.02) and benchtop knee scope + probe (480 ± 160 [95% CI, 373-588] versus 277 ± 64 [95% CI, 224-330] seconds, p = 0.002). The built-in motion analysis metrics also distinguished novices from proficient arthroscopists using the self-generated virtual loose body retrieval task scores (4 ± 1 [95% CI, 3

Can the introduction of a full-service supermarket in a food desert improve residents' economic status and health?

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Richardson, Andrea S; Ghosh-Dastidar, Madhumita; Beckman, Robin; Flórez, Karen R; DeSantis, Amy; Collins, Rebecca L; Dubowitz, Tamara

2017-12-01

To estimate the impacts of a new supermarket in a low-income desert, on residents' economic status and health. We surveyed a randomly selected cohort in two low-income Pittsburgh neighborhoods before and about 1 year following the opening of a supermarket. We used difference-in-difference approach to test changes across the two neighborhoods in residents' food security, United States Department of Agriculture Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women Infant and Children participation, employment, income, and self-reported health/chronic disease diagnoses. We observed declines in food insecurity (-11.8%, P supermarket relative to residents of the comparison neighborhood. We also found suggestive evidence that residents' incomes increased more ($1550, P = .09) and prevalence of diabetes increased less in the neighborhood with the supermarket than in the comparison neighborhood (-3.6%, P = .10). Locating a new supermarket in a low-income neighborhood may improve residents' economic well-being and health. Policymakers should consider broad impacts of neighborhood investment that could translate into improved health for residents of underserved neighborhoods. Copyright © 2017 Elsevier Inc. All rights reserved.

Proficiency test for tropane alkaloids in food en feed

NARCIS (Netherlands)

Pereboom-de Fauw, D.P.K.H.; Elbers, I.J.W.; Mulder, P.P.J.; Nijs, de W.C.M.

2014-01-01

Proficiency testing is conducted to provide laboratories with a powerful tool to evaluate and demonstrate the reliability of the data that are produced. Next to validation and accreditation, proficiency testing is an important requirement of the EU Additional Measures Directive 93/99/EEC [1] and is

The correlation between motor proficiency and physical activity in ...

African Journals Online (AJOL)

Background: One of the risks associated with low physical activity levels is the insufficient development of motor proficiency, which in turn has an impact on participation in physical activity and sport during adolescence. Objectives: To determine the relationship between motor proficiency and physical activity levels in ...

English language proficiency and smoking prevalence among California's Asian Americans.

Science.gov (United States)

Tang, Hao; Shimizu, Robin; Chen, Moon S

2005-12-15

The authors documented California's tobacco control initiatives for Asian Americans and the current tobacco use status among Asian subgroups and provide a discussion of the challenges ahead. The California Tobacco Control Program has employed a comprehensive approach to decrease tobacco use in Asian Americans, including ethnic-specific media campaigns, culturally competent interventions, and technical assistance and training networks. Surveillance of tobacco use among Asian Americans and the interpretation of the results have always been a challenge. Data from the 2001 The California Health Interview Survey (CHIS) were analyzed to provide smoking prevalence estimates for all Asian Americans and Asian-American subgroups, including Korean, Filipino, Japanese, South Asian, Chinese, and Vietnamese. Current smoking prevalence was analyzed by gender and by English proficiency level. Cigarette smoking prevalence among Asian males in general was almost three times of that among Asian females. Korean and Vietnamese males had higher cigarette smoking prevalence rates than males in other subgroups. Although Asian females in general had low smoking prevalence rates, significant differences were found among Asian subgroups, from 1.1% (Vietnamese) to 12.7% (Japanese). Asian men who had high English proficiency were less likely to be smokers than men with lower English proficiency. Asian women with high English proficiency were more likely to be smokers than women with lower English proficiency. Smoking prevalence rates among Asian Americans in California differed significantly on the basis of ethnicity, gender, and English proficiency. English proficiency seemed to have the effect of reducing smoking prevalence rates among Asian males but had just the opposite effect among Asian females. Cancer 2005. (c) 2005 American Cancer Society.

Study on team evaluation (6). Relationships among technical skill proficiency, leadership, and teamwork behaviors

International Nuclear Information System (INIS)

Misawa, Ryo; Sasou, Kunihide

2011-01-01

To maintain and improve the efficiency and safety of operations in numerous industries, it is necessary to develop programs that enhance teamwork. This can be achieved through empirical investigations that identify influential factors contributing to teamwork. This study focused on technical skill proficiency and leadership as influential factors and examined the relationships among these factors and teamwork behaviors. A series of measurements was performed on 54 operations teams with the cooperation of the training center of thermal power plants. Teamwork behaviors in training under simulated abnormal conditions were evaluated through instructors' observation using a behavior checklist. Technical skill proficiency was measured by conducting a brief survey on instructors. Leadership was measured on the basis of followers' responses on questionnaire scales. Based on the scores of technical skill proficiency and leadership, hierarchical cluster analysis revealed three types of teams: (a) F-type - the technical skills of followers are superior to those of leaders; (b) LF-type - both leaders and followers are proficient in technical skills; and (c) L-type - the technical skills of leaders are superior to those of followers. ANOVAs were conducted to examine differences in teamwork behavior for the three types of teams. The main results revealed that LF-type teams actively engaged in information gathering and that leaders played a central role in these activities. In addition, the followers of F-type teams freely exchanged their ideas and opinions regarding problems and actively discussed how to solve them. These findings suggest that teamwork behaviors can vary depending on technical skill proficiency and leadership in teams. Future research is needed to identify additional factors affecting teamwork that are not measured in this study. (author)

The accreditation programs and proficiency test in Taiwan for personnel dosimeter services (1991-1998)

International Nuclear Information System (INIS)

Lee, B.T.; Hwang, W.S.; Su, S.H.

2000-01-01

According to the ionizing radiation safety regulation approved by the ROC Atomic Energy Council (AEC), personnel dosimeter processors shall be accredited by the Chinese National Laboratory Accreditation (CNLA) program before offering dosimeter services and shall be accredited every two years (now has been rescheduled to be every three years since 1996). The aim of this program is to secure quality and technical capability of personnel dosimeters, and to provide systematic improvement for the internal calibration and testing laboratory applying for accreditation by means of assessment procedures. The criteria used to evaluate the capability at laboratories are ISO/IEC 25 (1990) and technical guide in different accreditation fields. The Institute of Nuclear Energy Research (INER) was entrusted by CNLA as the central laboratory to perform the proficiency test of personnel dosimeters for laboratory accreditation in December 1990. Such proficiency tests, based on ANSI N13.11 (1983), which is mainly separated to accident categories and protection categories which consists of eight parts of tests including single and mixture radiation of x-ray, gamma, beta and neutron, have been conducted four times, in 1991, 1993, 1995 and 1998. This paper deals with the test procedures and results of proficiency tests of personnel dosimeters from 1991 until 1998. The results of the four proficiency tests showed that, for accident categories, the pass rate is about 91%; for protection categories, the pass rate is about 98%. Meanwhile, the central laboratory will adopt a new version of HPS N13.11 (1993) to replace ANSI N13.11 (1983) as new criteria for the next proficiency test to be conducted in 2001. (author)

Reconnecting Proficiency, Literacy, and Culture: From Theory to Practice

Science.gov (United States)

Warford, Mark K.; White, William L.

2012-01-01

What does it mean to capably communicate across languages? This article introduces two theoretical models and a lesson plan format designed to facilitate the integration of proficiency, literacy, and culture teaching in foreign language teaching. The Second Symbolic Competencies Model configures proficiency and literacy as subordinate clusters of…

English Proficiency and Participation in Online Discussion for Learning

Science.gov (United States)

Leung, Steve

2013-01-01

Does English proficiency affect participation in online discussion? This study polled 14 students from a postgraduate online course that require online discussion. The students are divided into groups according to their home language spoken and self-assessed English proficiency, and measure against their participation level in the required…

Observed hierarchy of student proficiency with period, frequency, and angular frequency

Directory of Open Access Journals (Sweden)

Nicholas T. Young

2018-01-01

Full Text Available In the context of a generic harmonic oscillator, we investigated students’ accuracy in determining the period, frequency, and angular frequency from mathematical and graphical representations. In a series of studies including interviews, free response tests, and multiple choice tests developed in an iterative process, we assessed students in both algebra-based and calculus-based, traditionally instructed university-level introductory physics courses. Using the results, we categorized nine skills necessary for proficiency in determining period, frequency, and angular frequency. Overall results reveal that, postinstruction, proficiency is quite low: only about 20%–40% of students mastered most of the nine skills. Next, we used a semiquantitative, intuitive method to investigate the hierarchical structure of the nine skills. We also employed the more formal item tree analysis method to verify this structure and found that the skills form a multilevel, nonlinear hierarchy, with mastery of some skills being prerequisite for mastery in other skills. Finally, we implemented a targeted, 30-min group-work activity to improve proficiency in these skills and found a 1 standard deviation gain in accuracy. Overall, the results suggest that many students currently lack these essential skills, targeted practice may lead to required mastery, and that the observed hierarchical structure in the skills suggests that instruction should especially attend to the skills lower in the hierarchy.

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.

Residents' and preceptors' perceptions of the use of the iPad for clinical teaching in a family medicine residency program.

Science.gov (United States)

Archibald, Douglas; Macdonald, Colla J; Plante, Judith; Hogue, Rebecca J; Fiallos, Javier

2014-08-20

As Family Medicine programs across Canada are transitioning into a competency-based curriculum, medical students and clinical teachers are increasingly incorporating tablet computers in their work and educational activities. The purpose of this pilot study was to identify how preceptors and residents use tablet computers to implement and adopt a new family medicine curriculum and to evaluate how they access applications (apps) through their tablet in an effort to support and enhance effective teaching and learning. Residents and preceptors (n = 25) from the Family Medicine program working at the Pembroke Regional Hospital in Ontario, Canada, were given iPads and training on how to use the device in clinical teaching and learning activities and how to access the online curriculum. Data regarding the use and perceived contribution of the iPads were collected through surveys and focus groups. This mixed methods research used analysis of survey responses to support the selection of questions for focus groups. Reported results were categorized into: curriculum and assessment; ease of use; portability; apps and resources; and perceptions about the use of the iPad in teaching/learning setting. Most participants agreed on the importance of accessing curriculum resources through the iPad but recognized that these required enhancements to facilitate use. The iPad was considered to be more useful for activities involving output of information than for input. Participants' responses regarding the ease of use of mobile technology were heterogeneous due to the diversity of computer proficiency across users. Residents had a slightly more favorable opinion regarding the iPad's contribution to teaching/learning compared to preceptors. iPad's interface should be fully enhanced to allow easy access to online curriculum and its built-in resources. The differences in computer proficiency level among users should be reduced by sharing knowledge through workshops led by more skillful i

Testing Proficiency in Interpersonal Communication

Science.gov (United States)

Byers, Burton H.

1973-01-01

Discusses several hypotheses about the measurement of speech-communication proficiency which are being tested at the University of Hawaii and a testing instrument entitled Dy Comm'' (dyadic communication) which emerged from this research. (DD)

Improving the residency admissions process by integrating a professionalism assessment: a validity and feasibility study.

Science.gov (United States)

Bajwa, Nadia M; Yudkowsky, Rachel; Belli, Dominique; Vu, Nu Viet; Park, Yoon Soo

2017-03-01

The purpose of this study was to provide validity and feasibility evidence in measuring professionalism using the Professionalism Mini-Evaluation Exercise (P-MEX) scores as part of a residency admissions process. In 2012 and 2013, three standardized-patient-based P-MEX encounters were administered to applicants invited for an interview at the University of Geneva Pediatrics Residency Program. Validity evidence was gathered for P-MEX content (item analysis); response process (qualitative feedback); internal structure (inter-rater reliability with intraclass correlation and Generalizability); relations to other variables (correlations); and consequences (logistic regression to predict admission). To improve reliability, Kane's formula was used to create an applicant composite score using P-MEX, structured letter of recommendation (SLR), and structured interview (SI) scores. Applicant rank lists using composite scores versus faculty global ratings were compared using the Wilcoxon signed-rank test. Seventy applicants were assessed. Moderate associations were found between pairwise correlations of P-MEX scores and SLR (r = 0.25, P = .036), SI (r = 0.34, P = .004), and global ratings (r = 0.48, P applicants using composite score versus global rating differed significantly (z = 5.41, P improve the reliability of the residency admissions process by improving applicant composite score reliability.

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.

Utility of a Systematic Approach to Teaching Photographic Nasal Analysis to Otolaryngology Residents.

Science.gov (United States)

Robitschek, Jon; Dresner, Harley; Hilger, Peter

2017-12-01

Photographic nasal analysis constitutes a critical step along the path toward accurate diagnosis and precise surgical planning in rhinoplasty. The learned process by which one assesses photographs, analyzes relevant anatomical landmarks, and generates a global view of the nasal aesthetic is less widely described. To discern the common pitfalls in performing photographic nasal analysis and to quantify the utility of a systematic approach model in teaching photographic nasal analysis to otolaryngology residents. This prospective observational study included 20 participants from a university-based otolaryngology residency program. The control and intervention groups underwent baseline graded assessment of 3 patients. The intervention group received instruction on a systematic approach model for nasal analysis, and both groups underwent postintervention testing at 10 weeks. Data were collected from October 1, 2015, through June 1, 2016. A 10-minute, 11-slide presentation provided instruction on a systematic approach to nasal analysis to the intervention group. Graded photographic nasal analysis using a binary 18-point system. The 20 otolaryngology residents (15 men and 5 women; age range, 24-34 years) were adept at mentioning dorsal deviation and dorsal profile with focused descriptions of tip angle and contour. Areas commonly omitted by residents included verification of the Frankfort plane, position of the lower lateral crura, radix position, and ratio of the ala to tip lobule. The intervention group demonstrated immediate improvement after instruction on the teaching model, with the mean (SD) postintervention test score doubling compared with their baseline performance (7.5 [2.7] vs 10.3 [2.5]; P Otolaryngology residents demonstrated proficiency at incorporating nasal deviation, tip angle, and dorsal profile contour into their nasal analysis. They often omitted verification of the Frankfort plane, position of lower lateral crura, radix depth, and ala-to-tip lobule

Mastery-Based Virtual Reality Robotic Simulation Curriculum: The First Step Toward Operative Robotic Proficiency.

Science.gov (United States)

Hogg, Melissa E; Tam, Vernissia; Zenati, Mazen; Novak, Stephanie; Miller, Jennifer; Zureikat, Amer H; Zeh, Herbert J

Hepatobiliary surgery is a highly complex, low-volume specialty with long learning curves necessary to achieve optimal outcomes. This creates significant challenges in both training and measuring surgical proficiency. We hypothesize that a virtual reality curriculum with mastery-based simulation is a valid tool to train fellows toward operative proficiency. This study evaluates the content and predictive validity of robotic simulation curriculum as a first step toward developing a comprehensive, proficiency-based pathway. A mastery-based simulation curriculum was performed in a virtual reality environment. A pretest/posttest experimental design used both virtual reality and inanimate environments to evaluate improvement. Participants self-reported previous robotic experience and assessed the curriculum by rating modules based on difficulty and utility. This study was conducted at the University of Pittsburgh Medical Center (Pittsburgh, PA), a tertiary care academic teaching hospital. A total of 17 surgical oncology fellows enrolled in the curriculum, 16 (94%) completed. Of 16 fellows who completed the curriculum, 4 fellows (25%) achieved mastery on all 24 modules; on average, fellows mastered 86% of the modules. Following curriculum completion, individual test scores improved (p < 0.0001). An average of 2.4 attempts was necessary to master each module (range: 1-17). Median time spent completing the curriculum was 4.2 hours (range: 1.1-6.6). Total 8 (50%) fellows continued practicing modules beyond mastery. Survey results show that "needle driving" and "endowrist 2" modules were perceived as most difficult although "needle driving" modules were most useful. Overall, 15 (94%) fellows perceived improvement in robotic skills after completing the curriculum. In a cohort of board-certified general surgeons who are novices in robotic surgery, a mastery-based simulation curriculum demonstrated internal validity with overall score improvement. Time to complete the

Native language predictors of foreign language proficiency and foreign language aptitude.

Science.gov (United States)

Sparks, Richard L; Patton, Jon; Ganschow, Leonore; Humbach, Nancy; Javorsky, James

2006-06-01

Fifty-four students were tested at specific time intervals over 10 years to determine best native language (NL) predictors of oral and written foreign language (FL) proficiency and FL aptitude. All participants completed two years of Spanish, French, or German. Each was administered measures of NL literacy, oral language, and cognitive ability in elementary school. A measure of FL aptitude was administered at the beginning of ninth grade and FL proficiency was evaluated at the end of the 10th grade. Among the variables, NL literacy measures were the best predictors of FL proficiency, and NL achievement and general (verbal) intelligence were strong predictors of FL aptitude. Results suggest that indices of NL literacy as early as first grade are related to FL proficiency and FL aptitude nine and 10 years later. Findings provide strong support for connections between L1 and L2 skills, and for speculation that "lower level" skills in phonological processing are important for written language development and oral proficiency in a FL.

Advanced Proficiency EHR Training: Effect on Physicians’ EHR Efficiency, EHR Satisfaction and Job Satisfaction

Science.gov (United States)

Dastagir, M. Tariq; Chin, Homer L.; McNamara, Michael; Poteraj, Kathy; Battaglini, Sarah; Alstot, Lauren

2012-01-01

The best way to train clinicians to optimize their use of the Electronic Health Record (EHR) remains unclear. Approaches range from web-based training, class-room training, EHR functionality training, case-based training, role-based training, process-based training, mock-clinic training and “on the job” training. Similarly, the optimal timing of training remains unclear--whether to engage in extensive pre go-live training vs. minimal pre go-live training followed by more extensive post go-live training. In addition, the effectiveness of non-clinician trainers, clinician trainers, and peer-trainers, remains unclearly defined. This paper describes a program in which relatively experienced clinician users of an EHR underwent an intensive 3-day Peer-Led EHR advanced proficiency training, and the results of that training based on participant surveys. It highlights the effectiveness of Peer-Led Proficiency Training of existing experienced clinician EHR users in improving self-reported efficiency and satisfaction with an EHR and improvements in perceived work-life balance and job satisfaction. PMID:23304282

Advanced proficiency EHR training: effect on physicians' EHR efficiency, EHR satisfaction and job satisfaction.

Science.gov (United States)

Dastagir, M Tariq; Chin, Homer L; McNamara, Michael; Poteraj, Kathy; Battaglini, Sarah; Alstot, Lauren

2012-01-01

The best way to train clinicians to optimize their use of the Electronic Health Record (EHR) remains unclear. Approaches range from web-based training, class-room training, EHR functionality training, case-based training, role-based training, process-based training, mock-clinic training and "on the job" training. Similarly, the optimal timing of training remains unclear--whether to engage in extensive pre go-live training vs. minimal pre go-live training followed by more extensive post go-live training. In addition, the effectiveness of non-clinician trainers, clinician trainers, and peer-trainers, remains unclearly defined. This paper describes a program in which relatively experienced clinician users of an EHR underwent an intensive 3-day Peer-Led EHR advanced proficiency training, and the results of that training based on participant surveys. It highlights the effectiveness of Peer-Led Proficiency Training of existing experienced clinician EHR users in improving self-reported efficiency and satisfaction with an EHR and improvements in perceived work-life balance and job satisfaction.

Wii-Based Exercise Program to Improve Physical Fitness, Motor Proficiency and Functional Mobility in Adults with Down Syndrome

Science.gov (United States)

Silva, V.; Campos, C.; Sá, A.; Cavadas, M.; Pinto, J.; Simões, P.; Machado, S.; Murillo-Rodríguez, E.; Barbosa-Rocha, N.

2017-01-01

Background: People with Down syndrome (DS) usually display reduced physical fitness (aerobic capacity, muscle strength and abnormal body composition), motor proficiency impairments (balance and postural control) and physical functional limitations. Exergames can be an appealing alternative to enhance exercise engagement and compliance, whilst…

Improving the provision of language services at an academic medical center: ensuring high-quality health communication for limited-English-proficient patients.

Science.gov (United States)

Standiford, Connie J; Nolan, Elizabeth; Harris, Michelle; Bernstein, Steven J

2009-12-01

To evaluate and improve the provision of language services at an academic medicine center caring for a diverse population including many limited-English-proficient (LEP) patients. The authors performed a prospective observational study between November 2006 and December 2008 evaluating the provision of language services at the University of Michigan Health System. The primary performance measures were (1) screening patients for their preferred language for health care, (2) assessing the proportion of LEP patients receiving language services from a qualified language services provider, and (3) assessing whether there were any disparities in diabetes care for LEP patients compared with English-speaking patients. The proportion of patients screened for preferred language increased from 59% to 96% with targeted inventions, such as training staff to capture preferred language for health care and correcting prior inaccurate primary language data entry. The proportion of LEP outpatients with a qualified language services provider increased from 19% to 83% through the use of staff and contract interpreters, over-the-phone interpreting and bilingual providers. There were no systematic differences in diabetes quality performance measures between LEP and English-proficient patients. Academic medical centers should measure their provision of language services and compare quality and safety data (e.g., performance measures and adverse events) between LEP and English-speaking patients to identify disparities in care. Leadership support and ongoing training are needed to ensure language-specific services are embedded into clinical care to meet the needs of our diverse patient populations.

Perioperative self-reflection among surgical residents.

Science.gov (United States)

Peshkepija, Andi N; Basson, Marc D; Davis, Alan T; Ali, Muhammad; Haan, Pam S; Gupta, Rama N; Hardaway, John C; Nebeker, Cody A; McLeod, Michael K; Osmer, Robert L; Anderson, Cheryl I

2017-09-01

We studied prevalence and predictors of meaningful self-reflection among surgical residents and with prompting/structured interventions, sought to improve/sustain resident skills. Residents from six programs recorded 1032 narrative self-reflective comments (120 residents), using a web-based platform. If residents identified something learned or to be improved, self-reflection was deemed meaningful. Independent variables PGY level, resident/surgeon gender, study site/Phase1: July2014-August2015 vs. Phase2: September2015-September2016) were analyzed. Meaningful self-reflection was documented in 40.6% (419/1032) of entries. PGY5's meaningfully self-reflected less than PGY1-4's, 26.1% vs. 49.6% (p = 0.002). In multivariate analysis, resident narratives during Phase 2 were 4.7 times more likely to engage in meaningful self-reflection compared to Phase1 entries (p self-reflection, compared to Phase1. Surgical residents uncommonly practice meaningful self-reflection, even when prompted, and PGY5/chief residents reflect less than more junior residents. Substantial/sustained improvements in resident self-reflection can occur with both training and interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

The Nevada Proficiency Examination Program: Evaluating the Writing Samples.

Science.gov (United States)

Howard, Edward H.

Writing tests are part of the mandated statewide proficiency examination in Nevada. The ninth-grade screening test and the eleventh-grade diploma-certifying test require that a student write a paragraph and a business letter, each on an assigned topic and each at an acceptable level of proficiency. Pilot tests, extended discussion, and statistical…

Attempted establishment of proficiency levels for laparoscopic performance on a national scale using simulation: the results from the 2004 SAGES Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) learning center study.

Science.gov (United States)

Van Sickle, K R; Ritter, E M; McClusky, D A; Lederman, A; Baghai, M; Gallagher, A G; Smith, C D

2007-01-01

The Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) has been well validated as a training device for laparoscopic skills. It has been demonstrated that training to a level of proficiency on the simulator significantly improves operating room performance of laparoscopic cholecystectomy. The purpose of this project was to obtain a national standard of proficiency using the MIST-VR based on the performance of experienced laparoscopic surgeons. Surgeons attending the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) 2004 Annual Scientific Meeting who had performed more than 100 laparoscopic procedures volunteered to participate. All the subjects completed a demographic questionnaire assessing laparoscopic and MIST-VR experience in the learning center of the SAGES 2004 meeting. Each subject performed two consecutive trials of the MIST-VR Core Skills 1 program at the medium setting. Each trial involved six basic tasks of increasing difficulty: acquire place (AP), transfer place (TP), traversal (TV), withdrawal insert (WI), diathermy task (DT), and manipulate diathermy (MD). Trial 1 was considered a "warm-up," and trial 2 functioned as the test trial proper. Subject performance was scored for time, errors, and economy of instrument movement for each task, and a cumulative total score was calculated. Trial 2 data are expressed as mean time in seconds in Table 2. Proficiency levels for laparoscopic skills have now been established on a national scale by experienced laparoscopic surgeons using the MIST-VR simulator. Residency programs, training centers, and practicing surgeons can now use these data as guidelines for performance criterion during MIST-VR skills training.

Language proficiency and the international postgraduate student experience

OpenAIRE

Weaver, M

2016-01-01

In an increasingly competitive environment, with reduced government funding, full fee-paying international students are an important source of revenue for higher education institutions (HEIs). Although many previous studies have focused on the role of English language proficiency on academic success, there is little known about the extent to which levels of English language proficiency affect these non-native English speaking students’ overall course experience. There have been a wealth of st...

Comparing IM Residents with EM Resident for Their Skills of ECG Interpretation and Outlining Management Plan Accordingly

Directory of Open Access Journals (Sweden)

Hamid Reza Karimpoor Tari

2009-06-01

Full Text Available Background and Purpose: Electrocardiogram (ECG is one of the most commonly performed investigations in cardiac diseases and ECG abnormalities can reveal the early manifestations of cardiac ischemia, metabolic disorders, or life-threatening disrhythmias. Misinterpretation of ECG and its consequent mistreatment or performing inessential  interventions may cause life-threatening cardiac events. Since EM residents and internal medicine (IM residents are usually the first to visit at bedside and start treatments based on patient’s ECG, we intended to evaluate the ability of EM residents to interpret ECGs and to compare it with that of IM residents using various ECG samples.Method: 63 participants including 33 IM residents and 30 EM residents from two education hospitals of Shahid Beheshti University of Medical Sciences were enrolled in our study. A diagnosis test consisting of 15 ECG samples associated with a questionnaire containing questions about gender, academic year and proficiency in ECG interpretation was taken from all participants. This study was conducted under the supervision of a cardiologist and an emergency specialist who supervised the ECG selection, answers and scoring of each ECG. The maximum score for each ECG was 6 which were given to a completely correct diagnosis and -0.25 negative point was given if the answer was wrong or any differential diagnosis was mentioned. After the test, the answer sheets were collected and wereanalyzed with SPSS program, by two of study authors who were kept blind to the real identities of participants.Results: After classification of groups, the overall mean score was 45.5/100 (38-60. The mean score of IM and EM residents was 56.0/100 (44.9-72 and 38.9/100 (31.5-45.5, respectively (p< 0.001.No significant correlation was found between the diagnosis scores and participant’s self-judgment on her/his ECG interpretation skills (p=0.897, r=0.017. Five ECGs were considered as the most important and

Optimizing residence time, temperature and speed to improve TMP pulp properties and reduce energy

Energy Technology Data Exchange (ETDEWEB)

Sabourin, M.; Xu, E.; Cort, B.; Boileau, I.; Waller, A.

1997-04-01

The concept of reducing energy consumption in pulp mills by increasing the disc speed of refining has been established using single disc and double disc refiners in both pilot plant and mill applications. The RTS study evaluated in this paper reviews the effect of high-speed single disc refining coupled with shortdwell-high pressure retention conditions. Coupling these variables permitted evaluation of an optimum residence time, temperature and speed (RTS) operational window. The objective of the RTS conditions to sufficiently soften the wood chips through high temperature such that the fibre is more receptive to initial defiberization at high intensity. The improved pulp from the primary refiner at high intensity could potentially demonstrate improvements in physical pulp properties at a reduced specific energy requirement. The spruce/fir RTS-TMP described here required significantly less specific energy and produced TMP with slightly improved strength properties and equivalent optical properties compared to conventional TMP pulp. Studies on the radiate pine furnish indicated that the physical pulp property/specific energy relationships could be adjusted by manipulating the residence time. 4 refs., 10 tabs., 10 figs.

Improving STEM Student Learning Outcomes with GIS

Science.gov (United States)

Montgomery, W. W.

2013-12-01

Longitudinal data collection initiated a decade ago as part of a successful NSF-CCLI grant proposal has resulted in a large - and growing - sample (200+) of students who report on their perceptions of self-improvement in Technology, Critical Thinking, and Quantitative Reasoning proficiencies upon completion of an introductory (200-level) GIS course at New Jersey City University, a Hispanic-Serving and Minority Institution in Jersey City, NJ. Results from student satisfaction surveys indicate that, not surprisingly, 80% of respondents report improved confidence in Technology Literacy. Critical Thinking proficiency is judged to be significantly improved by 60% of respondents. On the other hand, Quantitative Reasoning proficiency confidence is improved in only 30% of students. This latter finding has prompted the instructor to search for more easily recognizable (to the student) ways of embedding quantitative reasoning into the course, as it is obvious to any GIS professional that there is an enormous amount of quantitative reasoning associated with this technology. A second post-course questionnaire asks students to rate themselves in these STEM proficiency areas using rubrics. Results mirror those from the self-satisfaction surveys. On a 5-point Likkert scale, students tend to see themselves improving about one letter grade on average in each proficiency area. The self-evaluation rubrics are reviewed by the instructor and are judged to be accurate for about 75% of the respondents.

Taxonomy of instructions given to residents in laparoscopic cholecystectomy.

Science.gov (United States)

Feng, Yuanyuan; Wong, Christopher; Park, Adrian; Mentis, Helena

2016-03-01

Although simulation-based training allows residents to become proficient in surgical skills outside the OR, residents still depend on senior surgeons' guidance in transferring skills accumulated from simulators into the operating room. This study aimed to identify and classify explicit instructions made by attending surgeons to their residents during laparoscopic surgery. Through these instructions, we examined the role gaze guidance plays in OR-based training. A total of ten laparoscopic cholecystectomy cases being performed by PGY4 residents were analyzed. The explicit directional instructions given by the mentoring attending surgeons to their residents were identified and classified into four categories based on their locations in the coordinate system. These categories were further combined into two classes, based on the target of instructions. The frequencies of instructions in the two classes were compared, and effect size was calculated. There were 1984 instructions identified in the ten cases. The instructions were categorized into instrument guidance (38.51%) and gaze guidance (61.49%). The instrument guidance focused on moving the instruments to perform surgical tasks, including directions to targets, instrument manipulation, and instrument interaction. The gaze guidance focused on achieving common ground during the operation, including target identification and target fixation. The frequency of gaze guidance is significantly higher than instrument guidance in a laparoscopic cholecystectomy (p guidance has become the main focus of OR-based training. The results show a tight connection between adopting expert gaze and performing surgical tasks and suggest that gaze training should be integrated into the simulation training.

Developing English Writing Proficiency in Limited English Proficient College Students through Cooperative Learning Strategies.

Science.gov (United States)

Gooden-Jones, Epsey M.; Carrasquillo, Angela L.

A study followed ten limited-English-proficient (LEP) community college students who were taught English largely using a cooperative learning approach. For four months, the students worked together using brainstorming techniques and collaborative reading and writing tasks. Task emphasis was on development of thinking skills through collaboration…

Knowledge and misconceptions about immunizations among medical students, pediatric, and family medicine resident.

Science.gov (United States)

Tañón, Vilmarie; Borrero, Clarimar; Pedrogo, Yasmín

2010-01-01

Previous research has indicated that, despite being the most trusted source of health information, medical students, residents and other health related professionals lack accurate and current knowledge regarding immunization practices. To evaluate medical students and primary care resident knowledge about immunizations. Self-administered survey given to students from four medical schools, Pediatrics residents (2 training programs) and Family Medicine residents (2 programs). Data was analyzed using Statistix 8.0. One-way ANOVA test was used to compare means, and a p-value less than 0.05 was considered statistically significant. Participants (N=376) included 3rd (64%) and 4th (18%) year medical students and a homogenous distribution of 1st, 2nd and 3rd year residents. The mean percent of correct answers about immunizations was 61%. The participants showed poor knowledge about indications (62% correct answers), contraindications (46% correct answers) and myths (71% correct answers). Knowledge about immunizations correlated with higher levels of education (p immunizations followed by books (48%) and the internet (36%). They referred poor exposure to immunizations in clinical settings. Most medical students do not have the expected knowledge about immunization indications and contraindications. Residents were not proficient in immunization contraindications. Both groups had an adequate understanding about vaccination myths. Efforts towards ensuring adequate exposure to immunizations education during training years are needed in order to eliminate one of the barriers to adequate immunizations in children.

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.

Surgical resident education in patient safety: where can we improve?

Science.gov (United States)

Putnam, Luke R; Levy, Shauna M; Kellagher, Caroline M; Etchegaray, Jason M; Thomas, Eric J; Kao, Lillian S; Lally, Kevin P; Tsao, KuoJen

2015-12-01

Effective communication and patient safety practices are paramount in health care. Surgical residents play an integral role in the perioperative team, yet their perceptions of patient safety remain unclear. We hypothesized that surgical residents perceive the perioperative environment as more unsafe than their faculty and operating room staff despite completing a required safety curriculum. Surgeons, anesthesiologists, and perioperative nurses in a large academic children's hospital participated in multifaceted, physician-led workshops aimed at enhancing communication and safety culture over a 3-y period. All general surgery residents from the same academic center completed a hospital-based online safety curriculum only. All groups subsequently completed the psychometrically validated safety attitudes questionnaire to evaluate three domains: safety culture, teamwork, and speaking up. Results reflect the percent of respondents who slightly or strongly agreed. Chi-square analysis was performed. Sixty-three of 84 perioperative personnel (75%) and 48 of 52 surgical residents (92%) completed the safety attitudes questionnaire. A higher percentage of perioperative personnel perceived a safer environment than the surgical residents in all three domains, which was significantly higher for safety culture (68% versus 46%, P = 0.03). When stratified into two groups, junior residents (postgraduate years 1-2) and senior residents (postgraduate years 3-5) had lower scores for all three domains, but the differences were not statistically significant. Surgical residents' perceptions of perioperative safety remain suboptimal. With an enhanced safety curriculum, perioperative staff demonstrated higher perceptions of safety compared with residents who participated in an online-only curriculum. Optimal surgical education on patient safety remains unknown but should require a dedicated, systematic approach. Copyright © 2015 Elsevier Inc. All rights reserved.

Use of simulation-based education to improve resident learning and patient care in the medical intensive care unit: a randomized trial.

Science.gov (United States)

Schroedl, Clara J; Corbridge, Thomas C; Cohen, Elaine R; Fakhran, Sherene S; Schimmel, Daniel; McGaghie, William C; Wayne, Diane B

2012-04-01

The purpose of this study is to determine the effect of simulation-based education on the knowledge and skills of internal medicine residents in the medical intensive care unit (MICU). From January 2009 to January 2010, 60 first-year residents at a tertiary care teaching hospital were randomized by month of rotation to an intervention group (simulator-trained, n = 26) and a control group (traditionally trained, n = 34). Simulator-trained residents completed 4 hours of simulation-based education before their medical intensive care unit (MICU) rotation. Topics included circulatory shock, respiratory failure, and mechanical ventilation. After their rotation, residents completed a standardized bedside skills assessment using a 14-item checklist regarding respiratory mechanics, ventilator settings, and circulatory parameters. Performance of simulator-trained and traditionally trained residents was compared using a 2-tailed independent-samples t test. Simulator-trained residents scored significantly higher on the bedside skills assessment compared with traditionally trained residents (82.5% ± 10.6% vs 74.8% ± 14.1%, P = .027). Simulator-trained residents were highly satisfied with the simulation curriculum. Simulation-based education significantly improved resident knowledge and skill in the MICU. Knowledge acquired in the simulated environment was transferred to improved bedside skills caring for MICU patients. Simulation-based education is a valuable adjunct to standard clinical training for residents in the MICU. Copyright © 2012 Elsevier Inc. All rights reserved.

Outcomes of an Advanced Ultrasound Elective: Preparing Medical Students for Residency and Practice.

Science.gov (United States)

Prats, Michael I; Royall, Nelson A; Panchal, Ashish R; Way, David P; Bahner, David P

2016-05-01

Many medical specialties have adopted the use of ultrasound, creating demands for higher-quality ultrasound training at all levels of medical education. Little is known about the long-term benefit of integrating ultrasound training during undergraduate medical education. This study evaluated the effect of a longitudinal fourth-year undergraduate medical education elective in ultrasound and its impact on the future use of ultrasound in clinical practice. A cross-sectional survey of medical graduates from The Ohio State University College of Medicine (2006-2011) was done, comparing those who participated and those who did not participate in a rigorous ultrasound program for fourth-year medical students. A 38-item questionnaire queried graduates concerning ultrasound education in residency, their proficiency, and their current use of ultrasound in clinical practice. Surveys were completed by 116 respondents, for a return rate of 40.8% (116 of 284). The participants of the undergraduate medical education ultrasound elective (n = 61) reported more hours of ultrasound training after graduation (hands-on training, bedside scanning, and number of scans performed; P practice (P medical education ultrasound elective produced physicians who were more likely to seek additional training in residency, evaluate themselves as more proficient, and use ultrasound in their clinical practice. Early training in bedside ultrasound during undergraduate medical education yields physicians who are better prepared for integration of ultrasound into clinical practice. © 2016 by the American Institute of Ultrasound in Medicine.

[An experimental proficiency test for ability to screen 104 residual pesticides in agricultural products].

Science.gov (United States)

Tsumura, Yukari; Ishimitsu, Susumu; Otaki, Kayo; Uchimi, Hiroyuki; Matsumoto, Nobuyuki; Daba, Masaki; Tsuchiya, Tetsu; Ukyo, Masaho; Tonogai, Yasuhide

2003-10-01

An experimental proficiency test program for ability to screen 104 residual pesticides in agricultural products has been conducted. Eight Japanese laboratories joined the program. Items tested in the present study were limit of detection, internal proficiency test (self spike) and external proficiency test (blind spike). All 104 pesticides were well detected and recovered from agricultural foods in the internal proficiency test. However, the results of the external proficiency test did not completely agree with those of the internal proficiency tests. After 5 rounds of the blind spike test, the ratio of the number of correctly detected pesticides to that of actually contained ones (49 total) ranged from 65% to 100% among laboratories. The numbers of mistakenly detected pesticides by a laboratory were 0 to 15. Thus, there was a great difference among the laboratories in the ability to screen multiresidual pesticides.

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

Mismatch repair proficiency is not required for radioenhancement by gemcitabine

International Nuclear Information System (INIS)

Bree, Chris van; Rodermond, Hans M.; Vos, Judith de; Haveman, Jaap; Franken, Nicolaas

2005-01-01

Purpose: Mismatch repair (MMR) proficiency has been reported to either increase or decrease radioenhancement by 24-h incubations with gemcitabine. This study aimed to establish the importance of MMR for radioenhancement by gemcitabine after short-exposure, high-dose treatment and long-exposure, low-dose treatment. Methods and Materials: Survival of MMR-deficient HCT116 and MMR-proficient HCT116 + 3 cells was analyzed by clonogenic assays. Mild, equitoxic gemcitabine treatments (4 h, 0.1 μM vs. 24 h, 6 nM) were combined with γ-irradiation to determine the radioenhancement with or without recovery. Gemcitabine metabolism and cell-cycle effects were evaluated by high-performance liquid chromatography analysis and bivariate flow cytometry. Results: Radioenhancement after 4 h of 0.1 μM of gemcitabine was similar in both cell lines, but the radioenhancement after 24 h of 6 nM of gemcitabine was reduced in MMR-proficient cells. No significant differences between both cell lines were observed in the gemcitabine metabolism or cell-cycle effects after these treatments. Gemcitabine radioenhancement after recovery was also lower in MMR-proficient cells than in MMR-deficient cells. Conclusion: Mismatch repair proficiency decreases radioenhancement by long incubations of gemcitabine but does not affect radioenhancement by short exposures to a clinically relevant gemcitabine dose. Our data suggest that MMR contributes to the recovery from gemcitabine treatment

Assessment of residency program outcomes via alumni surveys.

Science.gov (United States)

Lüer, Sonja; Aebi, Christoph

2017-01-01

One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals' acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR) data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland. Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback) were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages), and 2 alumni surveys (S1, S2). In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%). Forty-six alumni (42%) in private practice were eligible for alumni surveys. Response rates were 87% (S1) and 61% (S2). Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice) varied widely (late-training decision to enter private practice). Mean employment level in private practice was 60% (range 20%-100%). Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically. A broadened view on outcomes - beyond individuals' competency acquisition - provides informative insights into a training program, can allow for informed program updates, and guide future program development.

Implementing Cognitive Intervention to Educate and Improve Resident's Preparedness in Landslide Areas

Science.gov (United States)

Susanto, Novie; Putranto, Thomas Triadi; Prastawa, Heru; Ulfa, Ema Amalia

2018-02-01

Semarang city has the potential landslides were quite high in almost all regions. The previous research shows that the Manyaran and Kembang Arum is classified as "not ready" with vulnerability-prone of landslide areas. Therefore, design and implementation of cognitive interventions in human are needed to educate and improve the preparedness of the residents against landslide. This study aims to implement the various cognitive interventions to the residents in landslide areas and analysis of the different interventions toward the preparedness index. The study is conducted on 40 respondents from Kembang Arum and 40 respondents from Manyaran. They are aged ≥ 17 years, illiteracy and a RT/RW/PKK cadres. The independent variables in this study are Knowledge and Attitude, Emergency Planning, Warning System, and Resources Mobilization. The dependent variable is the preparedness index. The design of cognitive interventions is generated according to the demographic characteristics of the respondent and the result of Fault Tree Analysis. The preparedness index of the residents against landslides in Kembang Arum increases about 71.71% and in Manyaran up to 90.06%. Implementation of cognitive interventions with module, video and discussion in the Manyaran is more effective than using posters, videos and discussions in Kembang Arum.

Differences in Less Proficient and More Proficient ESL College Writing in the Philippine Setting

Science.gov (United States)

Gustilo, Leah E.

2016-01-01

The present study aimed at characterizing what skilled or more proficient ESL college writing is in the Philippine setting through a contrastive analysis of three groups of variables identified from previous studies: resources, processes, and performance of ESL writers. Based on Chenoweth and Hayes' (2001; 2003) framework, the resource level…

Critique of a language enrichment programme for Grade 4 ESL learners with limited English proficiency: a pilot study

Directory of Open Access Journals (Sweden)

Mirna Neli

2008-05-01

Full Text Available Some Grade 4 educators have expressed feelings of ineptitude regarding the support of ESL (English Second Language learners with limited English proficiency as they do not know how to support these learners effectively. Their litany emphasises ESL educators' need for supportive and preventive intervention. A Story-based Language Enrichment Programme (SLEP was compiled to suit the needs of educators teaching Grade 4 ESL learners with limited English proficiency. The programme was designed to maintain or improve the English proficiency of ESL learners. An intervention research method was followed to test the efficacy of SLEP. Forty teachers implemented SLEP over a six-week period. Thirty-nine teachers provided constructive feedback at the end of this period. Between 92% and 100% of the participants rated SLEP positively. Rural participants suggested some refinements to the programme. The overall conclusion was that SLEP makes a useful contribution to ESL practice.

Using a composite morbidity score and cultural survey to explore characteristics of high proficiency neonatal intensive care units.

Science.gov (United States)

Kaempf, Joseph W; Wang, Lian; Dunn, Michael

2018-01-03

Continuous quality improvement (CQI) collaboration has not eliminated the morbidity variability seen among neonatal intensive care units (NICUs). Factors other than inconstant application of potentially better practices (PBPs) might explain divergent proficiency. Measure a composite morbidity score and determine whether cultural, environmental and cognitive factors distinguish high proficiency from lower proficiency NICUs. Retrospective analysis using a risk-adjusted composite morbidity score (Benefit Metric) and cultural survey focusing on very low birth weight (VLBW) infants from 39 NICUs, years 2000-2014. The Benefit Metric and yearly variance from the group mean was rank-ordered by NICU. A comprehensive survey was completed by each NICU exploring whether morbidity variance correlated with CQI methodology, cultural, environmental and/or cognitive characteristics. 58 272 VLBW infants were included, mean (SD) age 28.2 (3.0) weeks, birth weight 1031 (301) g. The 39 NICU groups' Benefit Metric improved 40%, from 80 in 2000 to 112 in 2014 (Pexpectations of providers, enhanced learning opportunities, knowledge of CQI fundamentals and more generous staffing. Cultural, environmental and cognitive characteristics vary among NICUs perhaps more than traditional CQI methodology and PBPs, possibly explaining the inconstancy of VLBW infant morbidity reduction efforts. High proficiency NICUs foster spirited team work and camaraderie, sustained learning opportunities and support of favourable staffing that allows problem solving and widespread involvement in CQI activities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

Science.gov (United States)

McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A

2011-12-01

An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships. The Accreditation Council for Graduate Medical Education sponsored a full-day workshop for residency program directors and their incoming chief residents. Sessions focused on increased understanding of personality styles, using experiential learning, and open communication between chief residents and program directors, related to feedback and expectations of each other. Participants completed an anonymous survey immediately after the workshop and again 8 months later to assess its long-term impact. Participants found the workshop to be a valuable experience, with comments revealing common themes. Program directors and chief residents expect each other to act as a role model for the residents, be approachable and available, and to be transparent and fair in their decision-making processes; both groups wanted feedback on performance and clear expectations from each other for roles and responsibilities; and both groups identified the need to be innovative and supportive of changes in the program. Respondents to the follow-up survey reported that workshop participation improved their relationships with their co-chiefs and program directors. Participation in this experiential workshop improved the working relationships between chief residents and program directors. The themes that were identified can be used to foster communication between incoming chief residents and residency directors and to

Results of the Proficiency Test, PT1 and PT2, 2012

DEFF Research Database (Denmark)

Vendramin, Niccolò; Nicolajsen, Nicole; Christophersen, Maj-Britt

A comparative test of diagnostic procedures was provided by the European Union Reference Laboratory (EURL) for Fish Diseases. The test was divided into proficiency test 1 (PT1) and proficiency test 2 (PT2). The number of National Reference Laboratories (NRLs) participating in PT1 and PT2 was 43. ....... The tests were sent from the EURL in the beginning of September 2012. Both PT1 and PT2 are accredited by DANAK under registration number 515 for proficiency testing according to the quality assurance standard DS/EN ISO/IEC 17043....

[Laboratory accreditation and proficiency testing].

Science.gov (United States)

Kuwa, Katsuhiko

2003-05-01

ISO/TC 212 covering clinical laboratory testing and in vitro diagnostic test systems will issue the international standard for medical laboratory quality and competence requirements, ISO 15189. This standard is based on the ISO/IEC 17025, general requirements for competence of testing and calibration laboratories and ISO 9001, quality management systems-requirements. Clinical laboratory services are essential to patient care and therefore should be available to meet the needs of all patients and clinical personnel responsible for human health care. If a laboratory seeks accreditation, it should select an accreditation body that operates according to this international standard and in a manner which takes into account the particular requirements of clinical laboratories. Proficiency testing should be available to evaluate the calibration laboratories and reference measurement laboratories in clinical medicine. Reference measurement procedures should be of precise and the analytical principle of measurement applied should ensure reliability. We should be prepared to establish a quality management system and proficiency testing in clinical laboratories.

Using residents' perceptions to improve park-people relationships in Chatthin Wildlife Sanctuary, Myanmar.

Science.gov (United States)

Allendorf, Teri D; Aung, Myint; Songer, Melissa

2012-05-30

The complex and context-specific relationships that local residents have with neighboring protected areas present many challenges for protected area (PA) management. While long-term, interdisciplinary approaches may be necessary to fully understand park-people relationships within a particular PA, the reality is that management decisions for the majority of PAs in the world are made by protected area staff with little or no external assistance. One potential entry point for management to understand park-people relationships and improve management is through understanding people's perceptions of PAs. This paper presents a study from Chatthin Wildlife Sanctuary in central Myanmar designed to explore the impact of using residents' attitudes to directly inform management strategies. We conducted a survey to determine attitudes and determinants of attitudes toward CWS. In response to the survey, the warden made changes to the Sanctuary's management strategy to accommodate local needs and perceptions. Four years later, we repeated the survey to explore the effects of the management changes on people's perceptions and found that people were significantly more likely to like the sanctuary, less likely to mention problems, and more likely to mention benefits. People's negative perceptions of management conflicts and crop damage decreased and their positive perceptions of conservation and ecosystem service benefits and extraction benefits increased. This study demonstrates that residents' perceptions can be used by management as a starting point to improve park-people relationships through feasible and targeted interventions that are meaningful to local communities and their relationships with PAs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Relationships Between English Language Proficiency, Health Literacy, and Health Outcomes in Somali Refugees.

Science.gov (United States)

Murphy, Jessica E; Smock, Laura; Hunter-Adams, Jo; Xuan, Ziming; Cochran, Jennifer; Paasche-Orlow, Michael K; Geltman, Paul L

2018-06-15

Little is known about the impacts of health literacy and English proficiency on the health status of Somali refugees. Data came from interviews in 2009-2011 of 411 adult Somali refugees recently resettled in Massachusetts. English proficiency, health literacy, and physical and mental health were measured using the Basic English Skills Test Plus, the Short Test of Health Literacy in Adults, and the Physical and Mental Component Summaries of the Short Form-12. Associations were analyzed using multiple linear regression. In adjusted analyses, higher English proficiency was associated with worse mental health in males. English proficiency was not associated with physical health. Health literacy was associated with neither physical nor mental health. Language proficiency may adversely affect the mental health of male Somali refugees, contrary to findings in other immigrant groups. Research on underlying mechanisms and opportunities to understand this relationship are needed.

76 FR 66318 - Announcement of Funding Awards; Limited English Proficiency Initiative Program (LEPI), Fiscal...

Science.gov (United States)

2011-10-26

... limited English proficiency (LEP), and develop and implement a system to provide those services so LEP... Awards; Limited English Proficiency Initiative Program (LEPI), Fiscal Year 2010/2011 AGENCY: Office of... (NOFA) for the Limited English Proficiency Initiative (LEPI) Program for Fiscal Year (FY) 2010/2011...

Relationship Between Technical Errors and Decision-Making Skills in the Junior Resident.

Science.gov (United States)

Nathwani, Jay N; Fiers, Rebekah M; Ray, Rebecca D; Witt, Anna K; Law, Katherine E; DiMarco, ShannonM; Pugh, Carla M

The purpose of this study is to coevaluate resident technical errors and decision-making capabilities during placement of a subclavian central venous catheter (CVC). We hypothesize that there would be significant correlations between scenario-based decision-making skills and technical proficiency in central line insertion. We also predict residents would face problems in anticipating common difficulties and generating solutions associated with line placement. Participants were asked to insert a subclavian central line on a simulator. After completion, residents were presented with a real-life patient photograph depicting CVC placement and asked to anticipate difficulties and generate solutions. Error rates were analyzed using chi-square tests and a 5% expected error rate. Correlations were sought by comparing technical errors and scenario-based decision-making skills. This study was performed at 7 tertiary care centers. Study participants (N = 46) largely consisted of first-year research residents who could be followed longitudinally. Second-year research and clinical residents were not excluded. In total, 6 checklist errors were committed more often than anticipated. Residents committed an average of 1.9 errors, significantly more than the 1 error, at most, per person expected (t(44) = 3.82, p technical errors committed negatively correlated with the total number of commonly identified difficulties and generated solutions (r (33) = -0.429, p = 0.021, r (33) = -0.383, p = 0.044, respectively). Almost half of the surgical residents committed multiple errors while performing subclavian CVC placement. The correlation between technical errors and decision-making skills suggests a critical need to train residents in both technique and error management. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Improving resident's skills in the management of circulatory shock with a knowledge-based e-learning tool.

Science.gov (United States)

Riaño, David; Real, Francis; Alonso, Jose Ramon

2018-05-01

Correct clinical management of circulatory shock in emergency departments (ER) and intensive care units (ICU) is critical. In this context, the transmission of professional skills by means of the practical supervision of real cases at the point of care entails important issues that can be widely overcome with the use of computer knowledge-based e-learning tools. Shock-Instructor is a web-based e-learning tool implementing the already tested training program model (TPM) that uses a knowledge base about the evidence found in the clinical practice guidelines about seven types of shock. This tool is expected to reduce the learning times and to improve the skills of hospital residents with regard to both the correct application of the guidelines and patient recovery, suppressing the risks of direct interventions. Shock-Instructor has been used to train residents in the Emergency Department of the Hospital Clínic de Barcelona (Spain) in order to reduce the learning cycle without affecting quality. A case-base with the description of 51 cases with shock and a knowledge-base with 137 clinical rules about the treatment of shock were incorporated to the Shock-Instructor system. A group of 33 residents was involved in a randomized controlled trial to check whether the use of Shock-Instructor can significantly improve the skills of clinicians after one week of problem-based training. No significant differences were found in the skill levels of the intervention (IG) and control (CG) groups prior to learning. However, we observed an improvement of the IG clinicians capacity to stabilize patients with shock in better clinical conditions (5% improvement, p = 0.004), and to reduce the risk of death in 19.52% (p = 0.004), after training. First-year residents in IG enhanced 14.3% their sensitivity in the correct application of guidelines (p = 0.01), and 14.9% the mean survival rate of their patients (p = 0.01), after being trained with Shock-Instructor for a week

Residency Training: Quality improvement projects in neurology residency and fellowship: applying DMAIC methodology.

Science.gov (United States)

Kassardjian, Charles D; Williamson, Michelle L; van Buskirk, Dorothy J; Ernste, Floranne C; Hunderfund, Andrea N Leep

2015-07-14

Teaching quality improvement (QI) is a priority for residency and fellowship training programs. However, many medical trainees have had little exposure to QI methods. The purpose of this study is to review a rigorous and simple QI methodology (define, measure, analyze, improve, and control [DMAIC]) and demonstrate its use in a fellow-driven QI project aimed at reducing the number of delayed and canceled muscle biopsies at our institution. DMAIC was utilized. The project aim was to reduce the number of delayed muscle biopsies to 10% or less within 24 months. Baseline data were collected for 12 months. These data were analyzed to identify root causes for muscle biopsy delays and cancellations. Interventions were developed to address the most common root causes. Performance was then remeasured for 9 months. Baseline data were collected on 97 of 120 muscle biopsies during 2013. Twenty biopsies (20.6%) were delayed. The most common causes were scheduling too many tests on the same day and lack of fasting. Interventions aimed at patient education and biopsy scheduling were implemented. The effect was to reduce the number of delayed biopsies to 6.6% (6/91) over the next 9 months. Familiarity with QI methodologies such as DMAIC is helpful to ensure valid results and conclusions. Utilizing DMAIC, we were able to implement simple changes and significantly reduce the number of delayed muscle biopsies at our institution. © 2015 American Academy of Neurology.

Proficiency Test SYKE 8/2012. Volatile organic compounds in water and soil

OpenAIRE

Korhonen-Ylönen, Kaija; Nuutinen, Jari; Leivuori, Mirja; Ilmakunnas, Markku

2013-01-01

Proftest SYKE carried out the proficiency test for analysis of volatile organic compounds from water and soil in October 2012. One artificial sample and one river water sample and one soil sample were distributed. In total, 15 laboratories participated in the proficiency test. Either the calculated concentration or the robust mean value was chosen to be the assigned value for the measurement. The performance of the participants was evaluated by using z scores. In this proficiency test 72 % of...

Designing Cognitive Intervention to Improve the Awareness Index of the Residents in the Landslide Area

Science.gov (United States)

Susanto, N.; Putranto, T. T.; Ulfa, E. A.

2017-02-01

Considering Semarang as a city with a high potential of landslides occurrences in its almost area, human as the part of the system should be played as a centre of the disaster management system to reduce the natural disaster risk. The study area is located in Manyaran district (the west of Semarang) which is categorised as a vulnerable of landslide area. This study aims at establishing a cognitive intervention based on a cause analysis (Fault Tree Analysis/FTA) to find the cause of low value and improve the awareness index of residents as the implementation of human-based disaster management model. The FTA result was then combined with the demographical data to generate the design of the cognitive intervention. The FTA result conducted that the preparedness of emergency planning had the lowest value (18.2%) which was caused by the lack individual preparation including lack of residents knowledge, and the absence of observation facilities as well as the lack of evacuation planning. Analysis of demographical data resulted in a situation of lack socialisation and knowledge of the residents regarding the landslide occurrence. The model of cognitive intervention then utilised some tools such as video, module and discussion to improve the awareness index.

Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

Science.gov (United States)

Franklin, Corinna C; Bosch, Patrick P; Grudziak, Jan S; Dede, Ozgur; Ramirez, Rey N; Mendelson, Steven A; Ward, W Timothy; Brooks, Maria; Kenkre, Tanya; Lubahn, John D; Deeney, Vincent F; Roach, James W

2017-03-01

Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (Pdidactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores. Level III-retrospective case-control study.

Current robotic curricula for surgery residents: A need for additional cognitive and psychomotor focus.

Science.gov (United States)

Green, Courtney A; Chern, Hueylan; O'Sullivan, Patricia S

2018-02-01

Current robot surgery curricula developed by industry were designed for expert surgeons. We sought to identify the robotic curricula that currently exist in general surgery residencies and describe their components. We identified 12 residency programs with robotic curricula. Using a structured coding form to identify themes including sequence, duration, emphasis and assessment, we generated a descriptive summary. Curricula followed a similar sequence: learners started with online modules and simulation exercises, followed by bedside experience during R2-R3 training years, and then operative opportunities on the console in the final years of training. Consistent portions of the curricula reflect a device-dependent training paradigm; they defined the sequence of instruction. Most curricula lacked specifics on duration and content of training activities. None clearly described cognitive or psychomotor skills needed by residents and none required a proficiency assessment before graduation. Resident-specific robotic curricula remain grounded in initial industrial efforts to train experienced surgeons, are non-specific regarding the type and nature of hands on experience, and do not include discussion of operative technique and surgical concepts. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Language Proficiency and Cultural Identity as Two Facets of the Acculturation Process

Directory of Open Access Journals (Sweden)

Kmiotek Łukasz

2017-10-01

Full Text Available This article describes a cross-cultural study comparing bicultural identity of first generation Poles and high school students in the Rhône Alpes region (France, as well as French language university students in Poland. Studies show that two components, language and identity, are related. This article intends to answer questions regarding the relationship between the migrant’s bicultural identity and language proficiency. Bilingualism is operationalized as (i listening comprehension and (ii bidirectional translation. The results do not confirm that there is a relation between bilingual skills and identification with shared French and Polish values. Cultural identity appears to be inversely related to country of residence: Polish identity is strongest amongst immigrant youth in France and French identity is strongest amongst Polish students of French language and culture. These identities run in opposite direction to language competencies. The results suggest internalization of one of the cultures' negative stereotypes towards the other or towards itself.

Assessment of Proficiency During Simulated Rover Operations Following Long-Duration Spaceflight

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Wood, S. J.; Dean, S. L.; De Dios, Y. E.; MacDougall, H. G.; Moore, S. T.

2011-01-01

Following long-duration space travel, pressurized rovers will enhance crew mobility to explore Mars and other planetary surfaces. Adaptive changes in sensorimotor function may limit the crew s proficiency when performing some rover operations shortly after transition to the new gravitoinertial environment. The primary goal of this investigation is to quantify postflight decrements in operational proficiency in a motion-based rover simulation after International Space Station (ISS) expeditions. Given that postflight performance will also be influenced by the level of preflight proficiency attained, a ground-based normative study was conducted to characterize the acquisition of skills over multiple sessions.

Emergency Response Proficiency Test for Japanese Laboratories: Determination of Selected Radionuclides in Water, Soil, Vegetation and Aerosol Filters

International Nuclear Information System (INIS)

2013-01-01

Reliable determination of natural and artificial radionuclides in environmental samples is necessary for compliance with radiation protection and environmental regulations. The IAEA assists Member State laboratories in maintaining and improving their readiness in this regard by producing reference materials, by developing standardized analytical methods, and by conducting interlaboratory comparisons and proficiency tests as tools for quality control. To fulfil this obligation and ensure a reliable, rapid and consistent worldwide response, the IAEA Terrestrial Environment Laboratory in Seibersdorf, Austria, organizes interlaboratory comparisons and proficiency tests. In addition, the IAEA coordinates the worldwide network of Analytical Laboratories for the Measurement of Environmental Radioactivity (ALMERA). After the accident at the Fukushima Daiichi nuclear power plant in March 2011, Japan requested the IAEA to organize an emergency response proficiency test for Japanese laboratories with the aim of assessing their capacity to rapidly and accurately measure radionuclides in environmental samples. The IAEA responded to the request by assembling a special sample set covering the main environmental samples and radionuclides of interest in the case of a nuclear emergency situation. Water, soil, vegetation and aerosol filter samples were made available to Japanese laboratories for analysis by gamma ray spectrometry. This report presents the results of the IAEA-TEL-2011-08 emergency response proficiency test for Japanese laboratories on the determination of selected radionuclides in water, soil, vegetation and aerosol filters. The report includes descriptions of the methodologies and data evaluation approach used, as well as summary evaluations of each radionuclide and individual evaluation reports of each laboratory. This proficiency test was designed to identify analytical problems and to support Member State laboratories in their efforts to improve the quality of

Maintenance proficiency evaluation test bank

International Nuclear Information System (INIS)

Maier, Loran

2003-01-01

The Maintenance Proficiency Evaluation Test Bank (MPETB) is an Electric Power Research Institute- (EPRJ-) operated, utility-sponsored means of developing, maintaining, and disseminating secure, high-quality written and performance maintenance proficiency tests. EPRTs charter is to ensure that all tests and test items that go into the Test Bank have been validated, screened for reliability, and evaluated to high standards of psychometric excellence. Proficiency tests of maintenance personnel.(mechanics, electricians, and instrumentation and control [I and C] technicians) are most often used to determine if an experienced employee is capable of performing maintenance tasks without further training. Such tests provide objective evidence for decisions to exempt an employee from what, for the employee, is unnecessary training. This leads to considerable savings in training costs and increased productivity because supervisors can assign personnel to tasks at which their competence is proven. The ultimate objective of proficiency evaluation is to ensure that qualified maintenance personnel are available to meet the maintenance requirements of the plant Numerous task-specific MPE tests (both written and performance) have been developed and validated using the EPRI MPE methodology by the utilities participating in the MPETB project A task-specific MPE consists of a multiple-choice written examination and a multi-step performance evaluation that can be used to assess an individual's present knowledge and skill level for a given maintenance task. The MPETB contains MPEs and test items for the mechanical, electrical, and I and C classifications that are readily available to participating utilities. Presently, utilities are placing emphasis on developing MPEs to evaluate outage-related maintenance tasks that demonstrate the competency and qualifications of plant and contractor personnel before the start of outage work. Utilities are also using the MPE methodology and process to

A survey of resident perspectives on surgical case minimums and the impact on milestones, graduation, credentialing, and preparation for practice: AOA critical issues.

Science.gov (United States)

Jeray, Kyle J; Frick, Steven L

2014-12-03

residents and measuring the effectiveness of residency programs. However, the surgical ability of an individual resident should not be evaluated on case minimums alone. The development of the milestones to assess competency should continue, but, as surgical skill is not a specific core competency, perhaps other methods for assessing surgical proficiency need to be developed rather than case minimums. Surgical skills laboratories and proctoring residents independently performing procedures may help to assess surgical proficiency, in addition to traditional faculty and 360° evaluations. Combining these types of assessments with surgical case logs documenting the residents' educational experience seems to be the best path going forward in assessing the development of young surgeons. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Development of a proficiency-based virtual reality simulation training curriculum for laparoscopic appendicectomy.

Science.gov (United States)

Sirimanna, Pramudith; Gladman, Marc A

2017-10-01

Proficiency-based virtual reality (VR) training curricula improve intraoperative performance, but have not been developed for laparoscopic appendicectomy (LA). This study aimed to develop an evidence-based training curriculum for LA. A total of 10 experienced (>50 LAs), eight intermediate (10-30 LAs) and 20 inexperienced (<10 LAs) operators performed guided and unguided LA tasks on a high-fidelity VR simulator using internationally relevant techniques. The ability to differentiate levels of experience (construct validity) was measured using simulator-derived metrics. Learning curves were analysed. Proficiency benchmarks were defined by the performance of the experienced group. Intermediate and experienced participants completed a questionnaire to evaluate the realism (face validity) and relevance (content validity). Of 18 surgeons, 16 (89%) considered the VR model to be visually realistic and 17 (95%) believed that it was representative of actual practice. All 'guided' modules demonstrated construct validity (P < 0.05), with learning curves that plateaued between sessions 6 and 9 (P < 0.01). When comparing inexperienced to intermediates to experienced, the 'unguided' LA module demonstrated construct validity for economy of motion (5.00 versus 7.17 versus 7.84, respectively; P < 0.01) and task time (864.5 s versus 477.2 s versus 352.1 s, respectively, P < 0.01). Construct validity was also confirmed for number of movements, path length and idle time. Validated modules were used for curriculum construction, with proficiency benchmarks used as performance goals. A VR LA model was realistic and representative of actual practice and was validated as a training and assessment tool. Consequently, the first evidence-based internationally applicable training curriculum for LA was constructed, which facilitates skill acquisition to proficiency. © 2017 Royal Australasian College of Surgeons.

Improving education under work-hour restrictions: comparing learning and teaching preferences of faculty, residents, and students.

Science.gov (United States)

Jack, Megan C; Kenkare, Sonya B; Saville, Benjamin R; Beidler, Stephanie K; Saba, Sam C; West, Alisha N; Hanemann, Michael S; van Aalst, John A

2010-01-01

Faced with work-hour restrictions, educators are mandated to improve the efficiency of resident and medical student education. Few studies have assessed learning styles in medicine; none have compared teaching and learning preferences. Validated tools exist to study these deficiencies. Kolb describes 4 learning styles: converging (practical), diverging (imaginative), assimilating (inductive), and accommodating (active). Grasha Teaching Styles are categorized into "clusters": 1 (teacher-centered, knowledge acquisition), 2 (teacher-centered, role modeling), 3 (student-centered, problem-solving), and 4 (student-centered, facilitative). Kolb's Learning Style Inventory (HayGroup, Philadelphia, Pennsylvania) and Grasha-Riechmann's TSS were administered to surgical faculty (n = 61), residents (n = 96), and medical students (n = 183) at a tertiary academic medical center, after informed consent was obtained (IRB # 06-0612). Statistical analysis was performed using χ(2) and Fisher exact tests. Surgical residents preferred active learning (p = 0.053), whereas faculty preferred reflective learning (p style more often than surgical faculty (p = 0.01). Medical students preferred converging learning (42%) and cluster 4 teaching (35%). Statistical significance was unchanged when corrected for gender, resident training level, and subspecialization. Significant differences exist between faculty and residents in both learning and teaching preferences; this finding suggests inefficiency in resident education, as previous research suggests that learning styles parallel teaching styles. Absence of a predominant teaching style in residents suggests these individuals are learning to be teachers. The adaptation of faculty teaching methods to account for variations in resident learning styles may promote a better learning environment and more efficient faculty-resident interaction. Additional, multi-institutional studies using these tools are needed to elucidate these findings fully

Language Learning Strategies and English Proficiency: Interpretations from Information-Processing Theory

Science.gov (United States)

Rao, Zhenhui

2016-01-01

The research reported here investigated the relationship between students' use of language learning strategies and their English proficiency, and then interpreted the data from two models in information-processing theory. Results showed that the students' English proficiency significantly affected their use of learning strategies, with high-level…

Resident physicians' opinions and behaviors regarding the use of interpreters in New Orleans.

Science.gov (United States)

Sandler, Rachel; Myers, Leann; Springgate, Benjamin

2014-11-01

In academic medical centers, resident physicians are most involved in the care of patients, yet many have little training in the proper use of interpreters in the care of patients with limited English-language proficiency. Residents have cited lack of time and lack of access to trained medical interpreters as barriers to the use of professional interpreter services. The purpose of this study was to examine the usage patterns of interpreters and perceived barriers to using interpreters in New Orleans. Subjects included resident physicians training in internal medicine, pediatrics, and combined internal medicine and pediatrics at Tulane University and Louisiana State University in New Orleans. A survey that consisted of demographics, short-answer, and Likert-scale questions regarding attitudes related to the use of interpreters was used as the metric. The overall response rate was 55.5%. A total of 92.4% of subjects surveyed stated that they had used an interpreter during their residency. Telephone services and family members were the most commonly used types of interpreters (41.3% and 30.5%, respectively). Resident physicians were most likely to use interpreter services during their initial history taking as well as at discharge, but use declined throughout patients' hospitalization (P New Orleans have experience using interpreter services; however, they continue to use untrained interpreters and use varies during the hospital encounter. Targeted training for residents, including interpreter logistics, may help increase the use of interpreters.

Education Research: Neurology resident education

Science.gov (United States)

Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

2016-01-01

Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

76 FR 81958 - Notice of Submission of Proposed Information Collection to OMB; Limited English Proficiency...

Science.gov (United States)

2011-12-29

... Proposed Information Collection to OMB; Limited English Proficiency Initiative (LEPI) Program AGENCY... that support the assistance of persons with limited English proficiency in utilizing the services...: Limited English Proficiency Initiative (LEPI) Program. OMB Approval Number: 2529-0051. Form Numbers...

How Residents Learn From Patient Feedback: A Multi-Institutional Qualitative Study of Pediatrics Residents' Perspectives.

Science.gov (United States)

Bogetz, Alyssa L; Orlov, Nicola; Blankenburg, Rebecca; Bhavaraju, Vasudha; McQueen, Alisa; Rassbach, Caroline

2018-04-01

Residents may view feedback from patients and their families with greater skepticism than feedback from supervisors and peers. While discussing patient and family feedback with faculty may improve residents' acceptance of feedback and learning, specific strategies have not been identified. We explored pediatrics residents' perspectives of patient feedback and identified strategies that promote residents' reflection on and learning from feedback. In this multi-institutional, qualitative study conducted in June and July 2016, we conducted focus groups with a purposive sample of pediatrics residents after their participation in a randomized controlled trial in which they received written patient feedback and either discussed it with faculty or reviewed it independently. Focus group transcripts were audiorecorded, transcribed, and analyzed for themes using the constant comparative approach associated with grounded theory. Thirty-six of 92 (39%) residents participated in 7 focus groups. Four themes emerged: (1) residents valued patient feedback but felt it may lack the specificity they desire; (2) discussing feedback with a trusted faculty member was helpful for self-reflection; (3) residents identified 5 strategies faculty used to facilitate their openness to and acceptance of patient feedback (eg, help resident overcome emotional responses to feedback and situate feedback in the context of lifelong learning); and (4) residents' perceptions of feedback credibility improved when faculty observed patient encounters and solicited feedback on the resident's behalf prior to discussions. Discussing patient feedback with faculty provided important scaffolding to enhance residents' openness to and reflection on patient feedback.

Introducing routine HIV screening for patients on an internal medicine residency inpatient service: a quality improvement project.

Science.gov (United States)

Padrnos, Leslie J; Barr, Patrick J; Klassen, Christine L; Fields, Heather E; Azadeh, Natalya; Mendoza, Neil; Saadiq, Rayya A; Pauwels, Emanuel M; King, Christopher S; Chung, Andrew A; Sakata, Kenneth K; Blair, Janis E

2016-01-01

The US Centers for Disease Control and Prevention (CDC) recommend human immunodeficiency virus (HIV) screening for all persons aged 13 to 64 years who present to a health care provider. We sought to improve adherence to the CDC guidelines on the Internal Medicine Resident Hospital Service. We surveyed residents about the CDC guidelines, sent email reminders, provided education, and engaged them in friendly competition. Credit for guideline adherence was awarded if an offer of HIV screening was documented at admission, if a screening test was performed, or if a notation in the resident sign out sheet indicated why screening was not performed. We examined HIV screening of a postintervention group of patients admitted between August 8, 2012, and June 30, 2013, and compared them to a preintervention group admitted between August 1, 2011, and June 30, 2012. Postintervention offers of HIV screening increased significantly (7.9% [44/559] vs 55.5% [300/541]; P<.001), as did documentation of residents' contemplation of screening (8.9% [50/559] vs 67.5% [365/541]; P<.001). A significantly higher proportion of HIV screening tests was ordered postintervention (7.7% [43/559] vs 44.4% [240/541]; P<.001). Monthly HIV screening documentation ranged from 0% (0/53) to 17% (9/53) preintervention, whereas it ranged from 30.6% (11/36) to 100% (62/62) postintervention. HIV screening adherence can be improved through resident education, friendly competition, and system reminders. Barriers to achieving sustained adherence to the CDC guidelines include a heterogeneous patient population and provider discomfort with the subject.

From Universal Access to Universal Proficiency.

Science.gov (United States)

Lewis, Anne C.

2003-01-01

Panel of five education experts--Elliot Eisner, John Goodlad, Patricia Graham, Phillip Schlechty, and Warren Simons--answer questions related to recent school reform efforts, such as the No Child Left Behind Act, aimed at achieving universal educational proficiency. (PKP)

The organizational effects of pubertal testosterone on sexual proficiency in adult male Syrian hamsters.

Science.gov (United States)

De Lorme, Kayla C; Sisk, Cheryl L

2016-10-15

Social proficiency requires making appropriate behavioral adaptations as a result of social experience. For example, male rodents become sexually proficient with experience as demonstrated by a reduction in ectopic (misdirected) mounts, mount-to-intromission ratio, and latency to ejaculation. We previously found that over a series of timed tests with a receptive female, male hamsters deprived of testosterone specifically during puberty (NoT@P) have overall lower levels of sexual behavior and continue to display high levels of ectopic mounts, compared with males that experienced endogenous testosterone during puberty (T@P). These results suggested that pubertal testosterone programs sexual proficiency in adulthood, but because NoT@P males engaged in less sexual behavior than T@P males in these tests, the amount of sexual experience may have been insufficient to improve sexual proficiency. To more rigorously test the hypothesis that pubertal testosterone is necessary for social proficiency in adulthood, the present study compared the behavior of NoT@P and T@P males in a series of 4 trials with a 48-h interval between each trial. Sexual experience was equated by limiting each trial to 5 intromissions. Sexually-naïve males were either gonadectomized prepubertally (NoT@P) or in adulthood (T@P) and received subcutaneous testosterone capsules four weeks later. Two weeks after testosterone replacement, these groups and a group of adult gonad-intact controls began sexual behavior testing. We found that NoT@P males had more ectopic mounts/min across all four tests compared to gonad-intact and T@P males. Moreover, both gonad-intact and T@P males, but not NoT@P males, showed an increase in the number of mounts and intromissions/min between trials 1 and 3. Unexpectedly, both gonad-intact and T@P, but not NoT@P, males showed a decrease in sexual behaviors during trial 4. Thus, T@P males display multiple behavioral adaptations to sexual experience that are not observed in No

Probabilistic risk assessment of Chinese residents' exposure to fluoride in improved drinking water in endemic fluorosis areas.

Science.gov (United States)

Zhang, Li E; Huang, Daizheng; Yang, Jie; Wei, Xiao; Qin, Jian; Ou, Songfeng; Zhang, Zhiyong; Zou, Yunfeng

2017-03-01

Studies have yet to evaluate the effects of water improvement on fluoride concentrations in drinking water and the corresponding health risks to Chinese residents in endemic fluorosis areas (EFAs) at a national level. This paper summarized available data in the published literature (2008-2016) on water fluoride from the EFAs in China before and after water quality was improved. Based on these obtained data, health risk assessment of Chinese residents' exposure to fluoride in improved drinking water was performed by means of a probabilistic approach. The uncertainties in the risk estimates were quantified using Monte Carlo simulation and sensitivity analysis. Our results showed that in general, the average fluoride levels (0.10-2.24 mg/L) in the improved drinking water in the EFAs of China were lower than the pre-intervention levels (0.30-15.24 mg/L). The highest fluoride levels were detected in North and Southwest China. The mean non-carcinogenic risks associated with consumption of the improved drinking water for Chinese residents were mostly accepted (hazard quotient risk of children in most of the EFAs at the 95th percentile exceeded the safe level of 1, indicating the potential non-cancer-causing health effects on this fluoride-exposed population. Sensitivity analyses indicated that fluoride concentration in drinking water, ingestion rate of water, and the exposure time in the shower were the most relevant variables in the model, therefore, efforts should focus mainly on the definition of their probability distributions for a more accurate risk assessment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development and Validation of the Spanish-English Language Proficiency Scale (SELPS)

Science.gov (United States)

Smyk, Ekaterina; Restrepo, M. Adelaida; Gorin, Joanna S.; Gray, Shelley

2013-01-01

Purpose: This study examined the development and validation of a criterion-referenced Spanish-English Language Proficiency Scale (SELPS) that was designed to assess the oral language skills of sequential bilingual children ages 4-8. This article reports results for the English proficiency portion of the scale. Method: The SELPS assesses syntactic…

Students’ Perceived Level of English Proficiency in Secondary Schools in Dodoma, Tanzania

Directory of Open Access Journals (Sweden)

Lazarus Ndiku Makewa

2013-07-01

Full Text Available This paper looked at students’ perceived level of English proficiency among Dodoma secondary schools in Tanzania. Factors like attitude, anxiety, classroom activities, motivation, and learning resources were considered as influencing English learning. The study was guided by three theories: Input Hypothesis, Inter-language and Vygotsky’s theory of value. Correlation design was used to describe the association between the student and teacher-related factors and students’ perceived level of English proficiency. Purposive sampling was used to select 300 form three students. Questionnaires were used to collect data from the participants. Reliability of the research instrument was determined by conducting a pilot study. Pearson Descriptive statistics and Kendall’s Tau-b were used to analyze the data. The study revealed that the students’ perceived level of proficiency in spoken English was average. The findings indicated a significant positive correlation between perceived English proficiency and attitude toward the English language, classroom activities, teacher motivation, and classroom environment. It is suggested that further studies integrate qualitative research methods to the research design in order to get an in-depth understanding of students’ perception on English proficiency.

What's in It for Me? Maintenance of Certification as an Incentive for Faculty Supervision of Resident Quality Improvement Projects.

Science.gov (United States)

Rosenbluth, Glenn; Tabas, Jeffrey A; Baron, Robert B

2016-01-01

Residents are required to engage in quality improvement (QI) activities, which requires faculty engagement. Because of increasing program requirements and clinical demands, faculty may be resistant to taking on additional teaching and supervisory responsibilities without incentives. The authors sought to create an authentic benefit for University of California, San Francisco (UCSF) Pediatrics Residency Training Program faculty who supervise pediatrics residents' QI projects by offering maintenance of certification (MOC) Part 4 (Performance in Practice) credit. The authors identified MOC as an ideal framework to both more actively engage faculty who were supervising QI projects and provide incentives for doing so. To this end, in 2011, the authors designed an MOC portfolio program which included faculty development, active supervision of residents, and QI projects designed to improve patient care. The UCSF Pediatrics Residency Training Program's Portfolio Sponsor application was approved by the American Board of Pediatrics (ABP) in 2012, and faculty whose projects were included in the application were granted MOC Part 4 credit. As of December 2013, six faculty had received MOC Part 4 credit for their supervision of residents' QI projects. Based largely on the success of this program, UCSF has transitioned to the MOC portfolio program administered through the American Board of Medical Specialties, which allows the organization to offer MOC Part 4 credit from multiple specialty boards including the ABP. This may require refinements to screening, over sight, and reporting structures to ensure the MOC standards are met. Ongoing faculty development will be essential.

What Happened to the Complication? The Importance of ACS NSQIP Pediatric in Optimizing Quality Improvement Initiatives for Resident Education.

Science.gov (United States)

Calder, Bennett W; Sakran, Joseph V; Streck, Christian J; Cina, Robert A

Morbidity and Mortality (M&M) conference is considered the golden hour of surgical education. Most training programs lack standardized methods to evaluate self-reported outcomes and contributions to resident education. The purpose of this study was to determine whether residents underreport pediatric postoperative complications thereby limiting a comprehensive educational opportunity and the ability to adequately perform quality improvement during M&M conference. A retrospective analysis of resident reports submitted to the M&M committee at an academic medical center was conducted over 1 year. All complications were compared to the American College of Surgeons (ACS) Pediatric National Surgical Quality Improvement Program (NSQIP) data abstracted over the same period. A descriptive analysis of perioperative events was performed. This study was conducted at the Medical University of South Carolina Medical Center and MUSC Children's Hospital, an academic tertiary care center located in Charleston, South Carolina. Overall, 81 complications were captured. Resident and NSQIP databases captured 27 (33%) and 68 (84%) complications, respectively. Residents were more likely to report major complications. More common sources of postoperative morbidity, including surgical site infection and transfusion, were underreported at 20% and 5%, respectively. Resident reporting inadequately captures the full complement of pediatric perioperative complications. NSQIP-abstracted data serve as a useful adjunct to traditional M&M reporting in capturing complications underreported by trainees. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

National proficiency-gain curves for minimally invasive gastrointestinal cancer surgery.

Science.gov (United States)

Mackenzie, H; Markar, S R; Askari, A; Ni, M; Faiz, O; Hanna, G B

2016-01-01

Minimal access surgery for gastrointestinal cancer has short-term benefits but is associated with a proficiency-gain curve. The aim of this study was to define national proficiency-gain curves for minimal access colorectal and oesophagogastric surgery, and to determine the impact on clinical outcomes. All adult patients undergoing minimal access oesophageal, colonic and rectal surgery between 2002 and 2012 were identified from the Hospital Episode Statistics database. Proficiency-gain curves were created using risk-adjusted cumulative sum analysis. Change points were identified, and bootstrapping was performed with 1000 iterations to identify a confidence level. The primary outcome was 30-day mortality; secondary outcomes were 90-day mortality, reintervention, conversion and length of hospital stay. Some 1696, 15 008 and 16 701 minimal access oesophageal, rectal and colonic cancer resections were performed during the study period. The change point in the proficiency-gain curve for 30-day mortality for oesophageal, rectal and colonic surgery was 19 (confidence level 98·4 per cent), 20 (99·2 per cent) and three (99·5 per cent) procedures; the mortality rate fell from 4·0 to 2·0 per cent (relative risk reduction (RRR) 0·50, P = 0·033), from 2·1 to 1·2 per cent (RRR 0·43, P curve for reintervention in oesophageal, rectal and colonic resection was 19 (98·1 per cent), 32 (99·5 per cent) and 26 (99·2 per cent) procedures respectively. There were also significant proficiency-gain curves for 90-day mortality, conversion and length of stay. The introduction of minimal access gastrointestinal cancer surgery has been associated with a proficiency-gain curve for mortality and major morbidity at a national level. Unnecessary patient harm should be avoided by appropriate training and monitoring of new surgical techniques. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

Motor proficiency in normal children and with learning difficulty: a comparative and correlational study based on the motor proficiency test of Bruininks-Oseretsky

Directory of Open Access Journals (Sweden)

Nilson Roberto Moreira

2008-06-01

Full Text Available The aim of this investigation is to verify the difference between children with learning disabilities and children without learning disabilities through motor proficiency test of Bruininks and Ozeretsky (1978. The sample was constituted by 30 children, with 8-year average age, 15 males and 15 females, subdivided into two groups of 15 children from both sexes: children without learning disabilities attending 3rd grade and children with learning disabilities attending 2nd grade having failed a term once. All of them came from a middle class background, according to Grafar scale (adapted by Fonseca, 1991. All children presenting any other disabilities were excluded from the sample. Intelligence factor “G” was controlled by using a percentile, higher or equal to 50 (middle and high level, measured by Raven’s (1974 progressive combinations test. In motor proficiency, children with learning disabilities showed significant differences when compared with normal children of the same age, in all components of global, composed and fine motricity. The tests administered showed a strong correlation between the variables of the motor proficiency components. The results lead to the conclusion that there were significant differences in motor proficiency between normal children and children with learning disabilities, who showed specific motor difficulties evincing a more vulnerable motor profile and not the presence of neurological dysfunction signs.

Effect of Patternmaker’s Proficiency On the Creation of Clothing

Directory of Open Access Journals (Sweden)

Kim Kyoungok

2017-06-01

Full Text Available The effect of the patternmaker’s proficiency on the creation of clothing was investigated by the observation of the patternmaking process for clothing that satisfies the designer. We asked Japanese and French patternmakers to make a clothing pattern for the same design. The reasons for the differences in resultant clothing patterns and toiles made by the two patternmakers are discussed. Although the patternmaking processes used by the proficient patternmakers were similar, the resultant patterns were different owing to different recognition of the design. In particular, the shape and size of the collar that the designer emphasized in the illustration were different in the resultant patterns. Differences in patternmaking originated from differences in the patternmakers′ levels of expertise in terms of education, experience, and proficiency. However, the designer was satisfied with both patterns.

GE Fanuc推出Proficy Historian 3．0

Institute of Scientific and Technical Information of China (English)

无

2005-01-01

GE基础设施旗下的GE Fanuc自动化美洲公司推出了全新的ProficyTM Historian版本3．0个全新的厂级数据历史库版本。ProficyTM Historian 3．0能采集、归档并发布所有的实时现场生产数据，使用起来非常方便，可用性很高。凭藉Proficy Historian，制造商可以有效地从多个数据源采集并聚合实时工厂数据。对于诸如因设备故障和产品质量存在问题而造成的非满意事件，它能快速找出根本原因以实现最佳绩效。

Measuring receptive collocational competence across proficiency ...

African Journals Online (AJOL)

Kate H

frequency bands. A proficiency measure and a collocation test were administered to English ... battery may negatively impact the test-takers' performance. ..... examples. The major finding is that raising learners' awareness constitutes the best way forward ..... Amsterdam: John Benjamins Publishing Company. Green, R.

Effects of a Short Video-Based Resident-as-Teacher Training Toolkit on Resident Teaching.

Science.gov (United States)

Ricciotti, Hope A; Freret, Taylor S; Aluko, Ashley; McKeon, Bri Anne; Haviland, Miriam J; Newman, Lori R

2017-10-01

To pilot a short video-based resident-as-teacher training toolkit and assess its effect on resident teaching skills in clinical settings. A video-based resident-as-teacher training toolkit was previously developed by educational experts at Beth Israel Deaconess Medical Center, Harvard Medical School. Residents were recruited from two academic hospitals, watched two videos from the toolkit ("Clinical Teaching Skills" and "Effective Clinical Supervision"), and completed an accompanying self-study guide. A novel assessment instrument for evaluating the effect of the toolkit on teaching was created through a modified Delphi process. Before and after the intervention, residents were observed leading a clinical teaching encounter and scored using the 15-item assessment instrument. The primary outcome of interest was the change in number of skills exhibited, which was assessed using the Wilcoxon signed-rank test. Twenty-eight residents from two academic hospitals were enrolled, and 20 (71%) completed all phases of the study. More than one third of residents who volunteered to participate reported no prior formal teacher training. After completing two training modules, residents demonstrated a significant increase in the median number of teaching skills exhibited in a clinical teaching encounter, from 7.5 (interquartile range 6.5-9.5) to 10.0 (interquartile range 9.0-11.5; P<.001). Of the 15 teaching skills assessed, there were significant improvements in asking for the learner's perspective (P=.01), providing feedback (P=.005), and encouraging questions (P=.046). Using a resident-as-teacher video-based toolkit was associated with improvements in teaching skills in residents from multiple specialties.

A Blueprint for Developing Culturally Proficient/Responsive School Administrators in Special Education

Science.gov (United States)

Bakken, Jeffrey P.; Smith, Beverly A.

2011-01-01

This article addresses the important topic of culturally proficient/responsive school administrators for culturally and linguistically diverse (CLD) students with learning disabilities (LD). Culturally proficient/responsive school administrators with knowledge and strong leadership skills in multicultural education are essential to impact school…

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

Proficiency testing schemes as a quality rating in industrial hygiene laboratories

Directory of Open Access Journals (Sweden)

Marek Dobecki

2016-04-01

Full Text Available This publication presents the principles of organization, implementation, assessment and exploitation of proficiency testing results in the work environmental laboratory based on basic requirements included in standard PN-EN ISO/IEC 17043 and ISO 13528. The basis for the proper functioning of the laboratory is to use and observe the basic requirements for the competence to carry out the tests and the guidelines on ensuring reliable and accurate results, specified e.g., according to the guidelines described in the standard PN-EN ISO/IEC 17043. The confirmation of the laboratory competence is the obtained accreditation. To obtain this certificate several conditions, including proficiency testing (PT should be met. The main aspects of this paper is to show the role of proficiency testing in the process of assuring a properly functioning quality system in the laboratory. The accreditation requirements, the types of proficiency testing schemes, methods of statistical analysis and interpretation of results are also discussed by the authors. Med Pr 2016;67(2:267–283

The Effectiveness of Internet-Based Peer Feedback Training on Chinese EFL College Students' Writing Proficiency

Science.gov (United States)

Jiang, Jiahong; Yu, Yibing

2014-01-01

English writing, an indispensable skill in English learning, plays an important role in improving learners' language proficiency. With the wide spread and use of wired or wireless internet, EFL students can easily help and be helped with English writing. Therefore, the application of internet-based peer feedback training on writing to foreign or…

Predictors and Outcomes of Early vs. Later English Language Proficiency Among English Language Learners

Science.gov (United States)

Halle, Tamara; Hair, Elizabeth; Wandner, Laura; McNamara, Michelle; Chien, Nina

2011-01-01

The development of English language learners (ELLs) was explored from kindergarten through eighth grade within a nationally representative sample of first-time kindergartners (N = 19,890). Growth curve analyses indicated that, compared to native English speakers, ELLs were rated by teachers more favorably on approaches to learning, self control, and externalizing behaviors in kindergarten and generally continued to grow in a positive direction on these social/behavioral outcomes at a steeper rate compared to their native English-speaking peers, holding other factors constant. Differences in reading and math achievement between ELLs and native English speakers varied based on the grade at which English proficiency is attained. Specifically, ELLs who were proficient in English by kindergarten entry kept pace with native English speakers in both reading and math initially and over time; ELLs who were proficient by first grade had modest gaps in reading and math achievement compared to native English speakers that closed narrowly or persisted over time; and ELLs who were not proficient by first grade had the largest initial gaps in reading and math achievement compared to native speakers but the gap narrowed over time in reading and grew over time in math. Among those whose home language is not English, acquiring English proficiency by kindergarten entry was associated with better cognitive and behavioral outcomes through eighth grade compared to taking longer to achieve proficiency. Multinomial regression analyses indicated that child, family, and school characteristics predict achieving English proficiency by kindergarten entry compared to achieving proficiency later. Results are discussed in terms of policies and practices that can support ELL children’s growth and development. PMID:22389551

Provider Communication, Prompts, and Feedback to Improve HPV Vaccination Rates in Resident Clinics.

Science.gov (United States)

Rand, Cynthia M; Schaffer, Stanley J; Dhepyasuwan, Nui; Blumkin, Aaron; Albertin, Christina; Serwint, Janet R; Darden, Paul M; Humiston, Sharon G; Mann, Keith J; Stratbucker, William; Szilagyi, Peter G

2018-04-01

Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. Staff and providers in 8 resident clinics participated in a 12-month QI study. The intervention included training to strengthen provider communication about the HPV vaccine. Clinics also implemented provider prompts, received monthly performance feedback, and participated in learning collaborative calls. The primary outcome measure was eligible visits with vaccination divided by vaccine-eligible visits (captured HPV vaccination opportunities). Practices performed chart audits that were fed into monthly performance feedback on captured HPV vaccination opportunities. We used conditional logistic regression (conditioning on practice) to assess captured vaccination opportunities, with the time period of the study (before and after the QI intervention) as the independent variable. Overall, captured opportunities for HPV vaccination increased by 16.4 percentage points, from 46.9% to 63.3%. Special cause was demonstrated by centerline shift, with 8 consecutive points above the preintervention mean. On adjusted analyses, patients were more likely to receive a vaccine during, versus before, the intervention (odds ratio: 1.87; 95% confidence interval: 1.54-2.28). Captured HPV vaccination rates improved at both well-child and other visits (by 11.7 and 13.0 percentage points, respectively). A bundled intervention of provider prompts and training in communication skills plus performance feedback increased captured opportunities for HPV vaccination. Copyright © 2018 by the American Academy of Pediatrics.

Does childhood motor skill proficiency predict adolescent fitness?

Science.gov (United States)

Barnett, Lisa M; Van Beurden, Eric; Morgan, Philip J; Brooks, Lyndon O; Beard, John R

2008-12-01

To determine whether childhood fundamental motor skill proficiency predicts subsequent adolescent cardiorespiratory fitness. In 2000, children's proficiency in a battery of skills was assessed as part of an elementary school-based intervention. Participants were followed up during 2006/2007 as part of the Physical Activity and Skills Study, and cardiorespiratory fitness was measured using the Multistage Fitness Test. Linear regression was used to examine the relationship between childhood fundamental motor skill proficiency and adolescent cardiorespiratory fitness controlling for gender. Composite object control (kick, catch, throw) and locomotor skill (hop, side gallop, vertical jump) were constructed for analysis. A separate linear regression examined the ability of the sprint run to predict cardiorespiratory fitness. Of the 928 original intervention participants, 481 were in 28 schools, 276 (57%) of whom were assessed. Two hundred and forty-four students (88.4%) completed the fitness test. One hundred and twenty-seven were females (52.1%), 60.1% of whom were in grade 10 and 39.0% were in grade 11. As children, almost all 244 completed each motor assessments, except for the sprint run (n = 154, 55.8%). The mean composite skill score in 2000 was 17.7 (SD 5.1). In 2006/2007, the mean number of laps on the Multistage Fitness Test was 50.5 (SD 24.4). Object control proficiency in childhood, adjusting for gender (P = 0.000), was associated with adolescent cardiorespiratory fitness (P = 0.012), accounting for 26% of fitness variation. Children with good object control skills are more likely to become fit adolescents. Fundamental motor skill development in childhood may be an important component of interventions aiming to promote long-term fitness.

14 CFR 61.98 - Flight proficiency.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Flight proficiency. 61.98 Section 61.98 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN...) Navigation; (viii) Slow flight and stalls; (ix) Emergency operations; and (x) Postflight procedures. (2) For...

14 CFR 61.107 - Flight proficiency.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Flight proficiency. 61.107 Section 61.107 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN... reference maneuvers; (vii) Navigation; (viii) Slow flight and stalls; (ix) Basic instrument maneuvers; (x...

14 CFR 61.127 - Flight proficiency.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Flight proficiency. 61.127 Section 61.127 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN...; (x) High-altitude operations; and (xi) Postflight procedures. (2) For an airplane category rating...

Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality?

Science.gov (United States)

Poey, Judith L; Hermer, Linda; Cornelison, Laci; Kaup, Migette L; Drake, Patrick; Stone, Robyn I; Doll, Gayle

2017-11-01

Person-centered care (PCC) is meant to enhance nursing home residents' quality of life (QOL). Including residents' perspectives is critical to determining whether PCC is meeting residents' needs and desires. This study examines whether PCC practices promote satisfaction with QOL and quality of care and services (QOC and QOS) among nursing home residents. A longitudinal, retrospective cohort study using an in-person survey. Three hundred twenty nursing homes in Kansas enrolled or not enrolled in a pay-for-performance program, Promoting Excellent Alternatives in Kansas (PEAK 2.0), to promote PCC in nursing homes. A total of 6214 nursing home residents in 2013-2014 and 5538 residents in 2014-2015, with a Brief Interview for Mental Status score ≥8, participated in face-to-face interviews. Results were aggregated to the nursing home level. My InnerView developed a Resident Satisfaction Survey for Kansas composed of 32 questions divided into QOL, QOC, QOS, and global satisfaction subdomains. After controlling for facility characteristics, satisfaction with overall QOL and QOC was higher in homes that had fully implemented PCC. Although some individual measures in the QOS domain (eg, food) showed greater satisfaction at earlier levels of implementation, high satisfaction was observed primarily in homes that had fully implemented PCC. These findings provide evidence for the effectiveness of PCC implementation on nursing home resident satisfaction. The PEAK 2.0 program may provide replicable methods for nursing homes and states to implement PCC systematically. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Improved Resident Adherence to AAA Screening Guidelines via an Electronic Reminder.

Science.gov (United States)

Sypert, David; Van Dyke, Kenneth; Dhillon, Namrata; Elliott, John O; Jordan, Kim

The 2014 United States Preventive Services Task Force systematic review found abdominal aortic aneurysm (AAA) screening decreased related mortality by close to half. Despite the simplicity of screening, research suggests poor adherence to the recommended AAA screening guidelines. Using the quality improvement plan-study-do-act cycle, we retrospectively established poor adherence to AAA screening and poor documentation of smoking history in our resident clinic. An electronic reminder was prospectively implemented into our electronic medical record (EMR) with the goal of improving screening rates. After 1 year, a retrospective chart review was conducted. Comparisons of the pre- and post-electronic reminder intervention data were made using chi-square tests and odds ratios (OR). The purposeful AAA screening rate improved 27.8% during the intervention, 40.3% (95% confidence interval [CI]: 28.6-52.0%) versus 12.5% (95% CI: 3.1-21.9%), p = .002, suggesting patients were more likely to be screened as a result of the electronic reminder, OR = 4.73 (95% CI: 1.77-12.65). This improvement translates to a large effect size, Cohen's d = 0.86 (95% CI: 0.31-1.40). Electronic reminders are a simple EMR addition that can provide evidence-based education while improving adherence rates with preventive health screening measures.

Leadership Training in Otolaryngology Residency.

Science.gov (United States)

Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

2017-06-01

Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

First year evaluation of EPA's radon contractor proficiency (RCP) program

International Nuclear Information System (INIS)

Salmon, G.L.

1990-01-01

This paper reports that the Environmental Protection Agency (EPA) has developed a voluntary program to evaluate radon reduction contractors and provide this information to the public, as part of activities mandated by the Indoor Radon Abatement Act (IRAA) of 1988. The Radon Contractor Proficiency Program consists of several elements that collectively help to ensure the proficiency of radon mitigators and give the public greater confidence in their capability. Contractors who participate in the program must pass a written examination, adhere to mitigation guidelines, keep records of work, meet continuing education requirements and pass a re-examination every two years. Upon meeting the program's requirements, mitigators are listed in EPA's National RCP Proficiency Report. The first Report released on May 15, 1990 listed 636 contractors. The second Report, to be release in August, will list 895 contractors, representing an increase of 40 per cent

Evaluating the spoken English proficiency of graduates of foreign medical schools.

Science.gov (United States)

Boulet, J R; van Zanten, M; McKinley, D W; Gary, N E

2001-08-01

The purpose of this study was to gather additional evidence for the validity and reliability of spoken English proficiency ratings provided by trained standardized patients (SPs) in high-stakes clinical skills examination. Over 2500 candidates who took the Educational Commission for Foreign Medical Graduates' (ECFMG) Clinical Skills Assessment (CSA) were studied. The CSA consists of 10 or 11 timed clinical encounters. Standardized patients evaluate spoken English proficiency and interpersonal skills in every encounter. Generalizability theory was used to estimate the consistency of spoken English ratings. Validity coefficients were calculated by correlating summary English ratings with CSA scores and other external criterion measures. Mean spoken English ratings were also compared by various candidate background variables. The reliability of the spoken English ratings, based on 10 independent evaluations, was high. The magnitudes of the associated variance components indicated that the evaluation of a candidate's spoken English proficiency is unlikely to be affected by the choice of cases or SPs used in a given assessment. Proficiency in spoken English was related to native language (English versus other) and scores from the Test of English as a Foreign Language (TOEFL). The pattern of the relationships, both within assessment components and with external criterion measures, suggests that valid measures of spoken English proficiency are obtained. This result, combined with the high reproducibility of the ratings over encounters and SPs, supports the use of trained SPs to measure spoken English skills in a simulated medical environment.

Does empowering resident families or nursing home employees in decision making improve service quality?

Science.gov (United States)

Hamann, Darla J

2014-08-01

This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

Minerva: using a software program to improve resident performance during independent call

Science.gov (United States)

Itri, Jason N.; Redfern, Regina O.; Cook, Tessa; Scanlon, Mary H.

2010-03-01

We have developed an application called Minerva that allows tracking of resident discrepancy rates and missed cases. Minerva mines the radiology information system (RIS) for preliminary interpretations provided by residents during independent call and copies both the preliminary and final interpretations to a database. Both versions are displayed for direct comparison by Minerva and classified as 'in agreement', 'minor discrepancy' or 'major discrepancy' by the resident program director. Minerva compiles statistics comparing minor, major and total discrepancy rates for individual residents relative to the overall group. Discrepant cases are categorized according to date, modality and body part and reviewed for trends in missed cases. The rate of minor, major and total discrepancies for residents on-call at our institution was similar to rates previously published, including a 2.4% major discrepancy rate for second year radiology residents in the DePICTORS study and a 2.6% major discrepancy rate for resident at a community hospital. Trend analysis of missed cases was used to generate a topic-specific resident missed case conference on acromioclavicular (AC) joint separation injuries, which resulted in a 75% decrease in the number of missed cases related to AC separation subsequent to the conference. Using a software program to track of minor and major discrepancy rates for residents taking independent call using modified RadPeer scoring guidelines provides a competency-based metric to determine resident performance. Topic-specific conferences using the cases identified by Minerva can result in a decrease in missed cases.

Measures for Determining English Language Proficiency and the Resulting Implications for Instructional Provision and Intervention

Science.gov (United States)

Albers, Craig A.; Kenyon, Dorry M.; Boals, Timothy J.

2009-01-01

Although numerous English language proficiency (ELP) measures currently exist, many were developed prior to the No Child Left Behind Act of 2001 (NCLB). These pre-NCLB measures typically focused on social language proficiency, whereas post-NCLB measures are linked to ELP standards and focus on academic language proficiency (ALP). ELP measures are…

Use of proficiency samples to assess diagnostic laboratories in France performing a Trichinella digestion assay.

Science.gov (United States)

Vallée, Isabelle; Macé, Pauline; Forbes, Lorry; Scandrett, Brad; Durand, Benoit; Gajadhar, Alvin; Boireau, Pascal

2007-07-01

Routine diagnosis of animal trichinellosis for food safety and trade relies on a method of artificial digestion to free Trichinella muscle larvae from meat for subsequent identification by microscopy. As part of a quality control system, the French National Reference Laboratory (NRL) initiated ring trials to determine the sensitivity of the test performed in the 72 routine diagnostic laboratories in France. A method was devised to obtain calibrated meat samples containing known numbers of capsules with Trichinella spiralis muscle larvae. This method was based on an incomplete artificial digestion of Trichinella-infected mice carcasses to allow the collection of intact Trichinella capsules. Capsules were placed into a meatball of 100 +/- 2 g of pork and horsemeat to produce proficiency samples. Three categories of samples were prepared: small (3 to 5 capsules), medium (7 to 10), and large (12 to 15). The sensitivity was expressed as the percentage of muscle larvae recovered from each proficiency sample. Reproducibility was tested with ring trials organized between two NRLs (France and Canada), and a reference sensitivity of 84.9% was established. National ring trials were then organized in France, with the 72 routine diagnostic laboratories each receiving four proficiency samples per session. After five sessions, an improvement in the digest test sensitivity was observed. Results at the fifth session indicated sensitivities of 78.60% +/- 23.70%, 81.19% +/- 19.59%, and 80.52% +/- 14.71% muscle larvae for small, medium, and large samples, respectively. This study supports the use of proficiency samples to accurately evaluate the performance of routine diagnostic laboratories that conduct digestion tests for animal trichinellosis diagnosis.

Comprehensive proficiency-based inanimate training for robotic surgery: reliability, feasibility, and educational benefit.

Science.gov (United States)

Arain, Nabeel A; Dulan, Genevieve; Hogg, Deborah C; Rege, Robert V; Powers, Cathryn E; Tesfay, Seifu T; Hynan, Linda S; Scott, Daniel J

2012-10-01

We previously developed a comprehensive proficiency-based robotic training curriculum demonstrating construct, content, and face validity. This study aimed to assess reliability, feasibility, and educational benefit associated with curricular implementation. Over an 11-month period, 55 residents, fellows, and faculty (robotic novices) from general surgery, urology, and gynecology were enrolled in a 2-month curriculum: online didactics, half-day hands-on tutorial, and self-practice using nine inanimate exercises. Each trainee completed a questionnaire and performed a single proctored repetition of each task before (pretest) and after (post-test) training. Tasks were scored for time and errors using modified FLS metrics. For inter-rater reliability (IRR), three trainees were scored by two raters and analyzed using intraclass correlation coefficients (ICC). Data from eight experts were analyzed using ICC and Cronbach's α to determine test-retest reliability and internal consistency, respectively. Educational benefit was assessed by comparing baseline (pretest) and final (post-test) trainee performance; comparisons used Wilcoxon signed-rank test. Of the 55 trainees that pretested, 53 (96 %) completed all curricular components in 9-17 h and reached proficiency after completing an average of 72 ± 28 repetitions over 5 ± 1 h. Trainees indicated minimal prior robotic experience and "poor comfort" with robotic skills at baseline (1.8 ± 0.9) compared to final testing (3.1 ± 0.8, p reliability was 0.91 (p training for all nine tasks and according to composite scores (548 ± 176 vs. 914 ± 81, p reliability measures, demonstrated feasibility for a large cohort of trainees, and yielded significant educational benefit. Further studies and adoption of this curriculum are encouraged.

Assessing pediatrics residents' mathematical skills for prescribing medication: a need for improved training.

Science.gov (United States)

Glover, Mark L; Sussmane, Jeffrey B

2002-10-01

To evaluate residents' skills in performing basic mathematical calculations used for prescribing medications to pediatric patients. In 2001, a test of ten questions on basic calculations was given to first-, second-, and third-year residents at Miami Children's Hospital in Florida. Four additional questions were included to obtain the residents' levels of training, specific pediatrics intensive care unit (PICU) experience, and whether or not they routinely double-checked doses and adjusted them for each patient's weight. The test was anonymous and calculators were permitted. The overall score and the score for each resident class were calculated. Twenty-one residents participated. The overall average test score and the mean test score of each resident class was less than 70%. Second-year residents had the highest mean test scores, although there was no significant difference between the classes of residents (p =.745) or relationship between the residents' PICU experiences and their exam scores (p =.766). There was no significant difference between residents' levels of training and whether they double-checked their calculations (p =.633) or considered each patient's weight relative to the dose prescribed (p =.869). Seven residents committed tenfold dosing errors, and one resident committed a 1,000-fold dosing error. Pediatrics residents need to receive additional education in performing the calculations needed to prescribe medications. In addition, residents should be required to demonstrate these necessary mathematical skills before they are allowed to prescribe medications.

It Really Works: Cultural Communication Proficiency.

Science.gov (United States)

Bennett, Ruth, Ed.

This paper describes the cultural communication proficiency method of indigenous language instruction, developed at Humboldt State University's Center for Indian Community Development (California), and demonstrates the method with five Hupa lesson plans. The method is based on three principles: that Native American students learn by doing, learn…

Developing Adaptive Proficiency in Special Forces Officers

National Research Council Canada - National Science Library

White, Susan S; Mueller-Hanson, Rose A; Dorsey, David W; Pulakos, Elaine D; Wisecarver, Michelle M; Deagle, Edwin A., III; Mendini, Kip G

2005-01-01

Adaptive proficiency is critical for operating in the dynamic Special Forces (SF) mission environment and a recent focus on this requirement has resulted in a greater emphasis on adaptability in current training for SF...

Proficiency test in the accreditation system

International Nuclear Information System (INIS)

Legarda, F.; Herranz, M.; Idoeta, R.

2008-01-01

In the accreditation process of a radioactivity measurements laboratory, according to ISO standard 17025, proficiency tests play a fundamental role. These PTs constitute an irreplaceable tool for the validation of measuring methods. In the case of Spain, ENAC, which is the Spanish accreditation national body, requires that the laboratory has to take part in a PT for each one of the accredited measuring methods in the period of time between two reassessments of the accreditation, what happens every 4-5 years. In specific areas of determination procedures, among which radioactive measurements could be included, the number of methods which can be accredited is very large. The purpose of the present work is to establish a classification into families of the different radioactivity measurement procedures, as well as to establish complementary actions that guarantee that carrying out periodically proficiency-tests on any of the included procedures in each family, every measurement procedure include in that family is controlled, complying with the criteria established by ENAC

Factors influencing resident's decision to reside in gated and guarded community

Science.gov (United States)

Shamsudin, Zarina; Shamsudin, Shafiza; Zainal, Rozlin

2017-10-01

Gated communities are residential areas developed with restricted access with strictly controlled entrances and surrounded by a close perimeter of wall or fences. Developers, conscious of the need to fulfill the requirement of living in modern and sophisticated lifestyle and gated properties become the trend and mushroomed over the past decade. Nowadays, it is obvious that gated and guarded communities become almost a dominant feature of Malaysia housing development projects. The focus of this paper is to identify the factors contribute resident's decision to reside in gated and guarded community and to study social interaction among gated communities' residents. 150 questionnaires were distributed to the residents of selected gated and guarded community area in order to achieve the objectives and analyzed by using Statistical Package for Social Science (SPSS) and descriptive analysis. The result was tabulated and presented in charts and graphs for a clear and better understanding. The five main factors contribute to resident decision to reside in gated communities were identified and ranked; there are privacy, security, location, lifestyle and prestige. Besides, the residents are feeling neutral towards the facilities and services provided in their gated and guarded residential area. A comprehensive improvement towards the facilities and services is needed to reach higher satisfaction from the residents.

Evaluating Surgical Residents' Patient-Centered Communication Skills: Practical Alternatives to the "Apprenticeship Model".

Science.gov (United States)

Newcomb, Anna; Trickey, Amber W; Lita, Elena; Dort, Jonathan

2017-10-06

The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to assess communication skills and provide feedback to residents. We aimed to develop a feasible data collection process that generates objective clinical performance information to guide training activities, inform ACGME milestone evaluations, and validate assessment instruments. Residents care for patients in the surgical clinic and in the hospital, and participate in a communication curriculum providing practice with standardized patients (SPs). We measured perception of resident communication using the 14-item Communication Assessment Tool (CAT), collecting data from patients at the surgery clinic and surgical wards in the hospital, and from SP encounters during simulated training scenarios. We developed a handout of CAT example behaviors to guide patients completing the communication assessment. Independent academic medical center. General surgery residents. The primary outcome is the percentage of total items patients rated "excellent;" we collected data on 24 of 25 residents. Outpatient evaluations resulted in significantly higher scores (mean 84.5% vs. 68.6%, p communication assessments in their concurrent patient population (p = 0.017), and (2) receiving CAT example instructions was associated with a lower percentage of excellent ratings by 9.3% (p = 0.047). Our data collection process provides a model for obtaining meaningful information about resident communication proficiency. CAT evaluations of surgical residents by the inpatient population had not previously been described in the literature; our results provide important insight into relationships between the evaluations provided by inpatients, clinic patients, and SPs in simulation. Our example behaviors guide shows promise for addressing a common concern, minimizing ceiling effects when measuring physician-patient communication. Copyright © 2017 Association of Program Directors in Surgery. Published by

LOGICAL CONDITIONS ANALYSIS METHOD FOR DIAGNOSTIC TEST RESULTS DECODING APPLIED TO COMPETENCE ELEMENTS PROFICIENCY

Directory of Open Access Journals (Sweden)

V. I. Freyman

2015-11-01

Full Text Available Subject of Research.Representation features of education results for competence-based educational programs are analyzed. Solution importance of decoding and proficiency estimation for elements and components of discipline parts of competences is shown. The purpose and objectives of research are formulated. Methods. The paper deals with methods of mathematical logic, Boolean algebra, and parametrical analysis of complex diagnostic test results, that controls proficiency of some discipline competence elements. Results. The method of logical conditions analysis is created. It will give the possibility to formulate logical conditions for proficiency determination of each discipline competence element, controlled by complex diagnostic test. Normalized test result is divided into noncrossing zones; a logical condition about controlled elements proficiency is formulated for each of them. Summarized characteristics for test result zones are imposed. An example of logical conditions forming for diagnostic test with preset features is provided. Practical Relevance. The proposed method of logical conditions analysis is applied in the decoding algorithm of proficiency test diagnosis for discipline competence elements. It will give the possibility to automate the search procedure for elements with insufficient proficiency, and is also usable for estimation of education results of a discipline or a component of competence-based educational program.

Results of the 2003 Association of Residents in Radiation Oncology (ARRO) surveys of residents and chief residents in the United States

International Nuclear Information System (INIS)

Jagsi, Reshma; Buck, David A.; Singh, Anurag K.; Engleman, Mark; Thakkar, Vipul; Frank, Steven J.; Flynn, Daniel

2005-01-01

Purpose: To document demographic characteristics of current residents, career motivations and aspirations, and training program policies and resources. Methods: In 2003, the Association of Residents in Radiation Oncology (ARRO) conducted two nationwide surveys: one of all U.S. radiation oncology residents and one of chief residents. Results: The Chief Residents' Survey was completed by representatives from all 77 programs (response rate, 100%). The Residents' Survey was returned by 229 respondents (response rate, 44%). In each, 32% of respondents were female. The most popular career after residency was private practice (46%), followed by permanent academic practice (28%). Changes that would entice those choosing private practice to consider an academic career included more research experience as a resident (76%), higher likelihood of tenure (69%), lesser time commitment (66%), and higher salary (54%). Although the majority of respondents were satisfied with educational experience overall, a number of programs were reported to provide fewer resources than required. Conclusions: Median program resources and numbers of outliers are documented to allow residents and program directors to assess the relative adequacy of experience in their own programs. Policy-making bodies and individual programs should consider these results when developing interventions to improve educational experiences of residents and to increase retention of radiation oncologists in academic practice

Evaluation of the efficacy of the guideline on reading CT images of malignant pleural mesothelioma with reference CT films for improving the proficiency of radiologists

Energy Technology Data Exchange (ETDEWEB)

Zhou, Huashi, E-mail: zhouhua@u-fukui.ac.jp [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Tamura, Taro, E-mail: tarou@u-fukui.ac.jp [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Kusaka, Yukinori, E-mail: kusakayk@gmail.com [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Suganuma, Narufumi, E-mail: nsuganuma@kochi-u.ac.jp [Department of Environmental Medicine, Kochi University School of Medicine (Japan); Subhannachart, Ponglada, E-mail: pongladas@gmail.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi, 11000 (Thailand); Vijitsanguan, Chomphunut, E-mail: Chompoo_vj@yahoo.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi, 11000 (Thailand); Noisiri, Weeraya, E-mail: weeraya_tat@yahoo.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi, 11000 (Thailand); Hering, Kurt G., E-mail: k.g.hering@t-online.de [Department of Diagnostic Radiology, Radiooncology and Nuclear Medicine, Radiological Clinic, Miner' s Hospital, Radiologische Klinik, Lansppaschaftskranhaus Dortmund, Wieckesweg 27, 44309, Dortmund (Germany); Akira, Masanori, E-mail: akira@kch.hosp.go.jp [Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8555 (Japan); Itoh, Harumi, E-mail: hitoh@fmsrsa.fukui-med.ac.jp [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Department of Radiology, School of Medicine, University of Fukui, 23-3 Shimoaitsuki Matsuoka, Eiheizi-cho, Fukui Prefecture, 910-1193 (Japan); and others

2013-01-15

Purpose: To assess the efficacy of the developed guideline on reading CT images of malignant pleural mesothelioma for improving radiologists’ reading proficiency. Materials and Methods: Three radiologists independently read the CT films of 22 cases including definite mesothelioma and non-mesothelioma cases at two times before and after studying the malignant pleural mesothelioma CT Guideline. The sensitivity and specificity for mesothelioma were calculated and compared between the 1st and 2nd trials. The kappa statistics was examined for agreement with experts for mesothelioma probability and for mesothelioma features recorded by three radiologists. Results: After studying the mesothelioma CT Guideline, the sensitivity for mesothelioma shown by the three radiologists at the 2nd trial was 100%, 100% and 80%, which were higher than 80%, 85% and 60% at the 1st trial, respectively. The average kappa for agreement between radiologists and experts on dichotomized mesothelioma probability were 0.69 (good) at the 2nd trial vs. 0.38 (fair) at the 1st trial. The average kappa for the agreement with experts for each of 7 features by three radiologists were 0.52–0.80 at the 2nd trial, which were significantly higher than 0.34–0.58 at the 1st trial (Wilcoxon Signed Rank Test: P < 0.01), and as to five features “unilateral pleural effusion”, “nodular pleural thickening”, “tumoral encasement of lung”, “mediastinal pleural thickening”, and “diminished lung”, they achieved good agreement with average kappa of 0.61–0.80. Conclusion: The developed mesothelioma CT Guideline was suggested to have substantial effect in improving the radiologists’ proficiency for reading CT images of mesothelioma, and may contribute to accurate diagnosis of mesothelioma.

Evaluation of the efficacy of the guideline on reading CT images of malignant pleural mesothelioma with reference CT films for improving the proficiency of radiologists

International Nuclear Information System (INIS)

Zhou, Huashi; Tamura, Taro; Kusaka, Yukinori; Suganuma, Narufumi; Subhannachart, Ponglada; Vijitsanguan, Chomphunut; Noisiri, Weeraya; Hering, Kurt G.; Akira, Masanori; Itoh, Harumi

2013-01-01

Purpose: To assess the efficacy of the developed guideline on reading CT images of malignant pleural mesothelioma for improving radiologists’ reading proficiency. Materials and Methods: Three radiologists independently read the CT films of 22 cases including definite mesothelioma and non-mesothelioma cases at two times before and after studying the malignant pleural mesothelioma CT Guideline. The sensitivity and specificity for mesothelioma were calculated and compared between the 1st and 2nd trials. The kappa statistics was examined for agreement with experts for mesothelioma probability and for mesothelioma features recorded by three radiologists. Results: After studying the mesothelioma CT Guideline, the sensitivity for mesothelioma shown by the three radiologists at the 2nd trial was 100%, 100% and 80%, which were higher than 80%, 85% and 60% at the 1st trial, respectively. The average kappa for agreement between radiologists and experts on dichotomized mesothelioma probability were 0.69 (good) at the 2nd trial vs. 0.38 (fair) at the 1st trial. The average kappa for the agreement with experts for each of 7 features by three radiologists were 0.52–0.80 at the 2nd trial, which were significantly higher than 0.34–0.58 at the 1st trial (Wilcoxon Signed Rank Test: P < 0.01), and as to five features “unilateral pleural effusion”, “nodular pleural thickening”, “tumoral encasement of lung”, “mediastinal pleural thickening”, and “diminished lung”, they achieved good agreement with average kappa of 0.61–0.80. Conclusion: The developed mesothelioma CT Guideline was suggested to have substantial effect in improving the radiologists’ proficiency for reading CT images of mesothelioma, and may contribute to accurate diagnosis of mesothelioma

Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

NARCIS (Netherlands)

Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

2001-01-01

Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

Moving improvement research closer to practice: the Researcher-in-Residence model

Science.gov (United States)

Marshall, Martin; Pagel, Christina; French, Catherine; Utley, Martin; Allwood, Dominique; Fulop, Naomi; Pope, Catherine; Banks, Victoria; Goldmann, Allan

2014-01-01

The traditional separation of the producers of research evidence in academia from the users of that evidence in healthcare organisations has not succeeded in closing the gap between what is known about the organisation and delivery of health services and what is actually done in practice. As a consequence, there is growing interest in alternative models of knowledge creation and mobilisation, ones which emphasise collaboration, active participation of all stakeholders, and a commitment to shared learning. Such models have robust historical, philosophical and methodological foundations but have not yet been embraced by many of the people working in the health sector. This paper presents an emerging model of participation, the Researcher-in-Residence. The model positions the researcher as a core member of a delivery team, actively negotiating a body of expertise which is different from, but complementary to, the expertise of managers and clinicians. Three examples of in-residence models are presented: an anthropologist working as a member of an executive team, operational researchers working in a front-line delivery team, and a Health Services Researcher working across an integrated care organisation. Each of these examples illustrates the contribution that an embedded researcher can make to a service-based team. They also highlight a number of unanswered questions about the model, including the required level of experience of the researcher and their areas of expertise, the institutional facilitators and barriers to embedding the model, and the risk that the independence of an embedded researcher might be compromised. The Researcher-in-Residence model has the potential to engage both academics and practitioners in the promotion of evidence-informed service improvement, but further evaluation is required before the model should be routinely used in practice. PMID:24894592

Self-Efficacy Ratings of Technology Proficiency among Teachers in Mexico and Texas

Science.gov (United States)

Morales, Cesareo; Knezek, Gerald; Christensen, Rhonda

2008-01-01

The Technology Proficiency Self-Assessment (TPSA) questionnaire was administered to 978 elementary and middle school teachers from Mexico City, and 932 elementary and middle school teachers from the Dallas, Texas, metroplex in the USA, in order to examine self-efficacy similarities and differences for technology proficiency self-appraisals in a…

Issues in Vertical Scaling of a K-12 English Language Proficiency Test

Science.gov (United States)

Kenyon, Dorry M.; MacGregor, David; Li, Dongyang; Cook, H. Gary

2011-01-01

One of the mandates of the No Child Left Behind Act is that states show adequate yearly progress in their English language learners' (ELLs) acquisition of English language proficiency. States are required to assess ELLs' English language proficiency annually in four language domains (listening, reading, writing, and speaking) to measure their…

Self-Assessment, Preparation and Response Time on a Computerized Oral Proficiency Test

Science.gov (United States)

Malabonga, Valerie; Kenyon, Dorry M.; Carpenter, Helen

2005-01-01

Two studies investigated technical aspects of a computer-mediated test, the Computerized Oral Proficiency Instrument (COPI), particularly in contrast to a similar tape-mediated test, the Simulated Oral Proficiency Interview (SOPI). The first study investigated how examinees used self-assessment to choose an appropriate starting level on the COPI.…

Orthopedic resident work-shift analysis: are we making the best use of resident work hours?

Science.gov (United States)

Hamid, Kamran S; Nwachukwu, Benedict U; Hsu, Eugene; Edgerton, Colston A; Hobson, David R; Lang, Jason E

2014-01-01

Surgery programs have been tasked to meet rising demands in patient surgical care while simultaneously providing adequate resident training in the midst of increasing resident work-hour restrictions. The purpose of this study was to quantify orthopedic surgery resident workflow and identify areas needing improved resident efficiency. We hypothesize that residents spend a disproportionate amount of time involved in activities that do not relate directly to patient care or maximize resident education. We observed 4 orthopedic surgery residents on the orthopedic consult service at a major tertiary care center for 72 consecutive hours (6 consecutive shifts). We collected minute-by-minute data using predefined work-task criteria: direct new patient contact, direct existing patient contact, communications with other providers, documentation/administrative time, transit time, and basic human needs. A seventh category comprised remaining less-productive work was termed as standby. In a 720-minute shift, residents spent on an average: 191 minutes (26.5%) performing documentation/administrative duties, 167.0 minutes (23.2%) in direct contact with new patient consults, 129.6 minutes (17.1%) in communication with other providers regarding patients, 116.2 (16.1%) minutes in standby, 63.7 minutes (8.8%) in transit, 32.6 minutes (4.5%) with existing patients, and 20 minutes (2.7%) attending to basic human needs. Residents performed an additional 130 minutes of administrative work off duty. Secondary analysis revealed residents were more likely to perform administrative work rather than directly interact with existing patients (p = 0.006) or attend to basic human needs (p = 0.003). Orthopedic surgery residents spend a large proportion of their time performing documentation/administrative-type work and their workday can be operationally optimized to minimize nonvalue-adding tasks. Formal workflow analysis may aid program directors in systematic process improvements to better align

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

The Impact of Problem-Based Learning on Iranian EFL Learners’ Speaking Proficiency

Directory of Open Access Journals (Sweden)

Loghman Ansarian

2016-06-01

Full Text Available The study investigated the effect of problem-based learning through cognition-based tasks on speaking proficiency of Iranian intermediate EFL learners in comparison to the effect of objective-based tasks. To this end, a true experimental research design was employed. Ninety five (N=95 language learners studying at a language institute in the city of Esfahan, Iran were given an IELTS listening and speaking test as the proficiency test and 75 learners were selected. In the next phase of the study, a second IELTS speaking test was administered as the homogeneity test and the pre-test to seventy five (N=75 learners chosen from the population and forty-eight (N=48 homogeneous intermediate learners were selected for the study (i.e., 24 learners in control group and 24 in experimental one. The results of an independent-sample t-test gained from the study proved that not only does implementation of problem-based learning through cognition-based tasks significantly increased intermediate participants’ speaking proficiency, but also it had more positive effect in comparison to objective-based tasks on participants’ speaking proficiency. Therefore, it is suggested that problem-based learning ought to be taken into account by educational scholars, those in charge of syllabus, material producers, language teachers and language learners. Keywords: Cognition-Based Tasks, Objective-Based Tasks, EFL Learners, Speaking Proficiency, Problem-Based Learning

L2-proficiency-dependent laterality shift in structural connectivity of brain language pathways

NARCIS (Netherlands)

Xiang, H.; Leeuwen, T.M. van; Dediu, D.; Roberts, L.; Norris, D.; Hagoort, P.

2015-01-01

Diffusion tensor imaging (DTI) and a longitudinal language learning approach were applied to investigate the relationship between the achieved second language (L2) proficiency during L2 learning and the reorganization of structural connectivity between core language areas. Language proficiency tests

L2-Proficiency-Dependent Laterality Shift in Structural Connectivity of Brain Language Pathways

NARCIS (Netherlands)

Xiang, Huadong; van Leeuwen, Tessa Marije; Dediu, Dan; Roberts, Leah; Norris, David G.; Hagoort, Peter

2015-01-01

Diffusion tensor imaging (DTI) and a longitudinal language learning approach were applied to investigate the relationship between the achieved second language (L2) proficiency during L2 learning and the reorganization of structural connectivity between core language areas. Language proficiency tests

Anesthesiology resident personality type correlates with faculty assessment of resident performance.

Science.gov (United States)

Schell, Randall M; Dilorenzo, Amy N; Li, Hsin-Fang; Fragneto, Regina Y; Bowe, Edwin A; Hessel, Eugene A

2012-11-01

To study the association between anesthesiology residents' personality preference types, faculty evaluations of residents' performance, and knowledge. Convenience sample and prospective study. Academic department of anesthesiology. Consenting anesthesiology residents (n = 36). All participants completed the Myers Briggs Type Indicator® (MBTI®). All residents' 6-month summation of daily focal evaluations completed by faculty [daily performance score (DPS); 1 = unsatisfactory, 2 = needs improvement, 3 = meets expectations, 4 = exceeds expectations], as well as a global assessment of performance (GAP) score based on placement of each resident into perceived quartile compared with their peers (ie,1 = first, or top, quartile) by senior faculty (n = 7) who also completed the MBTI, were obtained. The resident MBTI personality preferences were compared with the DPS and GAP scores, the United States Medical Licensing Examination (USMLE) I and II scores, and faculty MBTI personality type. There was no association between personality preference type and performance on standardized examinations (USMLE I, II). The mean GAP score was better (higher quartile score) for Extraverts than Introverts (median 2.0 vs 2.6, P = 0.0047) and for Sensing versus Intuition (median 2.0 vs 2.6, P = 0.0206) preference. Faculty evaluator MBTI preference type did not influence the GAP scores they assigned residents. Like GAP, the DPS was better for residents with Sensing versus Intuition preference (median 3.5 vs 3.3, P = 0.0111). No difference in DPS was noted between Extraverts and Introverts. Personality preference type was not associated with resident performance on standardized examinations, but it was associated with faculty evaluations of resident performance. Residents with Sensing personality preference were evaluated more favorably on global and focal faculty evaluations than those residents who chose the Intuition preference. Extraverted residents were evaluated more favorably on

Informatics and Technology in Resident Education.

Science.gov (United States)

Niehaus, William

2017-05-01

Biomedical or clinical informatics is the transdisciplinary field that studies and develops effective uses of biomedical data, information technology innovations, and medical knowledge for scientific inquiry, problem solving, and decision making, with an emphasis on improving human health. Given the ongoing advances in information technology, the field of informatics is becoming important to clinical practice and to residency education. This article will discuss how informatics is specifically relevant to residency education and the different ways to incorporate informatics into residency education, and will highlight applications of current technology in the context of residency education. How informatics can optimize communication for residents, promote information technology use, refine documentation techniques, reduce medical errors, and improve clinical decision making will be reviewed. It is hoped that this article will increase faculty and trainees' knowledge of the field of informatics, awareness of available technology, and will assist practitioners to maximize their ability to provide quality care to their patients. This article will also introduce the idea of incorporating informatics specialists into residency programs to help practitioners deliver more evidenced-based care and to further improve their efficiency. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Research on the proficient machine system. Theoretical part; Jukutatsu machine system no chosa kenkyu. Rironhen

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-03-01

The basic theory of the proficient machine system to be developed was studied. Important proficient techniques in manufacturing industries are becoming extinct because of insufficient succession to next generation. The proficient machine system was proposed to cope with such situation. This machine system includes the mechanism for progress and evolution of techniques and sensibilities to be adaptable to environmental changes by learning and recognizing various motions such as work and process. Consequently, the basic research fields are composed of thought, learning, perception and action. This machine requires not only deigned fixed functions but also introduction of the same proficient concept as human being to be adaptable to changes in situation, purpose, time and machine`s complexity. This report explains in detail the basic concept, system principle, approaching procedure and practical elemental technologies of the proficient machine system, and also describes the future prospect. 133 refs., 110 figs., 7 tabs.

Gaining Proficiency through Task-Based Activities in the Portuguese Classroom (Beginning and Intermediate Year Case Studies)

Science.gov (United States)

Jones-Kellogg, Rebecca

2015-01-01

This paper describes a task-based activity used at the United States Military Academy, in their first- through third-semester Portuguese language sequence "Proficiencies" (Proficiências). The stand-alone task-based activity can be an effective tool in gaining foreign-language proficiency at even the lowest levels of classroom instruction…

Incorporation of proficiency criteria for basic laparoscopic skills training: How does it work?

NARCIS (Netherlands)

E. Verdaasdonk (Egg); J. Dankelman (Jenny); J.F. Lange (Johan); L.P. Stassen (Laurents)

2008-01-01

textabstractBackground: It is desirable that surgical trainees are proficient in basic laparoscopic motor skills (eye-hand coordination). The present study evaluated the use of predefined proficiency criteria on a basic virtual reality (VR) simulator in preparation for a laparoscopic course on

School-Age Test Proficiency and Special Education After Congenital Heart Disease Surgery in Infancy.

Science.gov (United States)

Mulkey, Sarah B; Bai, Shasha; Luo, Chunqiao; Cleavenger, Jordyn E; Gibson, Neal; Holland, Greg; Mosley, Bridget S; Kaiser, Jeffrey R; Bhutta, Adnan T

2016-11-01

To evaluate test proficiency and the receipt of special education services in school-age children who had undergone surgery for congenital heart disease (CHD) at age Education longitudinal database containing achievement test scores in literacy and mathematics for grades 3-4 and special education codes. The primary negative outcome was not achieving grade-level proficiency on achievement tests. Logistic regression accounting for repeated measures was used to evaluate for associations between achieving proficiency and demographic data, maternal education, and clinical factors. A total of 362 of 458 (79%) children who underwent surgery for CHD were matched to the Arkansas Department of Education database, 285 of whom had grade 3 and/or 4 achievement tests scores. Fewer students with CHD achieved proficiency in literacy and mathematics (P education predicted proficiency in literacy (P special education services (26.9% vs 11.6%; P special education services than all state students. Results from this study support the need for neurodevelopmental evaluations as standard practice in children with CHD. Copyright © 2016 Elsevier Inc. All rights reserved.

Uncertainty evaluation in 2008 IAEA proficiency test using phosphogypsum

International Nuclear Information System (INIS)

Dias, Fabiana F.; Taddei, Maria Helena T.; Geraldo, Bianca; Jacomino, Vanusa M.F.; Pontedeiro, Elizabeth M.B.

2009-01-01

LAPOC participated in the 2008 IAEA ALMERA (Analytical Laboratories for the Measurement of Environmental Radioactivity) Proficiency Test (PT) for phosphogypsum, which is a NORM (Naturally Occurring Radioactive Material) derived from phosphate industry, an abundant solid waste of low cost. Its reutilization would avoid environmental impact in large areas where the product is stored. Research involving possible uses for phosphogypsum is ever more important, from economic, technological, and environmental points of view. This paper describes results from this Proficiency Test (measured radionuclides: 234 U, 238 U, 226 Ra, 230 Th, and 210 Pb), as well as a short description of the nuclear analytical techniques emphasizing sources of uncertainty, such as Alpha Spectrometry (Alpha Analyst, Canberra, surface barrier detectors) and Gamma Spectrometry (Canberra, Hyper Pure Germanium Detector with 45 % efficiency). Corrections for decay, reference date, and recovery were applied. As an example, results obtained for 210 Pb through the use of a specific uncertainty calculation software are presented below. Each parameter whose uncertainty is quantified was carefully described, with appropriate numerical value and unit, to determine its partial contribution to the combined total uncertainty. Results from PTs provide independent information on performance of a Laboratory and have an important role in method validation; especially because it allows the assessment of the method performance over an entire range of concentrations and matrices. PTs are an important tool to demonstrate equivalence of measurements, if not their metrological comparability, and to promote education and improvement of Laboratory practice. (author)

Pediatric resident perceptions of shift work in ward rotations.

Science.gov (United States)

Nomura, Osamu; Mishina, Hiroki; Jasti, Harish; Sakai, Hirokazu; Ishiguro, Akira

2017-10-01

Although the long working hours of physicians are considered to be a social issue, no effective policies such as duty hour regulations have so far been proposed in Japan. We implemented an overnight call shift (OCS) system for ward rotations to improve the working environment for residents in a pediatric residency program. We later conducted a cross-sectional questionnaire asking the residents to compare this system with the traditional overnight call system. Forty-one pediatric residents participated in this survey. The residents felt that the quality of patient care improved (80.4% agreed). Most felt that there was less emphasis on education (26.8%) and more emphasis on service (31.7%). Overall, the residents reported that the OCS was beneficial (90.2%). In conclusion, the pediatric residents considered the OCS system during ward rotations as beneficial. Alternative solutions are vital to balance improvements in resident work conditions with the requirement for a high quality of education. © 2017 Japan Pediatric Society.

Hi-LAB: A New Measure of Aptitude for High-Level Language Proficiency

Science.gov (United States)

Linck, Jared A.; Hughes, Meredith M.; Campbell, Susan G.; Silbert, Noah H.; Tare, Medha; Jackson, Scott R.; Smith, Benjamin K.; Bunting, Michael F.; Doughty, Catherine J.

2013-01-01

Few adult second language (L2) learners successfully attain high-level proficiency. Although decades of research on beginning to intermediate stages of L2 learning have identified a number of predictors of the rate of acquisition, little research has examined factors relevant to predicting very high levels of L2 proficiency. The current study,…

Non-Discriminatory Assessment: Formal and Informal Assessment of Limited English Proficient Children.

Science.gov (United States)

Mares, Sharon

PEOPLE (Pruebas de Expresion Oral y Percepcion de la Lengua Espanol) was developed as a test to help distinguish between a language difference and a language deficit in non English proficient (NEP) and limited English proficient (LEP) elementary Hispanic students. PEOPLE was developed, pilot tested in 14 school districts in Los Angeles County with…

Worldwide proficiency test for X ray fluorescence laboratories PTXRFIAEA/05 determination of minor and trace elements in marine sediment

International Nuclear Information System (INIS)

2009-01-01

The proficiency test (code PTXRFIAEA05) was the fifth worldwide exercise organized by the IAEA Seibersdorf Laboratories in order to assist X ray fluorescence laboratories in assessment and improvement of their analytical performance. The test was carried out within the IAEA Project 1.4.3.4 (D.3.03) on Nuclear Spectrometry for Analytical Applications, under the Nuclear Science Programme. The main objective of the project was to enhance capability of interested Member States in effective utilization of nuclear spectrometries and analytical services in industry, human health, agriculture, and in monitoring and evaluation of environmental pollution. Marine sediment test samples with established homogeneity and well characterized known target values of the mass fractions of analytes were distributed to participating laboratories. The laboratories were requested to analyze the sample using established techniques following their analytical procedures. Based on the results of the proficiency test presented in the report each participating laboratory should assess its analytical performance results by using the specified criteria and, if appropriate, to identify discrepancies, and to correct relevant analytical procedures. The next proficiency test exercise will be executed in 2009

The Relationship of Endoscopic Proficiency to Educational Expense for Virtual Reality Simulator Training Amongst Surgical Trainees.

Science.gov (United States)

Raque, Jessica; Goble, Adam; Jones, Veronica M; Waldman, Lindsey E; Sutton, Erica

2015-07-01

With the introduction of Fundamentals of Endoscopic Surgery, training methods in flexible endoscopy are being augmented with simulation-based curricula. The investment for virtual reality simulators warrants further research into its training advantage. Trainees were randomized into bedside or simulator training groups (BED vs SIM). SIM participated in a proficiency-based virtual reality curriculum. Trainees' endoscopic skills were rated using the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES) in the patient care setting. The number of cases to reach 90 per cent of the maximum GAGES score and calculated costs of training were compared. Nineteen residents participated in the study. There was no difference in the average number of cases required to achieve 90 per cent of the maximum GAGES score for esophagogastroduodenoscopy, 13 (SIM) versus11 (BED) (P = 0.63), or colonoscopy 21 (SIM) versus 4 (BED) (P = 0.34). The average per case cost of training for esophagogastroduodenoscopy was $35.98 (SIM) versus $39.71 (BED) (P = 0.50), not including the depreciation costs associated with the simulator ($715.00 per resident over six years). Use of a simulator appeared to increase the cost of training without accelerating the learning curve or decreasing faculty time spent in instruction. The importance of simulation in endoscopy training will be predicated on more cost-effective simulators.

Physical activity and movement skills proficiency of young Filipino children.

Science.gov (United States)

Capio, Catherine M; Sit, Cindy H P; Eguia, Kathlynne F; Abernethy, Bruce

2014-08-01

Recent reports indicate an increasing prevalence of overweight among Filipino children. Considering the known association of physical activity (PA) with obesity, this study reports the findings of an objective monitoring of PA in a sample of Filipino children. The study also explores the relationship of PA with fundamental movement skills (FMS) proficiency. Thirty-two children (6.54 ± 2.45 years old) wore an accelerometer for 7 days of PA monitoring and were assessed on five FMS (throw, catch, kick, run, jump). The children met the World Health Organization's recommendation of 60 min of PA per day, with more active time being accrued during weekdays than weekends. Children with greater FMS proficiency were found to spend more time in PA than those who were less skillful during weekends. Further research is recommended to examine PA and FMS proficiency associations, exploring the role of social interactions on weekends and weekdays. © 2014 Japan Pediatric Society.

THE OBSERVATION OF TEACHER CANDIDATE RELATED SCIENCE AND TECHNOLOGY TEACHER'S PROFICIENCY

OpenAIRE

BAHŞİ, Muammer; TURAN, Mehmet; YILAYAZ, Ömer

2009-01-01

In this study it is evaluated science and tecnology teacher's proficiency based on students insights of science and tecnology education students in education faculty. It was used Standarts for Teacher Proficiency which is prepared from Ministry of National Education. The research was conducted on 85 Science and Tecnology students (4th classes) studying at the education faculty of Firat University. Data from results of study was analysed by using SPSS.

Association between pediatric asthma care quality and morbidity and English language proficiency in Ohio.

Science.gov (United States)

Montgomery, Martha P; Allen, Elizabeth D; Thomas, Olivia; Robinson, Byron F; Clark, Donnie; Connelly, Ann; Mott, Joshua A; Conrey, Elizabeth

2018-05-08

Limited English proficiency can be a barrier to asthma care and is associated with poor outcomes. This study examines whether pediatric patients in Ohio with limited English proficiency experience lower asthma care quality or higher morbidity. We used electronic health records for asthma patients aged 2-17 years from a regional, urban, children's hospital in Ohio during 2011-2015. Community-level demographics were included from U.S. Census data. By using chi-square and t-tests, patients with limited English proficiency and bilingual English-speaking patients were compared with English-only patients. Five asthma outcomes-two quality and three morbidity measures-were modeled using generalized estimating equations. The study included 15 352 (84%) English-only patients, 1744 (10%) patients with limited English proficiency, and 1147 (6%) bilingual patients. Pulmonary function testing (quality measure) and multiple exacerbation visits (morbidity measure) did not differ by language group. Compared with English-only patients, bilingual patients had higher odds of ever having an exacerbation visit (morbidity measure) (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.2-1.6) but lower odds of admission to intensive care (morbidity measure) (aOR, 0.3; 95% CI, 0.2-0.7), while patients with limited English proficiency did not differ on either factor. Recommended follow-up after exacerbation (quality measure) was higher for limited English proficiency (aOR, 1.8; 95% CI, 1.4-2.3) and bilingual (aOR, 1.6; 95% CI, 1.3-2.1), compared with English-only patients. In this urban, pediatric population with reliable interpreter services, limited English proficiency was not associated with worse asthma care quality or morbidity.

Residents as teachers: psychiatry and family medicine residents' self-assessment of teaching knowledge, skills, and attitudes.

Science.gov (United States)

Brand, Michael W; Ekambaram, Vijayabharathi; Tucker, Phebe; Aggarwal, Ruchi

2013-09-01

Residents are one of the prime sources of information and education for medical students. As an initial step in supporting residents as teachers, a baseline self-assessment of residents' knowledge, skills, attitudes, and values related to teaching was conducted among psychiatry and family medicine residents to compare and improve their confidence and skills as teachers. Psychiatry residents (N=12) and family medicine residents (N=23) completed self-assessments of their knowledge, skills, attitudes, and values related to teaching. Residents also were asked to list steps used in the One-Minute Preceptor process and estimate the time each spent in teaching. Descriptive summary statistics were used for four main areas related to teaching; t-test and chi-square analyses were conducted to ascertain whether there was a significant difference in resident groups. In the current study, the perceived amount of time spent for teaching patients was significantly higher among family practice residents, whereas no group differences were found for time teaching medical students, peers, community members, non-physicians, or others. However, family medicine residents rated themselves higher than psychiatry residents in their understanding of their roles in teaching medical students and teaching patients. Also, family medicine residents' self-reported teaching skills were more advanced (82.4%) than psychiatry residents' (54.2%). They most likely applied at least two different teaching methods in inpatient and outpatient settings, as compared with psychiatry residents. No significant group differences were found in the other 15 items assessing teaching knowledge, skills, attitudes, and values. Results indicate that residents' knowledge, skills, attitudes, and values regarding teaching varies across institutions and training programs. The psychiatry residents in this study do not clearly understand their role as educators with patients and medical students; they have a less clear

Simulation as a tool for improving acquisition of neonatal resuscitation skills for obstetric residents.

Science.gov (United States)

Bruno, C J; Angert, R; Rosen, O; Lee, C; Vega, M; Kim, M; Yu, Y; Bernstein, P S; Goffman, D

2016-01-01

Our goal was to compare the confidence, knowledge, and performance of obstetric residents taught initial neonatal resuscitation steps in a simulation-based versus lecture-based format. Our study was a prospective randomized controlled trial of 33 obstetric residents. Baseline confidence, knowledge, and clinical skills assessments were performed. Subjects were randomized to traditional lecture (n = 14) or simulation-based (n = 19) neonatal resuscitation curriculum with a focus on initial steps. Follow-up assessments were performed at 3 and 6 months. Total confidence, knowledge, and clinical performance scores and change from baseline in these scores were calculated and compared between groups. Both the lecture-based and simulated-based groups demonstrated significant improvement in confidence, knowledge, and performance over time. However, compared with the lecture group, the magnitude of the mean change from baseline in performance scores was significantly greater in the simulation group at 3 months (2.9 versus 10.1; p < 0.001), but not at 6 months (7.0 versus 9.3; p = 0.11). Our study demonstrates the superiority of simulation in teaching obstetric residents initial neonatal resuscitation steps compared with a traditional lecture format. Skills are retained for upwards of 3-6 months. Refresher instruction by 6 months post-instruction may be beneficial.

EFL Speech Production: Exploring the relationship between working memory capacity and proficiency level

Directory of Open Access Journals (Sweden)

Gicele Vergine Vieira PREBIANCA

2013-12-01

Full Text Available The present study explores the relationship between working memory capacity (WMC and proficiency level in EFL1 speech production. Forty-one participants performed two WMC tests – the Speaking Span Test in L1 and in L2. The statistical analysis indicated both a variation on WMC scores in L2 as a function of proficiency as well as a difference between WMC scores in L1 and in L2. Findings are explained mainly in respect to the interplay between automatic and controlled processes on memory retrieval and on the development of L2 proficiency.

Orthopaedic resident preparedness for closed reduction and pinning of pediatric supracondylar fractures is improved by e-learning: a multisite randomized controlled study.

Science.gov (United States)

Hearty, Thomas; Maizels, Max; Pring, Maya; Mazur, John; Liu, Raymond; Sarwark, John; Janicki, Joseph

2013-09-04

There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% ± 6.8% for the test group and 73.5% ± 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a

Factors influencing selection of internal medicine residency--a prospective study.

Science.gov (United States)

Pereg, David; Gronich, Naomi; Lishner, Michael

2006-08-01

Recently, the popularity of internal medicine residency has been decreasing. We studied the effect of an improved working environment and a decrease in residents' workload on the selection of internal medicine residency. An organizational diagnosis team joined our department and identified several causes for residents' heavy workload. These findings were subsequently discussed in a workshop and led to a modification of the daily routine and a parallel decrease in workload and rise in residents' satisfaction. Following these changes, the demand for residency in our department rose. We conclude that an improvement in the working environment and workload during residency increases the residents' satisfaction and the demand for residency in internal medicine.

Second language proficiency modulates conflict-monitoring in an oculomotor Stroop task: evidence from Hindi-English bilinguals.

Directory of Open Access Journals (Sweden)

Niharika eSingh

2013-06-01

Full Text Available Many studies have confirmed the presence of a bilingual advantage which is manifested as enhanced cognitive and attention control. However, very few studies have investigated the role of second language proficiency on the modulation of conflict-monitoring in bilinguals. We investigated this by comparing high and low proficient Hindi-English bilinguals on a modified saccadic arrow Stroop task under different monitoring conditions, and tested the predictions of the bilingual executive control advantage proposal. The task of the participants was to make an eye movement towards the colour patch in the same colour as the central arrow, ignoring the patch to which the arrow was pointing. High-proficient bilinguals had overall faster saccade latency on all types of trials as compared to the low proficient bilinguals. The overall saccadic latency for high proficiency bilinguals was similarly affected by the different types of monitoring conditions, whereas conflict resolution advantage was found only for high monitoring demanding condition. The results support a conflict-monitoring account in a novel oculomotor task and also suggest that language proficiency could modulate executive control in bilinguals.

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.

Proficiency testing in the light of a new rationale in metrology

DEFF Research Database (Denmark)

Heydorn, Kaj

2008-01-01

The novel proposed definition of measurement result in the international metrology vocabulary requires a revision of standards and guidelines for proficiency testing (PT), and a new approach to processing proficiency data is needed to test the ability of laboratories to present not only unbiased...... quantity values, but reliable estimates of their uncertainty. Hence, an accepted reference value with the smallest possible uncertainty is needed to ascertain the proficiency of laboratories reporting results with lower than average uncertainty. A strategy based on the T-statistic is proposed leading...... to an accepted reference value that fully reflects the uncertainties reported by participants in a PT scheme and permits calculation of En-numbers to distinguish whether or not measurement results are consistent with the accepted definition of the measurand. The strategy is applied to PT data from a recent...

Cell Phone Use and Child and Adolescent Reading Proficiency

Science.gov (United States)

Hofferth, Sandra L.; Moon, Ui Jeong

2016-01-01

This study examined the association between cell phone use, including minutes spent talking and number of text messages sent, and two measures of children’s reading proficiency — tests of word decoding and reading comprehension — in the United States. Data were drawn from the Child Development Supplement to the Panel Study of Income Dynamics, a nationally representative survey of 1,147 children 10–18 in 2009. Children whose parents were better educated, who had higher family incomes, who had fewer siblings, and who lived in urban areas were more likely to own or share a cell phone. Among those with access to a phone, children who spent more time talking on the phone were less proficient at word decoding, whereas children who spent more time sending text messages had greater reading comprehension. Although girls spent more time texting than did boys, there were no gender differences in the association between time spent talking or number of text messages sent with achievement. In spite of racial/ethnic differences in cell phone use levels, there were no racial/ethnic differences in the association between cell phone use and reading proficiency. PMID:27683624

Motor Proficiency in Young Children

Directory of Open Access Journals (Sweden)

Fotini Venetsanou

2016-01-01

Full Text Available This study aimed to examine motor proficiency in young children, focusing on potential gender differences. For that purpose, the Bruininks-Oseretsky Test of Motor Proficiency–Long Form (BOTMP-LF was administered to 540 children (272 boys, 4½ to 6 years old. First, the 2 (sex × 4 (age groups ANOVA computed on children’s total BOTMP-LF scores showed that age had a statistically significant effect, whereas gender did not. Second, the one-way MANCOVA applied on subtest scores, with age as covariate, revealed statistical significant gender differences; however, η2 values were found to be small or moderate. Finally, the MANCOVA applied on items where significant gender differences have been reported showed a significant effect of gender. Nonetheless, η2 values exceeded the limit of practical significance only on two items (“standing on preferred leg on floor”, “throwing a ball at a target with preferred hand” that are associated with gender-stereotyped activities. It can be concluded that (a besides statistical significance, effect sizes should be examined for the results of a study to be adequately interpreted; (b young boys’ and girls’ motor proficiency is similar rather than different. Gender differences in specific skills should be used for movement programs to be individualized.

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.

Effectiveness of different memory training programs on improving hyperphagic behaviors of residents with dementia: a longitudinal single-blind study.

Science.gov (United States)

Kao, Chieh-Chun; Lin, Li-Chan; Wu, Shiao-Chi; Lin, Ker-Neng; Liu, Ching-Kuan

2016-01-01

Hyperphagia increases eating-associated risks for people with dementia and distress for caregivers. The purpose of this study was to compare the long-term effectiveness of spaced retrieval (SR) training and SR training combined with Montessori activities (SR + M) for improving hyperphagic behaviors of special care unit residents with dementia. The study enrolled patients with dementia suffering from hyperphagia resident in eight institutions and used a cluster-randomized single-blind design, with 46 participants in the SR group, 49 in the SR + M group, and 45 participants in the control group. For these three groups, trained research assistants collected baseline data on hyperphagic behavior, pica, changes in eating habits, short meal frequency, and distress to caregivers. The SR and SR + M groups underwent memory training over a 6-week training period (30 sessions), and a generalized estimating equation was used to compare data of all the three groups of subjects obtained immediately after the training period and at follow-ups 1 month, 3 months, and 6 months later. Results showed that the hyperphagic and pica behaviors of both the SR and SR + M groups were significantly improved (P<0.001) and that the effect lasted for 3 months after training. The improvement of fast eating was significantly superior in the SR + M group than in the SR group. The improvement in distress to caregivers in both intervention groups lasted only until the posttest. Improvement in changes in eating habits of the two groups was not significantly different from that of the control group. SR and SR + M training programs can improve hyperphagic behavior of patients with dementia. The SR + M training program is particularly beneficial for the improvement of rapid eating. Caregivers can choose a suitable memory training program according to the eating problems of their residents.

The development and psychometric properties of the American sign language proficiency assessment (ASL-PA).

Science.gov (United States)

Maller, S; Singleton, J; Supalla, S; Wix, T

1999-01-01

We describe the procedures for constructing an instrument designed to evaluate children's proficiency in American Sign Language (ASL). The American Sign Language Proficiency Assessment (ASL-PA) is a much-needed tool that potentially could be used by researchers, language specialists, and qualified school personnel. A half-hour ASL sample is collected on video from a target child (between ages 6 and 12) across three separate discourse settings and is later analyzed and scored by an assessor who is highly proficient in ASL. After the child's language sample is scored, he or she can be assigned an ASL proficiency rating of Level 1, 2, or 3. At this phase in its development, substantial evidence of reliability and validity has been obtained for the ASL-PA using a sample of 80 profoundly deaf children (ages 6-12) of varying ASL skill levels. The article first explains the item development and administration of the ASL-PA instrument, then describes the empirical item analysis, standard setting procedures, and evidence of reliability and validity. The ASL-PA is a promising instrument for assessing elementary school-age children's ASL proficiency. Plans for further development are also discussed.

Effect of a 9-wk. after-school multiskills club on fundamental movement skill proficiency in 8- to 9-yr.-old children: an exploratory trial.

Science.gov (United States)

Foweather, Lawrence; McWhannell, Nicola; Henaghan, Jayne; Lees, Adrian; Stratton, Gareth; Batterham, Alan M

2008-06-01

This exploratory study examined the effects of a 9-wk. after-school multiskills club on fundamental movement skill proficiency in 8- to 9-yr.-old children. Two schools were randomly assigned to either a control (n = 15 children) or multiskill club (n = 19 children) condition. The multiskill club received 18 coaching sessions designed to improve fundamental movement skills. The control group followed normal routines. 7 skills were assessed using process-oriented measures with video analysis. Participation in the multiskill club yielded significant improvements in proficiency at posttest only in static balance, while potentially practically important improvements were observed in performance of the catch, throw, and kick skills. The after-school multiskill club offered a viable opportunity for movement skill acquisition, but any such programme would need to run for a longer duration to assess whether this type of activity could benefit all skills.

Pioneering partnerships: Resident involvement from multiple perspectives

NARCIS (Netherlands)

Baur, V.E.; Abma, T.A.; Boelsma, F.; Woelders, S.

2013-01-01

Resident involvement in residential care homes is a challenge due to shortcomings of consumerist and formal approaches such as resident councils. The PARTNER approach aims to involve residents through collective action to improve their community life and wellbeing. The purpose of this article is to

Acquisition of Skill Proficiency Over Multiple Sessions of a Novel Rover Simulation

Science.gov (United States)

Dean, S. L.; DeDios,Y. E.; MacDougall, H. G.; Moore, S. T.; Wood, S. J.

2011-01-01

Following long-duration exploration transits, adaptive changes in sensorimotor function may impair the crew's ability to safely perform manual control tasks such as operating pressurized rovers. Postflight performance will also be influenced by the level of preflight skill proficiency they have attained. The purpose of this study was to characterize the acquisition of skills in a motion-based rover simulation over multiple sessions, and to investigate the effects of varying the simulation scenarios. METHODS: Twenty healthy subjects were tested in 5 sessions, with 1-3 days between sessions. Each session consisted of a serial presentation of 8 discrete tasks to be completed as quickly and accurately as possible. Each task consisted of 1) perspective-taking, using a map that defined a docking target, 2) navigation toward the target around a Martian outpost, and 3) docking a side hatch of the rover to a visually guided target. The simulator utilized a Stewart-type motion base (CKAS, Australia), single-seat cabin with triple scene projection covering 150 deg horizontal by 50 deg vertical, and joystick controller. Subjects were randomly assigned to a control group (tasks identical in the first 4 sessions) or a varied-practice group. The dependent variables for each task included accuracy toward the target and time to completion. RESULTS: The greatest improvements in time to completion occurred during the docking phase. The varied-practice group showed more improvement in perspective-taking accuracy. Perspective-taking accuracy was also affected by the relative orientation of the rover to the docking target. Skill acquisition was correlated with self-ratings of previous gaming experience. DISCUSSION: Varying task selection and difficulty will optimize the preflight acquisition of skills when performing novel operational tasks. Simulation of operational manual control will provide functionally relevant evidence regarding the impact of sensorimotor adaptation on early

Proficiency test for paracitides in salmon muscle

NARCIS (Netherlands)

Elbers, I.J.W.

2012-01-01

The aim of this proficiency study was to give laboratories the possibility to evaluate or demonstrate their competence for the analysis of parasiticides in salmon muscle. This study also provided an evaluation of the methods applied for the quantitative analysis of parasiticides in salmon muscle.

High school science teacher perceptions of the science proficiency testing as mandated by the State of Ohio Board of Education

Science.gov (United States)

Jeffery, Samuel Shird

There is a correlation between the socioeconomic status of secondary schools and scores on the State of Ohio's mandated secondary science proficiency tests. In low scoring schools many reasons effectively explain the low test scores as a result of the low socioeconomics. For example, one reason may be that many students are working late hours after school to help with family finances; parents may simply be too busy providing family income to realize the consequences of the testing program. There are many other personal issues students face that may cause them to score poorly an the test. The perceptions of their teachers regarding the science proficiency test program may be one significant factor. These teacher perceptions are the topic of this study. Two sample groups ware established for this study. One group was science teachers from secondary schools scoring 85% or higher on the 12th grade proficiency test in the academic year 1998--1999. The other group consisted of science teachers from secondary schools scoring 35% or less in the same academic year. Each group of teachers responded to a survey instrument that listed several items used to determine teachers' perceptions of the secondary science proficiency test. A significant difference in the teacher' perceptions existed between the two groups. Some of the ranked items on the form include teachers' opinions of: (1) Teaching to the tests; (2) School administrators' priority placed on improving average test scores; (3) Teacher incentive for improving average test scores; (4) Teacher teaching style change as a result of the testing mandate; (5) Teacher knowledge of State curriculum model; (6) Student stress as a result of the high-stakes test; (7) Test cultural bias; (8) The tests in general.

Observational study using the tools of lean six sigma to improve the efficiency of the resident rounding process.

Science.gov (United States)

Chand, David V

2011-06-01

Recent focus on resident work hours has challenged residency programs to modify their curricula to meet established duty hour restrictions and fulfill their mission to develop the next generation of clinicians. Simultaneously, health care systems strive to deliver efficient, high-quality care to patients and families. The primary goal of this observational study was to use a data-driven approach to eliminate examples of waste and variation identified in resident rounding using Lean Six Sigma methodology. A secondary goal was to improve the efficiency of the rounding process, as measured by the reduction in nonvalue-added time. We used the "DMAIC" methodology: define, measure, analyze, improve, and control. Pediatric and family medicine residents rotating on the pediatric hospitalist team participated in the observation phase. Residents, nurses, hospitalists, and parents of patients completed surveys to gauge their attitudes toward rounds. The Mann-Whitney test was used to test for differences in the median times measured during the preimprovement and postimprovement phases, and the Student t test was used for comparison of survey data. Collaborative, family-centered rounding with elimination of the "prerounding" process, as well as standard work instructions and pacing the process to meet customer demand (takt time), were implemented. Nonvalue-added time per patient was reduced by 64% (P  =  .005). Survey data suggested that team members preferred the collaborative, family-centered approach to the traditional model of rounding. Lean Six Sigma provides tools, a philosophy, and a structured, data-driven approach to address a problem. In our case this facilitated an effort to adhere to duty hour restrictions while promoting education and quality care. Such approaches will become increasingly useful as health care delivery and education continue to transform.

Texting preferences in a Paediatric residency.

Science.gov (United States)

Draper, Lauren; Kuklinski, Cadence; Ladley, Amy; Adamson, Greg; Broom, Matthew

2017-12-01

Text messaging is ubiquitous among residents, but remains an underused educational tool. Though feasibility has been demonstrated, evidence of its ability to improve standardised test scores and provide insight on resident texting preferences is lacking. The authors set out to evaluate: (1) satisfaction with a hybrid question-and-answer (Q&A) texting format; and (2) pre-/post-paediatric in-training exam (ITE) performance. A prospective study with paediatrics and internal medicine-paediatrics residents. Residents were divided into subgroups: adolescent medicine (AM) and developmental medicine (DM). Messages were derived from ITE questions and sent Monday-Friday with a 20 per cent variance in messages specific to the sub-group. Residents completed surveys gauging perceptions of the programme, and pre- and post-programme ITE scores were analysed. Forty-one residents enrolled and 32 (78%) completed a post-programme survey. Of those, 21 (66%) preferred a Q&A format with an immediate text response versus information-only texts. The percentage change in ITE scores between 2013 and 2014 was significant. Comparing subgroups, there was no significant difference between the percentage change in ITE scores. Neither group performed significantly better on either the adolescent or developmental sections of the ITE. Text messaging… remains an underused educational tool CONCLUSIONS: Overall, participants improved their ITE scores, but no improvement was seen in the targeted subgroups on the exam. Although Q&A texts are preferred by residents, further assessment is required to assess the effect on educational outcomes. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Resident partnerships: an effective strategy for training in primary care.

Science.gov (United States)

Adam, P; Williamson, H A; Zweig, S C; Delzell, J E

1997-06-01

To facilitate resident training in the ambulatory setting, a few family practice residency programs use a partnership system to train residents. Partnerships are pairs of residents from the same year that rotate together on inpatient services. We identified and characterized the advantages and disadvantages of partnership programs in family practice residencies. We conducted a national survey of family practice residencies, followed by phone interviews with residency directors of programs with partnerships. A total of 305 of 407 (75%) residencies responded; 10 programs fit our definition of partnership. Program directors were positive about resident partnerships. Benefits included improved outpatient continuity, enhanced medical communication skills, and emotional and intellectual support. Disadvantages were decreased inpatient exposure and difficulty coordinating residents' schedules. Directors were favorable about partnerships, which seem to be an underutilized technique to improve residency training.

Ebola Preparedness: Diagnosis Improvement Using Rapid Approaches for Proficiency Testing.

Science.gov (United States)

Lau, Katherine A; Theis, Torsten; Gray, Joanna; Rawlinson, William D

2017-03-01

The unprecedented 2015 Ebolavirus (EBOV) outbreak in West Africa was declared a public health emergency, making diagnosis and quality of testing a global issue. The accuracy of laboratory diagnostic capacity for EBOV was assessed in 2014 to 2016 using a proficiency testing (PT) strategy developed by the Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) in Biosecurity. Following a literature search, EBOV-specific gene targets were ranked according to the frequency of their use in published methods. The most commonly used gene regions (nucleoprotein [NP], glycoprotein [GP], and RNA-dependent RNA polymerase [L]) were selected for the design of in vitro RNA transcripts to be included in the simulated EBOV specimens used for EBOV detection with PCR-based assays. Specimens were tested for stability and found to be stable on long-term storage (1 year) at -80°C and on shorter-term storage in lyophilized form (1 week at ambient temperature and a subsequent week at -80°C). These specimens were used in three EBOV PTs offered from April 2014 to March 2016. In the first and third PTs, all laboratories (3/3 and 9/9, respectively) correctly identified specimens containing EBOV RNA transcripts, while in the second PT, all but one laboratory (5/6) correctly confirmed the presence of EBOV. The EBOV PT panel was useful for ensuring the competency of laboratories in detecting EBOV in the absence of readily available clinical samples. The simulated EBOV specimen was safe, stable, and reliable and can be used in lyophilized form for future EBOV PT programs, allowing simplicity of transport. Copyright © 2017 American Society for Microbiology.

ELL High School Students' Metacognitive Awareness of Reading Strategy Use and Reading Proficiency

Science.gov (United States)

Hong-Nam, Kay

2014-01-01

This study investigated the metacognitive awareness and reading strategies use of high school-­aged English language learners (ELLs) and the relationship between ELL reading strategy use and reading proficiency as measured by a standardized reading test and self-­rated reading proficiency. Results reveal that participants reported moderate use of…

English Proficiency and Acculturation among Chinese Immigrant Youth in Canada: A Reciprocal Relationship

Science.gov (United States)

Jia, Fanli; Gottardo, Alexandra; Chen, Xi; Koh, Pohwee; Pasquarella, Adrian

2016-01-01

The main focus of this study was to refine our understanding of the link between English proficiency and mainstream acculturation in adolescent Chinese immigrants. The sample consisted of 112 adolescents in grades 7-12 living in urban areas in southern Ontario, Canada. English proficiency was assessed individually using standardised tests of…

Educational system factors that engage resident physicians in an integrated quality improvement curriculum at a VA hospital: a realist evaluation.

Science.gov (United States)

Ogrinc, Greg; Ercolano, Ellyn; Cohen, Emily S; Harwood, Beth; Baum, Karyn; van Aalst, Robertus; Jones, Anne C; Davies, Louise

2014-10-01

Learning about quality improvement (QI) in resident physician training is often relegated to elective or noncore clinical activities. The authors integrated teaching, learning, and doing QI into the routine clinical work of inpatient internal medicine teams at a Veterans Affairs (VA) hospital. This study describes the design factors that facilitated and inhibited the integration of a QI curriculum-including real QI work-into the routine work of inpatient internal medicine teams. A realist evaluation framework used three data sources: field notes from QI faculty; semistructured interviews with resident physicians; and a group interview with QI faculty and staff. From April 2011 to July 2012, resident physician teams at the White River Junction VA Medical Center used the Model for Improvement for their QI work and analyzed data using statistical process control charts. Three domains affected the delivery of the QI curriculum and engagement of residents in QI work: setting, learner, and teacher. The constant presence of the QI material on a public space in the team workroom was a facilitating mechanism in the setting. Explicit sign-out of QI work to the next resident team formalized the handoff in the learner domain. QI teachers who were respected clinical leaders with QI expertise provided role modeling and local system knowledge. Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.

Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta

Directory of Open Access Journals (Sweden)

Patten Scott

2005-06-01

Full Text Available Abstract Background Despite the critical importance of well-being during residency training, only a few Canadian studies have examined stress in residency and none have examined well-being resources. No recent studies have reported any significant concerns with respect to perceived stress levels in residency. We investigated the level of perceived stress, mental health and understanding and need for well-being resources among resident physicians in training programs in Alberta, Canada. Methods A mail questionnaire was distributed to the entire resident membership of PARA during 2003 academic year. PARA represents each of the two medical schools in the province of Alberta. Results In total 415 (51 % residents participated in the study. Thirty-four percent of residents who responded to the survey reported their life as being stressful. Females reported stress more frequently than males (40% vs. 27%, p Residents highly valued their colleagues (67%, program directors (60% and external psychiatrist/psychologist (49% as well-being resources. Over one third of residents wished to have a career counselor (39% and financial counselor (38%. Conclusion Many Albertan residents experience significant stressors and emotional and mental health problems. Some of which differ among genders. This study can serve as a basis for future resource application, research and advocacy for overall improvements to well-being during residency training.

Fundamental Motor Skill Proficiency of 6- to 9-Year-Old Singaporean Children.

Science.gov (United States)

Mukherjee, Swarup; Ting Jamie, Lye Ching; Fong, Leong Hin

2017-06-01

Fundamental movement proficiency (FMS) is most successfully acquired during early school years. This cross-sectional study assessed FMS proficiency in Singaporean children at the start of and following 2.5 years of primary school physical education (PE). Participants were 244 children from Primary 1 and 3 levels. Fundamental movement skills (FMS) were assessed with the Test of Gross Motor Development-Second Edition (TGMD-2) that includes locomotor (LOCO) and object control (OC) subtests. Most children were rated "average" and "below average" for LOCO skills but "poor" and "below average" for OC skills without significant gender differences on either subtest or overall FMS proficiency and without FMS mastery. These young Singaporean children failed to exhibit age-appropriate FMS proficiency despite early PE exposure, and they demonstrated lags in FMS compared with the TGMD-2 U.S. normative sample. We discuss implications for sports competence perception, difficulty in coping with later movement learning expectations and reduced later motivation to participate in PE and play. We also discuss implications for preschool and lower primary school PE curricula with a particular focus on both OC skills and LOCO skills requiring muscular fitness like hopping and jumping.

Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy.

Science.gov (United States)

Powell, Daniel K; Lin, Eaton; Silberzweig, James E; Kagetsu, Nolan J

2014-03-01

To retrospectively compare resident adherence to checklist-style structured reporting for maxillofacial computed tomography (CT) from the emergency department (when required vs. suggested between two programs). To compare radiology resident reporting accuracy before and after introduction of the structured report and assess its ability to decrease the rate of undetected pathology. We introduced a reporting checklist for maxillofacial CT into our dictation software without specific training, requiring it at one program and suggesting it at another. We quantified usage among residents and compared reporting accuracy, before and after counting and categorizing faculty addenda. There was no significant change in resident accuracy in the first few months, with residents acting as their own controls (directly comparing performance with and without the checklist). Adherence to the checklist at program A (where it originated and was required) was 85% of reports compared to 9% of reports at program B (where it was suggested). When using program B as a secondary control, there was no significant difference in resident accuracy with or without using the checklist (comparing different residents using the checklist to those not using the checklist). Our results suggest that there is no automatic value of checklists for improving radiology resident reporting accuracy. They also suggest the importance of focused training, checklist flexibility, and a period of adjustment to a new reporting style. Mandatory checklists were readily adopted by residents but not when simply suggested. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Sexual Health Education: A Psychiatric Resident's Perspective

Science.gov (United States)

Waineo, Eva; Arfken, Cynthia L.; Morreale, Mary K.

2010-01-01

Objective: This report discusses psychiatric residents' perceptions of sexual health education and their opinions regarding curricular improvements. Methods: An anonymous, web-based survey was sent to residents in one general psychiatry program (N = 33). The response rate was 69.7%. Results: Residents reported inadequate experience in multiple…

Samoan Philosophy of Nursing: a basis for culturally proficient care and policy.

Science.gov (United States)

Enoka, I S; Petrini, M A; Turale, S

2014-09-01

To explore nurses' perspectives about the Samoan Philosophy of Nursing, and determine its feasibility for nursing care of Samoans internationally. This philosophy is the conceptual cultural framework for nursing law, practice, education and research in Samoa, and was developed by Samoan nurses who recognized the need for guidance to deliver quality, culturally competent and proficient health care. A mixed method study, employing a questionnaire and ethnographic methods. The Samoan Philosophy of Nursing Questionnaire sought demographic data and aspects about the philosophy from 95 registered nurse clinicians, administrators and educators throughout Samoa during 2012. Descriptive statistics were used for data analysis. Additionally, 19 focus groups (5-6 participants each) and 19 in-depth interviews were held to further explore these aspects, as well as participant observations. Descriptive statistics were used to analyse quantitative data, and Spradley's ethnographic method was adopted for analysing the qualitative data. Of 95 questionnaires analysed, 70% of participants reported using the philosophy all the time, and 30% most of the time. They placed a high satisfaction rate, value and importance on this philosophy. From the ethnography, six major themes emerged: valuable framework of learning; conceptual framework for holistic assessment; benchmark for regulating and monitoring practice improving interaction and culturally proficient practice; potential use for Samoans overseas; and maintaining quality health and the dignity of people. This first-time study evaluated the Samoan Philosophy of Nursing and adds to nursing knowledge. Findings confirmed its usefulness as a culturally based conceptual framework to facilitate, regulate and monitor education, research and practice for sustainable health outcomes in Samoa, and for Samoans living abroad. It is important that Samoans living abroad receive culturally proficient care, but this requires the support of

40 CFR 798.5500 - Differential growth inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA...

Science.gov (United States)

2010-07-01

... repair proficient and repair deficient bacteria: âBacterial DNA damage or repair tests.â 798.5500 Section... inhibition of repair proficient and repair deficient bacteria: “Bacterial DNA damage or repair tests.” (a... killing or growth inhibition of repair deficient bacteria in a set of repair proficient and deficient...

Foreign language proficiency and working memory capacity

NARCIS (Netherlands)

Noort, M.W.M.L. van den; Bosch, M.P.C.; Hugdahl, K.

2006-01-01

In this study, the hypothesis that working memory capacity interacts with (foreign) language proficiency was tested on multilinguals, who were native (L1) Dutch speakers, were fluent in their second (L2) language, German, and had recently started the acquisition of their third (L3) language,

Recommending a minimum English proficiency standard for entry-level nursing.

Science.gov (United States)

O'Neill, Thomas R; Tannenbaum, Richard J; Tiffen, Jennifer

2005-01-01

When nurses who are educated internationally immigrate to the United States, they are expected to have English language proficiency in order to function as a competent nurse. The purpose of this research was to provide sufficient information to the National Council of State Boards of Nursing (NCSBN) to make a defensible recommended passing standard for English proficiency. This standard was based upon the Test of English as a Foreign Language (TOEFL). A large panel of nurses and nurse regulators (N = 25) was convened to determine how much English proficiency is required to be minimally competent as an entry-level nurse. Two standard setting procedures, the Simulated Minimally Competent Candidate (SMCC) procedure and the Examinee Paper Selection Method, were combined to produce recommendations for each panelist. In conjunction with collateral information, these recommendations were reviewed by the NCSBN Examination Committee, which decided upon an NCSBN recommended standard, a TOEFL score of 220. Because the adoption of this standard rests entirely with the individual state, NCSBN has little more to do with implementing the standard, other than answering questions and providing documentation about the standard.

Increased Access to Professional Interpreters in the Hospital Improves Informed Consent for Patients with Limited English Proficiency.

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Lee, Jonathan S; Pérez-Stable, Eliseo J; Gregorich, Steven E; Crawford, Michael H; Green, Adrienne; Livaudais-Toman, Jennifer; Karliner, Leah S

2017-08-01

Language barriers disrupt communication and impede informed consent for patients with limited English proficiency (LEP) undergoing healthcare procedures. Effective interventions for this disparity remain unclear. Assess the impact of a bedside interpreter phone system intervention on informed consent for patients with LEP and compare outcomes to those of English speakers. Prospective, pre-post intervention implementation study using propensity analysis. Hospitalized patients undergoing invasive procedures on the cardiovascular, general surgery or orthopedic surgery floors. Installation of dual-handset interpreter phones at every bedside enabling 24-h immediate access to professional interpreters. Primary predictor: pre- vs. post-implementation group; secondary predictor: post-implementation patients with LEP vs. English speakers. Primary outcomes: three central informed consent elements, patient-reported understanding of the (1) reasons for and (2) risks of the procedure and (3) having had all questions answered. We considered consent adequately informed when all three elements were met. We enrolled 152 Chinese- and Spanish-speaking patients with LEP (84 pre- and 68 post-implementation) and 86 English speakers. Post-implementation (vs. pre-implementation) patients with LEP were more likely to meet criteria for adequately informed consent (54% vs. 29%, p = 0.001) and, after propensity score adjustment, had significantly higher odds of adequately informed consent (AOR 2.56; 95% CI, 1.15-5.72) as well as of each consent element individually. However, compared to post-implementation English speakers, post-implementation patients with LEP had significantly lower adjusted odds of adequately informed consent (AOR, 0.38; 95% CI, 0.16-0.91). A bedside interpreter phone system intervention to increase rapid access to professional interpreters was associated with improvements in patient-reported informed consent and should be considered by hospitals seeking to improve

Effect of Hippotherapy on Motor Proficiency and Function in Children with Cerebral Palsy Who Walk.

Science.gov (United States)

Champagne, Danielle; Corriveau, Hélène; Dugas, Claude

2017-02-01

To evaluate the effects of hippotherapy on physical capacities of children with cerebral palsy. Thirteen children (4-12 years old) with cerebral palsy classified in Gross Motor Function Classification System Level I or II were included in this prospective quasi-experimental ABA design study. Participants received 10 weeks of hippotherapy (30 min per week). Gross motor function and proficiency were measured with the Bruininks-Oseretski Motor Proficiency short form [BOT2-SF]) and the Gross Motor Function Measure-88 [GMFM-88] (Dimension D and E) twice before the program (T1 and T1'), immediately after (T2), and 10 weeks following the end of the program (T3). Mean scores for dimensions D and E of the GMFM-88 Dimension scores (p = .005) and three out of the eight items of the BOT2-SF (fine motor precision (p = .013), balance (p = .025), and strength (p = .012) improved between baseline and immediately after intervention; mean scores immediately following and 10 weeks following intervention did not differ. Hippotherapy provided by a trained therapist who applies an intense and graded session for 10 weeks can improve body functions and performance of gross motor and fine motor activities in children with cerebral palsy.

The Reading Habits of Developmental College Students at Different Levels of Reading Proficiency.

Science.gov (United States)

Sheorey, Ravi; Mokhtari, Kouider

1994-01-01

Examines differences in reading habits of developmental college students with varying levels of reading proficiency. Finds that subjects spent an unusually low amount of time on academic reading and even less time on nonacademic reading. Finds no significant differences between high- and low-proficient readers with regard to amount of time spent…

The relationship between self-efficacy and reading proficiency of first-year students: An exploratory study

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Naomi A.N.Y. Boakye

2015-04-01

Full Text Available Self-efficacy, which is the belief about one’s ability to perform a task successfully, has been widely acknowledged as important in learning. This affective factor, though not explicitly evident, has been said to play an important role in academic performance. However, its role in reading development has not been widely investigated. To determine the relationship between self-efficacy and reading proficiency, a study was conducted with first-year students in a South African tertiary institution. Students’ self-efficacy levels were elicited through a questionnaire and their reading proficiency was obtained through the Test of Academic Literacy levels (TALL, which essentially assesses reading proficiency. An analysis of variance showed a robust relationship between reading self-efficacy and reading proficiency for this cohort of students. Regression analysis conducted with other affective factors showed self-efficacy as the best predictor of students’ reading proficiency. Results are discussed as they relate to previous research and recommendations are made to include the development of self-efficacy in reading instruction.

Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

Science.gov (United States)

Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

2015-01-01

To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The application of data from proficiency testing to laboratory accreditation according to ISO 17025

DEFF Research Database (Denmark)

Heydorn, Kaj

2008-01-01

Current methods of testing laboratories for their proficiency in reporting correct measurement results are liable to substantial errors of the 2nd kind. This means that laboratories with deflated uncertainties are accepted as proficient, even though their reported measurement results pave the way...

First Language Proficiency and Successful Foreign Language Learning: The Case of High School Students Learning French as a Foreign Language

Science.gov (United States)

Gnintedem, Antoine

2014-01-01

This study investigated whether there was a correlation between first language proficiency as measured by the Mississippi Curriculum Test (MCT II) Reading and Language Arts and foreign language proficiency as measured by the French Language Proficiency Test. Data for the independent variable, first language proficiency, was collected from the…

Improving Surgical Skills of OBGYN Residents through Partnership ...

African Journals Online (AJOL)

Odidika Ugochukwu Joannes Umeora

through Partnership with Rural Hospitals: Experience from Southeast Nigeria. ... of Sociology, Anthropology and Psychiatry, Ebonyi State University, Abakaliki, Nigeria .... of the junior residents who felt that their emotions and opinions .... which combined both quantitative and qualitative data to draw ... J Preg Child Health.

Self-efficacy and Its Relation to ESL Writing Proficiency and Academic Disciplines

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Saeid Raoofi

2017-07-01

Full Text Available Writing is an essential skill for academic development within any disciplinary area. Despite the rapidly growing body of research on the various aspects of second language writing, research on writing self-efficacy remains scarce. This study investigated the relationship the between writing self-efficacy and writing proficiency in English as a second language. In this cross-sectional study, 304 Malaysian undergraduate students completed a writing self-efficacy questionnaire. The participants’ writing proficiency was assessed using two different writing tasks. The results showed that there was a significant difference in writing self-efficacy among the three writing proficiency groups. It was also found that science students had significantly higher writing self-efficacy than those in social sciences. Limitations of the study and Implications for second language writing instruction are also discussed.

The Impact of Readers Theatre on the Development of Preintermediate Iranian EFL Learners’ Oral Proficiency

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Mina Boroojerdi Moghadam

2016-01-01

Full Text Available The significant effect of employing Readers Theater (RT in reading comprehension, fluency, and motivation of English language students has already been established. However, this study was an attempt to investigate the effect of RT on the oral proficiency of Iranian learners of English as a foreign language. From among the learners studying English at a language school in Isfahan, Iran, a sample of 90 female intermediate EFL learners were asked to participate in this study. Having been taken Quick Placement Test to make sure they were all homogeneous regarding their level of proficiency in English, 75 learners were chosen. Afterwards, an interview served as one of the pretests of the study was run as the homogenizing test of oral ability and 60 homogenous preintermediate learners were ultimately selected as the participants of the study. They were then assigned to the two groups of control and experimental. During the treatment, the learners in the experimental group were exposed to RT, but the control group attended their regular classes. To gauge the oral proficiency development of the subjects, an interview was administered. The results of data analysis indicated improvements of fluency and complexity because of the learners’ exposure to the treatment. The results may provide further impetus for teachers to make attempts at extending the students’ active knowledge for real time communication as well as providing language which is both more complex and fluent.

Fluctuation analysis of proficient and dysgraphic handwriting in children

Science.gov (United States)

Rosenblum, S.; Roman, H. E.

2009-03-01

We analyze handwriting records from several school children with the aim of characterizing the fluctuating behavior of the writing speed. It will be concluded that remarkable differences exist between proficient and dysgraphic handwritings which were unknown so far. It is shown that in the case of proficient handwriting, the variations in handwriting speed are strongly autocorrelated within times corresponding to the completion of a single character or letter, while become uncorrelated at longer times. In the case of dysgraphia, such correlations persist on longer time scales and the autocorrelation function seems to display algebraic time decay, indicating the presence of strong anomalies in the handwriting process. Applications of the results in educational/clinical programs are envisaged.

Digital Games and the US National Research Council's Science Proficiency Goals

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Martinez-Garza, Mario; Clark, Douglas B.; Nelson, Brian C.

2013-01-01

This review synthesises research on digital games and science learning as it supports the goals for science proficiency outlined in the report by the US National Research Council on science education reform. The review is organised in terms of these research-based goals for science proficiency in light of their alignment with current science…

Proficiency of virtual reality simulator training in flexible retrograde ureteroscopy renal stone management.

Science.gov (United States)

Cai, Jian-liang; Zhang, Yi; Sun, Guo-feng; Li, Ning-chen; Yuan, Xue-li; Na, Yan-qun

2013-10-01

Minimally invasive flexible ureteroscopy techniques have widely adopted in the management of patients with renal stones. We performed this study to investigate the value of virtual reality simulator training in retrograde flexible ureteroscopy renal stone treatment for catechumen. Thirty catechumen, included 17 attending physicians and 13 associate chief physicians, were selected for study. The trainees first underwent 1-hour basic training to get familiar with the instrument and basic procedures, then followed by 4-hour practice on virtual reality simulators. Before and after the 4-hour training, all trainees undertake an assessment with task 7 program (right low pole calyces stone management). We documented for each trainee the total time of procedure, time of progressing from the orifice to stone, stone translocation and fragmentation time, laser operate proficiency scale, total laser energy, maximal size of residual stone fragments, number of trauma from the scopes and tools, damage to the scope and global rating scale (GRS). The proficiency of this training program was analyzed by the comparison of the first and second assessment outcomes. Significant improvement was observed in retrograde flexible ureteroscopy management of renal stone on virtual reality simulators after finishing the 4 hour special-purpose training. This was demonstrated by improvement in total procedure time ((18.37±2.59) minutes vs. (38.67±1.94) minutes), progressing time from the orifice to stone ((4.00±1.08) minutes vs. (13.80±2.01) minutes), time of stone translocation ((1.80±0.71) minutes vs. (6.57±1.01) minutes), fragmentation time ((4.43±1.25) minutes vs. (13.53±1.46) minutes), laser operate proficiency scale (8.47±0.73 vs. 3.77±0.77), total laser energy ((3231.6±401.4) W vs. (5329.8±448.9) W), maximal size of residual stone fragments ((2.66±0.39) mm vs. (5.77±0.63) mm), number of trauma from the scopes and tools (3.27±1.01 vs. 10.37±3.02), damage to the scope (0 vs

Assessment of residency program outcomes via alumni surveys

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Lüer S

2017-04-01

Full Text Available Sonja Lüer, Christoph Aebi Department of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland Background: One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals’ acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland.Methods: Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages, and 2 alumni surveys (S1, S2. Results: In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%. Forty-six alumni (42% in private practice were eligible for alumni surveys. Response rates were 87% (S1 and 61% (S2. Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice varied widely (late-training decision to enter private practice. Mean employment level in private practice was 60% (range 20%–100%. Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically.Conclusion: A broadened view on outcomes – beyond individuals’ competency acquisition – provides informative insights into a training program, can allow for informed program updates, and guide future program development. Keywords: medical education, career choice, pediatrics, private practice

The Effects of Type and Quantity of Input on Iranian EFL Learners’ Oral Language Proficiency

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Zahra Hassanzadeh

2014-05-01

Full Text Available In the written texts on foreign language learning, a group of studies has stressed the function of learning context and learning chances for learners’ language input. The present thesis had two main goals: on the one hand, different types of input to which Iranian grade four high school EFL learners’ are exposed were looked at; on the other hand, the possible relationship between types and quantity of input and Iranian EFL learners’ oral proficiency was investigated. It was supposed that EFL learners who have access to more input will show better oral proficiency than those who do not have. Instruments used in the present study for the purpose of data collation included  PET test, researcher- made questionnaire, oral language proficiency test and face- to -face interview. Data were gathered from 50 Iranian female grade four high school foreign language learners who were selected from among 120 students whose score on PET test were +1SD from the mean score. The results of the Spearman rank –order correlation test for the types of input and oral language proficiency scores, showed that the participants’ oral proficiency score significantly correlated with the intended four sources of input including spoken (rho= 0.416, sig=0.003, written (rho= 0.364, sig=0.009, aural (rho= 0.343, sig=0.015 and visual or audio-visual types of input (rho= 0.47, sig=0.00. The findings of Spearman rank –order correlation test for the quantity of input and oral language proficiency scores also showed a significant relationship between quantity of input and oral language proficiency (rho= 0.543, sig= 0.00. The findings showed that EFL learners’ oral proficiency is significantly correlated with efficient and effective input. The findings may also suggest  answers to the question why most Iranian English learners fail to speak English fluently, which might be due to  lack of effective input. This may emphasize the importance of the types and quantity of

The role of race and english proficiency on the health of older immigrants.

Science.gov (United States)

Nguyen, Duy; Reardon, Leigh J

2013-01-01

This study applies the Commission on Social Determinants of Health model to identify the effect of ethnicity/race and English proficiency on the health of older immigrants. California Health Interview Survey data of foreign-born respondents aged 65 and over were used to examine the four outcomes of health-related quality of life (HRQOL). The study included 1,196 immigrant Latinos, Asians, and non-Hispanic Whites. The results show that ethnicity/race-based differences in HRQOL exist. Furthermore, the results indicate that English proficiency has a significant moderating relationship on racial/ethnic background. The likelihood of reporting more Limited Combined Days increased with lower levels of English proficiency for both Latino and Asian-American old adults as compared to non-Hispanic Whites. In addition to focusing on racial disparities, health promotion efforts with older immigrants need to examine language-based stratification. Social work and gerontological advocates need to develop and employ evidence-based interventions that reach limited-English-proficient older immigrants to address the health, psychosocial, and access to health care challenges they face.

Resident-Specific Morbidity Reduced Following ACS NSQIP Data-Driven Quality Program.

Science.gov (United States)

Turrentine, Florence E; Hanks, John B; Tracci, Megan C; Jones, R Scott; Schirmer, Bruce D; Smith, Philip W

2018-04-16

The Accreditation Council for Graduate Medical Education Milestone Project for general surgery provided a more robust method for developing and tracking residents' competence. This framework enhanced systematic and progressive development of residents' competencies in surgical quality improvement. A 22-month interactive, educational program based on resident-specific surgical outcomes data culminated in a quality improvement project for postgraduate year 4 surgery residents. Self- assessment, quality knowledge test, and resident-specific American College of Surgeons National Surgical Quality Improvement Program Quality In-Training Initiative morbidity were compared before and after the intervention. Quality in-training initiative morbidity decreased from 25% (82/325) to 18% (93/517), p = 0.015 despite residents performing more complex cases. All participants achieved level 4 competency (4/4) within the general surgery milestones improvement of care, practice-based learning and improvement competency. Institutional American College of Surgeons National Surgical Quality Improvement Program general surgery morbidity improved from the ninth to the sixth decile. Quality assessment and improvement self-assessment postintervention scores (M = 23.80, SD = 4.97) were not significantly higher than preintervention scores (M = 19.20, SD = 5.26), p = 0.061. Quality Improvement Knowledge Application Tool postintervention test scores (M = 17.4, SD = 4.88), were not significantly higher than pretest scores (M = 13.2, SD = 1.92), p = 0.12. Sharing validated resident-specific clinical data with participants was associated with improved surgical outcomes. Participating fourth year surgical residents achieved the highest score, a level 4, in the practice based learning and improvement competency of the improvement of care practice domain and observed significantly reduced surgical morbidity for cases in which they participated. Copyright © 2018. Published by Elsevier Inc.

[Oral health hygiene education programme for nursing personnel to improve oral health of residents in long-term care facilities 2010 in Frankfurt/Main, Germany].

Science.gov (United States)

Czarkowski, G; Allroggen, S; Köster-Schmidt, A; Bausback-Schomakers, S; Frank, M; Heudorf, U

2013-06-01

Many studies have shown the urgent need for improving oral health hygiene in nursing home residents. Deficits in the knowledge of the personnel about dental and oral hygiene are often cited as one of the causes. Therefore, an oral health education programme was provided to the personnel of 20 nursing homes in Frankfurt/Main. Here the results of the assessment of the impact of the education programme on knowledge and attitudes of the personnel as well as on oral health of the residents are presented. In May/June 2010, 471 nurses in 20 nursing homes in the Frankfurt/Main, Germany, received a two-hour education programme on oral health. The lessons were held by dentists with special education in geriatric dentistry. The personnel were asked to complete a questionnaire regarding knowledge and attitudes on oral health care before the education programme and 4-6 months afterwards. The oral health status of 313 residents (i. e., about 10% of the total residents) was examined by two dentists. Before and 4-6 months after education of the caregivers, the following data were recorded in the residents: number of teeth, caries, plaque index (PI), sulcus bleeding index (SBI), community periodontal index of treatment needs (CPITN) and denture hygiene index (DHI). By attending the lessons, good improvements in knowledge of the caregivers could be obtained. The education programme was rated as very good/good by 85% of the nurses, having reduced their fear of oral care in the seniors and having gained more competence in practical oral hygiene procedures. Mean age of the residents was 80±13 years. About 32% of the residents were edentulous. Teeth were carious in 53% of the residents. Initially, one half of the residents exhibited plaque index>2, in 29% of the residents a severe and in 59% of them a very severe parodontitis was found (CPITN 3 or, respectively, 4). At 4-6 months after the education programme, an improvement in oral and dental hygiene of the residents could be

Increasing faculty participation in resident education and providing cost-effective self-assessment module credit to faculty through resident-generated didactics.

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Kim, Hyun; Malatesta, Theresa M; Anné, Pramila R; McAna, John; Bar-Ad, Voichita; Dicker, Adam P; Den, Robert B

Board certified radiation oncologists and medical physicists are required to earn self-assessment module (SAM) continuing medical education (CME) credit, which may require travel costs or usage fees. Data indicate that faculty participation in resident teaching activities is beneficial to resident education. Our hypothesis was that providing the opportunity to earn SAM credit in resident didactics would increase faculty participation in and improve resident education. SAM applications, comprising CME certified category 1 resident didactic lectures and faculty-generated questions with respective answers, rationales, and references, were submitted to the American Board of Radiology for formal review. Surveys were distributed to assess main academic campus physician, affiliate campus physician, physicist, and radiation oncology resident impressions regarding the quality of the lectures. Survey responses were designed in Likert-scale format. Sign-test was performed with P motivation to attend resident didactics (P = .004). Residents reported an increased amount of time required to prepare lectures (P = .008). We are the first department, to our knowledge, to offer SAM credit to clinical faculty for participation in resident-generated didactics. Offering SAM credit at resident lectures is a cost-effective alternative to purchasing SAM resources, increases faculty attendance, and may improve the quality of radiation oncology resident education. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents.

Science.gov (United States)

Ng, Danny Siu-Chun; Sun, Zihan; Young, Alvin Lerrmann; Ko, Simon Tak-Chuen; Lok, Jerry Ka-Hing; Lai, Timothy Yuk-Yau; Sikder, Shameema; Tham, Clement C

2018-01-01

To identify residents' perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions. The ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann-Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor's intervention, and 3) prior simulation training. The study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong. Of the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks. Residents who had completed Eyesi simulation training had higher

Performance of laboratories analysing welding fume on filter samples: results from the WASP proficiency testing scheme.

Science.gov (United States)

Stacey, Peter; Butler, Owen

2008-06-01

This paper emphasizes the need for occupational hygiene professionals to require evidence of the quality of welding fume data from analytical laboratories. The measurement of metals in welding fume using atomic spectrometric techniques is a complex analysis often requiring specialist digestion procedures. The results from a trial programme testing the proficiency of laboratories in the Workplace Analysis Scheme for Proficiency (WASP) to measure potentially harmful metals in several different types of welding fume showed that most laboratories underestimated the mass of analyte on the filters. The average recovery was 70-80% of the target value and >20% of reported recoveries for some of the more difficult welding fume matrices were welding fume trial filter samples. Consistent rather than erratic error predominated, suggesting that the main analytical factor contributing to the differences between the target values and results was the effectiveness of the sample preparation procedures used by participating laboratories. It is concluded that, with practice and regular participation in WASP, performance can improve over time.

Immigration, language proficiency, and autobiographical memories: Lifespan distribution and second-language access.

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Esposito, Alena G; Baker-Ward, Lynne

2016-08-01

This investigation examined two controversies in the autobiographical literature: how cross-language immigration affects the distribution of autobiographical memories across the lifespan and under what circumstances language-dependent recall is observed. Both Spanish/English bilingual immigrants and English monolingual non-immigrants participated in a cue word study, with the bilingual sample taking part in a within-subject language manipulation. The expected bump in the number of memories from early life was observed for non-immigrants but not immigrants, who reported more memories for events surrounding immigration. Aspects of the methodology addressed possible reasons for past discrepant findings. Language-dependent recall was influenced by second-language proficiency. Results were interpreted as evidence that bilinguals with high second-language proficiency, in contrast to those with lower second-language proficiency, access a single conceptual store through either language. The final multi-level model predicting language-dependent recall, including second-language proficiency, age of immigration, internal language, and cue word language, explained ¾ of the between-person variance and (1)/5 of the within-person variance. We arrive at two conclusions. First, major life transitions influence the distribution of memories. Second, concept representation across multiple languages follows a developmental model. In addition, the results underscore the importance of considering language experience in research involving memory reports.

A Systematic Review of Interventions to Change Staff Care Practices in Order to Improve Resident Outcomes in Nursing Homes.

Directory of Open Access Journals (Sweden)

Lee-Fay Low

Full Text Available We systematically reviewed interventions that attempted to change staff practice to improve long-term care resident outcomes.Studies met criteria if they used a control group, included 6 or more nursing home units and quantitatively assessed staff behavior or resident outcomes. Intervention components were coded as including education material, training, audit and feedback, monitoring, champions, team meetings, policy or procedures and organizational restructure.Sixty-three unique studies were broadly grouped according to clinical domain-oral health (3 studies, hygiene and infection control (3 studies, nutrition (2 studies, nursing home acquired pneumonia (2 studies, depression (2 studies appropriate prescribing (7 studies, reduction of physical restraints (3 studies, management of behavioral and psychological symptoms of dementia (6 studies, falls reduction and prevention (11 studies, quality improvement (9 studies, philosophy of care (10 studies and other (5 studies. No single intervention component, combination of, or increased number of components was associated with greater likelihood of positive outcomes. Studies with positive outcomes for residents also tended to change staff behavior, however changing staff behavior did not necessarily improve resident outcomes. Studies targeting specific care tasks (e.g. oral care, physical restraints were more likely to produce positive outcomes than those requiring global practice changes (e.g. care philosophy. Studies using intervention theories were more likely to be successful. Program logic was rarely articulated, so it was often unclear whether there was a coherent connection between the intervention components and measured outcomes. Many studies reported barriers relating to staff (e.g. turnover, high workload, attitudes or organizational factors (e.g. funding, resources, logistics.Changing staff practice in nursing homes is possible but complex. Interventionists should consider barriers and

A Reduced Duty Hours Model for Senior Internal Medicine Residents: A Qualitative Analysis of Residents' Experiences and Perceptions.

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Mathew, Rebecca; Gundy, Serena; Ulic, Diana; Haider, Shariq; Wasi, Parveen

2016-09-01

To assess senior internal medicine residents' experience of the implementation of a reduced duty hours model with night float, the transition from the prior 26-hour call system, and the new model's effects on resident quality of life and perceived patient safety in the emergency department and clinical teaching unit at McMaster University. Qualitative data were collected during May 2013-July 2014, through resident focus groups held prior to implementation of a reduced duty hours model and 10 to 12 months postimplementation. Data analysis was guided by a constructivist grounded theory based in a relativist paradigm. Transcripts were coded; codes were collapsed into themes. Thematic analysis revealed five themes. Residents described reduced fatigue in the early morning, counterbalanced with worsened long-term fatigue on night float blocks; anticipation of negative impacts of the loss of distributed on-call experience and on-call shift volume; an urgency to sleep postcall in anticipation of consecutive night float shifts accompanied by conflicting role demands to stay postcall for care continuity; increased handover frequency accompanied by inaccurate/incomplete communication of patients' issues; and improvement in the senior resident experience on the clinical teaching unit, with increased ownership over patient care and improved relationships with junior housestaff. A reduced duty hours model with night float has potential to improve residents' perceived fatigue on call and care continuity on the clinical teaching unit. This must be weighed against increased handover frequency and loss of the postcall day, which may negatively affect patient care and resident quality of life.

Worldwide Open Proficiency Test for X Ray Fluorescence Laboratories PTXRFIAEA/06: Determination of Minor and Trace Elements in Grass Mixture

International Nuclear Information System (INIS)

2011-01-01

The IAEA assists its Member States laboratories to maintain their readiness by producing reference materials, by developing standardized analytical methods, and by conducting interlaboratory comparisons and proficiency tests as tools for quality control. To ensure a reliable worldwide, rapid and consistent response, the IAEA Nuclear Spectrometry and Applications Laboratory in Seibersdorf, Austria organises tests. This summary report presents the results of the worldwide proficiency test IAEA-PTXRF-06 on the determination of minor and trace elements in a grass mixture. Methodologies, data evaluation approach, summary evaluation of each element and individual evaluation reports for each laboratory are also described. The test was carried out under IAEA Project 1.4.3.4 (D.3.03), Nuclear Spectrometry for Analytical Applications, under the Nuclear Science Programme. The main objective of this project is to enhance the capability of interested Member States in effective utilization of nuclear spectrometries and analytical services in industry, human health, agriculture, and in monitoring and evaluation of environmental pollution. This proficiency test was designed to identify analytical problems, to support IAEA Member States laboratories to improve the quality of their analytical results, to maintain their accreditation and to provide a regular forum for discussion and technology transfer in this area. The type of sample and the concentration levels of the analytes were designed in a way to enable identification of potential analytical problems. The next proficiency test exercise is expected to be organized in 2010

Current integrated cardiothoracic surgery residents: a Thoracic Surgery Residents Association survey.

Science.gov (United States)

Tchantchaleishvili, Vakhtang; LaPar, Damien J; Stephens, Elizabeth H; Berfield, Kathleen S; Odell, David D; DeNino, Walter F

2015-03-01

After approval by the Thoracic Surgery Residency Review Committee in 2007, 6-year integrated cardiothoracic surgery (I-6) residency programs have gained in popularity. We sought to assess and objectively quantify the level of satisfaction I-6 residents have with their training and to identify areas of improvement for future curriculum development. A completely anonymous, electronic survey was created by the Thoracic Surgery Residents Association that asked the responders to provide demographic information, specialty interest, and lifestyle priorities, and to rate their experience and satisfaction with I-6 residency. The survey was distributed nationwide to all residents in I-6 programs approved by the Accreditation Council for Graduate Medical Education. Of a total of 88 eligible I-6 residents, 49 completed the survey (55.7%). Career choice satisfaction was high (75.5%), as was overall satisfaction with integrated training (83.7%). The majority (77.6%) were interested in cardiac surgery. Overall, the responders reported sufficient time for life outside of the hospital (57.1%), but experienced conflicts between work obligations and personal life at least sometimes (75.5%). Early exposure to cardiothoracic surgery was reported as the dominant advantage of the I-6 model, whereas variable curriculum structure and unclear expectations along with poor integration with general surgery training ranked highest among perceived disadvantages. Current I-6 residents are largely satisfied with the integrated training model and report a reasonable work/life balance. The focused nature of training is the primary perceived advantage of the integrated pathway. Curriculum variability and poor integration with general surgery training are identified by residents as primary areas of concern. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Accuracy of electrocardiogram reading by family practice residents.

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Sur, D K; Kaye, L; Mikus, M; Goad, J; Morena, A

2000-05-01

This study evaluated the electrocardiogram (EKG) reading skills of family practice residents. A multicenter study was carried out to evaluate the accuracy of EKG reading in the family practice setting. Based on the frequency and potential for clinical significance, we chose 18 common findings on 10 EKGs for evaluation. The EKGs were then distributed to residents at six family practice residencies. Residents were given one point for the identification of each correct EKG finding and scored based on the number correct over a total of 18. Sixty-one residents (20 first year, 23 second year, and 18 third year) completed readings for 10 EKGs and were evaluated for their ability to identify 18 EKG findings. The median score out of 18 possible points for all first-, second-, and third-year residents was 12, 12, and 11.5, respectively. Twenty-one percent of residents did not correctly identify a tracing of an acute myocardial infarction. Data analysis showed no statistically significant difference among the three groups of residents. We evaluated the accuracy of EKG reading skills of family practice residents at each year of training. This study suggests that EKG reading skills do not improve during residency, and further study of curricular change to improve these skills should be considered.

Competitive Team-Based Learning versus Group Investigation with Reference to the Language Proficiency of Iranian EFL Intermediate Students

Directory of Open Access Journals (Sweden)

Seyed Mohammad Hassan Hosseini

2014-01-01

Full Text Available This paper is a report on an experimental study which intended to look into the possible effects of Competitive Team-Based Learning (CTBL vis-à-vis Group Investigation (GI method of Cooperative Learning (CL on the language proficiency of Iranian EFL intermediate students. Seventy homogeneous Iranian intermediate students were selected out of a total population of 110 to serve the present study. The results of the study indicated the advantage of CTBL over GI in terms of its effect on improving the target group’s language proficiency. The results of the study were in contrast to the reports of researchers like Ab-Raza (2007, an Israeli language specialist, who have argued that students in Islamic countries “do not value diversity of ideas, beliefs, and perspectives” (p. 5 and so cannot be taught through modern methods like those of CL.

A influência do sistema de gestão de laboratórios nos resultados dos ensaios de proficiência da construção civil The influence of the laboratory management system on the results of civil construction proficiency testing

Directory of Open Access Journals (Sweden)

Morgana Pizzolato

2008-12-01

Full Text Available A participação de laboratórios em atividades de ensaio de proficiência (EP é uma das formas de avaliar e demonstrar a confiabilidade das suas atividades de medição. Isso significa dizer que, por intermédio dos ensaios de proficiência (EP, pode-se avaliar a habilidade do laboratório de realizar ensaios e calibrações de forma competente. Os ensaios de proficiência fornecem informações importantes para avaliação de laboratórios, postulantes à acreditação, acreditados, notificados ou designados por agências reguladoras e para os laboratórios em geral. Este artigo teve por objetivo verificar se o tipo de sistema de gestão dos laboratórios de ensaio da construção civil do Brasil influencia nos resultados dos ensaios de proficiência (EP. Objetiva ainda discutir como contemplar o resultado dos ensaios de proficiência no cálculo da incerteza de medição dos ensaios. Como resultado do estudo, conclui-se que não existe efeito dos tipos de sistema de gestão sobre os resultados dos ensaios de proficiência (EP. Logo, foi sugerido o uso do desvio padrão dos resultados de um grupo representativo de ensaios de proficiência de determinados ensaios (químico, físico, etc. para gerar um cálculo genérico da incerteza de medição para o setor de atuação do laboratório. Esta abordagem, além de simplificar o cálculo da incerteza de medição contempla um maior número de fontes de incerteza de medição.Laboratories participation in proficiency testing is one way to evaluate and demonstrate the reliability of their measurement results. That is to say, through the proficiency testing, the laboratory ability of accomplishing tests and calibrations successfully can be evaluated. The proficiency testing supplies important information for the evaluation of laboratories, candidates to accreditation, accredited laboratories, notified or designated laboratories by regulatory bodies, and laboratories in general. This paper aims at

Optimizing Automatic Speech Recognition for Low-Proficient Non-Native Speakers

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Catia Cucchiarini

2010-01-01

Full Text Available Computer-Assisted Language Learning (CALL applications for improving the oral skills of low-proficient learners have to cope with non-native speech that is particularly challenging. Since unconstrained non-native ASR is still problematic, a possible solution is to elicit constrained responses from the learners. In this paper, we describe experiments aimed at selecting utterances from lists of responses. The first experiment on utterance selection indicates that the decoding process can be improved by optimizing the language model and the acoustic models, thus reducing the utterance error rate from 29–26% to 10–8%. Since giving feedback on incorrectly recognized utterances is confusing, we verify the correctness of the utterance before providing feedback. The results of the second experiment on utterance verification indicate that combining duration-related features with a likelihood ratio (LR yield an equal error rate (EER of 10.3%, which is significantly better than the EER for the other measures in isolation.

The Interplay among Emotional Intelligence, Classroom Management, and Language Proficiency of Iranian EFL Teachers

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Hadi Hamidi

2016-06-01

Full Text Available The present study was an attempt to investigate the interplay among Iranian EFL teachers’ emotional intelligence, classroom management, and their general English language proficiency. The result of the data analysis showed that: 1 there was a statistically significant relationship between the emotional intelligence and the classroom management of Iranian EFL teachers, 2 there was a statistically significant relationship between the emotional intelligence and the language proficiency of Iranian EFL teachers, and 3 there was a statistically significant relationship between the classroom management and the language proficiency of Iranian EFL teachers. Teacher trainers, researchers in teacher education, and language teachers may benefit from the findings of the present research.

Perceptual Assessment of Velopharyngeal Dysfunction by Otolaryngology Residents.

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Butts, Sydney C; Truong, Alan; Forde, Christina; Stefanov, Dimitre G; Marrinan, Eileen

2016-12-01

To assess the ability of otolaryngology residents to rate the hypernasal resonance of patients with velopharyngeal dysfunction. We hypothesize that experience (postgraduate year [PGY] level) and training will result in improved ratings of speech samples. Prospective cohort study. Otolaryngology training programs at 2 academic medical centers. Thirty otolaryngology residents (PGY 1-5) were enrolled in the study. All residents rated 30 speech samples at 2 separate times. Half the residents completed a training module between the rating exercises, with the other half serving as a control group. Percentage agreement with the expert rating of each speech sample and intrarater reliability were calculated for each resident. Analysis of covariance was used to model accuracy at session 2. The median percentage agreement at session 1 was 53.3% for all residents. At the second session, the median scores were 53.3% for the control group and 60% for the training group, but this difference was not statistically significant. Intrarater reliability was moderate for both groups. Residents were more accurate in their ratings of normal and severely hypernasal speech. There was no correlation between rating accuracy and PGY level. Score at session 1 positively correlated with score at session 2. Perceptual training of otolaryngology residents has the potential to improve their ratings of hypernasal speech. Length of time in residency may not be best predictor of perceptual skill. Training modalities incorporating practice with hypernasal speech samples could improve rater skills and should be studied more extensively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Reading Habits of University ESL Students at Different Levels of English Proficiency and Education.

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Mokhtari, Kouider; Sheorey, Ravi

1994-01-01

Examines the degree to which the levels of English proficiency (high vs. low) and education (graduate vs. undergraduate) of English-as-a-Second-Language (ESL) students were associated with differences in their reading behaviors. Finds that the subjects' level of education and English proficiency were associated with their reading behavior…

Number needed to eat: pizza and resident conference attendance.

Science.gov (United States)

Cosimini, Michael J; Mackintosh, Liza; Chang, Todd P

2016-12-01

The didactic conference is a common part of the resident education curriculum. Given the demands of clinical responsibilities and restrictions on duty hours, maximising education is a challenge faced by all residency programmes. To date, little research exists with respect to how the provision of complimentary food affects physician and resident conference attendance. The objective of this study was to determine whether complimentary food improves resident arrival times and attendance at educational conferences and, furthermore, to test whether this provision is a potentially cost-effective tool for improving education. A retrospective review of 36 resident educational Friday noon conferences, including 1043 resident arrivals, was performed. Data were analysed for total attendance, arrival times, number needed to eat (NNE) and the percentage of residents arriving on time, and compared between days on which food was and was not provided. Median attendance was 3.7% higher (p = 0.04) on days on which food was provided, at a cost of US$46 for each additional resident in attendance. Arrival times were also statistically significantly improved when food was provided, with a median improvement of 0.7 minutes (p = 0.02) and an 11.0% increase in on-time arrivals (p < 0.001). The NNE was 10.6. Complimentary food improves both attendance and arrival times by a small, but statistically significant, degree. The provision of complimentary food can be considered as an incentive for attendance and on-time arrival at didactic educational sessions, although more cost-effective modalities may exist. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Transgender health care: improving medical students' and residents' training and awareness

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Dubin SN

2018-05-01

interventions proved effective in improving attitudes, knowledge, and/or skills necessary to achieve clinical competency with transgender patients. Conclusion: Transgender populations experience health inequities in part due to the exclusion of transgender-specific health needs from medical school and residency curricula. Currently, transgender medical education is largely composed of one-time attitude and awareness-based interventions that show significant short-term improvements but suffer methodologically. Consensus in the existing literature supports educational efforts to shift toward pedagogical interventions that are longitudinally integrated and clinical skills based, and we include a series of recommendations to affirm and guide such an undertaking. Keywords: medical education, transgender, LGBT health, medical training, residency

Use of veterinary services by Latino dog and cat owners with various degrees of English-language proficiency.

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Landau, Ruth E; Beck, Alan; Glickman, Larry T; Litster, Annette; Widmar, Nicole J Olynk; Moore, George E

2016-03-15

To characterize patterns of dog and cat ownership and veterinary service use among Latino dog and cat owners with various degrees of English-language proficiency. DESIGN :Cross-sectional telephone survey. Data from 393 Latino pet owners. Telephone surveys were conducted with Latino dog and cat owners from a random sample of US households to determine the number of dogs and cats owned, factors associated with veterinary service use, and satisfaction with veterinary care. 393 of 1,026 (38.3%) respondents were pet owners. Two hundred fifty-nine of 330 (78.5%) dog owners and 70 of 115 (60.9%) cat owners reported taking their pet to the veterinarian in the past 12 months, most commonly for vaccination or examination or because of illness. Respondents were most satisfied with veterinary care provided, least satisfied with cost, and moderately satisfied with quality of communication. English-language proficiency was not significantly associated with whether owners sought veterinary care. A large proportion of respondents who wanted to receive pet health information in Spanish described themselves as speaking English well or very well. Although having limited proficiency in English was not associated with Latino pet owners seeking veterinary care, opportunities exist for veterinary personnel to improve communications with these clients. Personnel can assess their clients' language needs by asking each about the language in which they would prefer to receive their pet's health information.

Effect of protected research time on ABSITE scores during general surgery residency.

Science.gov (United States)

Orkin, Bruce A; Poirier, Jennifer; Kowal-Vern, Areta; Chan, Edie; Ohara, Karen; Mendoza, Brian

2018-02-01

Objective - To determine whether residents with one or more years of dedicated research time (Research Residents, RR) improved their ABSITE scores compared to those without (Non-Research Residents, N-RR). A retrospective review of general surgery residents' ABSITE scores from 1995 to 2016 was performed. RR were compared to N-RR. Additional analysis of At Risk (AR) v Not At Risk residents (NAR) (35th percentile as PGY1-2) was also performed. Cohort - 147 residents (34 RR and 113 N-RR). There were no differences in initial ABSITE scores (p = 0.47). By definition, the AR group had lower scores than NAR. Overall, post-research RR v PGY-4 N-RR scores did not differ (p = 0.84). Only the AR residents improved their scores (p = 0.0009 v NAR p = 0.42), regardless of research group (p = 0.70). Protected research time did not improve residents' ABSITE scores, regardless of initial scores. At Risk residents improved regardless of research group status. Copyright © 2017 Elsevier Inc. All rights reserved.

Radon Measurement Proficiency (RMP) Program methods and devices

International Nuclear Information System (INIS)

Harrison, J.; Hoornbeek, J.; Jalbert, P.; Sensintaffar, E.; Hopper, R.

1991-01-01

The US EPA developed the voluntary Radon Measurement Proficiency Program in 1986 in response to a Federal and State need for measurement services firms to demonstrate their proficiency with radon measurement methods and devices. Since that time, the program has set basic standards for the radon measurement industry. The program has grown dramatically since its inception. In 1986, fewer than 50 companies participated in the program. By 1989, more than 5,000 companies were participating. Participants represent firms with an analytical capability as well as firms that rely upon another firm for analysis service. Since the beginning of the RMP Program, the Agency has learned a great deal about radon measurement methods and devices. This paper reviews the measurement devices used in the program and what the EPA has learned about them since the program's inception. Performance data from the RMP Program are used to highlight relevant findings

Motor Proficiency and Body Mass Index of Preschool Children: In Relation to Socioeconomic Status

Science.gov (United States)

Mülazimoglu-Balli, Özgür

2016-01-01

The aim of the study was to investigate the correlation between motor proficiency and body mass index and to assess the socioeconomic status differences in motor proficiency and body mass index of preschool children. Sixty preschool children in the different socioeconomic status areas of central Denizli in Turkey participated in the study. The…

Technological Proficiency as a Key to Job Security. Trends and Issues Alert No. 6.

Science.gov (United States)

Imel, Susan

Although not all current jobs require basic computer skills, technological advances in society have created new jobs and changed the ways many existing jobs are performed. Clearly, workers who are proficient in technology have a greater advantage in the current workplace and the need for technologically proficient workers will only continue to…

Practice on an augmented reality/haptic simulator and library of virtual brains improves residents' ability to perform a ventriculostomy.

Science.gov (United States)

Yudkowsky, Rachel; Luciano, Cristian; Banerjee, Pat; Schwartz, Alan; Alaraj, Ali; Lemole, G Michael; Charbel, Fady; Smith, Kelly; Rizzi, Silvio; Byrne, Richard; Bendok, Bernard; Frim, David

2013-02-01

Ventriculostomy is a neurosurgical procedure for providing therapeutic cerebrospinal fluid drainage. Complications may arise during repeated attempts at placing the catheter in the ventricle. We studied the impact of simulation-based practice with a library of virtual brains on neurosurgery residents' performance in simulated and live surgical ventriculostomies. Using computed tomographic scans of actual patients, we developed a library of 15 virtual brains for the ImmersiveTouch system, a head- and hand-tracked augmented reality and haptic simulator. The virtual brains represent a range of anatomies including normal, shifted, and compressed ventricles. Neurosurgery residents participated in individual simulator practice on the library of brains including visualizing the 3-dimensional location of the catheter within the brain immediately after each insertion. Performance of participants on novel brains in the simulator and during actual surgery before and after intervention was analyzed using generalized linear mixed models. Simulator cannulation success rates increased after intervention, and live procedure outcomes showed improvement in the rate of successful cannulation on the first pass. However, the incidence of deeper, contralateral (simulator) and third-ventricle (live) placements increased after intervention. Residents reported that simulations were realistic and helpful in improving procedural skills such as aiming the probe, sensing the pressure change when entering the ventricle, and estimating how far the catheter should be advanced within the ventricle. Simulator practice with a library of virtual brains representing a range of anatomies and difficulty levels may improve performance, potentially decreasing complications due to inexpert technique.

Minimizing Barriers in Learning for On-Call Radiology Residents-End-to-End Web-Based Resident Feedback System.

Science.gov (United States)

Choi, Hailey H; Clark, Jennifer; Jay, Ann K; Filice, Ross W

2018-02-01

Feedback is an essential part of medical training, where trainees are provided with information regarding their performance and further directions for improvement. In diagnostic radiology, feedback entails a detailed review of the differences between the residents' preliminary interpretation and the attendings' final interpretation of imaging studies. While the on-call experience of independently interpreting complex cases is important to resident education, the more traditional synchronous "read-out" or joint review is impossible due to multiple constraints. Without an efficient method to compare reports, grade discrepancies, convey salient teaching points, and view images, valuable lessons in image interpretation and report construction are lost. We developed a streamlined web-based system, including report comparison and image viewing, to minimize barriers in asynchronous communication between attending radiologists and on-call residents. Our system provides real-time, end-to-end delivery of case-specific and user-specific feedback in a streamlined, easy-to-view format. We assessed quality improvement subjectively through surveys and objectively through participation metrics. Our web-based feedback system improved user satisfaction for both attending and resident radiologists, and increased attending participation, particularly with regards to cases where substantive discrepancies were identified.

Students' proficiency scores within multitrait item response theory

Science.gov (United States)

Scott, Terry F.; Schumayer, Daniel

2015-12-01

In this paper we present a series of item response models of data collected using the Force Concept Inventory. The Force Concept Inventory (FCI) was designed to poll the Newtonian conception of force viewed as a multidimensional concept, that is, as a complex of distinguishable conceptual dimensions. Several previous studies have developed single-trait item response models of FCI data; however, we feel that multidimensional models are also appropriate given the explicitly multidimensional design of the inventory. The models employed in the research reported here vary in both the number of fitting parameters and the number of underlying latent traits assumed. We calculate several model information statistics to ensure adequate model fit and to determine which of the models provides the optimal balance of information and parsimony. Our analysis indicates that all item response models tested, from the single-trait Rasch model through to a model with ten latent traits, satisfy the standard requirements of fit. However, analysis of model information criteria indicates that the five-trait model is optimal. We note that an earlier factor analysis of the same FCI data also led to a five-factor model. Furthermore the factors in our previous study and the traits identified in the current work match each other well. The optimal five-trait model assigns proficiency scores to all respondents for each of the five traits. We construct a correlation matrix between the proficiencies in each of these traits. This correlation matrix shows strong correlations between some proficiencies, and strong anticorrelations between others. We present an interpretation of this correlation matrix.

Next-Generation Summative English Language Proficiency Assessments for English Learners: Priorities for Policy and Research. Research Report. ETS RR-16-08

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Wolf, Mikyung Kim; Guzman-Orth, Danielle; Hauck, Maurice Cogan

2016-01-01

This paper is the third in a series concerning English language proficiency (ELP) assessments for K-12 English learners (ELs). The series, produced from Educational Testing Service (ETS), is intended to provide theory- and evidence-based principles and recommendations for improving next-generation ELP assessment systems, policies, and practices…

An exploratory study of proficient undergraduate Chemistry II students' application of Lewis's model

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Lewis, Sumudu R.

This exploratory study was based on the assumption that proficiency in chemistry must not be determined exclusively on students' declarative and procedural knowledge, but it should be also described as the ability to use variety of reasoning strategies that enrich and diversify procedural methods. The study furthermore assumed that the ability to describe the structure of a molecule using Lewis's model and use it to predict its geometry as well as some of its properties is indicative of proficiency in the essential concepts of covalent bonding and molecule structure. The study therefore inquired into the reasoning methods and procedural techniques of proficient undergraduate Chemistry II students when solving problems, which require them to use Lewis's model. The research design included an original survey, designed by the researcher for this study, and two types of interviews, with students and course instructors. The purpose of the survey was two-fold. First and foremost, the survey provided a base for the student interview selection, and second it served as the foundation for the inquiry into the strategies the student use when solving survey problems. Twenty two students were interviewed over the course of the study. The interview with six instructors allowed to identify expected prior knowledge and skills, which the students should have acquired upon completion of the Chemistry I course. The data, including videos, audios, and photographs of the artifacts produced by students during the interviews, were organized and analyzed manually and using QSR NVivo 10. The research found and described the differences between proficient and non-proficient students' reasoning and procedural strategies when using Lewis's model to describe the structure of a molecule. One of the findings clearly showed that the proficient students used a variety of cues to reason, whereas other students used one memorized cue, or an algorithm, which often led to incorrect representations in

The Influence of an Orthopedic, Manual Therapy Residency Program on Improved Knowledge, Psychomotor Skills, and Clinical Reasoning in Nairobi, Kenya.

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Cunningham, Shala; McFelea, Joni

2017-01-01

��< 0.001). The study results suggest that the residency program had a positive influence on the residents' ability to perform musculoskeletal examination and evaluation and to determine a treatment diagnosis. Future studies should be performed to determine if the improvements in assessment have a positive impact on clinical practice.

Improving auscultatory proficiency using computer simulated heart sounds

Directory of Open Access Journals (Sweden)

Hanan Salah EL-Deen Mohamed EL-Halawany

2016-09-01

Full Text Available This study aimed to examine the effects of 'Heart Sounds', a web-based program on improving fifth-year medical students' auscultation skill in a medical school in Egypt. This program was designed for medical students to master cardiac auscultation skills in addition to their usual clinical medical courses. Pre- and post-tests were performed to assess students' auscultation skill improvement. Upon completing the training, students were required to complete a questionnaire to reflect on the learning experience they developed through 'Heart Sounds' program. Results from pre- and post-tests revealed a significant improvement in students' auscultation skills. In examining male and female students' pre- and post-test results, we found that both of male and female students had achieved a remarkable improvement in their auscultation skills. On the other hand, students stated clearly that the learning experience they had with 'Heart Sounds' program was different than any other traditional ways of teaching. They stressed that the program had significantly improved their auscultation skills and enhanced their self-confidence in their ability to practice those skills. It is also recommended that 'Heart Sounds' program learning experience should be extended by assessing students' practical improvement in real life situations.

Reliability and Validity of 3 Methods of Assessing Orthopedic Resident Skill in Shoulder Surgery.

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Bernard, Johnathan A; Dattilo, Jonathan R; Srikumaran, Uma; Zikria, Bashir A; Jain, Amit; LaPorte, Dawn M