Full Text Available Abstract Background Efforts to redress racial and gender inequalities in the training of medical specialists has been a central part of a dedicated programme in the Faculty of Health Sciences at the University of Cape Town (UCT. This study aimed to describe trends in race and gender profiles of postgraduate students in medical specialties (registrars from 1999 to 2006 and to identify factors affecting recruitment and retention of black and female trainees. Method Review of faculty databases for race and gender data from 1999 to 2006. Distribution of an anonymous self-administered questionnaire to all registrars in 2005/2006. Results The percentage of African registrars doubled from 10% to 19% from 1999 to beyond 2002. The percentages of Africans, Coloureds and Indians rose steadily from 26% to 46% from 1999 to 2005, as did that of women from 27% to 44%. The institution's perceived good reputation, being an alumnus and originating from Cape Town were common reasons for choosing UCT for training. A quarter of respondents reported knowledge of a friend who decided against studying at UCT for reasons which included anticipated racial discrimination. Black respondents (23%, particularly African (50%, were more likely to describe registrarship at UCT as unwelcoming than white respondents (12%. Specific instances of personal experience of discrimination were uncommon and not associated with respondents' race or gender. Registrars who had had a child during registrarship and those reporting discrimination were more likely to rate the learning and research environment as poor (Odds Ratio, 4.01; 95% CI 0.98 – 16.47 and 1.99 95% CI 0.57 – 6.97, respectively. Conclusion The proportion of black and female registrars at the University of Cape Town has increased steadily from 1999 to 2006, most likely a result of systematic equity policies and procedures adopted in the faculty during this period. The data point to a need for policies to make the
Butler, Grainne; Breatnach, Colm; Harty, Sinead; Gavin, Patrick; O'Donnell, Colm; O'Grady, Michael J
A survey of paediatric higher specialist trainees was carried out in 2002 assessing career intentions and perception of training. Fourteen years later, with increased numbers of trainees and a national model of care and a tertiary paediatric hospital on the horizon, we re-evaluated the career intentions of the current trainee workforce. To assess the career intentions of the current paediatric higher specialist trainees. A 28-item questionnaire was developed based on a previously validated instrument and distributed online using the Royal College of Physicians of Ireland trainee database. We distributed the questionnaire to 118 eligible trainees and received responses from 92 (78%). Seventy-nine (86%) respondents desire a consultant post in Ireland. Seventy-five (82%) indicated that their preferred consultant post location was in a tertiary paediatric centre. Sixty-two trainees (67%) intend to become subspecialists with 25 (27%) planning a career in general paediatrics. This contrasts with the 2002 survey when 76% wished to work in urban centres and 61% of trainees planned a career in general paediatrics. There appears to be a mismatch between the career goals of the future paediatric consultant workforce and the requirements for staffing paediatric units nationally. This has the potential to complicate the proposed expansion of general paediatricians in regional centres and result in a significant proportion of current trainees failing to secure a post in their desired location.
Weller, J M; Castanelli, D J; Chen, Y; Jolly, B
Workplace-based assessments should provide a reliable measure of trainee performance, but have met with mixed success. We proposed that using an entrustability scale, where supervisors scored trainees on the level of supervision required for the case would improve the utility of compulsory mini-clinical evaluation exercise (CEX) assessments in a large anaesthesia training program. We analysed mini-CEX scores from all Australian and New Zealand College of Anaesthetists trainees submitted to an online database over a 12-month period. Supervisors' scores were adjusted for the expected supervision requirement for the case for trainees at different stages of training. We used generalisability theory to determine score reliability. 7808 assessments were available for analysis. Supervision requirements decreased significantly (P 0.7) with a feasible number of assessments. Adjusting scores against the expected supervision requirement considerably improved reliability, with G > 0.8 achieved with only nine assessments. Three per cent of trainees generated average mini-CEX scores below the expected standard. Using an entrustment scoring system, where supervisors score trainees on the level of supervision required, mini-CEX scores demonstrated moderate reliability within a feasible number of assessments, and evidence of validity. When scores were adjusted against an expected standard, underperforming trainees could be identified, and reliability much improved. Taken together with other evidence on trainee ability, the mini-CEX is of sufficient reliability for inclusion in high stakes decisions on trainee progression towards independent specialist practice. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: email@example.com.
This study was undertaken to evaluate uncertainty from the Basic Specialist Trainee perspective. The survey of trainees explored 1) factors in decision making, 2) the personal impact of uncertainty, 3) the responses to both clinical errors and challenges to their decision making and 4) the potential strategies to address uncertainty. Forty-one (93%) of trainees surveyed responded. Important factors in decision making were clinical knowledge and senior colleague’s opinion. Sixty percent experienced significant anxiety post call as a consequence of their uncertainty. When errors are made by colleagues, the trainee’s response is acceptance (52.5%), and sympathy (32%).Trainees are strongly influenced by the opinions of senior colleagues often changing their opinions having made confident decisions. Solutions to address uncertainty include enhanced knowledge translation, and to a lesser extent, enhanced personal awareness and resilience awareness. To enhance the training experience for BST and lessen the uncertainty experienced these strategies need to be enacted within the training milieu.
Seddon, Frederick; Biasutti, Michele
Prior research has revealed that non-music specialist trainee primary school teachers lack confidence in teaching music in spite of changes to teacher training and the introduction of music in the National Curriculum in England. The current study investigated the effects on non-music specialist trainee primary teachers' confidence to teach music…
Sandhu, Ravinder S; Ong, Bie Nio; Cooper, Vincent; Hassell, Andrew B
Within rheumatology specialty training, direct observation and formal assessment of consultation skills rarely occur. This study explored the attitudes and perceptions of rheumatology specialist registrars (SpRs) and consultants regarding consultation skills training and potential barriers to its successful implementation in the context of specialist training. Semi-structured interviews with rheumatology consultants and focus groups with rheumatology SpRs were conducted in four UK deanery regions. All participants value consultation skills training and believe it requires observation of trainees consulting. The skills of consultant trainers in providing feedback on consulting skills are sometimes sub-optimal. Direct, real time observation of trainees is difficult and happens infrequently. Recording consultations is a potentially attractive alternative. Important issues regarding the successful implementation of videotaped consultations include time constraints, consistency in the assessment of consultation skills, and expertise in providing constructive feedback that is individualised and tailored to the trainee's learning needs.
Petek, Davorina; Gajsek, Tadeja; Petek Ster, Marija
Women physicians face many challenges while balancing their many roles: doctor, specialist trainee, mother and partner. The most opportune biological time for a woman to start a family coincides with a great deal of demands and requirements at work. In this study we explored the options and capabilities of women GP specialist trainees in coordinating their family and career. This is a phenomenological qualitative research. Ten GP specialist trainees from urban and rural areas were chosen by the purposive sampling technique, and semi-structured in-depth interviews were conducted, recorded, transcribed and analysed by using thematic analysis process. Open coding and the book of codes were formed. Finally, we performed the process of code reduction by identifying the themes, which were compared, interpreted and organised in the highest analytical units--categories. One hundred fifty-five codes were identified in the analysis, which were grouped together into eleven themes. The identified themes are: types, causes and consequences of burdens, work as pleasure and positive attitude toward self, priorities, planning and help, and understanding of superiors, disburdening and changing in specialisation. The themes were grouped into four large categories: burdens, empowerment, coordination and needs for improvement. Women specialist trainees encounter intense burdens at work and home due to numerous demands and requirements during their specialisation training. In addition, there is also the issue of the work-family conflict. There are many consequences regarding burden and strain; however, burnout stands out the most. In contrast, reconciliation of work and family life and needs can be successful. The key element is empowerment of women doctors. The foremost necessary systemic solution is the reinforcement of general practitioners in primary health care and their understanding of the specialisation training scheme with more flexible possibilities for time adaptations of
Minen, Mia T; Monteith, Tesha; Strauss, Lauren D; Starling, Amaal
/most of the time. About 82.4% strongly agree that there needs to be improved headache education for physicians of all specialties (primary care, emergency department, psychiatry); 84.4% feel that they are appreciated by their patients; 68.6% feel that there is strong support in their departments for headache; 56.9% believe that their work schedule leaves enough time for personal and family life; and 60.8% agreed that their professional life will improve in years to come. Participants agreed/strongly agreed that they like to treat the following diseases/symptoms: migraine headache (98.0%), cluster headache (92%), chronic daily headache (84%), and post-concussive syndrome (71.4%). Participants disagreed/strongly disagreed that they like to treat the following comorbid conditions/symptoms: low back pain (66.6%), dizziness (42.9%), sleep apnea (36.7%), depression (32.0%), and anxiety (32.0%). In this detailed survey on the recruitment and retention of headache specialists, the following themes emerged: mentorship and exposure to a headache center are key foundations in the young investigator/trainee experience. Young headache specialists appear positive about their field of medicine. These specialists like to treat various headache types but not necessarily some of the related comorbidities (sleep disorders, depression, anxiety, back pain, and dizziness). Finally, there was strong agreement that there needs to be improved headache education for physicians of other medical specialties. © 2015 American Headache Society.
Sabey, Abigail; Harris, Michael
Workplace-based assessment (WBPA) was introduced in 2007 as a new approach to monitoring competence of GP specialist trainees (GPSTs). It includes a raft of assessments carried out in the workplace to assess what a trainee actually does in clinical practice. The assessment tools used are adapted from other contexts of doctors' training but little is known about how they function in day-to-day practice within GP training or how valid and useful they are found to be by trainees. To establish how the new system of WPBA is working in day-to-day practice for GPSTs in hospital posts. A mixed methods design including quantitative and qualitative phases of data collection. Two training locations within Severn Deanery. A questionnaire was completed by 52 GPSTs (67% response rate) currently in hospital posts. Twenty-two took part in focus groups and semi-structured interviews to explore key findings from the questionnaire in greater depth. There is value in the face-to-face contact between trainees and senior doctors. However, quality and depth of feedback are not consistent and there is evidence of poor use of the tools, reducing the value of the assessments. The system is further undermined by a clear perception of bias and lack of honesty in judgements which limit the scope for assessment to lead to learning. Overall, these weaknesses may impair the validity and usefulness of the system and its potential to improve the performance of doctors. General practice trainees in this study have a low opinion of how WPBA assessments function in the hospital setting. Changes are needed to optimise the potential of WPBA to improve the performance of doctors in training and to increase its credibility.
Morgan, J.; Porter, S.
A survey was carried out of psychiatric trainees' work-related experiences of unwanted sexual contact. A structured postal questionnaire was administered to 100 psychiatric trainees from senior house officer to specialist registrar level in a large psychiatric rotation. There was an 85% response rate; 86% (73) of the sample had experienced unwanted sexual contact, with 47% (40) experiencing deliberate touching, leaning over or cornering, and 18% (15) receiving letters, telephone calls or material of a sexual nature. Three-quarters (64) of respondents had experienced unwanted sexual contact from patients and 64% (54) from staff. Experiences and attitudes did not generally differ by gender, grade or training experience. Four out of 48 female respondents described stalking by patients. Of the 39 respondents who had reported harassment by patients, 31 felt supported by colleagues, while of the 13 who had reported harassment by colleagues, eight felt supported. Two-thirds of the respondents considered sexual harassment `sometimes' or `frequently' a problem for the profession. Diagnoses of confusional states, mania or schizophrenia made subjects less likely to consider unwanted sexual behaviour to be `sexual harassment' (86%, 80%, and 67%, respectively), but not for other diagnoses. Levels of threatening and intrusive sexual harassment are unacceptably high in this study group. Health trusts should adopt policies of `zero tolerance' and all incidents should be reported. Psychological impact on victims should be acknowledged even when the behaviour of the perpetrator can be explained by diagnosis. PMID:10474725
Yeo Chay Leng
Full Text Available Abstract Our prospective-audit-and-feedback antimicrobial stewardship (AS program for hematology and oncology inpatients was switched from one led by dedicated clinicians to a rotating team of infectious diseases trainees in order to provide learning opportunities and attempt a “de-escalation” of specialist input towards a more protocol-driven implementation. However, process indicators including the number of recommendations and recommendation acceptance rates fell significantly during the year, with accompanying increases in broad-spectrum antibiotic prescription. The trends were reversed only upon reverting to the original setup. Dedicated clinicians play a crucial role in AS programs involving immunocompromised patients. Structured training and adequate succession/contingency planning is critical for sustainability.
Full Text Available Abstract Background Part-time training (PTT is accessed by approximately 10% of Australian obstetrics and gynaecology trainees, a small but increasing minority which reflects the growing demand for improved work/life balance amongst the Australian medical workforce. This survey reports the attitudes and experiences of both full-time and part-time trainees to PTT. Methods An email-based anonymous survey was sent to all Australian obstetrics and gynaecology trainees in April 2009, collecting demographic and training status data, data on personal experiences of PTT and/or trainees, and attitudes towards PTT. Results 105 responses were received (20% response rate. These indicated strong support (90% from both full-time (FT and part-time (PT trainees for the availability of PTT. PT trainees were significantly more likely than FT trainees to be female with children. Improved morale was seen as a particular advantage of PTT; decreased continuity of care as a disadvantage. Conclusions Although limited by poor response rate, both PT and FT Australian obstetric trainees were supportive of part-time training. Both groups recognised important advantages and disadvantages of this mode of training. Currently, part-time training is accessed primarily by female trainees with family responsibilities, with many more trainees considering part-time training than the number that access it.
McEvoy, M M; Butler, B; MacCarrick, G; Nicholson, A J
Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.
McEvoy, M M
Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23\\/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24\\/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.
Muniraju, T M; Lillicrap, M H; Horrocks, J L; Fisher, J M; Clark, R M W; Kanagasundaram, N S
Enhanced education has been recommended to improve non-specialist management of acute kidney injury (AKI). However, the extent of any gaps in knowledge has yet to be defined fully. The aim of this study was to assess understanding of trainee doctors in the prevention, diagnosis and initial management of AKI. An anonymised questionnaire was completed by hospital-based trainees across Newcastle Renal Unit's catchment area. Responses were evaluated against a panel of pre-defined ideal answers. The median score was 9.5 out of 20 (n = 146; range 0-17) and was lower in more junior trainees. Fifty percent of trainees could not define AKI, 30% could not name more than two risk factors for AKI and 37% could not name even one indication for renal referral. These serious gaps in knowledge highlight the need for enhanced education aimed at all training grades. Organisational changes may also be required to optimise patient safety.
McNeill, Helen; Brown, Jeremy M.; Shaw, Nigel J.
Doctors in specialist training posts in the Mersey Deanery are expected to reflect on their clinical practice and to document their learning experiences in an e-portfolio. This study aims specifically to explore how they have engaged in reflection on their practice and how they utilise their learning portfolio to document evidence of this. A…
Seale, Josephine; Elamin, Wael; Millar, Michael
Training in microbiology is continuing to evolve. Standardisation of this process has, in part, been achieved through the development of a training curriculum by the Royal College of Pathologists (RCPath). A substantial proportion of microbiology training occurs through telephone consultations. To ascertain the content of these interactions and the extent to which the necessary skills outlined by the curriculum are attainable via these consultations. Records of telephone consultations made by microbiology registrars (SpR) on the Laboratory Information Management System (LIMS) over a 6 month period were analysed with regard to who initiated contact and the type of advice provided. An average of 426 SpR entries per month were made on the LIMS following telephone consultations. These consultations were predominantly initiated by fellow clinicians as opposed to the SpR. The majority (79%) of advice entailed guidance as to the use of antimicrobials which resulted in an alteration of the current regimen in 54% of cases. This study represents the first attempt to quantify the telephone consultations of microbiology trainees. It is concluded that although such interactions provide a means of attaining some of the competencies outlined by the RCPath curriculum, the bias towards antimicrobial advice reflects a discrepancy between the needs of the service users and the broad skill set advocated by the current microbiology training programme. Future modifications will need to take this into account to ensure both the training of SpRs and the microbiology service is fit for purpose.
Eyal, Roy; O'Connor, Mary J.
Background/Objective: Alcohol is a teratogen. Fetal alcohol spectrum disorders (FASDs) affect about 1% of live births, causing severe impairment. Individuals affected by FASDs are overrepresented in psychiatric settings. This study reports on the education and experience of psychiatry trainees in approaching FASDs. Method: Data were collected from…
Wahidi, Momen M; Hulett, Cidney; Pastis, Nicholas; Shepherd, R Wesley; Shofer, Scott L; Mahmood, Kamran; Lee, Hans; Malhotra, Rajiv; Moser, Barry; Silvestri, Gerard A
Linear endobronchial ultrasound (EBUS) allows real-time guidance of transbronchial needle aspiration of thoracic structures and has become an increasingly important diagnostic tool for chest physicians. Little has been published about the learning experience of operators with this technology. The purpose of this study was to define the learning experience of EBUS-guided transbronchial needle aspiration (EBUS-TBNA) among pulmonary trainees. This was a multicenter cohort study of fellows in pulmonary medicine over the first 2 years of their training. Prior to performing EBUS-TBNA, all participants had to complete 30 conventional bronchoscopies, an EBUS-specific didactic curriculum, and a simulation session with a plastic airway model. Each consecutive EBUS procedure was scored with a checklist that evaluated the ability to pass a bronchoscope through vocal cords, identify the appropriate node for sampling, acquire adequate ultrasound images, guide the bronchoscopy team through the technical steps of EBUS-TBNA, and obtain adequate tissue samples. Thirteen pulmonary trainees from three training programs were enrolled in the study and were observed over a 2-year period. The majority of trainees were able to perform all essential steps of EBUS-TBNA and obtain adequate tissue after performing an average of 13 (95% CI, 7-16) procedures. Pulmonary trainees needed an average of 13 procedures to achieve first independent successful performance of EBUS-TBNA following a training protocol that included a didactic curriculum and simulation-based practice. Our findings could guide pulmonary fellowship directors in planning EBUS training and establishing a reasonable juncture to assess EBUS skills with validated assessment tools.
Jaffer, Usman; Pennell, Aaron; Musonda, Patrick
Mentoring is advocated as an essential adjunct in work-based learning providing support in career and noncareer related issues. This study aims to investigate trainee experiences and satisfaction with mentoring arrangements. E-mail survey of surgical trainees from the East of England Higher Surgical Training Deanery, UK. Factors affecting presence of a mentoring relationship and satisfaction with mentoring arrangements were analyzed. Of all respondents, 62.85% stated that they were not sure or did not have a mentor; 34.29% said that they had had a meaningful meeting with their mentor; 57.14% said that they were aware of the responsibilities of a mentor; 34.29% strongly agreed or agreed that mentoring had been useful; 25.71% said that mentoring had been useful in career development; and 20% found it useful in noncareer related issues. Of those with a mentor, only 31.43% were satisfied with mentoring. Factors affecting satisfaction with mentoring included having had a meaningful meeting, having clear objectives set, and help in job transition and noncareer related issues. Knowledge of a mentor's responsibilities was also associated with satisfaction. The only factor associated with the presence of a mentoring relationship was having a mentor appointed. We advocate the establishment of a mentoring matching scheme for mentors and mentees together with mentor training to improve mentoring provision for surgical trainees. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Giroldi, E.; Veldhuijzen, W.; Geelen, K.; Muris, J.; Bareman, F.; Bueving, H.; Weijden, T.T. van der; Vleuten, C. van der
To inform the development of recommendations to facilitate learning of skilled doctor-patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees' learning in the
In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression2) perceived functional effectiveness at work 3) psychological impact of hospital based training and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships. Seventy-five percent of trainees had a definite career plan with 86% intending to undertake fellowship training. Seventy percent believed they were efficient time managers but 53% had difficulty in making time for academic pursuits and fifty percent experienced negative feelings, which lingered after work and interfered with their relationships at home. Seventy-four percent stated training was undertaken at significant personal cost with only 21% achieving a very satisfactory work\\/life balance. To address these difficulties trainee wellbeing should be addressed at the Basic Specialist Training (BST) level and the career path clearly explained outlining the challenges that are likely to be encountered.
Lonergan, Peter E
Abstract Background There is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices. We aimed to quantify the operative exposure of all trainees on the National Basic Surgical Training (BST) programme in Ireland and compare the results with arbitrary training targets. Methods Retrospective analysis of data obtained from a web-based logbook (http:\\/\\/www.elogbook.org) for all general surgery and orthopaedic training posts between July 2007 and June 2009. Results 104 trainees recorded 23,918 operations between two 6-month general surgery posts. The most common general surgery operation performed was simple skin excision with trainees performing an average of 19.7 (± 9.9) over the 2-year training programme. Trainees most frequently assisted with cholecystectomy with an average of 16.0 (± 11.0) per trainee. Comparison of trainee operative experience to arbitrary training targets found that 2-38% of trainees achieved the targets for 9 emergency index operations and 24-90% of trainees achieved the targets for 8 index elective operations. 72 trainees also completed a 6-month post in orthopaedics and recorded 7,551 operations. The most common orthopaedic operation that trainees performed was removal of metal, with an average of 2.90 (± 3.27) per trainee. The most common orthopaedic operation that trainees assisted with was total hip replacement, with an average of 10.46 (± 6.21) per trainee. Conclusions A centralised web-based logbook provides valuable data to analyse training programme performance. Analysis of logbooks raises concerns about operative experience at junior trainee level. The provision of adequate operative exposure for trainees should be a key performance indicator for training programmes.
Magin, Parker; Morgan, Simon; Henderson, Kim; Tapley, Amanda; McElduff, Patrick; Pearlman, James; Goode, Susan; Spike, Neil; Laurence, Caroline; Scott, John; Thomson, Allison; van Driel, Mieke
A broad case-mix in family physicians' (general practitioners', GPs') vocational trainee experience is deemed essential in producing competent independent practitioners. It is suggested that the patient-mix should include common and significant conditions and be similar to that of established GPs. But the content of contemporary GP trainees' clinical experience in training is not well-documented. In particular, how well trainees' experience reflects changing general practice demographics (with an increasing prevalence of chronic disease) is unknown. We aimed to establish levels of trainees' clinical exposure to chronic disease in training (and associations of this exposure) and to establish content differences in chronic disease consultations (compared to other consultations), and differences in trainees' actions arising from these consultations. A cross-sectional analysis from the Registrars' Clinical Encounters in Training (ReCEnT) study, a cohort study of GP registrars' (trainees') consultations in four Australian GP training organisations. Trainees record detailed data from 60 consecutive consultations per six-month training term. Diagnoses/problems encountered are coded using the International Classification of Primary Care-2 PLUS (ICPC-2 PLUS). A classification system derived from ICPC-2 PLUS was used to define diagnoses/problems as chronic/non-chronic disease. The outcome factor for analyses was trainees' consultations in which chronic disease was encountered. Independent variables were a range of patient, trainee, practice, consultation and educational factors. Of 48,112 consultations (of 400 individual trainees), 29.5% included chronic disease problems/diagnoses. Associations of a consultation including chronic disease were the patient being older, male, and having consulted the trainee previously, and the practice routinely bulk-billing (not personally charging) patients. Consultations involving a chronic disease lasted longer, dealt with more problems
Fisher, James Michael; Garside, Mark J; Brock, Peter; Gibson, Vicky; Hunt, Kelly; Briggs, Sally; Gordon, Adam Lee
there is concern that there are insufficient numbers of geriatricians to meet the needs of the ageing population. A 2005 survey described factors that influenced why UK geriatricians had chosen to specialise in the field-in the decade since, UK postgraduate training has undergone a fundamental restructure. to explore whether the reasons for choosing a career in geriatric medicine in the UK had changed over time, with the goal of using this knowledge to inform recruitment and training initiatives. an online survey was sent to all UK higher medical trainees in geriatric medicine. survey questions that produced categorical data were analysed with simple descriptive statistics. For the survey questions that produced free-text responses, an inductive, iterative approach to analysis, in keeping with the principles of framework analysis, was employed. two hundred and sixty-nine responses were received out of 641 eligible respondents. Compared with the previous survey, a substantially larger number of respondents regarded geriatric medicine to be their first-choice specialty and a smaller number regretted their career decision. A greater number chose geriatric medicine early in their medical careers. Commitments to the general medical rota and the burden of service provision were considered important downsides to the specialty. there are reasons to be optimistic about recruitment to geriatric medicine. Future attempts to drive up recruitment might legitimately focus on the role of the medical registrar and perceptions that geriatricians shoulder a disproportionate burden of service commitments and obligations to the acute medical take. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: firstname.lastname@example.org
Due to content-based analysis of marketing specialists' professional training and approaches to development of their educational trajectory, it has been revealed that curricula and their content are given much attention by employers whose demands are focused on meeting current labour market conditions. It has been justified that despite the…
Microteaching is widely used in many countries to prepare trainees for the complexity of the actual classroom environment but has limited use in Turkey. The main objective of this action research was to evaluate and increase in the effectiveness of microteaching, and determine the contribution of microteaching to trainees from their own…
Farrell, Renée; Mahant, Sanjay; Wadhwa, Anupma; Bismilla, Zia; Zhao, Xiu Yan; Martimianakis, Tina; Cohen, Eyal
Medical education relies heavily on workplace learning where trainees are educated through their clinical experience. Few studies have explored trainees' perceptions of the educational value of these patient care experiences. The aim of this study was to identify pediatric patient characteristics that medical trainees perceive as educationally valuable. Over 2 months, trainees on pediatric inpatient wards ranked the perceived educational value of patients under their care on a 4-point bipolar Likert scale. Three patient characteristics were examined: complex-chronic and noncomplex-chronic preexisting conditions, difficult social circumstances, and rare diseases. Patient-level predictors of cases perceived as educationally valuable (defined as scores≥3) were examined by using univariate and multivariate analyses. A total of 325 patients were rated by 51 trainees (clinical medical students [45%], first-year residents [29%], third-year residents/fellows [26%]). Rare diseases had a higher educational value score (adjusted odds ratio 1.76, 95% confidence interval 1.08-2.88, P=.02). Complex-chronic and noncomplex-chronic preexisting conditions and difficult social circumstances did not affect the perceived educational value. Trainees attribute the most educational value to caring for patients with rare diseases. Although trainees' perceptions of learning do not necessarily reflect actual learning, they may influence personal interest and limit learning from an educational experience. Knowledge of trainee perceptions of educational experience therefore can direct medical educators' approaches to inpatient education. Copyright © 2015 by the American Academy of Pediatrics.
E. Giroldi (Esther); I.K. Veldhuijzen (Irene); Geelen, K. (Kristel); J. Muris; F. Bareman (Frits); H.J. Bueving (Herman); T. van der Weijden (Trudy); C.P.M. van der Vleuten (Cees)
textabstractTo inform the development of recommendations to facilitate learning of skilled doctor–patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees’ learning
Van Nuland, Marc; Thijs, Gabie; Van Royen, Paul; Van den Noortgate, Wim; Goedhuys, Jo
To explore the views and experiences of general practice (GP) vocational trainees regarding communication skills (CS) and the teaching and learning of these skills. A purposive sample of second and third (final) year GP trainees took part in six focus group (FG) discussions. Transcripts were coded and analysed in accordance with a grounded theory approach by two investigators using Alas-ti software. Finally results were triangulated by means of semi-structured telephone interviews. The analysis led to three thematic clusters: (1) trainees acknowledge the essential importance of communication skills and identified contextual factors influencing the learning and application of these skills; (2) trainees identified preferences for learning and receiving feedback on their communication skills; and (3) trainees perceived that the assessment of communication skills is subjective. These themes are organised into a framework for a better understanding of trainees' communication skills as part of their vocational training. The framework helps in leading to a better understanding of the way in which trainees learn and apply communication skills. The unique context of vocational training should be taken into account when trainees' communication skills are assessed. The teaching and learning should be guided by a learner-centred approach. The framework is valuable for informing curricular reform and future research.
de Costa, Caroline M; Russell, Darren B; Carrette, Michael
To determine the opinions and current practice of obstetricians and gynaecologists and trainees in the specialty with regard to induced abortion. A voluntary, anonymous survey of Australian Fellows and specialist trainees of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists was conducted between 23 June and 31 July 2009 using an email invitation to proceed to an online questionnaire. Attitudes to abortion; self-reported usual practice of induced abortion. Of 1498 Fellows and trainees invited to complete the questionnaire, 740 (49%) did so. Of these respondents, 632 (85%) stated that they did not hold religious or conscientious views that would make them totally opposed to abortion; 463 of these (73%) reported performing abortion as part of their personal practice, with 204 (44%) doing so only for severe fetal abnormality or serious maternal medical conditions. 108 respondents reported holding views that made them totally opposed to abortion - 60 (56%) opposed it in any situation at all and 48 (44%) opposed it with limited exceptions. Of those opposed, 34 (32%) added comment that they perform abortion for severe fetal abnormality or serious maternal medical conditions, and a further 17 (16%) commented that they refer women requesting abortion in these circumstances to colleagues. Of the respondents not opposed to abortion, 89% supported the availability of induced abortion within the public health system, and half felt that national availability of mifepristone would modify their practice of induced abortion. There was broad support among responding specialist obstetricians and gynaecologists and trainees for the availability of induced abortion in Australia. This study highlights the difficulties of accurately reporting a wide range of views on a contentious issue.
Boland, Daubney; White, Traci; Adams, Eve
Interprofessional education is essential in that it helps healthcare disciplines better utilize each other and provide team-based collaboration that improves patient care. Many pharmacy training programs struggle to implement interprofessional education. This purpose of the study was to examine the effect of a 30-h interprofessional training that included pharmacy students to determine if the training helped these students build valuable knowledge and skills while working alongside other health care professions. The interprofessional training included graduate-level trainees from pharmacy, behavioral health, nursing, and family medicine programs where the trainees worked within teams to build interprofessional education competencies based on the Interprofessional Education Collaborative core competencies. Sixteen pharmacy trainees participated in the training and completed pre- and post-test measures. Data were collected over a two-year period with participants completing the Team Skills Scale and the Interprofessional Attitudes Scale. Paired sample t -tests indicated that, after this training, pharmacy trainees showed significant increases in feeling better able to work in healthcare teams and valuing interprofessional practice.
Full Text Available Interprofessional education is essential in that it helps healthcare disciplines better utilize each other and provide team-based collaboration that improves patient care. Many pharmacy training programs struggle to implement interprofessional education. This purpose of the study was to examine the effect of a 30-h interprofessional training that included pharmacy students to determine if the training helped these students build valuable knowledge and skills while working alongside other health care professions. The interprofessional training included graduate-level trainees from pharmacy, behavioral health, nursing, and family medicine programs where the trainees worked within teams to build interprofessional education competencies based on the Interprofessional Education Collaborative core competencies. Sixteen pharmacy trainees participated in the training and completed pre- and post-test measures. Data were collected over a two-year period with participants completing the Team Skills Scale and the Interprofessional Attitudes Scale. Paired sample t-tests indicated that, after this training, pharmacy trainees showed significant increases in feeling better able to work in healthcare teams and valuing interprofessional practice.
Giroldi, Esther; Veldhuijzen, Wemke; Geelen, Kristel; Muris, Jean; Bareman, Frits; Bueving, Herman; van der Weijden, Trudy; van der Vleuten, Cees
To inform the development of recommendations to facilitate learning of skilled doctor-patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees' learning in the workplace. We conducted a qualitative study in a…
Since the development of percutaneous tracheostomy, the number of tracheostomy patients on hospital wards has increased. Problems associated with adequate tracheostomy care on the wards are well documented, particularly the management of tracheostomy-related emergencies. A survey was conducted among non-consultant hospital doctors (NCHDs) starting their Critical Care Medicine training rotation in a university affiliated teaching hospital to determine their basic knowledge and skills in dealing with tracheostomy emergencies. Trainees who had received specific tracheostomy training or who had previous experience of dealing with tracheostomy emergencies were more confident in dealing with such emergencies compared to trainees without such training or experience. Only a minority of trainees were aware of local hospital guidelines regarding tracheostomy care. Our results highlight the importance of increased awareness of tracheostomy emergencies and the importance of specific training for Anaesthesia and Critical Care Medicine trainees.
Gordon, Lisi J.; Rees, Charlotte E.; Ker, Jean S.; Cleland, Jennifer
This research was part of LJG’s PhD research which was generously funded by NHS Education for Scotland through SMERC. OBJECTIVES: To explore medical trainees' experiences of leadership and followership in the interprofessional healthcare workplace. DESIGN: A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. SETTING: Multisite study across four UK health boards. PARTICIPANTS: Through maximum variation sampling, 65...
Al-Jundi, Wissam; Kayssi, Ahmed; Papia, Giuseppe; Dueck, Andrew
Smartphones have become the most important personal technological device. M-learning is learning through mobile device educational technology. We aim to assess the acceptability of a smartphone learning experience among the vascular trainees and determine if results could inform formal teaching efforts. A survey of the vascular trainees at a single center was conducted following a trial of smartphone learning experience. A vascular fellow used a smartphone response system application (Polltogo, Inspirapps Inc.) to send a daily multiple-choice question to the vascular residents for 20 consecutive working days. The application allows for only one attempt from each user, and the answers are registered anonymously. However, each participant receives instant feedback on his/her response by viewing the correct answer after answering each question along with a distribution of answers among other users. A total of 9 trainees participated in the trial, and all of them filled a posttrial survey. All the trainees possessed smartphones. The majority (78%) were not aware of the concept of m-learning. The mobile engagement score (number of answers received divided by total possible answers) was 145/180 (81%). All the trainees were "satisfied" or "very satisfied" with the experience, and the same number stated that they were "likely" or "very likely" to use this technology in the future. The majority (89%) agreed that such an application could assist them in preparing for their board examination. On 3 occasions, 75% or more of the participating trainees answered the multiple-choice question incorrectly, which resulted in addressing the relevant topics in the unit's weekly teaching conference. Using smartphones for education is acceptable among the vascular trainees, and the trial of a response system application with instant written feedback represents a novel method for using smartphones for collaborative learning. Such an application can also inform program directors and
Carson, Amy Alice; Clark, Sarah Emily
Aims and method To explore core psychiatry trainees' experiences of cognitive–behavioural therapy (CBT) training by using interpretative phenomenological analysis of semi-structured interviews conducted with seven core trainee psychiatrists in Yorkshire and the Humber Deanery. Results Four key themes emerged: (1) barriers to training; (2) guidance, with emphasis on the importance of supervision groups; (3) acquisition of new skills and confidence; (4) personal influence on the training experience. Clinical implications Many trainees in Yorkshire have a positive experience of CBT training; however, some also experience barriers to acquiring the relevant skills. Further research should build on the positive factors and barriers identified here, with a view to guiding improvements in training nationwide. PMID:28400968
Raine, Susan P
With interest in global health experiences (GHEs) by medical trainees remaining high, the number of global health programs offering educational experiences in resource limited settings has proliferated. Development and implementation of GHEs has outpaced the critical evaluation of ethical considerations inherent in these programs. Global health programs must adhere to the four principles of beneficence, nonmaleficence, respect of autonomy, and justice in crafting a GHE focused on maximizing the experience of the learners, host country, and patients. The four ethical principles provide a guideline for the development and implementation of highly ethical GHEs for medical trainees. Copyright © 2017. Published by Elsevier Ltd.
Bindal, Natish; Goodyear, Helen; Bindal, Taruna; Wall, David
Workplace based assessments (WBAs) have been part of UK training for the last 3 years. Carrying out procedures efficiently and safely is of paramount importance in anaesthesia. To explore opinions and experiences of Direct Observation of Procedural Skills (DOPS) assessments in a regional anaesthetic training programme. 19 and 20-item questionnaires were distributed to trainees and consultants respectively. Questionnaire response rate was 76% (90/119) for trainees and 65% (129/199) for consultants. 43% of consultants and 33% of trainees were not trained in DOPS use. Assessments were usually not planned. 50% were ad hoc and the remainder mainly retrospective. Time spent on assessment was short with DOPS and feedback achieved in ≤15 minutes in the majority of cases with lack of suggestions for further improvement. Both trainees and consultants felt that DOPS was not a helpful learning tool (p = 0.001) or a reflection of trainee competency. DOPS assessments are currently not valued as an educational tool. Training is essential in use of this WBA tool which needs to be planned and sufficient time allocated so as to address current negative attitudes.
Lund, Emily M; Andrews, Erin E; Holt, Judith M
To better understand the characteristics and experiences of psychologists and trainees with disabilities. An invitation to participate in a survey of psychologists and psychology trainees with disabilities was sent to professional listservs related to psychology and/or disability. Fifty-six trainees and psychologists with doctoral training in clinical, counseling, school, or rehabilitation psychology completed the survey. Over half (57.1%) were practicing psychologists and 42.9% were current trainees. The most commonly reported disabilities were physical, sensory, and chronic health. The majority of the participants reported experiencing disability-related discrimination during their training, and less than one third had received mentorship from psychologists with disabilities. Less than half of respondents disclosed their disability to a university disability services office, and many relied on informal accommodations alone. Most participants did not disclose their disability during the graduate school, internship, or postdoctoral application processes. Professional psychology programs and training sites should work to remove barriers and provide support for trainees with disabilities, especially during preinternship doctoral training. Programs should not expect disability services offices to provide all support for students with disabilities, especially support related to clinical training. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Lai, Pauline Siew Mei; Tan, Sing Yee; Liew, Su May
Sociocultural factors have been shown to be important influencers of sexual health and sexuality. Hence, the aim of our study was to explore the views and experiences of family medicine trainees regarding female sexual dysfunction (FSD) with a focus on the barriers and facilitators towards the initiation of conversation on this topic. A qualitative study design involving semi-structured focus group discussions (FGDs) was conducted with 19 family medicine trainees in Malaysia. The conceptual framework used was based on the Theory of Planned Behavior. Thematic approach was used to analyze the data. Participants perceived FSD as being uncommon and unimportant. According to our participants, patients often presented with indirect complaints, and doctors were not proactive in asking about FSD. Three main barriers were identified: doctor factors, perceived patient factors, and system factors. Lack of confidence, knowledge, experience, time, and embarrassment were the key barriers identified at the doctors' level. Lack of awareness, among patients regarding FSD, and local cultural and religious norms were the perceived patient barriers. System barriers were lack of time and privacy. Various facilitators, such as continuous medical education and public forums, were suggested as means to encourage family medicine trainees to initiate discussion on sexual matters during consultations. In conclusion, family medicine trainees found it difficult to initiate conversation on FSD with patients. Interventions to encourage conversation on FSD should target this and other identified barriers.
de Sousa, Valdemar Donizeti; Cury, Vera Engler
This study shows a qualitative research based on a humanist theory in relation to the experiences of trainees from the psychology course of PUC-Campinas, that are participating in family health teams in the areas of Health/Clinic and basic attention in public health. The participants were six trainees in the last year of the course and located in two Health-School Centers in the Northwest region of Campinas. The methodology used was an ethnographic view. The processes of data composition were produced in two different moments: a) by weekly register on the trainee's personal diary during five months; b) semi-directed individual interviews at the end of the term. These data were analyzed according to a phenomenological reading. It was found evolutive stages in the process of the trainee formation. Initially, the experience was lived with surprise and strangeness, resulting in contradictory feelings of innapropriation to their inexperience to work in teams. On the other hand, because they were well received by the group, there was a personal transformation considered to be very enriching, symbolized as a single felling of belonging, motivating efforts to a creative and integrating clinic practice.
Background. The logged experience of specialist general surgical trainees has made it possible to analyse their surgical procedural exposure. Objective. To evaluate the exposure to key surgical procedures of South African (SA) trainees in general surgery from logbooks submitted to the Colleges of Medicine of South Africa ...
Clancy, Kathryn B H; Nelson, Robin G; Rutherford, Julienne N; Hinde, Katie
Little is known about the climate of the scientific fieldwork setting as it relates to gendered experiences, sexual harassment, and sexual assault. We conducted an internet-based survey of field scientists (N = 666) to characterize these experiences. Codes of conduct and sexual harassment policies were not regularly encountered by respondents, while harassment and assault were commonly experienced by respondents during trainee career stages. Women trainees were the primary targets; their perpetrators were predominantly senior to them professionally within the research team. Male trainees were more often targeted by their peers at the research site. Few respondents were aware of mechanisms to report incidents; most who did report were unsatisfied with the outcome. These findings suggest that policies emphasizing safety, inclusivity, and collegiality have the potential to improve field experiences of a diversity of researchers, especially during early career stages. These include better awareness of mechanisms for direct and oblique reporting of harassment and assault and, the implementation of productive response mechanisms when such behaviors are reported. Principal investigators are particularly well positioned to influence workplace culture at their field sites.
Kathryn B H Clancy
Full Text Available Little is known about the climate of the scientific fieldwork setting as it relates to gendered experiences, sexual harassment, and sexual assault. We conducted an internet-based survey of field scientists (N = 666 to characterize these experiences. Codes of conduct and sexual harassment policies were not regularly encountered by respondents, while harassment and assault were commonly experienced by respondents during trainee career stages. Women trainees were the primary targets; their perpetrators were predominantly senior to them professionally within the research team. Male trainees were more often targeted by their peers at the research site. Few respondents were aware of mechanisms to report incidents; most who did report were unsatisfied with the outcome. These findings suggest that policies emphasizing safety, inclusivity, and collegiality have the potential to improve field experiences of a diversity of researchers, especially during early career stages. These include better awareness of mechanisms for direct and oblique reporting of harassment and assault and, the implementation of productive response mechanisms when such behaviors are reported. Principal investigators are particularly well positioned to influence workplace culture at their field sites.
Clancy, Kathryn B. H.; Nelson, Robin G.; Rutherford, Julienne N.; Hinde, Katie
Little is known about the climate of the scientific fieldwork setting as it relates to gendered experiences, sexual harassment, and sexual assault. We conducted an internet-based survey of field scientists (N = 666) to characterize these experiences. Codes of conduct and sexual harassment policies were not regularly encountered by respondents, while harassment and assault were commonly experienced by respondents during trainee career stages. Women trainees were the primary targets; their perpetrators were predominantly senior to them professionally within the research team. Male trainees were more often targeted by their peers at the research site. Few respondents were aware of mechanisms to report incidents; most who did report were unsatisfied with the outcome. These findings suggest that policies emphasizing safety, inclusivity, and collegiality have the potential to improve field experiences of a diversity of researchers, especially during early career stages. These include better awareness of mechanisms for direct and oblique reporting of harassment and assault and, the implementation of productive response mechanisms when such behaviors are reported. Principal investigators are particularly well positioned to influence workplace culture at their field sites. PMID:25028932
Orvis, Karin A; Orvis, Kara L; Belanich, James; Mullin, Laura N
.... The purpose of the current research was to investigate the influence of two trainee characteristics, prior videogame experience and computer self-efficacy, on learner outcomes of a videogame-based training environment...
Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L
The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.
Dowling, Stephanie; Rouse, Martin; Farrell, John; Brennan, Darach
International health electives provide doctors and medical students with unique educational experiences. The HSE South East GP training programme in Waterford, Ireland has run a four-month elective to Malawi since 2006, and also ran a four-month placement in Australia between 2004 and 2011. The aim of this study was to see whether these overseas electives provide Irish GP trainees with any positive or negative experiences, and to make recommendations regarding future similar rotations abroad. This study used the Delphi survey technique, a qualitative research method. The first round questionnaire asked about challenges faced while overseas, what the trainees learned, and how the placement influenced their clinical practice on their return to Ireland. Doctors were also asked about the benefits and/or limitations of an overseas placement during GP training. These Irish GP trainees reported very positive outcomes from time spent in Malawi and Australia. They reported improved knowledge and skills, and increased awareness of health issues and cultural differences in another country. Moreover, they had an opportunity to reflect and grow personally as doctors. This is the first study looking at an international health elective as part of a vocational training programme in Ireland.
Elsey, E J; Griffiths, G; Humes, D J; West, J
General surgical training curricula around the world set defined operative numbers to be achieved before completion of training. However, there are few studies reporting total operative experience in training. This systematic review aimed to quantify the published global operative experience at completion of training in general surgery. Electronic databases were searched systematically for articles in any language relating to operative experience in trainees completing postgraduate general surgical training. Two reviewers independently assessed citations for inclusion using agreed criteria. Studies were assessed for quantitative data in addition to study design and purpose. A meta-analysis was performed using a random-effects model of studies with appropriate data. The search resulted in 1979 titles for review. Of these, 24 studies were eligible for inclusion in the review and data from five studies were used in the meta-analysis. Studies with published data of operative experience at completion of surgical training originated from the USA (19), UK (2), the Netherlands (1), Spain (1) and Thailand (1). Mean total operative experience in training varied from 783 procedures in Thailand to 1915 in the UK. Meta-analysis produced a mean pooled estimate of 1366 (95 per cent c.i. 1026 to 1707) procedures per trainee at completion of training. There was marked heterogeneity between studies (I 2 = 99·6 per cent). There is a lack of robust data describing the operative experiences of general surgical trainees outside the USA. The number of surgical procedures performed by general surgeons in training varies considerably across the world. © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
Giroldi, Esther; Veldhuijzen, Wemke; Geelen, Kristel; Muris, Jean; Bareman, Frits; Bueving, Herman; van der Weijden, Trudy; van der Vleuten, Cees
To inform the development of recommendations to facilitate learning of skilled doctor-patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees' learning in the workplace. We conducted a qualitative study in a general practice training setting, triangulating various sources of data to obtain a rich understanding of trainees and supervisors' experiences: three focus group discussions, five discussions during training sessions and five individual interviews. Thematic network analysis was performed during an iterative process of data collection and analysis. We identified a communication learning cycle consisting of six phases: impactful experience, change in frame of reference, identification of communication strategies, experimentation with strategies, evaluation of strategies and incorporation into personal repertoire. Supervisors supported trainees throughout this process by creating challenges, confronting trainees with their behaviour and helping them reflect on its underlying mechanisms, exploring and demonstrating communication strategies, giving concrete practice assignments, creating safety, exploring the effect of strategies and facilitating repeated practice and reflection. Based on the experiences of trainees and supervisors, we conclude that skilled communication involves the development of a personal communication repertoire from which learners are able to apply strategies that fit the context and their personal style. After further validation of our findings, it may be recommended to give learners concrete examples, opportunities for repeated practise and reflection on personal frames of reference and the effect of strategies, as well as space for authenticity and flexibility. In the workplace, the clinical supervisor is able to facilitate all these essential conditions to support his/her trainee in becoming a skilled
Full Text Available The article deals with blended learning in the context of pre-graduate English language teacher education. Firstly, the concept of blended learning is defined, then, the attention is focused on the online component of a blend, namely on the issue of interpersonal interaction including the challenges, which learning through online networking poses. Finally, results of a small–scale research are provided to offer insights into teacher trainees´ perspective of the blended learning experience at the University of Pardubice, Czech Republic.
Pedersen, Rose C; Li, Yiping; Chang, Jason S; Lew, Wesley K; Patel, Kaushal Kevin
Vascular surgery fellowship training has evolved with the widespread adoption of endovascular interventions. The purpose of this study is to examine how general surgery trainee exposure to vascular surgery has changed over time. Review of the Accreditation Council for Graduate Medical Education national case log reports for graduating Vascular Surgery Fellows (VF), and general surgery residents (GSR) from 2001 to 2012 was performed. The number of GSR increased from 1021 to 1098, and the number of VF increased from 96 to 121 from 2001 to 2012. The total number of vascular cases done by VF increased by 1161 since 2001 (298-762), whereas the total number of vascular cases done by GSR has decreased by 40% during this time period (186-116). Vascular fellows increase was due primarily to an increase in endovascular experience; a finding not noted in general surgery residents. Vascular fellow case log changes are due primarily to an increase in endovascular experience that has not been mirrored by general surgery trainees. Open surgery experience has decreased overall for general surgery residents in all major categories, a change not seen in vascular surgery fellows. Copyright © 2016 Elsevier Inc. All rights reserved.
Eismann, Sabine; Brandl, Mario; Spinnewijn, Laura; Everden, Caroline; Campolo, Federica; Schott, Sarah
The European Network of Trainees in Obstetrics and Gynaecology (ENTOG) is an organization representing trainees from 30 European member countries. Together with the European Board and College of Obstetrics and Gynaecology (EBCOG), it seeks to achieve the highest possible standards of training and consequently to improve the quality of medical care in the field of gynaecology and obstetrics. Every year, the ENTOG council meets and holds a scientific meeting in a different European country. To coincide with this, the host country arranges an exchange, to which each member country can send two trainees. This exchange allows trainees to gain insight into both daily clinical work and the structure of the health care system. This article reports the experiences of participants in the May 2016 ENTOG exchange to Turin, Italy. The aim is to outline differences in training between Germany and Italy as well as some striking differences with other European countries. The participants' personal benefit from this unique experience was not only to get familiar with the Italian trainee programme and health care system, but also to exchange experiences among representatives from other European countries and build up a young gynaecological network within Europe.
Nagendran, Myura; Toon, Clare D; Davidson, Brian R; Gurusamy, Kurinchi Selvan
Surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time consuming, costly, and of variable effectiveness. Training using a box model physical simulator - either a video box or a mirrored box - is an option to supplement standard training. However, the impact of this modality on trainees with no prior laparoscopic experience is unknown. To compare the benefits and harms of box model training versus no training, another box model, animal model, or cadaveric model training for surgical trainees with no prior laparoscopic experience. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index Expanded to May 2013. We included all randomised clinical trials comparing box model trainers versus no training in surgical trainees with no prior laparoscopic experience. We also included trials comparing different methods of box model training. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager for analysis. For each outcome, we calculated the standardised mean difference (SMD) with 95% confidence intervals (CI) based on intention-to-treat analysis whenever possible. Twenty-five trials contributed data to the quantitative synthesis in this review. All but one trial were at high risk of bias. Overall, 16 trials (464 participants) provided data for meta-analysis of box training (248 participants) versus no supplementary training (216 participants). All the 16 trials in this comparison used video trainers. Overall, 14 trials (382 participants) provided data for quantitative comparison of different methods of box training. There were no trials comparing box model training versus animal model or cadaveric model training. Box model training versus no training: The meta-analysis showed that the time
Felder, Tisha M; Braun, Kathryn L; Wigfall, Lisa; Sevoyan, Maria; Vyas, Shraddha; Khan, Samira; Brandt, Heather M; Rogers, Charles; Tanjasiri, Sora; Armstead, Cheryl A; Hébert, James R
The study aims to explore variation in scholarly productivity outcomes by underrepresented status among a diverse sample of researchers in a community-engaged training program. We identified 141 trainees from a web-based survey of researchers in the National Cancer Institute-funded, Community Networks Program Centers (CNPCs) (2011-2016). We conducted a series of multiple logistic regression models to estimate the effect of National Institutes of Health (NIH)-defined underrepresented status on four, self-reported, scholarly productivity outcomes in the previous 5 years: number of publications (first-authored and total) and funded grants (NIH and any agency). Sixty-five percent (n = 92) indicated NIH underrepresented status. In final adjusted models, non-NIH underrepresented (vs. underrepresented) trainees reported an increased odds of having more than the median number of total publications (> 9) (OR = 3.14, 95% CI 1.21-8.65) and any grant funding (OR = 5.10, 95% CI 1.77-14.65). Reporting ≥ 1 mentors (vs. none) was also positively associated (p < 0.05) with these outcomes. The CNPC underrepresented trainees had similar success in first-authored publications and NIH funding as non-underrepresented trainees, but not total publications and grants. Examining trainees' mentoring experiences over time in relation to scholarly productivity outcomes is needed.
Highton, Lyndsey; Lamb, Andrew; Fitzgerald, Aidan; Wood, Simon; Lees, Vivien; Winterton, Robert
We performed a comprehensive analysis of the operative experience of UK Plastic Surgery Trainees using the web-based eLogbook. An analysis of data recorded prospectively by Plastic Surgery Registrars 2010-2014 in eLogbook. The eLogbook data of 336 Specialty Registrars entered from 2010 to 2014 was analysed. Over the six-year training programme, trainees participated in a mean of 2117 procedures and performed a mean of 1571 procedures with or without supervision. We also determined the mean number of procedures for 14 indicative operative domains performed during training and compared these to current (2012) indicative numbers required prior to the award of a Certificate of Completion of Training (CCT). The eLogbook contains valuable data to determine the operative experience of UK Plastic Surgery trainees. This new data will be reflected in the updated indicative numbers required for CCT. Both trainees and trainers may use the data to monitor the acquisition of operative experience over time and target training where necessary. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.
Giroldi, Esther; Veldhuijzen, Wemke; de Leve, Tijme; van der Weijden, Trudy; Bueving, Herman; van der Vleuten, Cees
Collecting information during patient encounters is essential for the delivery of patient-centered care. To obtain insight into areas that require more attention in medical communication training, this study explores what difficulties GP trainees encounter when gathering information. In this phenomenological study, we observed a morning clinic of 15 GP trainees. To explore trainees' experiences with information-gathering, we held brief interviews after every consultation and a lengthier interview directly after the morning clinic. The resulting data were analyzed using template analysis. From trainees' reflections, we distilled five difficulties that trainees experience when gathering information: (1) Goal conflicts; (2) Ineffectiveness of trained communication skills in specific situations; (3) Trainees' distress hampers open communication; (4) Untrustworthy information; (5) Tunnel vision. Information-gathering is difficult for GP trainees. Current generic communication skills training does not seem to support trainees sufficiently to handle effectively the challenges they encounter during consultations. Medical communication training needs to support trainees in handling their goal-conflicts and feelings that hamper information-gathering, while also providing them with communication strategies adapted to handling specific challenging situations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Buchan, J C; Cassels-Brown, A
The volume of cataract surgery performed by trainee ophthalmologists in the UK, and the complication rates experienced by those trainees is unknown. As a result, no appropriate audit benchmark exists for trainees or their trainers. This study describes the surgical opportunities and rates of posterior capsule rupture (PCR) experienced by higher specialist trainees in one UK training region and explores influencing factors. Number of cataract operations and episodes of PCR in each calendar month were recorded from surgical logbooks for all Specialist Registrars (SpRs) who had completed at least 6 months of training by January 2007. Dates and details of the posts in which the surgery was performed were also recorded. Data from 475 completed months were collected from 19 trainees including 4322 cataract operations and 99 episodes of PCR. Trainees performed a mean 9.1 operations per month. This varied significantly between different subspeciality posts; the fewest cataracts were on paediatric and oculo-plastic firms. District General Hospitals offered more surgery than Teaching Hospitals; mean 10.9 vs 8.5 cataracts per month (P=0.005). No difference in surgical opportunity was found between male and female trainees. An overall PCR rate of 2.3% (95% CI 2.25-2.33%) was found, which decreased significantly with increasing experience (Ptraining. A PCR rate of 2.3% was found for trainees with a mean of 25 months higher specialist training which compares favourably with published series of trainees from other countries.
Schafheutle, Ellen I; Jee, Samuel D; Willis, Sarah C
In Great Britain (GB), pharmacy technicians (PTs) are registered professionals, with their education and training regulated; little is known about this or the learning environment in which it takes place. This study aimed to profile recently registered pre-registration trainee pharmacy technicians (PTPTs) in GB and capture views on PTPTs' training experiences, focussing on differences in community and hospital settings. A mixed methods study was conducted in 2013-14, following university ethics approval. One-to-one, semi-structured telephone interviews with face-to-face and distance education providers, and hospital and community pharmacy employers of PTPTs explored views on education delivery, work-based learning, and assessment. Interviews were transcribed verbatim, analysed thematically and findings informed design of a census survey of all 1457 recently registered PTs, investigating satisfaction with various aspects of their training. Quantitative data were analysed using SPSS v20, employing comparative statistics (Mann-Whitney U, Chi-Square). Six-hundred and forty-six questionnaires were returned (response rate 44.3%), 632 were usable. Three-quarters (75.9%) of respondents had trained in community; the majority (88.0%) were female, the average age was 35.26 ± 10.22. Those based in hospitals were more satisfied with their training: hospital trainees worked in larger teams and tended to be better supported, they had more study time, and were more likely to complete their training in the intended two-year period. Interviews with staff in 17 Further Education colleges, 6 distance providers, 16 community pharmacies and 15 NHS organisations confirmed survey findings and offered explanations into why differences in training experiences may exist. This study has identified differences between PTPTs' work-based experiences in hospital and community pharmacy. Perceiving PTPTs as 'apprentices' vs. 'employees' may define how their training is managed by employers
Full Text Available Abstract Background Specialist nurses may play an important role in helping to improve the experiences of patients with prostate cancer, however there is concern that the specialist nurse role is under threat in the UK due to financial pressures in the NHS. This study explored the role and value of specialist nurses in prostate cancer care via a survey and patient interviews. Methods This paper reports findings from two studies. A survey of patients from three hospitals across the UK (289/481, 60%, investigated whether patients who saw a specialist nurse had different experiences of information provision and involvement in decision-making, to those who did not. Qualitative interviews were also carried out with 35 men recently tested or treated for prostate cancer, recruited from two hospitals in the UK. Interviews explored patients' views on the role and value of the specialist nurse. Results Survey findings indicated that patients who saw a specialist nurse had more positive experiences of receiving written information about tests and treatment, and about sources of advice and support, and were more likely to say they made the treatment decision themselves. In interviews, patients described specialist nurse input in their care in terms of providing information and support immediately post-diagnosis, as well as being involved in ongoing care. Two key aspects of the specialist nurse role were seen as unique: their availability to the patient, and their ability to liaise between the patient and the medical system. Conclusion This study indicates the unique role that specialist nurses play in the experience of patients with prostate cancer, and highlights the importance of maintaining specialist nurse roles in prostate cancer care.
Al-Rayes, H.; Al-Sheikh, A.; Al-Dalaan, A.; Al-Saleh, S.
The aim of this study was to assess the clinical presentation, complications and serological analysis of mixed connective tissue disease (MCTD) at King Faisal Specialist Hospital and Research Centre (KFSHRC), and to determine the long-term clinical and immunologic outcomes. This was a retrospective study with prospective follow-up of 18 patients with MCTD who were followed at KFSHRC between 1982 and 1999. The age at onset of the disease ranged from 6 to 44 years, with mean age of 17.9 years. The female to male ratio was 2.5:1 and the mean follow-up time was 5 years. The most frequent presenting symptoms were arthralgia in all patients, Raynaud's phenomenon in 16 patients (88%) and swollen hands in 11 patients (61%). Arthritis was seen in 12 patients in (67%) and definite myositis in 10 patients (58%). The most common skin rashes encountered included lupus-like rash in 8 patients (44%) and cutaneous vasculitis in 5 patients (28%). Pulmonary hypertension occurred in 4 patients (22%). Other clinical manifestations encountered were esophageal hypomotility in 10 patients (56%), myocarditis in 2 patients (11%) and proteinurea in 2 patients (11%), while various neurological manifestations were present in 7 patients (39%). All patients exhibited higher titer of ANA and anti-nRNP antibodies. Five of the 18 patients (28%) had marked reduction in the anti-nRNP during remission. Following treatment, features of inflammation as well as Raynaud's phenomenon and esophageal hypomotility diminished, while pulmonary hypertension persisted. A favorable outcome was observed in 12 patients (67%), 3 patients (17%) had continued active disease, while 3 patients (17%) died, with death related to pulmonary hypertension occurring in 2 patients (11%). The studied patients demonstrated the typical clinical and serological findings of MCTD, which support the correlation between anti-nRNP antibody specificities and MCTD. Autoantibody reactivity against nRNP polypeptides tends to regress during
М А Ignatskaya; G А Kulikovskaya
The article offers the analysis of the issues related to the social administration of professional management personnel training which have become particularly complicated over the past two decades. Social schemes, conditions and factors of management are shown to be closely interconnected with the characteristics of human capital as the basis for social, economic and cultural development of the contemporary society. World experience and Russian specificity in the sphere of human resource man...
Crosstabulation --------------------------B1 APPENDIX C: IFR Operations Experience • Academy Training Performance Crosstabulation ---------C1 APPENDIX...into general and specialized experience. General experience is used to hire applicants with no background in ATC. However, applicants must have...Control Specialist (ATCS) rating? (n=9,333) BQ35 – Do you have prior Instrument Flight Rules ( IFR ) operations experience? (n = 9,349) 2. Hold or
Loterina, Roel A.; Relunia, Estrella D.
The Philippine National Standard, PNS/ISO9712:2006, entitled ''Nondestructive Testing Qualification and Certification of Personnel'' requires education, training and experience to quality personnel to take the National Certifying Body (NCB) examination. The NDT training courses offered by the Philippine Society for Nondestructive Testing (PSNT) in cooperation with the Philippine Nuclear Research Institute (PNRI) is designed to qualify trainees to take the National Certifying Body (NCB) for NDT. (author)
Developing future surgical workforce structures: a review of post-training non-Consultant grade specialist roles and the results of a national trainee survey from the Association of Surgeons in Training.
Shalhoub, J; Giddings, C E B; Ferguson, H J M; Hornby, S T; Khera, G; Fitzgerald, J E F
The optimal workforce model for surgery has been much debated historically; in particular, whether there should be a recognised role for those successfully completing training employed as non-Consultant grade specialists. This role has been termed the 'sub-consultant' grade. This paper discusses historical and future career structures in surgery, draws international comparisons, and presents the results of a national trainee survey examining the post-Certificate of Completion of Training (CCT) non-consultant specialist grade. Junior doctors in surgical training (i.e. pre-CCT) were invited to participate in an electronic, 38-item, self-administered national training survey. Of 1710 questionnaires submitted, 1365 were appropriately completed and included in the analysis. Regarding the question 'Do you feel that there is a role in the surgical workforce for a post-CCT non-consultant specialist ("sub-consultant") grade in surgery?', 56.0% felt there was no role, 31.1% felt there was a role and 12.8% were uncertain. Only 12.6% of respondents would consider applying for such a post, while 72.4% would not and 15.0% were uncertain. Paediatric (23.3%), general (15.7%) and neurosurgery (11.6%) were the specialties with the highest proportions of trainees prepared to consider applying for such a role. For both questions, there was a significant gender difference in responses (p consultant specialist grade would impact positively upon service provision, however, only 21.6% felt it would have a positive impact on patient care, 13.9% a positive impact on surgical training, 11.1% a positive impact on the surgical profession and just 7.9% a positive impact on their surgical career. This survey indicates that the introduction of a 'sub-consultant' grade for surgeons who have completed training would be unpopular, with the majority believing it would be to the detriment of both patient care and surgical training. Changes to surgical career structures must be made in the interests of
This study examines intercultural learning during an email collaboration project carried out as part of an EFL didactics course attended by Polish and Romanian teacher-trainees. Email entries and the results of a final questionnaire were used as sources of data that offered insight into the intercultural dimension of the participants'…
Rossi, Martha Howe
Expressive arts group supervision is the use of music, stories, movement, poetry or prose, role-play or psychodrama, art, guided imagery, or play to help trainees develop reflective skills (Wilkins, 1995), express thoughts and feelings (Knill, Levine & Levine, 2005; Lahad, 2000), develop new perspectives (Gladding, 2005), increase communication…
Whiting, Georgina; Magin, Parker; Morgan, Simon; Tapley, Amanda; Henderson, Kim; Oldmeadow, Chris; Ball, Jean; van Driel, Mieke; Spike, Neil; McArthur, Lawrie; Scott, John; Stocks, Nigel
Skin conditions are commonly encountered in general practice but dermatology is underrepresented in undergraduate medical courses. Australian and international studies have shown that the dermatological diagnostic ability of general practitioners (GPs) is suboptimal, contributing to increased dermatology outpatient referrals. Dermatological experience in GP vocational training is thus of particular importance. We aimed to document the prevalence of skin disease presentations and the range of skin diseases encountered by GP trainees. We also sought to establish associations of GP trainee's skin disease experience, including their personal characteristics, consultation factors, and the actions arising from the consultation. This study took place in the Registrars Clinical Encounters in Training (ReCEnT) study. ReCEnT is an ongoing, prospective, multi-site cohort study of Australian GP trainees' consultations. A descriptive cross-sectional analysis was performed on trainees' consultation data. In total, 645 individual trainees contributed data from 84 615 consultations. Altogether, 11% of all problems managed were skin problems. Infections, dermatitis, injury and wounds were the most common presentations. Associations of consultations for skin problems (compared with all other problems) included seeking in-consultation advice, planning patient follow up and generating learning goals. These findings suggest GP trainees find skin problems challenging and may indicate a need for more and better targeted undergraduate and GP trainee education. © 2016 The Australasian College of Dermatologists.
Olson-Garriott, Amber N; Garriott, Patton O; Rigali-Oiler, Marybeth; Chao, Ruth Chu-Lien
Financial debt accrued by graduate psychology students has increased in recent years and is a chief concern among psychology trainees (El-Ghoroury, Galper, Sawaqdeh, & Bufka, 2012). This study examined debt stress among counseling psychology trainees using a complementary mixed methods research design. Qualitative analyses (N = 11) using the consensual qualitative research method (CQR; Hill, Thompson, & Williams, 1997; Hill et al., 2005) revealed six domains, 15 categories, and 34 subcategories. Domains included social class contributions, institutional contributions, long-term effects, coping mechanisms, personal relationships, and effect on well-being. The transactional model of stress and coping (Lazarus & Folkman, 1984) and social class worldview model (Liu, Soleck, Hopps, Dunston, & Pickett, 2004) guided quantitative analyses. Results of a path analysis (N = 285) indicated total debt and subjective social class were significant predictors of debt stress and that the relationship between debt stress and psychological distress was mediated by avoidant coping. Avoidant coping also moderated the association between debt stress and psychological distress. Results are discussed in relation to professional training and the career development of counseling psychology trainees. (c) 2015 APA, all rights reserved).
Annette M. Johansson
Full Text Available Introduction. Video consultation (VC can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients’ experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme “confident with the technology” was constructed from the categories “possibilities and obstacles in using VC encounters” and “advantages and disadvantages of the technology.” The theme “personal satisfaction with the VC encounters” was constructed from the categories “support from the healthcare personnel,” “perceived security,” and “satisfaction with the specialist consultation.” Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients’ perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient’s perception of security during the VC encounter.
Johansson, Annette M.; Lindberg, Inger; Söderberg, Siv
Introduction. Video consultation (VC) can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients' experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme “confident with the technology” was constructed from the categories “possibilities and obstacles in using VC encounters” and “advantages and disadvantages of the technology.” The theme “personal satisfaction with the VC encounters” was constructed from the categories “support from the healthcare personnel,” “perceived security,” and “satisfaction with the specialist consultation.” Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients' perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient's perception of security during the VC encounter. PMID:25243009
Full Text Available Foreign experience in forming social competency of future specialists in service sector being the system of social, psychological and pedagogical knowledge, skills, life and professional experience, values, motives of life activities and personal qualities that makes it possible to effectively execute social functions in the society has been revealed in the article. The specificity and influence of the educational process in the educational establishment on the forming of social competency of a student’s personality have been analyzed. The social competency requires from an individual such qualities as integrity, ability to protect his/her own opinion, to resist unwanted influence as well as tolerance and the ability to adapt and, moreover, to operate effectively in constantly changing social conditions. The socially competent person should not only understand the nature and the specific character of a situation or a problem, but also be able to solve it practically, be motivated to do it, be able to analyze both his/her own performance and its consequences. The study of theory and practice of training specialists in service sector has showed that nowadays there are only few researches dedicated to theoretical study and approbation of the content and methodology of forming social competency of future specialists in service sector.
Zambrano, Sofia C; Chur-Hansen, Anna; Crawford, Gregory B
Research on the experiences, coping mechanisms, and impact of death and dying on the lives of palliative medicine specialists is limited. Most research focuses on the multidisciplinary team or on nurses who work with the dying. Fewer studies consider medical professionals trained in palliative medicine. This study aimed to explore the experiences, coping mechanisms, and impact of death and dying on palliative medicine specialists when dealing with their patients at the end of life. A qualitative research approach guided the study, one-on-one interview data were analyzed thematically. A purposeful sampling technique was employed for participant recruitment. Seven palliative medicine specialists practicing in one city participated in open-ended, in-depth interviews. The analysis of participants' accounts identified three distinct themes. These were Being with the dying, Being affected by death, and dying and Adjusting to the impact of death and dying. This study further contributes to the understanding of the impact of death and dying on professionals who care for dying patients and their families. Despite the stressors and the potential for burnout and compassion fatigue, these participants employed strategies that enhanced meaning-making and emphasized the rewards of their work. However, the consequences of work stressors cannot be underestimated in the practice of palliative care.
The regulations for advanced specialist training passed by the German Medical Council in May 2003 make it possible for any clinical physician to complete advanced training for "specialty-related psychotherapy". Critics see this as a "watering down" of medical psychotherapy. The majority applaud the greater proximity to practice and the possibility of achieving psychosomatic expertise. The new advanced specialist training regulations permit therapeutic interventions by the primary care physician beyond psychosomatic primary care. A curriculum has been developed in the Department of Psychosomatic Medicine and Psychotherapy of the University Hospital Freiburg, which has completed the pilot phase and is now offered in block courses over a period of 2 years. We present here experience with the new concept and the results of the evaluation.
Amos, L; Toussaint, N D; Phoon, R K; Elias, T J; Levidiotis, V; Campbell, S B; Walker, A M; Harrex, C
Advanced training in nephrology should provide broad experience in all aspects of nephrology. In Australia, the Specialist Advisory Committee in Nephrology oversees nephrology training, and recent increases in advanced trainee numbers have led to concern about dilution of training experience. No study has examined variations in clinical exposure for nephrology trainees in Australia. To assess the changes in nephrology advanced training in Australia with respect to trainee numbers and exposure to patients and procedures over the past 10 years. A retrospective study was performed by obtaining all available Royal Australasian College of Physician supervisor reports from 2000 to 2010 to determine differences in clinical exposure and procedures performed by nephrology trainees. Five hundred and forty-two reports were reviewed involving 208 nephrology trainees in Australia across 53 different training sites. In 2000, 22 trainees were undertaking a core clinical year of training. Trainee numbers have steadily risen from 33 in 2004 to 84 in 2010. The greatest increases have occurred in New South Wales, Victoria and Queensland (sixfold, threefold and fivefold increases respectively). Trainee exposure to dialysis patients has gradually decreased in the past decade. The average number per trainee per year in 2000 compared with 2010 were 66 versus 43 (P = 0.02) and 28 versus 16 (P = 0.01) for haemodialysis and peritoneal dialysis respectively. Acute kidney injury cases per trainee showed a gradual nonsignificant reduction over time and average procedural numbers per trainee decreased significantly from 2000 to 2010 with fewer temporary dialysis catheters inserted per year (39 vs 10, P nephrology advanced trainee numbers over the past decade at a more rapid rate than the growth in dialysis and transplant patient numbers. This study suggests that training experience has diminished over the past decade and supports a 3-year core clinical nephrology training programme in Australia
Guthrie, G J K; Hussey, K K; Wilson, A M; Jamieson, R W; Marron, C D; Suttie, S A
The last decade has seen the evolution of vascular surgery from a sub-specialty of general surgery to that of an independent, stand-alone specialty. The introduction of a vascular-only curriculum is anticipated to require significant change from the current provision for vascular surgical training to allow vascular trainees to acquire the specialist skills in elective, emergency, and endovascular surgery to provide endovascular services in the future. To provide an insight into current vascular training in Scotland and Northern Ireland. Specialty trainees in general surgery, with a sub-specialty interest in vascular in Scotland and Northern Ireland were asked to carry out a voluntary online survey between May 2012 and July 2012. 22 specialty trainees/specialist registrars who have declared a sub-specialty interest in vascular surgery were identified and polled. 20 trainees completed the survey. 13 trainees still participated in general surgical on-call rotas. Formal teaching opportunities were readily available but only 10 trainees could attend regularly. All trainees worked in units offering endovascular treatment for aneurysm and occlusive disease, but few had dedicated training sessions in endovascular skills. All endovascular simulation-based training was industry sponsored. The majority of trainees report a good overall training experience and are keen to see the implementation of a vascular-specific curriculum. 15 trainees had undertaken a dedicated period of research towards a higher degree, with only 50% based on a vascular topic. The majority of trainees reported a positive training experience with Scotland and Northern Ireland having great potential as vascular training deaneries. The survey identifies specific areas that could be improved by the development of the new curriculum in vascular surgery to provide excellent vascular training in Scotland and Northern Ireland. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC
The reliability of on-site electric power sources of nuclear power plants usually consisting of diesel generators, gas turbine generators and DC power sources, has been a matter of concern during reactor operations. The frequent recurrence and the important consequences of failures relating to on-site electric power sources have led to a general consensus that they form one of the most significant features influencing the total performance of the safety Systems. This has also been confirmed by surveys performed on the incidents reported through the NEA Incident Reporting System (IRS). Accordingly, a recommendation to organise a Specialist Meeting on the subject was made at the third annual meeting of CSNI Principal Working Group No. 1 (Operating Experience and Human Factors). At the 12. meeting of the CSNI held in November 1984. the Committee endorsed the proposal and accepted an offer by the United Kingdom to host and organise the Specialist Meeting. The Specialist Meeting, sponsored by the CSNI, was held in London, United Kingdom from 16 to 18 October 1985. It was hosted by H.M. Nuclear Installations Inspectorate of the Health and Safety Executive. The purpose of the meeting was to promote the exchange of Information on operating experience relating to on-site electric power sources and to look for measures to further improve their reliability In the areas of design, operation and licensing. The meeting was organised by a Programme Group which included nominated members of CSNI PWG No. 1. the Programme Group met in May and June 1985 in Paris to agree on the programme and practical arrangements for the meeting. As a result of the review of the abstracts which had been contributed in response to the Call for Papers, 28 papers were accepted for presentation during the meeting. Approximately 60 delegates from 13 Member countries, and the NEA Secretariat, attended the meeting. Session summaries prepared by the respective session chairmen are Included prior to the
Tilakaratne, Dev; Warren, Lachlan; Menz, Jennifer
For 8 years South Australian dermatologists have provided an outreach service to the Northern Territory (NT), including rural and remote areas. In 2012 and 2013, a trainee accompanied a dermatologist on these outreach visits. This is the first prospective study that documents the spectrum of dermatological diseases requiring outpatient specialist input in various settings in the NT, and also the first study to compare the clinical experience of one Australian dermatology trainee in urban and rural settings. Characteristics of patients managed primarily by the outreach dermatology registrar were recorded prospectively from February 2013 to July 2013. The data from the trainee's urban encounters were compared to that of the rural centres. The spectrum of conditions seen in these two settings was placed in the disease categories specified in the Australasian College of Dermatologists (ACD) curriculum. The Royal Adelaide Hospital outpatient experience provided greater exposure to skin neoplasms, lymphoproliferative and myeloproliferative disorders and non-infectious neutrophilic/eosinophilic disorders. The outreach sites provided greater exposure to infections, adnexal diseases and genodermatoses. Both urban and rural experiences provided a broad exposure to the disease categories outlined in the ACD curriculum. The spectrum of disease requiring specialist dermatology input varies between urban South Australia and rural NT. The inclusion of dermatology trainees in outreach visits broadens their clinical exposure. It is recommended that other dermatology service providers in Australia consider documenting clinical casemix comparisons to assess dermatology demand, outcomes and trainee exposure. © 2014 The Australasian College of Dermatologists.
Seierstad, Tori Guldahl; Brekke, Mette; Toftemo, Ingun; Haavet, Ole Rikard
The study is an exploration of a joint consultation model, a collaboration between general practitioners (GPs) and specialists from child and adolescent mental health services (CAMHS) in Lillehammer, Norway. A qualitative study based on two focus group interviews, one with participating GPs and one with participating specialists from the local CAMHS. Participants were five GPs, with work experience varying from 6 months to 20 years (four of them specialists in general medicine) and two CAMHS specialists-a psychiatrist and a psychologist-both with more than 20 years of experience. The focus group discussions revealed that both GPs and CAMHS specialists saw the joint consultations as a good teaching method for improving GPs' skills in child and adolescent psychiatry. Both groups believed that this low-threshold service benefits the patients and that the joint consultation is especially suited to sort problems and determine the level of help required. The GPs and CAMHS specialists shared the impression that the collaboration model is beneficial for both patients and health care providers. Close collaboration with primary health care is recommended in the guidelines for child and adolescent psychiatry outpatient clinics. We suggest that the joint consultation model could be a good way for GPs and CAMHS specialists to collaborate.
Barrett, Aileen; Galvin, Rose; Scherpbier, Albert J J A; Teunissen, Pim W; O'Shaughnessy, Ann; Horgan, Mary
Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conceptual framework of experience, trajectories and reifications in workplace learning, we aimed to explore trainer and trainee experiences and perceptions of the learning value of WBAs. Trainers and trainees who had used at least one WBA in the previous year were invited to participate in semistructured interviews for this phenomenological study. We used a template analysis method to explore and compare the experiences of the two groups, using the emergent themes to develop an understanding of the impact of these experiences on perceptions of learning value. Nine trainers and eight trainees participated in the study. Common themes emerged among the two groups around issues of responsibility and engagement along with (mis)understandings of the purpose of the individual tools. Trainer-specific themes emerged related to the concurrent implementation of a new e-portfolio and perceptions of increased workload. Trainees associated WBA with a training structure support value but could not translate experiences into learning values. WBAs provide trainees with a justified reason to approach trainers for feedback. WBAs, however, are not being reified as the formative assessments originally intended. A culture change may be required to change the focus of WBA research and reconceptualise this set of tools and methods as a workplace learning practice . Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
ABSTRACT In this article, insights into the lived experience of homeless women arising from a PhD study on the specialist role of the SCPHN in homelessness are presented. A key narrative text of a rough sleeping pregnant woman is included. The reflexive narrative study, used an eclectic, philosophical framework which included reflective practice/guidance, narrative inquiry, and storytelling methodologies. Story texts uniquely illuminated complex knowledge about homelessness and homeless health care. Homeless women were found to be a heterogeneous group which included former health professionals. The women's stories were often shocking; they were frequently contextualised against a background of service exclusion, including GP services, learning disability services, mental health services, housing services and social services. The role of the specialist nurse (SCPHN) in engagement with homeless people is illuminated. A therapeutic model of 'Effective Engagement with Homeless People and Homeless Families' is presented to guide health professionals in holistic care. The author invites the reader to dialogue within their teams on how homeless people are included or excluded from SCPHN services. In this way, the term 'audiencing' rather than transferability of findings is used in a continuing dialogue with the reader to improve the health and wellbeing of homeless women.
Mohan, S; Wilkes, L M; Ogunsiji, O; Walker, A
This study aims to describe the experiences of nurses caring for cancer patients in non-specialist wards. The study was conducted in a large (420 beds) and small (32 beds) hospital in an area health service with urban and rural populations in the west of Sydney. A qualitative descriptive approach was utilized to collect data from the nurses. Data were collected using a survey and in-depth interviews of nurses working in non-specialist cancer wards. Transcribed data were managed with Nudist Vivo software and analysed for common themes using process of constant comparison and contrast. Twenty-five surveys were returned and five nurses volunteered to be interviewed. The six major themes that emerged from analysis of data were: emotional nature of care, lack of time, lack of knowledge of cancer treatment, family support, environment not conducive to proper care and dealing with patient's non-acceptance of cancer diagnosis. The nurses in this study wished to provide quality supportive care for cancer patients and their families but the inconducive environment and inadequate relevant training hindered the nurses' efforts. This then presents further need of relevant training for nurses in cancer care and time management, to meet up with these challenges.
and colleagues. During the visits to the different headquarters the trainees got a very good overview of Westinghouse's activities around the world and got familiar with the company's philosophy and way of work. It was also a fantastic opportunity to meet high level managers and visit interesting places related to Westinghouse business and the nuclear industry. One of the most valuable parts of the program was the experience of being part of a group with people of different cultures. It was a useful insight to see how different even European cultures can be in the way of doing business. The international assignment was of course also a good way of broadening the mind to different ways of working. It was also a great opportunity of networking for the future. This will definitely be useful in sharing opportunities and knowledge across different countries. (authors)
Reardon, Candice; George, Gavin; Enigbokan, Oluwatobi
The value of international health experience for doctors from developed nations is well recognised. Provisions have been made for medical staff in the United Kingdom to embark on work experiences abroad during their careers in the National Health Service. The London Deanery and Africa Health Placements provide an Out of Programme Experience for British General Practice trainee doctors wanting to work for a year in rural hospitals in South Africa. A qualitative study was conducted among fifteen British General Practice trainees who participated in the programme. The research aim was to understand the perceived benefit and value of their experience and their opinions about the structure of the programme. The data was analysed using thematic analysis. Their experience provided an accelerated year of learning and development that contributed to their professional and personal development. In addition to their general development, their improved ability to work in resource limited settings, enhancement of soft skills, a greater appreciation for the National Health Service and a better understanding of working within foreign health care systems were important gains. The timing of the experience, the security of re-employment on their return, assistance with administrative requirements of destination countries and the opportunity to gain varied, hands-on experience were highly valued components of the Out of Programme Experience. The value and benefits derived from the doctors' experience in South Africa are discussed in relation to another evaluation of the Out of Programme Experience, as well as issues of transferability of skills and competencies and future impacts on career decisions. This study provides evidence to suggest programmes such as the OOPE have the potential to create substantial benefits for trainee doctors, both in terms of their medical skills and competencies and through the development of softer skills. This programme, through the supply of scarce
Broughton, Jessica; Harris, Sarah; Beasant, Lucy; Crawley, Esther; Collin, Simon M
Few studies have explored patients' experiences of treatment for CFS/ME. This study aims to fill this gap by capturing the perspective of patients who have been treated by NHS specialist CFS/ME services in England. Semi-structured interviews were conducted during the period June-September 2014 with 16 adults who were completing treatment at one of three outpatient NHS specialist CFS/ME services. Interviews were analysed thematically using constant comparison techniques, with particular attention paid to contrasting views. Three themes were identified: 'Journey to specialist services'; 'Things that help or hinder treatment'; and 'Support systems'. Within these themes nine sub-themes were identified. A wide range of factors was evident in forming participants' experiences, including personal characteristics such as perseverance and optimism, and service factors such as flexibility and positive, supportive relationships with clinicians. Participants described how specialist services played a unique role, which was related to the contested nature of the condition. Many participants had experienced a lack of validation and medical and social support before attending a specialist service. Patients' experiences of life before referral, and the concerns that they expressed about being discharged, highlighted the hardship and obstacles which people living with CFS/ME continue to experience in our society. The experiences of CFS/ME patients in our study showed that NHS specialist CFS/ME services played a vital role in patients' journeys towards an improved quality of life. This improvement came about through a process which included validation of patients' experiences, acceptance of change, practical advice and support, and therapeutic outcomes.
Stinchfield, Tracy A.; Hill, Nicole R.; Kleist, David M.
Triadic supervision has been considered a credible and effective form of clinical supervision within counselor education programs since being included in the 2001 standards for the Council for Accreditation of Counseling and Related Educational Programs (CACREP). A phenomenological study was conducted to examine the experiences of masters-level…
Woods, Kevin; Atkinson, Cathy; Bond, Caroline; Gibbs, Simon; Hill, Vivian; Howe, Julia; Morris, Sue
As part of initial professional training, educational psychologists in England undertake substantial periods of practice placement, within which the role of supervision is instrumental to their professional learning and effectiveness. The research reported here provides up-to-date and comprehensive information on the experiences and needs of…
Song, Guanli; Wang, Yinghui; Zhang, Runshun; Liu, Baoyan; Zhou, Xuezhong; Zhou, Xiaji; Zhang, Hong; Guo, Yufeng; Xue, Yanxing; Xu, Lili
The current modes of experience inheritance from famous specialists in traditional Chinese medicine (TCM) include master and disciple, literature review, clinical-epidemiology-based clinical research observation, and analysis and data mining via computer and database technologies. Each mode has its advantages and disadvantages. However, a scientific and instructive experience inheritance mode has not been developed. The advent of the big data era as well as the formation and practice accumulation of the TCM clinical research paradigm in the real world have provided new perspectives, techniques, and methods for inheriting experience from famous TCM specialists. Through continuous exploration and practice, the research group proposes the innovation research mode based on the real-world TCM clinical research paradigm, which involves the inheritance and innovation of the existing modes. This mode is formulated in line with its own development regularity of TCM and is expected to become the main mode of experience inheritance in the clinical field.
Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E
This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center
Joan, D. R. Robert
The objective of the study was to find out the effect of learning through Wireless technologies and the traditional method in teaching and learning Mathematics. The investigator adopted experimental research to find the effectiveness of implementing Wireless technologies in the population of B.Ed. trainees. The investigator selected 32 B.Ed.…
Simulators became an indispensable part of training world-wide. Therefore, international exchange of information is important to share the experience gained in different countries in order to assure high international standards. A second aspects is the tremendous evolution in the computing capacities of the simulator hardware and the increasing functionality of the simulator software. This background has let the IAEA to invite the simulator experts for an experience exchange. The German Simulator Centre in Essen, which is operated by the companies KSG and GfS, was asked to host this Specialists' Meeting. The Specialists' Meeting on ''Training Simulators in Nuclear Power Plants: Experience, Programme Design and Assessment Methodology'' was organized by IAEA in-cooperation with the German Simulator Centre operated by KSG Kraftwerks-Simulator-Gesellschaft mbH and GfS Gesellschaft fuer Simulatorschulung mbH and was held from 17 - 19 November 1997 in Essen, Germany. The meeting focused on developments in simulation technology, experiences with simulator upgrades, utilization of computerized tools as support and complement of simulator training, use of simulators for other purposes. The meeting was attended by 50 participants from 16 countries. In the course of four sessions 21 technical presentations were made. The present volume contains the papers by national delegates at the Specialists' Meeting
Lopez, Robert H.
The problem addressed was the need to maintain data security in the field of information technology. Specifically, the breakdown of communication between business leaders and data security specialists create risks to data security. The purpose of this qualitative phenomenological study was to determine which factors would improve communication…
Malewski, Henryk; Kurapka, Vidmantas Egidijus; Matulienė, Snieguolnė; Navickienė, Žaneta
The article investigates the characteristics and forms of cooperation between criminal investigation officers* and forensic laboratory specialists in pre-trial proceedings, as well as practical problems in such cooperation. Recently there have been a number of particularly heated debates about the relationship between determining a person possessing special knowledge and his/her status in pre-trial proceedings. Other discussed aspects include cooperation between entities involved in pre-trial proceedings in international contexts. A less intensive (albeit equally important) discussion relates to the form and characteristics of cooperation between criminal investigation officers on the one hand and specialists and experts on the other in investigating criminal acts. Bearing in mind the high practical importance and the existing differences in scholarly approaches to these issues, the current study concentrates on the forms and content of cooperation between law enforcement officers and specialists (experts) from forensic laboratories, as well as on problems resulting from such cooperation and directions for improvement. The first part of the article presents selected views on the definition of a person possessing special knowledge currently used in Lithuania** and in a number of other states. In the authors' opinion, unification (harmonization) of various notions (definitions), terms and statuses of an expert, a specialist and special knowledge should be one of the objectives in implementing the vision of the joint European forensic science area 2020. Achieving this objective requires a comprehensive analysis of standards in law and management in using special knowledge of each state***. The second part, supported by empirical study results, discusses practical problems of cooperation between a law enforcement officer and a specialist (expert), analyzes three basic forms of their cooperation and presents the content of those forms: activities at the crime scene
Full Text Available The article investigates the characteristics and forms of cooperation between criminal investigation officers* and forensic laboratory specialists in pre-trial proceedings, as well as practical problems in such cooperation. Recently there have been a number of particularly heated debates about the relationship between determining a person possessing special knowledge and his/her status in pre-trial proceedings. Other discussed aspects include cooperation between entities involved in pre-trial proceedings in international contexts. A less intensive (albeit equally important discussion relates to the form and characteristics of cooperation between criminal investigation officers on the one hand and specialists and experts on the other in investigating criminal acts. Bearing in mind the high practical importance and the existing differences in scholarly approaches to these issues, the current study concentrates on the forms and content of cooperation between law enforcement officers and specialists (experts from forensic laboratories, as well as on problems resulting from such cooperation and directions for improvement. The first part of the article presents selected views on the definition of a person possessing special knowledge currently used in Lithuania** and in a number of other states. In the authors’ opinion, unification (harmonization of various notions (definitions, terms and statuses of an expert, a specialist and special knowledge should be one of the objectives in implementing the vision of the joint European forensic science area 2020. Achieving this objective requires a comprehensive analysis of standards in law and management in using special knowledge of each state***. The second part, supported by empirical study results, discusses practical problems of cooperation between a law enforcement officer and a specialist (expert, analyzes three basic forms of their cooperation and presents the content of those forms: activities at the
Harries, Rhiannon L; Gokani, Vimal J; Smitham, Peter; Fitzgerald, J Edward F
Generational changes in lifestyle expectations, working environments and the feminisation of the medical workforce have seen an increased demand in postgraduate less than full-time training (LTFT). Despite this, concerns remain regarding access to, and information about, flexible training for surgeons. This study aimed to assess the opinions and experiences of LTFT for surgical trainees. Prospective, questionnaire-based cross-sectional study. An electronic, self-administered questionnaire was distributed in the UK and Republic of Ireland through mailing lists via the Association of Surgeons in Training and British Orthopedic Trainee Association. Overall, 876 completed responses were received, representing all grades of trainee across all 10 surgical specialties. Median age was 33 years and 63.4% were female. Of those who had undertaken LTFT, 92.5% (148/160) were female. Most worked 60% of a full-time post (86/160, 53.8%). The reasons for either choosing or considering LTFT were childrearing (82.7%), caring for a dependent (12.6%) and sporting commitments (6.8%). Males were less likely to list childrearing than females (64.9% vs 87.6%; p<0.0001). Only 38% (60/160) found the application process easy and 53.8% (86/160) experienced undermining behaviour from workplace staff as a result of undertaking LTFT. Of all respondents, an additional 53.7% (385/716) would consider LTFT in future; 27.5% of which were male (106/385). Overall, only 9.9% of all respondents rated current LTFT information as adequate. Common sources of information were other trainees (47.3%), educational supervisors (20.6%) and local postgraduate school website (19.5%). Over half of surgical trainees working LTFT have experienced undermining behaviour as a result of their LTFT. Despite a reported need for LTFT in both genders, this remains difficult to organise, access to useful information is poor and negative attitudes among staff remain. Recommendations are made to provide improved support and
Gilbert, Barnabas J; Miller, Calum; Corrick, Fenella; Watson, Robert A
The 2012 Varsity Medical Debate between Oxford University and Cambridge University provided a stage for representatives from these famous institutions to debate the motion "This house believes that trainee doctors should be able to use the developing world to gain clinical experience." This article brings together many of the arguments put forward during the debate, centring around three major points of contention: the potential intrinsic wrong of 'using' patients in developing countries; the effects on the elective participant; and the effects on the host community. The article goes on to critically appraise overseas elective programmes, offering a number of solutions that would help optimise their effectiveness in the developing world.
Henryk Malewski; Vidmantas Egidijus Kurapka; Snieguolnė Matulienė; Žaneta Navickienė
The article investigates the characteristics and forms of cooperation between criminal investigation officers* and forensic laboratory specialists in pre-trial proceedings, as well as practical problems in such cooperation. Recently there have been a number of particularly heated debates about the relationship between determining a person possessing special knowledge and his/her status in pre-trial proceedings. Other discussed aspects include cooperation between entities involved in pre-trial...
Higgins, Niall S; Taraporewalla, Kersi; Steyn, Michael; Brijball, Rajesh; Watson, Marcus
International medical graduate (IMG) specialists in anaesthesia need education to be part of the assessment process for pre-registration college fellowship. Fellowship of the anaesthetic college is required in Australia for registration as a specialist in this field. Marked differences exist between local trainees and IMG specialists in terms of training, stakes of the exam and isolation of practice. We have examined the reasons for the low pass rate for IMG specialists compared to the local trainees in the Australian and New Zealand College of Anaesthetists (ANZCA) final fellowship examinations. We also offer an IMG specialists' view of this perceived problem. It highlights their difficulties in obtaining adequate supervision and education.
Edwall, Lise-Lotte; Hellström, Anna-Lena; Ohrn, Ingbritt; Danielson, Ella
The aim was to elucidate the lived experience of regular diabetes nurse specialist check-ups among patients with type 2 diabetes. Diabetes care with diabetes nurse-led clinics in primary care has been established in Sweden since the 1980s. Information about patients' lived experience of these regular check-ups is important in the further development of diabetes nursing in primary care. Narrative interviews were conducted with 10 women and 10 men with type 2 diabetes regarding their lived experience in everyday life and the regular check-ups by the diabetes nurse specialist. A phenomenological-hermeneutic method inspired by Ricoeur was used in the analysis. Patients'- with type 2 diabetes - lived experience of regular check-ups showed an overall positive influence on the patients' way of living with the disease by underpinning and developing their understanding and management of daily life. This influence was interpreted as an interlinked chain comprising the following elements; being confirmed, being guided within the disease process, becoming confident and independent and being relieved. Every link contained a positive influence from being dependent-independent, autonomous and a feeling of freedom in patients striving for an everyday life with a disease under control. The development of diabetes-nurse-led clinics from the perspective of the patient must consider the patient's individual need for support and continuity with the diabetes nurse specialist. Consultations with collaborative partnership and specific expertise that is easy to access implied autonomous disease self-management in terms of patients' own control of the disease over time. In view of the increasing number of patients with diabetes, this could positively impact the availability of diabetes nursing care.
Thorn, Hrønn; Uhrenfeldt, Lisbeth
knowledge and personal growth. Objective/question: What are non-specialist nurses’ experiences when providing palliative end-of-life cancer care that involves the psychosocial and existential transitions of their patients and significant others? Inclusion criteria Types of participants: The current review......Background: Non-specialist nurses, who are providing palliative end-of-life cancer care to patients and significant others undergoing psychosocial and existential transitions, may experience dissatisfaction, frustration and sorrow. On the other hand, they may also experience happiness, increased...... considered studies that included a description of the experiences of non-specialist trained registered nurses (RNs) working in non-specialist wards. Phenomena of interest: The current review considered studies that investigated experiences of RNs when providing palliative end-of-life cancer care...
Caroline T. SUMANDE
Full Text Available This study intends to assess the ICT needs of the course specialists at Polytechnic University of the Philippines under the Open University System (PUP-OUS which may be the basis in conducting training on the different applications such as word processing, electronic spread sheet, presentation software, YouTube and etc. for the successful implementation of the community Learning Management System (LMS endeavor in the University. This is also a review of the current practices of the course specialists in the use of ICT to better facilitate teaching and learning process through the LMS or the PUP Open University eMabini Learning Portal. This particularly identifies various training programs that may be considered in order to successfully implement the system. Internally, the quality and success implementation of a certain program can be best determined if both of the faculty members and students had maximized its utility and made a gratifying experience afterwards. The overarching research questions – Are the Course Specialists (CS confident to utilize the LMS in teaching? Are they aware of various eLearning strategies that may help geographically dispersed learners? And what is the extent of eLearning utilization for instructions by the CS? Though a high percentage of course specialists are fully competent with computer applications such as word documents, PDF documents, email, multi-media presentations, e-learning tools for submission of requirements, assessment of students performance, and other systems integrated in handling OU Cyber classes, still the meager percentage of responses stating, “using these systems but need further practice/training” or “not aware of the application” can be alarming for PUP Open University’s goal to achieve pure online implementation in the next few years. This study concludes to create a long-term vision for the future of DE system in the University to best serve its clientele, “the DE students.”
Cohen, S N; Farrant, P B J; Taibjee, S M
The workplace assessments, direct observation of procedural skills (DOPS), mini-clinical evaluation exercise (mini-CEX) and multisource feedback (MSF, formerly known as 360 degrees appraisal), are now mandatory during dermatology specialist training in the U.K. The opinions of those undergoing such assessments in any medical specialty have rarely been sought. To collate the experience and views of U.K. dermatology trainees on the three workplace assessments. A questionnaire was circulated in autumn 2006 to all U.K. dermatology specialist registrars (SpRs) registered as members of the British Association of Dermatologists (n = 269). A total of 138 responses were received (51%). Seventeen SpRs had not experienced any of the assessments; 92 had undergone MSF, 95 DOPS and 54 mini-CEX. The total experience of the respondents amounted to a minimum of 251 DOPS, 122 MSF and 142 mini-CEX. Trainees appreciated the formative aspects of the assessments, especially feedback and training opportunities, although not all trainees reported receiving useful feedback. MSF was praised for the insights that it provides. All of the assessments were found to be time-consuming and difficult to organize. DOPS and mini-CEX carried a degree of stress and artificiality. Concerns were raised over the possibility of victimization by MSF raters. Discussion of performance in the assessments was rarely prominent in trainees' annual summative reviews. Trainees appreciate the formative benefits which derive from the assessments, namely feedback, reassurance of satisfactory performance and, in the case of DOPS and mini-CEX, additional one-to-one training from consultants. Some problems came to light. The issues raised will not be unique to dermatology and other specialties should take note.
Kvasnovsky, Charlotte L; Adams, Katie; Papagrigoriadis, Savvas
Although diverticular disease is a prevalent condition and a significant burden on the healthcare system, care is devolved across gastrointestinal, GP, and colorectal surgery clinics. We created a specialist Diverticular Disease Clinic to streamline care, enhance evidence-based practice and provide a base for research. The aim of this study was to assess patient referral sources, predictors of persistent disease and surgical outcomes. We retrospectively reviewed all patients attending our clinic. Patients younger than 50 years of age on initial presentation were considered 'younger' patients. Persistent symptoms lasted for at least 3 months. Overall, 177 patients had confirmed diverticular disease. Patients were referred following hospital admission (82 patients, 46.3%) or from the community (95 patients, 53.7%). Ninety-five patients (53.7%) had persistent symptoms. Patients with more than two episodes of diverticulitis were more likely to have persistent symptoms (Pdiverticular disease. Specialized clinics are a model for this care, provided by either gastroenterologists or surgeons, in centres with adequate demand. Our findings reinforce the hypotheses that chronic abdominal pain in diverticular disease may be related to sensation abnormalities similar to postinfective irritable bowel syndrome.
Qualification standards published by the U.S. Office of Personnel Management (OPM) describe the minimum experience or education that individuals must have to qualify for specific positions within the federal government (OPM, 2009). These standards ar...
Gafson, Irene; Currie, Jane; O'Dwyer, Sabrina; Woolf, Katherine; Griffin, Ann
Physician dissatisfaction in the workplace has consequences for patient safety. Currently in the UK, 1 in 5 doctors who enter specialist training in obstetrics and gynaecology leave the programme before completion. Trainee attrition has implications for workforce planning, organization of health-care services and patient care. The authors conducted a survey of current trainees' and former trainees' views concerning attrition and 'peri-attrition' - a term coined to describe the trainee who has seriously considered leaving the specialty. The authors identified six key themes which describe trainees' feelings about attrition in obstetrics and gynaecology: morale and undermining; training processes and paperwork; support and supervision; work-life balance and realities of life; NHS environment; and job satisfaction. This article discusses themes of an under-resourced health service, bullying, lack of work-life balance and poor personal support.
Ibrahim, Abdulla; Katechia, Devvrat
Early in their careers, trainees contemplating a career in plastic surgery may have limited specialty experience. Courses can provide valuable insight into specialty training and help develop necessary basic skills. However, this is not without a significant financial burden.Plastic Surgery for Surgical Trainees is a 1-day course that only costs £50 GBP (US $65). Accredited by the Royal College of Surgeons, this course held in Bristol, United Kingdom, offers an inexpensive practical introduction toward plastic surgical techniques for trainees interested in plastic surgery and those in other surgical specialties. In this review, we provide an evaluation of the course.
Pan, Chong; Zhang, Dali; Kon, Audrey Wan Mei; Wai, Charity Sue Lea; Ang, Woo Boon
Continuous improvement in process efficiency for specialist outpatient clinic (SOC) systems is increasingly being demanded due to the growth of the patient population in Singapore. In this paper, we propose a discrete event simulation (DES) model to represent the patient and information flow in an ophthalmic SOC system in the Singapore National Eye Centre (SNEC). Different improvement strategies to reduce the turnaround time for patients in the SOC were proposed and evaluated with the aid of the DES model and the Design of Experiment (DOE). Two strategies for better patient appointment scheduling and one strategy for dilation-free examination are estimated to have a significant impact on turnaround time for patients. One of the improvement strategies has been implemented in the actual SOC system in the SNEC with promising improvement reported.
Stapleton, Helen; Murphy, Rebecca; Correa-Velez, Ignacio; Steel, Michelle; Kildea, Sue
In response to an identified need, a specialist antenatal clinic for women from refugee backgrounds was introduced in 2008, with an evaluation planned and completed in 2010. Can maternity care experiences for women from refugee backgrounds, attending a specialist antenatal clinic in a tertiary Australian public hospital, be improved? The evaluation employed mixed methods, generating qualitative and quantitative data from two hospital databases, a chart audit, surveys and interviews with service users, providers and stakeholders. Contributions were received from 202 participants. The clinic was highly regarded by all participants. Continuity of care throughout the antenatal period was particularly valued by newly arrived women as it afforded them security and support to negotiate an unfamiliar Western maternity system. Positive experiences decreased however; as women transitioned from the clinic to labour and postnatal wards where they reported that their traditional birthing and recuperative practices were often interrupted by the imposition of Western biomedical notions of appropriate care. The centrally located clinic was problematic, frequently requiring complex travel arrangements. Appointment schedules often impacted negatively on traditional spousal and family obligations. Providing comprehensive and culturally responsive maternity care for women from refugee backgrounds is achievable, however it is also resource intensive. The production of translated information which is high quality in terms of production and content, whilst also taking account of languages which are only rarely encountered, is problematic. Cultural competency programmes for staff, ideally online, require regular updating in light of new knowledge and changing political sensitivities. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Punshon, Geoffrey; Endacott, Ruth; Aslett, Phillippa; Brocksom, Jane; Fleure, Louisa; Howdle, Felicity; Masterton, Morven; O'Connor, Anita; Swift, Adrian; Trevatt, Paul; Leary, Alison
United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study. The study consisted of a national survey with descriptive statistics and thematic analysis. A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT. Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients' wishes to be expressed. Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients' nonmedical needs.
Design and management of nuclear fuel has undergone a strong evolution process during past years. The increase of the operating cycle length and of the discharge burnup has led to the use of more advanced fuel designs, as well as to the adoption of fuel efficient operational strategies. The analysis of recent operational experience highlighted a number of issues related to nuclear fuel and control rod events raising concerns about the safety aspects of these new designs and operational strategies, which led to the organisation of this Specialists Meeting on fuel and control rod issues. The meeting was intended to provide a forum for the exchange of information on lessons learned and safety concern related to operating experience with fuel and control rods (degradation, reliability, experience with high burnup fuel, and others). After an opening session 6 papers), this meeting was subdivided into four sessions: Operating experience and safety concern (technical session I - 6 papers), Fuel performance and operational issues (technical session II - 7 papers), Control rod issues (technical session III - 9 papers), Improvement of fuel design (technical session IV.A - 4 papers), Improvement on fuel fabrication and core management (technical session IV.B - 6 papers)
Full Text Available The paper is about the training, the mission and the condition of the 21th century specialist, who must keep up with the challenges of the informational era, which is rapidly establishing and embracing human society. It analyzes the characteristics of the digital age, information overload, technological impact, communication, which requiring specialists to increasingly leverage their digital techniques, both in training and activity.
The specialists' meeting on predictions and experience of core distortion behaviour was held at Mottram Hall, Wilmslow, England, under the auspices of the National Nuclear Corporation on 1 to 4 October 1984. The meeting was sponsored by the IAEA on the recommendation of the International Working Group on Fast Reactors (IWGFR) and was attended by 28 participants including observers from Belgium, France, the Federal Republic of Germany, India, Italy, Japan, the United Kingdom, the United States, the Union of Soviet Socialist Republics and the IAEA. The meeting was chaired by Mr. K.F. Allbeson of NNC. The purpose of the meeting was to provide a forum for the exchange of information on core distortion in fast breeder reactors. Emphasis was placed on the predictive computer codes. The technical parts of the meeting were divided into five major sessions as follows: 1) Overview of National Programmes including the identification of key issues to be considered in the following sessions (8 papers); 2) Calculation methods for core distortion and mechanical behaviour (6 papers); 3) Validation and qualification methods (3 papers); 4) Design and evaluation of core styles (5 papers); 5) Operating experience (5 papers). A separate abstract was prepared for each of these papers
Emmerton, Lynne M; Smith, Lorraine; LeMay, Kate S; Krass, Ines; Saini, Bandana; Bosnic-Anticevich, Sinthia Z; Reddel, Helen K; Burton, Deborah L; Stewart, Kay; Armour, Carol L
The role of community pharmacists in disease state management has been mooted for some years. Despite a number of trials of disease state management services, there is scant literature into the engagement of, and with, pharmacists in such trials. This paper reports pharmacists' feedback as providers of a Pharmacy Asthma Management Service (PAMS), a trial coordinated across four academic research centres in Australia in 2009. We also propose recommendations for optimal involvement of pharmacists in academic research. Feedback about the pharmacists' experiences was sought via their participation in either a focus group or telephone interview (for those unable to attend their scheduled focus group) at one of three time points. A semi-structured interview guide focused discussion on the pharmacists' training to provide the asthma service, their interactions with health professionals and patients as per the service protocol, and the future for this type of service. Focus groups were facilitated by two researchers, and the individual interviews were shared between three researchers, with data transcribed verbatim and analysed manually. Of 93 pharmacists who provided the PAMS, 25 were involved in a focus group and seven via telephone interview. All pharmacists approached agreed to provide feedback. In general, the pharmacists engaged with both the service and research components, and embraced their roles as innovators in the trial of a new service. Some experienced challenges in the recruitment of patients into the service and the amount of research-related documentation, and collaborative patient-centred relationships with GPs require further attention. Specific service components, such as the spirometry, were well received by the pharmacists and their patients. Professional rewards included satisfaction from their enhanced practice, and pharmacists largely envisaged a future for the service. The PAMS provided pharmacists an opportunity to become involved in an
Emmerton Lynne M
Full Text Available Abstract Background The role of community pharmacists in disease state management has been mooted for some years. Despite a number of trials of disease state management services, there is scant literature into the engagement of, and with, pharmacists in such trials. This paper reports pharmacists’ feedback as providers of a Pharmacy Asthma Management Service (PAMS, a trial coordinated across four academic research centres in Australia in 2009. We also propose recommendations for optimal involvement of pharmacists in academic research. Methods Feedback about the pharmacists’ experiences was sought via their participation in either a focus group or telephone interview (for those unable to attend their scheduled focus group at one of three time points. A semi-structured interview guide focused discussion on the pharmacists’ training to provide the asthma service, their interactions with health professionals and patients as per the service protocol, and the future for this type of service. Focus groups were facilitated by two researchers, and the individual interviews were shared between three researchers, with data transcribed verbatim and analysed manually. Results Of 93 pharmacists who provided the PAMS, 25 were involved in a focus group and seven via telephone interview. All pharmacists approached agreed to provide feedback. In general, the pharmacists engaged with both the service and research components, and embraced their roles as innovators in the trial of a new service. Some experienced challenges in the recruitment of patients into the service and the amount of research-related documentation, and collaborative patient-centred relationships with GPs require further attention. Specific service components, such as the spirometry, were well received by the pharmacists and their patients. Professional rewards included satisfaction from their enhanced practice, and pharmacists largely envisaged a future for the service. Conclusions The
Giroldi, E.; Veldhuijzen, W.; Leve, T. de; Weijden, T.T. van der; Bueving, H.; Vleuten, C.P.M. van der
OBJECTIVE: Collecting information during patient encounters is essential for the delivery of patient-centered care. To obtain insight into areas that require more attention in medical communication training, this study explores what difficulties GP trainees encounter when gathering information.
Highly professional and knowledgeable employees for chemical, and especially radiochemical, technology companies are very much sought after these days. Taking into account the advancement of nuclear power and the associated expansion of radioactive waste management facilities, the demand for staff that possesses all the necessary knowledge is set to increase multi-tenfold. In such circumstances, training of personnel is becoming a key element of the human resource management process. The author says that training of personnel at SUE SIA Radon Moscow is conducted in accordance with the Program of Training, Advanced Training and Personnel Qualification, which prescribes areas of training, categories of trainees, approximate number of trainees for each area, schedule and budget of training sessions. The cooperation of SUE SIA Radon Moscow with higher-education institutions in the field of young specialists training and advanced training of managerial, technical and administrative staff is reported [ru
Wiggins, Helen; Hartley, Anna; Clarke, Emily; Foley, Elizabeth; Nandwani, Rak; Carlin, Elizabeth; Waters, Laura; Ahmed, Nadia
In April 2013, local authorities gained responsibility for commissioning sexual health services in England. With many services going out to tender and resultant change in services or service provider, there is anecdotal evidence that this has impacted on the education, training and morale of genitourinary medicine (GUM) trainees. The aim of this study was to evaluate the impact of tendering on GUM trainees. An electronic survey designed by the British Association for Sexual Health and HIV Trainees' Collaborative for Audit, Research and Quality Improvement Projects (T-CARQ) was distributed to GUM trainees and newly appointed consultants. Eighty-two individuals responded (74% GUM trainees, 25% newly appointed consultants, 1% locum appointed for service). Sixty-three per cent (45/72) had experience of training within a service which was being tendered. Of these, 59% (24/41) felt their training was not considered during the tendering process and 20% (8/41) felt that it was. Forty-four per cent (18/41) felt adequately supported. Thirty per cent (12/40) reported active participation in the tendering process. On a scale of 0 (no impact) to 5 (major impact), the median score for impact of tendering on training was 2. The positive/negative impact of tendering on different training elements was rated: other than management experience the overall impact on all parameters was negative, namely morale, senior support and education. In conclusion, this survey describes the variable impact of service tendering on GUM training. Our recommendations for maintaining training standards despite tendering include actively involving trainees and education partners, inclusion of specialist GUM training in service specifications, development of guidance for commissioners and services for the management of GUM training within tendering.
Umoren, Rachel A; Einterz, Robert M; Litzelman, Debra K; Pettigrew, Ronald K; Ayaya, Samuel O; Liechty, Edward A
Global health programs that allow international experiences for US learners should also enable reciprocal learning experiences for international learners, particularly if that is a need identified by the partner institution. A partnership between Indiana University and Moi University, Kenya, has successfully hosted 41 visiting Kenyan internal medicine and pediatrics registrars at Indiana University since 2006. The program's logistics, curriculum, and evaluation are described. The registrars rotated through nephrology, cardiology, hematology and oncology, infectious diseases, and intensive care, as well as related ambulatory experiences, functioning on a level comparable to fourth-year medical students. They showed significant improvement in pretest and posttest scores on a standardized National Board of Medical Examiners examination (P = .048). International learners experienced culture shock, yet they felt the Indiana University elective was helpful and would recommend it to future participants. Global health programs can reciprocate the benefits derived for US students and residents by offering learning experiences to international learners if that is an expressed need from the international partner. Barriers to those experiences can be overcome, and the hands-on, elective experience has the potential to positively affect the knowledge and attitudes of participants as well as the home nation.
This report presents the proceedings of the Specialist`s Meeting on Experience in Aging, Maintenance and Modernization of Instrumentation and Control Systems for Improving Nuclear Power Plant Availability that was held at the Ramada Inn in Rockville, Maryland on May 5--7, 1993. The Meeting was presented in cooperation with the Electric Power Research Institute, Oak Ridge National Laboratory and the International Atomic Energy Agency. There were approximately 65 participants from 13 countries at the Meeting. Individual reports have been cataloged separately.
Hoskins, Kate; Smedley, Sue
Drawing on life-history interview data collected as part of a research project funded by the Froebel Trust, this paper explores the family backgrounds and educational experiences reported by nine women who attended Froebel College located in London in the United Kingdom (UK), in the 1950s and 1960s. Informed by Bourdieu's theories of habitus and…
O'Sullivan, K E
Application to the Irish basic surgical training (BST) program in Ireland has decreased progressively over the past 5 years. We hypothesised that this decline was secondary to dissatisfaction with training correlated with reduced operative experience and lack of mentorship among BSTs.
For more than thirty years nuclear power plants have been supplying electricity to national grids. Today, the nuclear power community is facing great challenges. The safe, reliable operation of existing nuclear power plants (NPPs) must continue to be ensured. From an economic viewpoint, because of the long lead times associated with bringing new plants into service, securing the continued operation of existing plants for their planned lifetimes and possible life extension will be very important in the near term for meeting electrical power demands. The IAEA programmes in nuclear power plant ageing and life extension and in control and instrumentation promote technical information exchange between Member States with new programmes, offers assistance to Member States with an interest in reliability of NPP components, in-service inspection methods and programmes using on-line techniques, component monitoring and special technological topics of nuclear reactors. Significant experience already exists in the nuclear industry in developing and applying the monitoring techniques for different nuclear power plant applications, especially in monitoring of ageing phenomena for improving NPP availability. The purpose of this Specialists' Meeting was to bring together experts from operations, design, research and development and licensing to share their experience in: ageing mechanics of key structural components, methods of monitoring such ageing, tools for cost-effective implementation of the methods and methodologies, life management approaches and examples from current reactors, future direction for monitoring of key structural components in nuclear power plants. The meeting was organized by the IAEA International Working Groups on Life Management of Nuclear Power Plants (IWG-LMNPP) and Nuclear Power Plant Control and Instrumentation (TWG-NPPCI) in co-operation with the Czechoslovak Atomic Energy Commission and Skoda concern. Around 40 participants from 10 countries
Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)
This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.
Farver, Carol F; Smalling, Susan; Stoller, James K
Challenges in healthcare demand great leadership. In response, leadership training programs have been developed within academic medical centers, business schools, and healthcare organizations; however, we are unaware of any well-developed programs for physicians-in-training. To address this gap, we developed a two-day leadership development course for chief residents (CRs) at the Cleveland Clinic, framed around the concept of emotional intelligence. This paper describes our five-year experience with the CRs leadership program. Since inception, 105 CRs took the course; 81 (77%) completed before-and-after evaluations. Participants indicated that they had relatively little prior knowledge of the concepts that were presented and that the workshop greatly enhanced their familiarity with leadership competencies. Qualitative analysis of open-ended responses indicated that attendees valued the training, especially in conflict resolution and teamwork, and indicated specific action plans for applying these skills. Furthermore, the workshop spurred some participants to express plans to learn more about leadership competencies. This study extends prior experience in offering an emotional intelligence-based leadership workshop for CRs. Though the program is novel, further research is needed to more fully understand the impact of leadership training for CRs and for the institutions and patients they serve. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Lazarus, Jenny Lynn; Hosseini, Motahar; Kamangar, Farin; Levien, David H; Rowland, Pamela A; Kowdley, Gopal C; Cunningham, Steven C
To better understand verbal aggressiveness among physicians and trainees, including specialty-specific differences. The Infante Verbal Aggressiveness Scale (IVAS) was administered as part of a survey to 48 medical students, 24 residents, and 257 attending physicians. The 72 trainees received the IVAS and demographic questions, whereas the attending physicians received additional questions regarding type of practice, career satisfaction, litigation, and personality type. The IVAS scores showed high reliability (Cronbach α = 0.83). Among all trainees, 56% were female with mean age 28 years, whereas among attending physicians, 63% were male with mean age 50 years. Average scores of trainees were higher than attending physicians with corresponding averages of 1.88 and 1.68, respectively. Among trainees, higher IVAS scores were significantly associated with male sex, non-US birthplace, choice of surgery, and a history of bullying. Among attending physicians, higher IVAS scores were significantly associated with male sex, younger age, self-reported low-quality of patient-physician relationships, and low enjoyment talking to patients. General surgery and general internal medicine physicians were significantly associated with higher IVAS scores than other specialties. General practitioners (surgeons and medical physicians) had higher IVAS scores than the specialists in their corresponding fields. No significant correlation was found between IVAS scores and threats of legal action against attending physicians, or most personality traits. Additional findings regarding bullying in medical school, physician-patient interactions, and having a method to deal with inappropriate behavior at work were observed. Individuals choosing general specialties display more aggressive verbal communication styles, general surgeons displaying the highest. The IVAS scoring system may identify subgroups of physicians with overly aggressive (problematic) communication skills and may provide a
Aghamir, Seyed Mohammad Kazem; Behtash, Negar; Hamidi, Morteza; Farahmand, Hasan; Salavati, Alborz; Mortaz Hejri, Sara
Percutaneous nephrolithotomy (PNL) is a complicated procedure for urology trainees. This study was designed to investigate the effect of trainees' ages and previous experience, as well as the number of operated cases, on proficiency at PNL by using patient outcomes. A cross sectional observational study was designed during a five-year period. Trainees in PNL fellowship programs were included. At the end of the program, the trainees' performance in PNL was assessed regarding five competencies and scored 1-5. If the overall score was 4 or above, the trainee was considered as proficient. The trainees' age at the beginning of the program and the years passed from their residency graduation were asked and recorded. Also, the number of PNL cases operated by each trainee was obtained via their logbooks. The age, years passed from graduation, and number of operated cases were compared between two groups of proficient and non-proficient trainees. Univariate and multivariate binary logistic regression analysis was applied to estimate the effect of aforementioned variables on the occurrence of the proficiency. Forty-two trainees were included in the study. The mean and standard deviation for the overall score were 3.40 (out of 5) and 0.67, respectively. Eleven trainees (26.2%) recognized as proficient in performing PNL. Univariate regression analysis indicated that each of three variables (age, years passed from graduation and number of operated cases) had statistically significant effect on proficiency. However, the multivariate regression analysis revealed that just the number of cases had significant effect on achieving proficiency. Although it might be assumed that trainees' age negatively correlates with their scores, in fact, it is their amount of practice that makes a difference. A certain number of cases is required to be operated by a trainee in order to reach the desired competency in PNL.
This report presents the proceedings of the Specialist's Meeting on Experience in Aging, Maintenance and Modernization of Instrumentation and Control Systems for Improving Nuclear Power Plant Availability that was held at the Ramada Inn in Rockville, Maryland on May 5--7, 1993. The Meeting was presented in cooperation with the Electric Power Research Institute, Oak Ridge National Laboratory and the International Atomic Energy Agency. There were approximately 65 participants from 13 countries at the Meeting. Individual reports have been cataloged separately
Porcerelli, John H; Fowler, Shannon L; Murdoch, William; Markova, Tsveti; Kimbrough, Christina
This article will describe a training curriculum for family medicine residents to practice collaboratively with psychology (doctoral) trainees at the Wayne State University/Crittenton Family Medicine Residency program. The collaborative care curriculum involves a series of patient care and educational activities that require collaboration between family medicine residents and psychology trainees. Activities include: (1) clinic huddle, (2) shadowing, (3) pull-ins and warm handoffs, (4) co-counseling, (5) shared precepting, (6) feedback from psychology trainees to family medicine residents regarding consults, brief interventions, and psychological testing, (7) lectures, (8) video-observation and feedback, (9) home visits, and (10) research. The activities were designed to teach the participants to work together as a team and to provide a reciprocal learning experience. In a brief three-item survey of residents at the end of their academic year, 83% indicated that they had learned new information or techniques from working with the psychology trainees for assessment and intervention purposes; 89% indicated that collaborating with psychology trainees enhanced their patient care; and 89% indicated that collaborating with psychology trainees enhanced their ability to work as part of a team. Informal interviews with the psychology trainees indicated that reciprocal learning had taken place. Family medicine residents can learn to work collaboratively with psychology trainees through a series of shared patient care and educational activities within a primary care clinic where an integrated approach to care is valued.
Kwok, I H Y; Silk, Z M; Quick, T J; Sinisi, M; MacQuillan, A; Fox, M
We aimed to identify the pattern of nerve injury associated with paediatric supracondylar fractures of the humerus. Over a 17 year period, between 1996 and 2012, 166 children were referred to our specialist peripheral nerve injury unit. From examination of the medical records and radiographs were recorded the nature of the fracture, associated vascular and neurological injury, treatment provided and clinical course. Of the 166 patients (111 male, 55 female; mean age at time of injury was seven years (standard deviation 2.2)), 26 (15.7%) had neurological dysfunction in two or more nerves. The injury pattern in the 196 affected nerves showed that the most commonly affected nerve was the ulnar nerve (43.4%), followed by the median (36.7%) and radial (19.9%) nerves. A non-degenerative injury was seen in 27.5%, whilst 67.9% were degenerative in nature. Surgical exploration of the nerves was undertaken in 94 (56.6%) children. The mean follow-up time was 12.8 months and 156 (94%) patients had an excellent or good clinical outcome according to the grading of Birch, Bonney and Parry. Following paediatric supracondylar fractures we recommend prompt referral to a specialist unit in the presence of complete nerve palsy, a positive Tinel's sign, neuropathic pain or vascular compromise, for consideration of nerve exploration. When managed appropriately, nerve recovery and clinical outcomes for this paediatric population are extremely favourable. Cite this article: Bone Joint J 2016;98-B:851-6. ©2016 The British Editorial Society of Bone & Joint Surgery.
Orvis, Karin A; Horn, Daniel B; Belanich, James
.... Specifically, this follow-up research examines prior videogame experience, videogame self-efficacy, and goal orientation as antecedents that maximize trainee motivation, as well as other learner...
Kollias, James; Davies, Giles; Bochner, Melissa A; Gill, Peter G
Oncoplastic breast surgery is an integral and fundamental component of the clinical management of breast cancer. The aim of this study was to determine the proportion of oncoplastic and reconstructive breast cancer procedures undertaken within a specialist breast practice. An audit of breast-related cancer procedures was undertaken for patients with early breast cancer between 1 January 2001 and 31 December 2005, treated at the Royal Adelaide Hospital and in private practice. The proportion of oncoplastic and breast reconstructive procedures was calculated to determine the clinical effects on a specialist breast-surgical practice. Breast cancer resection procedures accounted for 1514 of 2113 of operations (72%). Most of these (897 of 1514, 59.2%) were wide local excision or re-excision procedures. Total breast reconstruction operations (i.e. autogenous tissue flaps, tissue expander/implant reconstructions) accounted for 251 procedures. Of these, 67 (26.7%) were carried out at the time of simple mastectomy. Contralateral breast procedures (i.e. reduction mammaplasty, mastopexy and augmentation) accounted for 138 procedures and nipple-areola reconstruction/tattoo accounted for 153 procedures. Oncoplastic procedures, such as skin-sparing mastectomy, latissimus dorsi miniflap and therapeutic mammaplasty accounted for 57 of 599 procedures (9.5%). Breast reconstruction and oncoplastic operations accounted for 599 of 2113 procedures (28%). Specialist breast surgeons trained in breast reconstruction and oncoplastic techniques can expect a substantial proportion of their breast practice to include such operative procedures (28% in this series). Subspecialist training in breast surgery should incorporate experience in breast reconstructive and aesthetic surgery for trainees who wish to practise as specialist breast surgeons in the future.
Wray, Jo; Hobden, Sylvie; Knibbs, Sarah; Oldham, Geralyn
To develop and test patient-reported experience measures (PREMs) for children and young people in a specialist paediatric hospital setting. Six PREMs were developed and tested by children and young people for children and young people aged 8-11, 12-13 and 14-16 years in inpatient and outpatient settings. A week-long pilot was implemented across inpatient wards and outpatient clinics to identify facilitators and barriers to the routine use of PREMs in a real-time setting across our organisation. Tertiary paediatric hospital. Final PREMs; identified facilitators and barriers to implementation. 543 children and young people aged 8-16 years attending outpatient clinics or inpatient wards across a range of specialties. Three key themes about hospital experience were identified during focus groups: facilities, treatment and tests and people working at the hospital, and these provided the structure for the questionnaires. During cognitive testing the questionnaires were generally understood but some revisions to language and length of the questionnaires were required. Two designs were selected for the final PREMs. During acceptability and feasibility testing it was evident that children and young people liked the PREMs and wanted to give feedback on their hospital experience. Particular challenges for routine use of the PREMs focused on sustainability and resources. The new PREMs will provide children and young people receiving care in specialist paediatric hospitals with the opportunity to provide feedback on their experience. Sustainability and ensuring that feedback results in improvements need to be addressed in future work. © 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.
Nicholls, Gordon Michael Mike; Lawrey, Emma; Jones, Peter
The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring. Online survey of EM trainees in the Auckland region in June 2015. Of 61 potential respondents, 40 (65.6%) respondents replied to the survey. Of the 40, 38 (95%; 95% confidence interval (CI) 82.6-99.5) respondents indicated they would like some form of mentoring system, and of the 38, 25 (65.8%; 95% CI 49.8-78.9) preferred this to be formal. Of the 38, 19 (50%; 95% CI 34.9-65.2) currently wanted assistance obtaining a mentor. Of the 40, 30 (75%; 95% CI 59.6-86.0) are not currently in any form of mentoring relationship. Respondents believed that mentors would be most beneficial in critical incidents, career development and with work/life balance. The attributes participants considered most important in a mentor were respecting confidentiality, being honest and the ability to provide constructive feedback. Many EM trainees in Auckland want a formal mentoring system and would like a mentor. Appropriate mentor-mentee matching through a formalised voluntary system, with adequate mentor training, may enable the Auckland region to develop a suitable mentoring programme for EM trainees. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Sánchez, Ana M; Alonso-Valiente, Patricia; Albert, M José; Escudero, Adrián
Local adaptation and phenotypic plasticity are considered key mechanisms for coping with climate warming, especially for plant species that inhabit island-like habitats. In Spain a complete guild of edaphic specialists, most of them threatened, occurs in gypsum outcrops, but how these species will respond to climate change has received little attention. A reciprocal sowing experiment was performed to determine the extent of local adaptation and phenotypic plasticity in five gypsophytes with contrasting distributions along a climate gradient. Germination, seedling growth and survival were recorded during a 4-year period. Plants responded plastically according to their positions along the regional climate gradient, as well as locally between matched locations. All species exhibited highly plastic responses and stress-tolerant behaviours, especially in terms of seedling survival during summer drought. However, no evidence of local adaptation was detected in any of the locations, where local individuals never performed better than those from other sites. In some sites, both germination and seedling recruitment were higher irrespective of parent plant origin. The lack of local adaptation to drought displayed at the regeneration stage indicates limited capacity for in situ genetic response to new climate scenarios. Nevertheless, a plastic response along the climatic gradient does suggest a wider species-level capacity to enable these edaphic specialists to cope with increasing aridity over coming decades. © The Author 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: email@example.com
Full Text Available Introduction. Quality is a part of curricula in medical schools worldwide. It has a special position in family medicine, because it follows specific rules that are adapted to this discipline. Because of its specificities, teaching quality is even more important to become a part of specialist training curricula. Objective. Our aim was to describe quality improvement in family medicine specialist training curriculum in Slovenia and its practical implications and experiences. Methods. The paper describes the family medicine specialist training curriculum also including the topic on the ways quality improvement. Assignments and research protocols are used to enhance the usage of quality methods in everyday practice. An example of such a research protocol, developed by one of the trainees, is used to illustrate the process. Trainees’ evaluations of the quality improvement curriculum are analyzed. Results. In the quality improvement project, 199 patients with arterial hypertension younger than 80 years were included. At the first measurement only 21 patients (10.6% had their blood pressure within the recommended level. Six months after the quality improvement intervention 77 patients (38.9% had controlled their blood pressure, a statistically significant improvement (p<0.001. Conclusion. Teaching quality in family medicine must be a generic part of specialist training curriculum. The use of specific assignments can underpin the necessity to use methods that follow the principles of modern education. The result of teaching process can be even measured in actual improvement in the quality of care.
Purpose: This study aims to explore the lived experience of learning for a group of staff nurses in the Middle East, who undertook a post-registration nursing education programme in the speciality of nephrology nursing (the NNP) between 2001 and 2002. The broad-based curriculum seeks to develop the staff nurses into active learners, able to…
Simmons Magenta B
Full Text Available Abstract Background Clinical guidelines advocate for the inclusion of young people experiencing depression as well as their caregivers in making decisions about their treatment. Little is known, however, about the degree to which these groups are involved, and whether they want to be. This study sought to explore the experiences and desires of young people and their caregivers in relation to being involved in treatment decision making for depressive disorders. Methods Semi-structured interviews were carried out with ten young people and five caregivers from one primary care and one specialist mental health service about their experiences and beliefs about treatment decision making. Interviews were audio taped, transcribed verbatim and analysed using thematic analysis. Results Experiences of involvement for clients varied and were influenced by clients themselves, clinicians and service settings. For caregivers, experiences of involvement were more homogenous. Desire for involvement varied across clients, and within clients over time; however, most clients wanted to be involved at least some of the time. Both clients and caregivers identified barriers to involvement. Conclusions This study supports clinical guidelines that advocate for young people diagnosed with depressive disorders to be involved in treatment decision making. In order to maximise engagement, involvement in treatment decision making should be offered to all clients. Involvement should be negotiated explicitly and repeatedly, as desire for involvement may change over time. Caregiver involvement should be negotiated on an individual basis; however, all caregivers should be supported with information about mental disorders and treatment options.
В С Томашевская
Full Text Available The article describes the experience of implementing educational programs for bachelors and masters with focus on areas of training in the field of computer science with the introduction into educational process modern technologies, attracting the largest enterprises-employers and experts of the subject domain. As an example of this approach, describes the implementation of educational programs at the intersection of information technology and health care, and especially their Information Technology Services.
Full Text Available Introduction: Patient centered decision making is one of the main aspects of evidence –based medicine, in addition to being morally important. The aim of this study was to extract the experiences of clinicians on patient-centered decision making. Method: A qualitative study based on descriptive phenomenology method was done. Purposive sampling was used to select the clinicians from among faculty members of medical school. Focus Group Discussion (FGD was used to gather the data .The discussion continued till the saturation of data was achieved. Content analysis was used for data analysis. Results: The participants of FGD were 6 clinicians from various specialties. 218 codes were extracted from the data and they were categorized in 4 themes and 16 subthemes. The main themes were: good relationship with patients, respect to the opinions and beliefs of the patients, taking into account the needs, preferences and experiences of the patients, comfort and safety of outpatient and inpatient setting for patient, shared decision making. Conclusion: Patient centeredness based on the experiences of clinicians in an educational hospital is similar to other studies but in developing countries like Iran clinicians have contextual and cultural barriers to apply it.
Sagasser, Margaretha H; Kramer, Anneke W M; Fluit, Cornelia R M G; van Weel, Chris; van der Vleuten, Cees P M
Clinical workplaces offer postgraduate trainees a wealth of opportunities to learn from experience. To promote deliberate and meaningful learning self-regulated learning skills are foundational. We explored trainees' learning activities related to patient encounters to better understand what aspects of self-regulated learning contribute to trainees' development, and to explore supervisor's role herein. We conducted a qualitative non-participant observational study in seven general practices. During two days we observed trainee's patient encounters, daily debriefing sessions and educational meetings between trainee and supervisor and interviewed them separately afterwards. Data collection and analysis were iterative and inspired by a phenomenological approach. To organise data we used networks, time-ordered matrices and codebooks. Self-regulated learning supported trainees to increasingly perform independently. They engaged in self-regulated learning before, during and after encounters. Trainees' activities depended on the type of medical problem presented and on patient, trainee and supervisor characteristics. Trainees used their sense of confidence to decide if they could manage the encounter alone or if they should consult their supervisor. They deliberately used feedback on their performance and engaged in reflection. Supervisors appeared vital in trainees' learning by reassuring trainees, discussing experience, knowledge and professional issues, identifying possible unawareness of incompetence, assessing performance and securing patient safety. Self-confidence, reflection and feedback, and support from the supervisor are important aspects of self-regulated learning in practice. The results reflect how self-regulated learning and self-entrustment promote trainees' increased participation in the workplace. Securing organized moments of interaction with supervisors is beneficial to trainees' self-regulated learning.
Banks, L N
British Trainees have gradually had their working week curtained over the last 8 years. The Republic of Ireland Trainees have not been subjected to the European Working Time Directive prior to 2009 and have therefore worked on average, more hours than their British counterparts. We wanted to see if the differing schemes had an impact on recruiting and training orthopaedic surgeons. We surveyed Republic of Ireland orthopaedic specialist registrars (SpRs) and North West (NW) British SpRs\\/specialist trainees (ST3 and above) to see if there were any discernable differences in working patterns and subsequent training exposure. A standard proforma was given to Irish Trainees and to NW SpRs\\/STs at their National or regional teaching (January\\/February 2009). 62% of Irish and 47% of British NW Trainees responded. Irish trainees were more likely to have obtained a post-graduate degree (p = 0.03). The Irish worked more hours per week (p < 0.001) doing more trauma operative lists (p = 0.003) and more total cases per 6 months than the NW British (p = 0.003). This study suggests that more hours worked, equals more operative exposure, without detriment to the academic side of training. Obviously it is not possible to say whether fewer operations make for a poorer surgeon, but the evidence suggests that it may be true.
Seyed Mohammad Kazem Aghamir
Full Text Available Percutaneous nephrolithotomy (PNL is a complicated procedure for urology trainees. This study was designed to investigate the effect of trainees’ ages and previous experience, as well as the number of operated cases, on proficiency at PNL by using patient outcomes. A cross sectional observational study was designed during a five-year period. Trainees in PNL fellowship programs were included. At the end of the program, the trainees’ performance in PNL was assessed regarding five competencies and scored 1-5. If the overall score was 4 or above, the trainee was considered as proficient. The trainees’ age at the beginning of the program and the years passed from their residency graduation were asked and recorded. Also, the number of PNL cases operated by each trainee was obtained via their logbooks. The age, years passed from graduation, and number of operated cases were compared between two groups of proficient and non-proficient trainees. Univariate and multivariate binary logistic regression analysis was applied to estimate the effect of aforementioned variables on the occurrence of the proficiency. Forty-two trainees were included in the study. The mean and standard deviation for the overall score were 3.40 (out of 5 and 0.67, respectively. Eleven trainees (26.2% recognized as proficient in performing PNL. Univariate regression analysis indicated that each of three variables (age, years passed from graduation and number of operated cases had statistically significant effect on proficiency. However, the multivariate regression analysis revealed that just the number of cases had significant effect on achieving proficiency. Although it might be assumed that trainees’ age negatively correlates with their scores, in fact, it is their amount of practice that makes a difference. A certain number of cases is required to be operated by a trainee in order to reach the desired competency in PNL.
Paterson, P; Allison, K
The Specialist Advisory Committee (SAC) in plastic surgery within the United Kingdom (UK) recommends a modular training programme to include aesthetic surgery. The intercollegiate board examinations test candidates on all aspects of aesthetic practice yet there is no formal, national aesthetic training in the UK. Closure of National Health Service (NHS) private patient facilities has reduced training opportunity [Nicolle FV. Sir Harold Gillies Memorial Lecture; Aesthetic plastic surgery and the future plastic surgeon. Br J Plast Surg 1998;51:419-24.] Calmanisation [Hospital doctors: training for the future. The Report of the Working Group on Specialist Medical Training (The Calman Report). London: HMSO; 1993.], the European Working Time Directive (EWTD) [; Phillips H, Fleet Z, Bowman K. The European Working time Directive-interim report and guidance from The Royal College of Surgeons of England working party chaired by Mr Hugh Phillips; 2003 ; Chesser S, Bowman K, Phillips H. The European Working Time Directive and the training of surgeons. BMJ Careers Focus 2002;s69-7.], and more importantly the implementation of "local" aesthetic guidelines have placed further pressures on training. Reductions of NHS case mix will ultimately lead to a reduction in trainee experience. With increasing regulatory pressure from the Commission for Healthcare Improvement, standards of aesthetic practice can only be maintained by increasing private/independent sector involvement. At present a disparity exists between the demand and provision of aesthetic surgery training in the UK. Aesthetic surgery forms part of the training curriculum for plastic surgery and as such remains a training issue. A review of aesthetic surgery training is needed in the UK through consultation with trainers and trainee representatives.
The delivery of general paediatric surgery is changing in Ireland. Fewer paediatric surgical procedures are being performed by newly appointed consultant general surgeons, resulting in increased referrals to the specialist paediatric surgeons of uncomplicated general paediatric surgical problems. We surveyed current higher surgical trainees about their views on provision of paediatric surgical services.
Petroll, Andrew E; Walsh, Jennifer L; Owczarzak, Jill L; McAuliffe, Timothy L; Bogart, Laura M; Kelly, Jeffrey A
HIV pre-exposure prophylaxis (PrEP) was FDA approved in 2012, but uptake remains low. To characterize what would facilitate health care providers' increased PrEP prescribing, we conducted a 10-city, online survey of 525 primary care providers (PCPs) and HIV providers (HIVPs) to assess awareness, knowledge, and experience with prescribing PrEP; and, comfort with and barriers to PrEP-related activities. Fewer PCPs than HIVPs had heard of PrEP (76 vs 98%), felt familiar with prescribing PrEP (28 vs. 76%), or had prescribed it (17 vs. 64%). PCPs were less comfortable than HIVPs with PrEP-related activities such as discussing sexual activities (75 vs. 94%), testing for acute HIV (83 vs. 98%), or delivering a new HIV diagnosis (80 vs. 95%). PCPs most frequently identified limited knowledge about PrEP and concerns about insurance coverage as prescribing barriers. PCPs and HIVPs differ in needs that will facilitate their PrEP prescribing. Efforts to increase PrEP uptake will require interventions to increase the knowledge, comfort, and skills of providers to prescribe PrEP.
Full Text Available Objective To investigate and evaluate whether the present physical examination standards for selection of pilot trainees meet the requirements for the medical selection of pilot trainees. Methods The experimental procedure was divided into three steps to evaluate the physical examination standards for the selection of pilot trainees. The first step was to compile a manual of investigation, which was composed of suitability assessments and the result of its use. The second step was to screen for specialists. A social science survey was adopted, and 119 specialists were selected composing 98 specialists in recruitment of pilots and 21 aviation medical clinicians. A total of 359 standard items were evaluated for suitability approval, and then the reliability of evaluation results was analyzed. The final step was the formation of criteria for final judgment. The worthiness of the items was based on the specialists' opinions. When a certain item was deemed suitable by more than 80% of the specialists, it was considered as appropriate, and when a certain item was deemed suitable by less than 60% of the specialists, it was not appropriate. Results A total of 134 survey brochures were sent out, and 128 out of 134 were retrieved. The positive index of specialist participation was 0.95, and the authority index was 0.86. 271 (75.5% of the 359 items were generally accepted by specialists as appropriate, and 27 (7.5% items were not accepted. Most of these rejected items involved function evaluation, the concept and essence of which could not be easily grasped. Conclusions Although the majority of the items in the physical examination standards were deemed appropriate by the specialists, there were a few items not accepted. These standards should be revised after being applied in the future.
Background Following implementation of Modernising Medical Careers (MMC) in the UK, potential radiology trainees must decide on their career and apply sooner than ever before. We aimed to determine whether current trainees were sufficiently informed to make an earlier career decision by comparing the early radiology experiences of Traditional and Foundation Trainees. Methods 344 radiology trainees were appointed through MMC in 2007/08. This cohort was surveyed online. Results Response rate was 174/344 (51%). Traditional Trainees made their career decision 2.6 years after graduation compared with 1.2 years for Foundation Trainees (57/167, 34%). Nearly half of responders (79/169, 47%) experienced no formal radiology teaching as undergraduates. Most trainees regularly attended radiology meetings, spent time in a radiology department and/or performed radiology research. Many trainees received no career advice specific to radiology (69/163, 42%) at any point prior to entering the specialty; this includes both formal and informal advice. Junior doctor experiences were more frequently cited as influencing career choice (98/164, 60%). An earlier career decision was associated with; undergraduate radiology projects (-0.72 years, p = 0.018), career advice (-0.63 years, p = 0.009) and regular attendance at radiology meetings (-0.65 years, p = 0.014). Conclusion Early experience of radiology enables trainees to make an earlier career decision, however current radiology trainees were not always afforded relevant experiences prior to entering training. Radiologists need to be more proactive in encouraging the next generation of trainees. PMID:23031228
Full Text Available Abstract Background Following implementation of Modernising Medical Careers (MMC in the UK, potential radiology trainees must decide on their career and apply sooner than ever before. We aimed to determine whether current trainees were sufficiently informed to make an earlier career decision by comparing the early radiology experiences of Traditional and Foundation Trainees. Methods 344 radiology trainees were appointed through MMC in 2007/08. This cohort was surveyed online. Results Response rate was 174/344 (51%. Traditional Trainees made their career decision 2.6 years after graduation compared with 1.2 years for Foundation Trainees (57/167, 34%. Nearly half of responders (79/169, 47% experienced no formal radiology teaching as undergraduates. Most trainees regularly attended radiology meetings, spent time in a radiology department and/or performed radiology research. Many trainees received no career advice specific to radiology (69/163, 42% at any point prior to entering the specialty; this includes both formal and informal advice. Junior doctor experiences were more frequently cited as influencing career choice (98/164, 60%. An earlier career decision was associated with; undergraduate radiology projects (-0.72 years, p = 0.018, career advice (-0.63 years, p = 0.009 and regular attendance at radiology meetings (-0.65 years, p = 0.014. Conclusion Early experience of radiology enables trainees to make an earlier career decision, however current radiology trainees were not always afforded relevant experiences prior to entering training. Radiologists need to be more proactive in encouraging the next generation of trainees.
Teacher in Space trainees on the KC-135 for zero-G training. Sharon Christa McAuliffe, right, and Barbara R. Morgan, team up with Bob Mayfield, a JSC aerospace educations specialist, to preview some experiments in zero-G. McAuliffe, prime crewmember, injects a hydroponic solution into a cylinder to review one of the experiments for the flight (42470); McAuliffe experiences a few moments of weightlessness provided by the KC-135. She and Mayfield are previewing a molecular mixing experiment which was designed to demonstrate differences of separation process in one-G and zero-G (42471); McAuliffe and Morgan play leap-frog in the temporary weightlessness of the KC-135 (42472); McAuliffe is seated near the controls of the KC-135 aircraft (42473); McAuliffe (center frame) and Morgan, her backup, monitor an experiment involving magnetic effects. The experiment uses a control box, a square receptical containing rubber tubing, stainless steel rod, a filter with desiccant, soft iron wire and a m
Spanager, Lene; Konge, Lars; Dieckmann, Peter
BACKGROUND: Trainee surgeons would benefit from regular, formative assessments to ensure they learn the nontechnical aspects of surgical performance. Non-Technical Skills for Surgeons in Denmark (NOTSSdk) is a tool to assess surgeons' nontechnical skills (NTS) during an operation. The aims......, although 2 elements of leadership ("supporting others" and "coping with pressure") were considered irrelevant in 27% to 31% of the cases. Assessments of 5 procedures were sufficient to gain reliable ratings (Generalizability coefficient > 0.80) of a trainee surgeon's NTS. CONCLUSION: As supervisors used...
Rees, Alun L. W.
This handbook, based on the author's experience of supervising the English practice-classes of trainee teachers, was originally compiled for the specific use of students at the National University of Trujillo, Peru, and consists of a list of pointers embracing the most prevalent of trainees' shortcomings observed over a period of years at all…
Sagasser, Margaretha H.; Kramer, Anneke W. M.; Fluit, Cornelia R. M. G.; van Weel, Chris; van der Vleuten, Cees P. M.
Clinical workplaces offer postgraduate trainees a wealth of opportunities to learn from experience. To promote deliberate and meaningful learning self-regulated learning skills are foundational. We explored trainees' learning activities related to patient encounters to better understand what aspects of self-regulated learning contribute to…
The proceedings are presented of an IAEA specialists meeting devoted to the exchange of views and experience with respect to understanding and quantifying materials ageing and degradation processes, to assessing residual life of components, to in-service materials testing, all this with the objective of improving reliability and, wherever possible, extending the useful life of nuclear power plants. (L.O.)
Aiken, Catherine E; Aiken, Abigail R; Park, Hannah; Brockelsby, Jeremy C; Prentice, Andrew
This study was conducted to determine whether UK obstetrics trainees transitioning from directly to indirectly supervised practice have a higher likelihood of recording adverse patient outcomes in operative deliveries compared with other indirectly supervised trainees, and to examine whether performing more procedures under direct supervision is associated with fewer adverse outcomes in initial practice under indirect supervision. We examined all deliveries (13 856) conducted by obstetricians at a single centre over 6 years (2008-2013). Mixed-effects logistic regression models were used to compare estimated blood loss (EBL), maternal trauma, umbilical arterial pH, delayed neonatal respiration, failed instrumental delivery, and critical incidents for trainees in their first indirectly supervised year with those for trainees in all other years of indirect supervision. Outcomes for trainees in their first indirectly supervised 3 months were compared with their outcomes for the remainder of the year. Linear regression was used to examine the relationship between number of procedures performed under direct supervision and initial outcomes under indirect supervision. Trainees in their first indirectly supervised year had a higher likelihood of recording EBL of > 2 L at any delivery (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.01-1.64; p 1 L (OR 2.54, 95% CI 1.88-3.20; p 1 L (p Obstetrics trainees in their first year of indirectly supervised practice have a higher likelihood of recording immediate adverse delivery outcomes, which are primarily maternal rather than neonatal. Undertaking more directly supervised procedures prior to transitioning to indirectly supervised practice may reduce adverse outcomes, which suggests that experience is a key consideration in obstetrics training programme design. © 2015 John Wiley & Sons Ltd.
Sharma, Savita; Attri, Poonam
This study investigates the library anxiety in Teacher Trainees and found it to be a prevalent phenomenon in students. The five dimensions of library anxiety, namely, barriers with staff, affective barriers, comfort with the library, knowledge of the library, and mechanical barriers have been identified. The sample of the study constituted 58…
Thompson, Ron; Russell, Lisa
This paper explores the experiences and perceptions of a little-known category of in-service trainee teachers in the Further Education (FE) and Skills sector in England: those who meet the practical teaching requirements of their course mainly through unpaid teaching as "volunteers." The paper reports findings from mixed-methods research…
Dalack, Gregory W.; Jibson, Michael D.
Objective: The authors describe the implementation of Clinical Skills Verification (CSV) in their program as an in-training assessment intended primarily to provide formative feedback to trainees, strengthen the supervisory experience, identify the need for remediation of interviewing skills, and secondarily to demonstrating resident competence…
Wand, Anne; Maheshwari, Rajesh; Holton, Matthew
The aim of this study was to develop and pilot a workshop for basic trainees in psychiatry to address perceived gaps in the specialist training program and to foster a culture of mentorship. A literature review and consultations with clinicians and managers determined interest in the workshop, preferences for content, and feasibility. Six psychiatrists met on several occasions to plan the workshop. Supervisors were surveyed prior to the workshop to ascertain their perceptions of their trainees' knowledge of particular topics and the content of supervision. Registrar self-evaluations and knowledge were assessed before and after the workshop. Twenty-four registrars attended the first session of the workshop and 22 the second. Following the workshop, self-ratings of knowledge and confidence of trainees in topics including risk assessment and duty of care were significantly better. Registrars rated the program highly for collegiate interactions, format, originality and usefulness. Supervisors identified weaknesses in trainee knowledge corresponding to workshop topics. Trainee self-evaluations of key aspects of clinical psychiatry improved significantly after the workshop. The development process described here for implementing a service-based initiative in psychiatry trainee education tailored to local needs may be transferable to other services.
Walker, Abigail; Hines, John; Brecknell, John
"Grit" can be defined as the passion and perseverance for long-term goals, and it can be measured by a validated scale. It has been associated with success in diverse fields such as basic military training and spelling tests. Surgical training is arduous with large number of trainees reporting burnout, and it could be expected that grit is a fundamental requirement to complete training. This study aimed to examine the relationship of grit in surgical training, whether grit varies by grade of surgeon, and the association of grit with burnout. This was a prospective survey-based study, using the validated tools Short Grit Scale and Oldenburg Burnout Inventory. UK-based ear, nose, and throat doctors based in secondary care were invited to participate. Ear, nose, and throat surgeons were used as the sample population, with subgroups of core trainees (core surgical trainees), specialist registrars (higher surgical training), and consultants. A total of 102 participants completed the study (33 core surgical trainees, 49 mid-career trainees in higher surgical training, and 22 consultants). Consultants were significantly grittier than trainees (p consultants. Age and sex were not associated with grit or burnout. These findings reinforce the concept that grit is fundamentally important to completion of surgical training. In addition, grittier individuals are more likely to resist burnout than their less gritty counterparts. These findings carry implications for retention and recruitment of trainee surgeons, and further study is required to investigate whether surgical training influences grit levels or selects out the grittiest trainees to survive to completion. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Gooding, Amanda; Block, Cady K; Brown, Daniel S; Sunderaraman, Preeti
Leadership experiences are vital not only to individual long-term career success but also the development, direction, and operation of higher spheres including professional organizations and the field of clinical neuropsychology itself. The present paper presents a blueprint guide for neuropsychology trainees on available opportunities and resources for increasing their involvement in professional governance and developing leadership skills. First, we present a discussion of the benefits of leadership and professional service, including the acquisition of interpersonal skills and new professional competencies, the prospect of recognition and advancement, and the opportunity to participate in advocacy efforts. Then, we present an overview of existing opportunities for involvement, followed by the provision of specific, actionable items for trainees, mentors and leadership committees, and for neuropsychology organizations to ensure continued trainee engagement. These resources can serve as a guide for trainees and early career neuropsychologists seeking to acquire leadership proficiencies, and the recommendations aspire to promote advancement for trainees, professionals, and organizations alike.
Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ahmed, Awad A. [Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Jagsi, Reshma [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Stentz, Natalie Clark [Department of Obstetrics and Gynecology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Woodward, Wendy A.; Fuller, Clifton D. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Thomas, Charles R., E-mail: firstname.lastname@example.org [Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States)
Purpose: Medical training spans nearly a decade, during which many physicians traditionally begin families. Although childrearing responsibilities are shared by men and women in the modern era, differences in time allocated to child care by sex and its potential impact on residency experience merit discussion. Methods and Materials: An anonymous, voluntary, 102-item survey was distributed to 540 current radiation oncology residents and 2014 graduates that asked about marital and parental status, pregnancy during residency, publication productivity, career aspirations, and experiences working with pregnant co-residents. Respondents with children were asked about childcare arrangements, and women who were pregnant during residency were asked about radiation safety, maternity leave, and breastfeeding experiences. Results: A total of 190 respondents completed the survey, 107 men (56.3%) and 84 women (43.7%). Ninety-seven respondents (51.1%) were parents, and 84 (44.2%) reported a pregnancy during residency. Respondents with children more often were male (65% vs 47.3%; P=.014), in a higher level of training (79.3% vs 54.8% were PGY4 or higher; P=.001), were older (median age of 32, interquartile range [IQR]:31-35] vs age 30 [IQR: 29-33]; P<.001), had a PhD (33% vs 19.3%, respectively; P=.033), were married (99% vs 43%, respectively; P<.001), and had a partner who did not work (24.7% vs 1.9%, respectively; <.001). There were no differences in the number of manuscripts published or the number of residents who expressed likelihood of pursing an academic career by parental status. Among parents, men more frequently had partners who did not work (38.1% vs 0%, respectively; P<.001) and reported that their partner performed a greater percentage of childcare duties (70% [IQR: 60%-80%] vs 35% [IQR: 20%-50%], respectively; P<.001). Conclusions: Pregnancy and parenthood are common during residency. Female residents are frequently responsible for more childcare duties than males
Holliday, Emma B.; Ahmed, Awad A.; Jagsi, Reshma; Stentz, Natalie Clark; Woodward, Wendy A.; Fuller, Clifton D.; Thomas, Charles R.
Purpose: Medical training spans nearly a decade, during which many physicians traditionally begin families. Although childrearing responsibilities are shared by men and women in the modern era, differences in time allocated to child care by sex and its potential impact on residency experience merit discussion. Methods and Materials: An anonymous, voluntary, 102-item survey was distributed to 540 current radiation oncology residents and 2014 graduates that asked about marital and parental status, pregnancy during residency, publication productivity, career aspirations, and experiences working with pregnant co-residents. Respondents with children were asked about childcare arrangements, and women who were pregnant during residency were asked about radiation safety, maternity leave, and breastfeeding experiences. Results: A total of 190 respondents completed the survey, 107 men (56.3%) and 84 women (43.7%). Ninety-seven respondents (51.1%) were parents, and 84 (44.2%) reported a pregnancy during residency. Respondents with children more often were male (65% vs 47.3%; P=.014), in a higher level of training (79.3% vs 54.8% were PGY4 or higher; P=.001), were older (median age of 32, interquartile range [IQR]:31-35] vs age 30 [IQR: 29-33]; P<.001), had a PhD (33% vs 19.3%, respectively; P=.033), were married (99% vs 43%, respectively; P<.001), and had a partner who did not work (24.7% vs 1.9%, respectively; <.001). There were no differences in the number of manuscripts published or the number of residents who expressed likelihood of pursing an academic career by parental status. Among parents, men more frequently had partners who did not work (38.1% vs 0%, respectively; P<.001) and reported that their partner performed a greater percentage of childcare duties (70% [IQR: 60%-80%] vs 35% [IQR: 20%-50%], respectively; P<.001). Conclusions: Pregnancy and parenthood are common during residency. Female residents are frequently responsible for more childcare duties than males
Kurien, Matthew; Azmy, Iman A F; Sanders, David S
Out-of-programme (OOP) activities enable postgraduate trainees to undertake an experience outside of their individual subspecialty training programmes. Activities vary but may include a period of research, additional clinical experiences or time for a planned career break. Determining whether to go OOP is a common dilemma faced by many trainees as they progress through postgraduate training. This review assesses the options trainees have with regards to going OOP, evaluates the potential advantages and disadvantages and also provides advice for those considering an OOP activity.
Benstead, Kim; Turhal, Nazim Serdar; O'Higgins, Niall
. Questionnaires were sent to National Societies of Radiation Oncology and Medical Oncology concerning similarities and differences in training programs and multidisciplinary care in member states in Europe. Results indicated wide variation in training systems and practice. Data were lacking for Surgery because...... Surgical Oncology is not recognised as a speciality in the EU and most specialist training in cancer surgery is organ based. A period of time in cross-disciplinary training in each of the other two disciplines for all trainees in Medical Oncology, Radiation Oncology and Surgical Oncology (including all...... surgeons training in cancer surgery) is recommended. This is likely to improve the value of multidisciplinary meetings and may result in improved patient care. The Expert Group on Cancer Control of the European Commission has endorsed this recommendation....
O'Neill, Lotte; Norberg, Karen; Thomsen, Maria
), or transferred (i.e. had unplanned changes in place of training/ward due to failure to thrive or due to inadequate development of competences), or dropped out (i.e. were dismissed from, had resigned from, or changed their speciality). Controls were a random sample of doctors in the source population, who were......Abstract summary The aim of this cummulative incidence case-control study was to examine: if struggling trainees in medical specialist training (cases) tended to struggle already in medical school or not compared to non-struggling controls, and which performance indicators during medical school...... seemed to predict struggling in postgraduate education if any. The study design is rooted in epidemiological methodology. Struggling doctors in specialist training: a case-control study. It has been reported in the international literature, that around 3-10% of doctors in post-garduate specialist...
Magin, Parker; Morgan, Simon; Wearne, Susan; Tapley, Amanda; Henderson, Kim; Oldmeadow, Chris; Ball, Jean; Scott, John; Spike, Neil; McArthur, Lawrie; van Driel, Mieke
Answering clinical questions arising from patient care can improve that care and offers an opportunity for adult learning. It is also a vital component in practising evidence-based medicine. GPs' sources of in-consultation information can be human or non-human (either hard copy or electronic). To establish the prevalence and associations of GP trainees' in-consultation information-seeking, and to establish the prevalence of use of different sources of information (human, hard copy and electronic) and the associations of choosing particular sources. A cross-sectional analysis of data (2010-13) from an ongoing cohort study of Australian GP trainees' consultations. Once each 6-month training term, trainees record detailed data of 60 consecutive consultations. The primary outcome was whether the trainee sought in-consultation information for a problem/diagnosis. Secondary outcomes were whether information-seeking was from a human (GP, other specialist or other health professional) or from a non-human source (electronic or hard copy), and whether a non-human source was electronic or hard copy. Six hundred forty-five trainees (response rate 94.3%) contributed data for 84,723 consultations including 131,583 problems/diagnoses. In-consultation information was sought for 15.4% (95% confidence interval=15.3-15.6) of problems/diagnoses. Sources were: GP in 6.9% of problems/diagnoses, other specialists 0.9%, other health professionals 0.6%, electronic sources 6.5% and hard-copy sources 1.5%. Associations of information-seeking included younger patient age, trainee full-time status and earlier training stage, longer consultation duration, referring the patient, organizing follow-up and generating learning goals. Associations of choosing human information sources (over non-human sources) were similar, but also included the trainee's training organization. Associations of electronic rather than hard-copy information-seeking included the trainee being younger, the training
Full Text Available Aims and Method. The Developmental Disability Database in the Department of Rehabilitation Medicine at a metropolitan hospital was audited for observations on adults with Intellectual Disability living in the local region (total population 180,000 who were seen in an identified multidisciplinary specialist clinic, during 2006–2010. Results. There were 162 people (representing half the known number of adults with Intellectual Disability living in the region: 77 females, 85 males, age range 16–86 years. The most common complex disabilities referred to the specialists in this clinic were epilepsy (52%, challenging or changing behavior (42% and movement disorders (34%. Early onset dementia was a feature of the group (7%. The prevalence of prescription of medications for gastro-oesophageal reflux was high (36% and similar to the numbers of people taking psychotropic medications. The rates of chronic cardiovascular disease (2%, chronic respiratory disease (10% and generalised arthritis (11% were low overall, but did rise with increasing age. Conclusions. Complex neurological disabilities are common, and chronic medical illnesses are uncommon in adults with Intellectual Disability referred to specialist clinicians in this region. A combined, coordinated, multidisciplinary clinic model addresses some of the barriers experienced by adults with Intellectual Disability in the secondary health system.
Farley, Samuel; Coyne, Iain; Sprigg, Christine; Axtell, Carolyn; Subramanian, Ganesh
Workplace bullying is an occupational hazard for trainee doctors. However, little is known about their experiences of cyberbullying at work. This study examines the impact of cyberbullying among trainee doctors, and how attributions of blame for cyberbullying influence individual and work-related outcomes. Doctors at over 6 months into training were asked to complete an online survey that included measures of cyberbullying, blame attribution, negative emotion, job satisfaction, interactional justice and mental strain. A total of 158 trainee doctors (104 women, 54 men) completed the survey. Overall, 73 (46.2%) respondents had experienced at least one act of cyberbullying. Cyberbullying adversely impacted on job satisfaction (β = - 0.19; p cyberbullying influenced its impact and the path of mediation. Negative emotion mediated the relationship between self-blame for a cyber-bullying act and mental strain, whereas interactional injustice mediated the association between blaming the perpetrator and job dissatisfaction. Acts of cyberbullying had been experienced by nearly half of the sample during their training and were found to significantly relate to ill health and job dissatisfaction. The deleterious impact of cyberbullying can be addressed through both workplace policies, and training for trainee doctors and experienced medical professionals. © 2015 John Wiley & Sons Ltd.
Bhola, Poornima; Sinha, Ananya; Sonkar, Suruchi; Raguram, Ahalya
Ethical dilemmas are inevitable during psychotherapeutic interactions, and these complexities and challenges may be magnified during the training phase. The experience of ethical dilemmas in the arena of therapy and the methods of resolving these dilemmas were examined among 35 clinical psychologists in training, through an anonymous and confidential online survey. The trainees' responses to four open-ended questions on any one ethical dilemma encountered during therapy were analysed, using thematic content analysis. The results highlighted that the salient ethical dilemmas related to confidentiality and boundary issues. The trainees also raised ethical questions regarding therapist competence, the beneficence and non-maleficence of therapeutic actions, and client autonomy. Fifty-seven per cent of the trainees reported that the dilemmas were resolved adequately, the prominent methods of resolution being supervision or consultation and guidance from professional ethical guidelines. The trainees felt that the professional codes had certain limitations as far as the effective resolution of ethical dilemmas was concerned. The findings indicate the need to strengthen training and supervision methodologies and professional ethics codes for psychotherapists and counsellors in India.
Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls. PMID:27134485
Full Text Available This study reports the usage of three commercial Internet search engines in information seeking among trainee teachers at a teacher training institute in Malaysia. It attempts to investigate the information seeking behavior of the trainees via three Internet search engines (Google, Yahoo and MSN as gateways to information for research in academic learning using two cohorts of trainee teachers. The study surveyed 166 trainee teachers undergoing a 5-year Bachelor’s Degree program and compares the statistical differences on gender, programs and years of computer technology experiences. The results revealed that there were significant differences between gender for all the three search engines. Furthermore it also indicated that there was a significant difference between TESL and PISMP group for Yahoo and MSN but not for Google. A significant difference was also observed between years of computer technology experiences and the frequency of usage in the case of MSN. Post hoc test revealed a significant difference in the Internet search between those with more than 7 years of experience with those with less than 2 years experience and those between 2-4 years computing experience. The results provide insight into TESL and PPISMP trainee teachers’ use of the Internet search engines as a tool in information seeking when approaching research for their academic learning activities. Implications on the impact of the Internet to the trainee teachers’ academic learning in approaching research needs were discussed.
Presents thought from school library media specialists regarding collection development. Topics include first-year experiences; the importance of cataloging; selection criteria; selection sources; and weeding. (LRW)
Wong, Teck Yee; Koh, Gerald Ch; Lee, Eng Hin; Cheong, Seng Kwing; Goh, Lee Gan
In many countries, family medicine (FM) training has been conducted mainly by senior family physicians alone. However, FM training in Singapore in the last 30 years has involved specialists working in close collaboration with family physicians. The areas in which specialists are currently involved include the training of FM trainees in tertiary hospitals, the Master of Medicine in Family Medicine [MMed (FM)] and Graduate Diploma in Family Medicine (GDFM) programmes. This close relationship has been crucial in the continuing vocational and professional development of family physicians and in fostering closer collaboration between family physicians and specialists, thus ultimately benefiting patient care.
Holm, Ellen; Holm, Kirsten; Sørensen, Jette Led
In 360-degree feedback medical colleagues and collaborators give a trainee feedback by answering a questionnaire on behaviour of the trainee. The questionnaire may contain questions answered on a scale or/and they may contain open questions. The result from 360-degree feedback is used for formative...
Byrne, J. Stephen; Shufelt, Brett
The present study explored the use of counseling among counselor trainees and the characteristics of consumers and nonconsumers. Approximately 61% of those surveyed (n = 85) reported that they had received counseling, with the majority being mental health counseling trainees. Nonconsumers (n = 54) indicated that they coped with problems in other…
Buskov, L; Abild, A; Christensen, A
To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital.......To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital....
Background: Trainees' skills and the teaching process can be improved by consideration of candidates' views. Aim: To find out the trainees' perception and views about the features and teaching methods of the Family Practice Training Program (FPSTP) in Kuwait to upgrade its standard. Methods: The study design is cross ...
Lawson, David M.; Gaushell, Harper
Compared intergenerational relationships of counselor trainees (n=125-232) and nonclinical sample (n=312-525). Counselor trainees reported healthier relationships with their parents and spouses concerning intergenerational triangulation, intergenerational intimidation and spousal fusion and less healthy relationships with spouses and children on…
Full Text Available The article focuses on the coverage of the most effective methods and technologies on improving communicative skills during the professional training of maritime fleet specialists. A complex study of skills formation process for communication in a foreign language in the Danube Institute of National University «Odessa Maritime Academy» has identified its the most problematic areas. In the result of using interactive technologies («brainstorming», project techniques, etc. was established positive dynamics in formation of skills of professional communication.
Whiteside, Douglas M; Guidotti Breting, Leslie M; Butts, Alissa M; Hahn-Ketter, Amanda E; Osborn, Katie; Towns, Stephanie J; Barisa, Mark; Santos, Octavio A; Smith, Daniel
Surveys of practicing neuropsychologists have been conducted for years; however, there have been no comprehensive surveys of neuropsychology trainees, which may result in important issues being overlooked by the profession. This survey assessed trainees' experiences in areas such as student debt, professional development, and training satisfaction. Survey items were written by a task force of the AACN Student Affairs Committee (SAC), and neuropsychology trainees were recruited via neuropsychology-focused listservs. In total, 344 trainees completed the survey (75% female) and included participants from every region of the US and Canada. Based on the survey questions, nearly half of all trainees (47%) indicated financial factors were the greatest limitation in their training. Student debt had a bimodal distribution; 32.7% had minimal debt, but 45% had debt >$100,000. In contrast, expected starting salaries were modest, but consistent with findings ($80-100,000). While almost all trainees intended to pursue board certification (97% through ABPP), many were 'not at all' or only 'somewhat' familiar with the process. Results indicated additional critical concerns beyond those related to debt and lack of familiarity with board certification procedures. The results will inform SAC conference programming and the profession on the current 'state of the trainees' in neuropsychology.
Bender, David R.
The American Association of School Librarians (AASL) supports the development by media specialists of the competencies and skills they need, whether derived from training in general and professional education, or from media specialization. The "Certification Model for Professional School Media Personnel," developed and designed by an…
Air Force Training Command, Sheppard AFB, TX.
This instructional package is intended for use in training Air Force personnel enrolled in a program for apprentice heating systems specialists. Training includes instruction in fundamentals and pipefitting; basic electricity; controls, troubleshooting, and oil burners; solid and gas fuel burners and warm air distribution systems; hot water…
Shah, Benoy N; Lindsay, Alistair C; Nicol, Edward D
Higher specialist training in cardiology has undergone significant reform across numerous countries in recent years. A number of factors have driven these changes, from the legal requirement to reduce working hours (i.e., the European Working Time Directive) to the increasing sub-specialisation within cardiology and the need for appropriately focussed training within these sub-specialties. Cardiac imaging provides a neat framework in which to examine the effect of such changes. Technological advances in echocardiography, nuclear cardiology, computed tomography and magnetic resonance imaging have seen an unprecedented increase in the utilisation of all techniques. The need to deliver appropriate training is recognised and numerous accreditation schemes exist within cardiovascular imaging, with the aim of demonstrating that specified levels of experience and expertise have been attained. However, in the United Kingdom, there has been a change from the traditional experience-based training scheme to a new, competency-based training program, with regular use of workplace-based assessments to prove competence in a specified area or procedure. As this training model is implemented, it will produce a generation of trainees for whom individual accreditation schemes carry less value, given the competency assessment inherently present within their new training system. This article discusses the role of accreditation in the era of competency-based specialist training from a cardiac imaging perspective using the UK experience to highlight the challenges facing trainees and to encourage a debate around how best to ensure cardiac imaging specialists are fully competent at the end of their specific training programs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
DeCamp, Matthew; Rodriguez, Joce; Hecht, Shelby; Barry, Michele; Sugarman, Jeremy
Background Interest in short-term global health training and service programs continues to grow, yet they can be associated with a variety of ethical issues for which trainees or others with limited global health experience may not be prepared to address. Therefore, there is a clear need for educational interventions concerning these ethical issues. Methods We developed and evaluated an introductory curriculum, ?Ethical Challenges in Short-term Global Health Training.? The curriculum was deve...
Bennett, D; Dornan, T; Bergin, C; Horgan, M
In 2006, the Buttimer report highlighted the paucity of demographic data on those applying for and entering postgraduate medical education and training (PGMET) in Ireland. Today, concerns that there is an "exodus" of graduates of Irish medical schools are at the forefront of national discussion, however, published data on PGMET remains inadequate. The objectives of this study were to collate existing data relating to trainees and training programmes at three stages of training and to examine the career plans of junior trainees. Data from application forms for training programmes, commencing July 2012, under the Royal College of Physicians of Ireland (n = 870), were integrated with data from other existing sources. Candidates entering basic specialist training were surveyed with regard to career plans. Descriptive and comparative analysis was performed in SPSS version 18. Graduates of Irish medical schools made up over 70 % of appointees. Over 80 % of BST trainees aspired to work as consultants in Ireland, but 92.5 % planned to spend time working abroad (response rate 77 %). Decisions to leave the Irish system were linked to lifestyle, but also to failure to be appointed to higher specialist training. Significant numbers of trainees return to Ireland after a period abroad. The trainee "exodus" is more complex than is often portrayed. The desire to spend time working outside Ireland must be accounted for in workforce planning and configuration of training programmes. Expansion of HST is a potential solution to reduce the numbers of graduates leaving Ireland post-BST.
Schwill, Simon; Magez, Julia; Jäger, Cornelia; von Meißner, Wolfgang Cg; Szecsenyi, Joachim; Flum, Elisabeth
In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five. The aim of this study was to understand the reasons of specialists for changing to a career in general practice. The postgraduate training program Verbundweiterbildung plus Baden-Württemberg had 597 trainees at the time of the study in December 2015. Previously qualified specialists in another medical discipline were identified and invited to participate in this study. Qualitative data was gathered using semi-structured interviews with content analysis of the interviews performed by three independent members of the research team. In total, 36 out of 597 trainees were identified as previously qualified specialists in another medical discipline. All 36 were invited to take part and 15 agreed to participate in this study. Overall, 15 interviews were performed, with a mean time of 24.19minutes. Participants with a median age of 40 years (33-59 years) - mainly anesthesiologists (n=7), surgeons (n=3) and internists (n=3) - presented with an average of 6.5 years of professional experience in their specialty. First, the participants' motivation to switch career arose from the wish to intensify the quality of patient contacts with a holistic approach including family and social background and from the infinite variety of general practice. Another reason given for a career change was self-employment opportunities. Finally, feelings of frustration over poor working conditions in hospitals resulted in a job search elsewhere in medicine, taking account of
Ridolo, E; Incorvaia, C; Senna, G E; Montagni, M; Olivieri, E; Canonica, G W
We performed a survey, based on a questionnaire including 20 items, submitted anonymously to Italian trainees in Allergology and Clinical Immunology, in order to obtain information about their specific allergen immunotherapy (AIT) practices. The questionnaire was sent to 40 trainees, who had attended the last two years of the training course. Thirty-four subjects (mean age: 27 years, 65% females) adequately completed the survey. The answers to the questionnaire showed that only 60% of the training programs included lectures on AIT. Among the trainees using AIT, only 40% declared being able to prescribe it independently, while 60% were guided by a tutor. Of the trainees who were able to prescribe AIT autonomously, 60% were familiar with both routes of administration, i.e. subcutaneous (SCIT) and sublingual immunotherapy (SLIT), while 25% of these used only SLIT. In 80% of the training institutions involved, the trainees could attend a dedicated AIT outpatient ward for SCIT administration; only 40% administered AIT personally, and in half of these cases, they were guided by a tutor. Only 70% of trainees had experience in the follow-up of patients still under treatment and of patients who had completed treatment. Analysis of the answers obtained for questions on venom immunotherapy (VIT) showed that, in 90% of cases, the trainees attended a dedicated outpatients ward where VIT is administered, but with a role limited to observation/cooperation. Only 30% were involved in the follow-up of patients who were under treatment or who had completed VIT. Only 20% of the trainees felt confident enough about VIT to prescribe this treatment independently, 80% knew there were several administration protocols, and the majority prescribed products from three different manufacturers. These findings suggest that there is significant room for improving the instructions provided regarding allergology and clinical immunology to trainees in Italy with respect to AIT.
Gorniak, Richard J T; Flanders, Adam E; Sharpe, Richard E
During their radiology residency, trainees must learn multiple facets of radiology practice, including the writing of radiology reports. An important factor in the trainee's development of reporting skills is feedback from the attending radiologist on the trainee's preliminary reports. The quality and quantity of feedback may vary and are not typically documented. As radiology department workloads have increased and stricter limitations have been imposed on trainee work hours, less time is available for attending radiologists and trainees to perform a joint retrospective review of radiology reports. To compensate, the authors have developed a Web-based dashboard that provides trainees with case-specific feedback about their reports. Components include an attending radiologist-trainee report discrepancy logging and communication system that is integrated with the institutional picture archiving and communication system, an automated preliminary report-final report comparator, modules showing statistics related to the discrepancy logger and report comparator components, and a Web page that unifies these components with image and report display capabilities. Both the actual report feedback and the trainee's use of the system are documented, and the resultant data may be used for evaluating trainee competence in written communication, as mandated by the Accreditation Council for Graduate Medical Education. With these tools, trainees can obtain near-real-time feedback, which may pinpoint issues that can be corrected to improve the quality of their radiology reporting. This system, although it does not supplant face-to-face training sessions with attending radiologists, can augment traditional methods of learning. © RSNA, 2013.
Aabakke, Anna J M; Kristufkova, Alexandra; Boyon, Charlotte; Bune, Laurids T; Van de Venne, Maud
To describe the infrastructural differences in training in Obstetrics and Gynaecology (ObGyn) across Europe. Descriptive web-based survey of 31 national ObGyn trainee societies representing the 30 member countries of the European Network of Trainees in Obstetrics and Gynaecology. Answers were verified in a telephone interview and only countries which had completed the telephone interview were included in the final analysis. The final analysis included 28 of 31 societies representing 27 countries (response rate 90%). The median formal duration of training was 5 years (range 4-7). There were mandatory requirements in addition to medical school graduation before specialisation could be started in 20 (71%) countries. The job opportunities after completion of training varied and included academic fellowships (n=21 [75%]), clinical fellowships/junior consultancy (n=21 [75%]), consultancy (n=11 [40%]), and private practice (n=23 [82%)]. Training and working as a specialist abroad was uncommon (≤20% in 21 [78%] and 26 [96%] countries respectively). Exams during ObGyn training were offered in 24 (85%) countries. Unemployment after completion of training was rare (Europe; A) The requirements to obtain a training post vary causing differences in the qualifications of trainees starting training. B) The duration of training varies. And C) newly trained specialists carry varying levels of responsibility. The results suggest that the content, organisation, and outcome of training differ across Europe. Differences due to political, social and cultural reasons are expected. However, further harmonisation of training across Europe still seems desirable in order to improve women's healthcare and facilitate the mobility of ObGyn trainees and specialists across Europe. There are currently several European initiatives, however, national and local measures are essential for training to improve. Copyright © 2017 Elsevier B.V. All rights reserved.
Holm, Ellen; Holm, Kirsten; Sørensen, Jette Led
In 360-degree feedback medical colleagues and collaborators give a trainee feedback by answering a questionnaire on behaviour of the trainee. The questionnaire may contain questions answered on a scale or/and they may contain open questions. The result from 360-degree feedback is used for formative...... feedback and assessment. In order to secure reliability 8-15 respondents are needed. It is a matter of discussion whether the respondents should be chosen by the trainee or by a third part, and if respondents should be anonymous. The process includes a feedback session with a trained supervisor....
Ida Maria Morales Marins
Full Text Available The job, here presented, is a literacy practices result, in special, developed during the letters students trainee, through a extension project called Experiences of reading/writing: the readers/writers formation. This text has as objective relate two teaching proposals, bringing a specific methodology which tries to show, to the future letters professionals, a fertile possibility of working with language and literature at school. Also, bring a brief theoretical approaching about literacy, to situate the lector about the meaning of this term. Through practices developed during the trainee results, was possible to realize the diversity and richness of actions which has the potential of overarching the language and literature classroom, transforming this space in a pleasure space, of significant learning which mobilize the creativity, the criticality and the development of the reading and writing pleasure.
Emerson, Kim; Moore, Penny; Edwards, Jill
This work aimed to evaluate the effectiveness of using GP trainees in place of professional actors, to role-play trainees with 'difficulties' or various challenging characteristics, as an educational tool for skills development of experienced GP trainers. The context was a residential experienced GP trainers' course and the role players were local ST3 GP trainees. Professional actors have been used for this purpose for many years in medical education at all levels, particularly in teaching communication and consultation skills in the Thames Valley area of the UK. We wanted to trial and evaluate whether using GP trainees themselves, with their own more authentic 'hinterland' of experience, (but no acting training) would be as, or more, effective than using actors. The exercise was successful and showed, through post-course feedback (immediate written feedback and later on-line questionnaire), that the use of trainees was considered by the delegates to be an effective, adaptable and realistic training tool, and more so than using professional actors. The trainees also reported educational benefit from the experience.
Parvizi, Nassim; Bhuva, Shaheel
A national survey was designed to better understand factors influencing special interest choices, future aspirations of UK radiology trainees and perceptions of breast radiology. A SurveyMonkey questionnaire was developed and distributed to all radiology trainees in the UK through the British Institute of Radiology, RCR Junior Radiologists Forum and by directly contacting UK training schemes as well as by social media between December 2015 and January 2016. From 21 training schemes across the UK, 232 responses were received. Over half entered radiology after foundation training and 62% were ST1-3; one-fifth of trainees intended to leave the NHS. The most popular special interests were musculoskeletal (18%), abdominal imaging (16%) and neuroradiology (13%). Gynaecological and oncological imaging proved to be the least popular. Strong personal interest, a successful rotation during training, a mix of imaging modalities, direct impact on patient care and job prospects were the most popular factors influencing career choice. Research and potential for private income were the least influential factors. Respondents detailed their perceptions of breast radiology, selecting an awareness of career prospects (41%) and a better trainee experience (36%) as factors that would increase their interest in pursuing it as a career. Understanding the factors that influence special interest choice is essential to addressing the alarming staffing shortfalls that will befall certain radiology special interests. Addressing trainee's preconceptions and improving the trainee experience are key to attracting trainees to breast radiology. Advances in knowledge: This is the first survey of its kind in the UK literature designed to evaluate special interest career choices and the factors that influence those among radiology trainees.
Sturgiss, Elizabeth; Haesler, Emily; Anderson, Katrina
Objectives The aim of the present secondary analysis of data collected in a grounded theory study was to explore the perceptions of Registrars and new Fellows to practice ownership and management. Methods Focus groups and interviews with Registrars and recent Fellows were undertaken to explore the desire to become an owner, facilitators and barriers to practice ownership and delivery models for practice ownership education. A secondary thematic analysis was conducted to understand emerging concepts related to perceptions of general practice ownership. Results A surprisingly strong theme of fear was evident across focus group and interview participants. Expressed fear was specifically related to financial concerns, lack of relevant knowledge and skills and concern over balancing different roles. Moderating factors included previous life and educational experiences, as well as role modelling. Conclusions Graduation of a cohort of new general practitioners (GPs) who express fear towards practice ownership is concerning. Creating more positive learning environments and opportunity for open discussion regarding practice management and ownership is an important step in providing adequate support for new GPs to give serious consideration to career options. What is known about the topic? The traditional model of general practice ownership has been for a doctor to own and/or manage the practice. Fewer new GPs are taking on the role of owning a general practice, and disinterest has been presumed to play a significant role in this trend. It has been reported that current curricula provide insufficient focus on providing learning opportunities for general practice trainees on ownership and management models; however, recent research has shown that general practice trainees have a strong interest in receiving this knowledge during their training. What does this paper add? The present qualitative research evaluated the emotional response that general practice trainees
Vincenzo De Sanctis
Full Text Available Background: Multi-transfused thalassemia major (TM patients frequently develop severe endocrine complications, mainly due to iron overload, anemia and chronic liver disease, which require prompt diagnosis, treatment and follow-up by specialists. The most common endocrine complication documented is hypogonadotropic hypogonadism which increases with age and associated comorbidities. It is thus important for physicians to have a clear understanding of the pathophysiology and management of this disorder. Also to be aware of the side effects, contraindications and monitoring of sex steroid therapy. In this paper practical ICET-A recommendations for the management of hypogonadism in adult females with TM are addressed. Methods: In March 2015, the Coordinator of the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescent Medicine (ICET-A conducted a two-step survey to assess the attitudes and practices of doctors in the ICET-A network taking care of adult female TM patients with hypogonadism. They were clinically characterized by the absence of pubertal development, or discontinuation or regression of the maturation of secondary sex characteristics, and biochemically by persistent low FSH, LH and estradiol levels. Recently a supplementary survey on adult female hypogonadism in TM was undertaken within the ICET-A network. Results: The completed questionnaires were returned by 16 of 27 specialists (59.2% following 590 female TM patients over the age of 18 years; 315 patients (53.3% had hypogonadism and only 245 (74.6% were on hormone replacement therapy (HRT. Contraceptive oral pills (COC were the first treatment choice in 11 centres (68.7%. A wide range of COCs were used with different progestin contents. In general, the patients’ compliance to treatment was reported as good in 81.2 % of centres. The frequency of required tests for follow-up HRT, in addition to the regular check-up for thalassemia, was variable
Gravengaard, Gitte; Rimestad, Lene
In this article we investigate socialisation practices in the newsroom. The analyses demonstrate how journalist trainees are socialised into this particular professional culture and community of practice. Theoretically, we combine the traditional news ethnography with linguistic anthropology...
Mohan, Helen M; Fitzgerald, Edward; Gokani, Vimal; Sutton, Paul; Harries, Rhiannon; Bethune, Robert; McDermott, Frank D
There is a wide chasm in access to essential and emergency surgery between high and low/middle income countries (LMICs). Surgeons worldwide are integral to solutions needed to address this imbalance. Involving surgical trainees, who represent the future of surgery, is vital to this endeavour. The Association of Surgeons in Training (ASiT) is an independent charity that support surgical trainees of all ten surgical specialties in the UK and Ireland. ASiT convened a consensus meeting at the ASiT conference in Liverpool 2016 to discuss trainee engagement with global surgery, including potential barriers and solutions. A face-to-face consensus meeting reviewed the engagement of, and roles for, surgical trainees in global surgery at the ASiT Conference (Liverpool, England), March 2016. Participants self-identified based on experience and interest in the field, and included trainees (residents and students) and consultants (attending grade). Following expert review, seven pre-determined core areas were presented for review and debate. Extensive discussion was facilitated by a consultant and a senior surgical trainee, with expertise in global surgery. The draft derived from these initial discussions was circulated to all those who had participated, and an iterative process of revision was undertaken until a final consensus and recommendations were reached. There is increasing interest from trainee surgeons to work in LMICs. There are however, ethical considerations, and it is important that trainees working in LMICs undertake work appropriate to their training stage and competencies. Visiting surgeons must consider the requirements of the hosting centres rather than just their own objectives. If appropriately organised, both short and long-term visits, can enable development of transferable clinical, organisational, research and education skills. A central repository of information on global surgery would be useful to trainees, to complement existing resources. Challenges
Smeds, Matthew R; Huynh, Cindy; Thrush, Carol R; Moursi, Mohammed M; Amankwah, Kwame S
Mentorship within surgery, particularly vascular surgery, has not been extensively evaluated. This study sought to examine mentorship experiences in graduating vascular trainees (VTs). An anonymous electronic survey examining current mentor relationships, ideal characteristics, academic productivity, and operative comfort level was emailed to all US graduating 2015 (n = 141) and 2016 (n = 144) VTs during their last year of training. A parallel survey was emailed to program/associate program directors (PDs) of all US vascular training programs (n = 169). Surveys were completed by 65 (38%) PDs and 62 (22%) VTs. Forty-three (69%) VTs identified a mentor with no difference in frequency of having a mentor noted among gender, type of training (fellowship/residency), or geographical region. The majority (41/43, 95%) recognized a vascular surgeon as their mentor; the mentor was assigned to 10 of 43 (23%) trainees and was their PD to 9 of 43 (21%). Ideal mentor characteristics, identified by VTs using 4-point Likert scales, were approachability, supportiveness, and accessibility (3.94, 3.76, and 3.74, respectively), while those of a good mentee were enthusiasm, ethical work, and commitment (3.79, 3.69, and 3.45, respectively). Trainees scored accessibility, approachability, compassion, and same gender significantly higher than PDs as characteristics of ideal mentors (P nether group feels comfortable with complex endovascular cases. More research is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.
Ruskin, R; Sakinofsky, I; Bagby, R M; Dickens, S; Sousa, G
The authors investigated the impact of patient suicides on trainees and psychiatrists and their utilization of supports. Graduates in practice and trainees of the residency program of the University of Toronto from 1980-1995 (N=495) were surveyed, retrospectively, with 239/495 responding (48%). Demographic and educational information, exposure to suicide, impact of the suicide(s), use of support systems, acute stress disorder and posttraumatic stress disorder symptoms, and impact of events and social relationship scores were collected. One-half of the respondents (120/239) experienced at least one suicide of a patient, 62% of them (74/120) during postgraduate training. Biologically oriented psychiatrists in practice were more at risk for patient suicide. An important minority (one-quarter) among those who experienced patient suicide had substantially higher (morbid) scores than the overall group. They also scored higher on an acute stress disorder and a posttraumatic stress disorder symptom checklist. The impact was more severe when the patient suicide occurred during training than after graduation and was inversely correlated with clinicians' perceived social integration into their relational professional network. The experience of patient suicide is common during training and in clinical practice. The majority of trainees and clinicians are able to cope normally with the trauma, but in an important minority the emotional impact approaches morbid levels. Training programs should prepare students for this occupational hazard and implement systematic protocols to support those trainees who are especially vulnerable to their patient's suicide and reduce their social isolation from their peer group. Formal and informal professional networks should heighten awareness of the impact of patient suicide on practicing colleagues and take adequate measures to support them.
O'Shaughnessy, S M
The purpose of this study is to introduce peer teaching of communication skills to first-year anaesthesia trainees in Ireland and to evaluate their perception of this teaching modality. Seventy-nine first-year anaesthesia trainees participated in a novel peer-led communication skills programme over a 2-year period (Y1, Y2). A Likert scaling questionnaire was developed to explore trainee perception of the peer teaching programme. Of the 79 respondents (36 in Y1 and 43 in Y2), 99% either agreed or strongly agreed that the peer teachers were successful in their role. Ninety-two percent requested formal peer teaching in other areas of training. The trainees regarded a peer teacher as an appropriate information provider (92%), role model (88%), planner (88%) and facilitator (94%), but less so as an assessor (70%). The most consistently stated strength of peer teaching was the relatability of peer teachers with their lack of experience cited as the main weakness. Eighty percent of participants preferred peer teaching to regular expert teaching. This study highlights the positive attitudes of first-year anaesthesia trainees towards a novel peer teaching programme in communication skills. This author recommends that peer teaching is further developed within postgraduate medical programmes to maximise learning for trainees in the student and teacher roles and to redistribute the teaching burden within clinical departments.
McKensey, Andrew; Sullivan, Leonie
The paper presents a pilot study of Balint group work to establish it as a potential training tool in psychiatry. The aim was to test whether, in the training setting, it was possible for a cohesive group to form, such that trainees could make use of a Balint group experience. Nine psychiatry trainees were offered three 90-minute Balint sessions and provided written feedback. The trainees reported unanimously that group participation was a positive and worthwhile experience. They began to feel supported by their colleagues and experienced the method as an effective way to manage stress and anxiety. They reported that they experienced doctor-patient interactions in a different way, which appeared to correspond with a greater understanding of the patient's experience. The pilot suggested that, within the public health training setting, a cohesive group could form such that trainees were able to make use of a Balint group experience. It suggested that this practice could be beneficial in managing the stresses, isolation and intense feelings of working with patients in this setting. The feedback indicated that the group helped trainees 'think differently' by fostering self-awareness and so furthered their development of psychodynamic skills. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Austin, Lynn; Luker, Karen; Roland, Martin; Ronald, Martin
This qualitative study explored the experiences of two groups of clinical nurse specialists--continence advisors and tissue viability nurses--working in primary care in the UK. In particular, the study focused on how clinical nurse specialists' relationships with other health-care professionals had an impact on their role. Clinical nurse specialists are recognized worldwide as having expertise in a given field, which they use to develop the practice of others. Additionally, clinical nurse specialists share many of the characteristics of entrepreneurs, which they use to develop services related to their speciality. However, little research has been conducted in relation to clinical nurse specialists' experiences as they attempt to diversify nursing practice. An ethnographic approach was adopted comprising many elements of Glaserian grounded theory. Data were collected via participant observation and face-to-face interviews with 22 clinical nurse specialists. Services provided by clinical nurse specialists were not static, clinical nurse specialists being the main drivers for service developments. However, clinical nurse specialists encountered difficulties when introducing new ideas. Given their role as advisors, clinical nurse specialists lacked authority to bring about change and were dependent on a number of mechanisms to bring about change, including 'cultivating relationships' with more powerful others, most notably the speciality consultant. The UK government has pledged to 'liberate the talents of nurses' so that their skills can be used to progress patient services. This study highlights the fact that a lack of collaborative working practices between health-care professionals led to clinical nurse specialists being constrained. Health-care organizations need to provide an environment in which the entrepreneurial skills of clinical nurse specialists may be capitalized on. In the absence of an outlet for their ideas regarding service developments, clinical
Mathews, Maria; Kandar, Rima; Slade, Steve; Yi, Yanqing; Beardall, Sue; Bourgeault, Ivy; Buske, Lynda
Visa trainees are international medical graduates (IMG) who come to Canada to train in a post-graduate medical education (PGME) program under a student or employment visa and are expected to return to their country of origin after training. We examined the credentialing and retention of visa trainees who entered PGME programs between 2005 and 2011. Using the Canadian Post-MD Education Registry's National IMG Database linked to Scott's Medical Database, we examined four outcomes: (1) passing the Medical Council of Canada Qualifying Examination Part 2 (MCCQE2), (2) obtaining a specialty designation (CCFP, FRCPC/SC), and (3) working in Canada after training and (4) in 2015. The National IMG Database is the most comprehensive source of information on IMG in Canada; data were provided by physician training and credentialing organizations. Scott's Medical Database provides data on physician locations in Canada. There were 233 visa trainees in the study; 39.5% passed the MCCQE2, 45.9% obtained a specialty designation, 24.0% worked in Canada after their training, and 53.6% worked in Canada in 2015. Family medicine trainees (OR = 8.33; 95% CI = 1.69-33.33) and residents (OR = 3.45; 95% CI = 1.96-6.25) were more likely than other specialist and fellow trainees, respectively, to pass the MCCQE2. Residents (OR = 7.69; 95% CI = 4.35-14.29) were more likely to obtain a specialty credential than fellows. Visa trainees eligible for a full license were more likely than those not eligible for a full license to work in Canada following training (OR = 3.41; 95% CI = 1.80-6.43) and in 2015 (OR = 3.34; 95% CI = 1.78-6.27). Visa training programs represent another route for IMG to qualify for and enter the physician workforce in Canada. The growth in the number of visa trainees and the high retention of these physicians warrant further consideration of the oversight and coordination of visa trainee programs in provincial and in pan
Dennis, A. A.; Foy, M. J.; Monrouxe, L. V.; Rees, C. E.
Emotion characterises learners' feedback experiences. While the failure-to-fail literature suggests that emotion may be important, little is known about the role of emotion for educators. Secondary analyses were therefore conducted on data exploring 110 trainers' and trainees' feedback experiences. Group and individual narrative interviews were…
Hopkins, Dianne McAfee
Discussion of school library media specialist's involvement in reconsideration of materials from library media collection focuses on what media specialist should bring to complaint situation (school board-approved materials selection policy, training and experience, knowledge of available resources in intellectual freedom) and reconsideration…
Sammut, Mario R.
Introduction: As a result of Malta’s EU accession in 2004, family medicine was accepted as a speciality and the Malta College of Family Doctors prepared a Specialist Training Programme in Family Medicine. To facilitate its launch, potential GP trainers and trainees participated in its preimplementation evaluation. Method: Participants’ views were gathered quantitatively through a questionnaire using scales to rate closed statements regarding the programme and its sections. Qualitative openend...
Winston, A P; Baxter, H; Rogers, D
This study investigated the effect of a specialist eating disorders service on the attitudes and knowledge of local healthcare professionals. A questionnaire was sent to fully qualified psychiatrists, postgraduate trainees in psychiatry and general (internal) medicine, general practitioners (family physicians) and dietitians in two comparable cities: Leicester (which had a specialist eating disorders service) and Nottingham (which did not). Psychiatrists in training in Leicester had a greater knowledge of eating disorders than those in Nottingham. There was greater satisfaction with services in Leicester but no difference in attitudes. The presence of a local eating disorders service enhances postgraduate training and increases knowledge.
Sawyer, Susan M; Farrant, Bridget; Hall, Anganette; Kennedy, Andrew; Payne, Donald; Steinbeck, Kate; Vogel, Veronica
In Australia and New Zealand, a critical mass of academic and clinical leadership in Adolescent Medicine has helped advance models of clinical services, drive investments in teaching and training, and strengthen research capacity over the past 30 years. There is growing recognition of the importance of influencing the training of adult physicians as well as paediatricians. The Royal Australasian College of Physicians (RACP) is responsible for overseeing all aspects of specialist physician training across the two countries. Following advocacy from adolescent physicians, the RACP is advancing a three-tier strategy to build greater specialist capacity and sustain leadership in adolescent and young adult medicine (AYAM). The first tier of the strategy supports universal training in adolescent and young adult health and medicine for all basic trainees in paediatric and adult medicine through an online training resource. The second and third tiers support advanced training in AYAM for specialist practice, based on an advanced training curriculum that has been approved by the RACP. The second tier is dual training; advanced trainees can undertake 2 years training in AYAM and 2 years training in another area of specialist practice. The third tier consists of 3 years of advanced training in AYAM. The RACP is currently seeking formal recognition from the Australian Government to have AYAM accredited, a process that will be subsequently undertaken in New Zealand. The RACP is expectant that the accreditation of specialist AYAM physicians will promote sustained academic and clinical leadership in AYAM to the benefit of future generations of young Australasians.
Full Text Available Abstract Background Little is known about the factors influencing treatment choice in psychosis, the majority of this work being conducted with specialists (consultant in psychiatry. We sought to examine trainees' choices of treatment for psychosis if they had to prescribe it for themselves, their patients, and factors influencing decision-making. Methods Cross-sectional, semi-structured questionnaire-based study. Results Of the 726 respondents (response rate = 66%, the majority chose second-generation antipsychotics (SGAs if they had to prescribe it for themselves (n = 530, 93% or for their patients (n = 546, 94%. The main factor influencing choice was perceived efficacy, 84.8% (n = 475 of trainees stating this was the most important factor for the patient, and 77.8% (n = 404 stating this was the most important factor for their own treatment. Trainees with knowledge of trials questioning use of SGAs (CATIE, CUtLASS, TEOSS were more likely to choose second-generation antipsychotics than those without knowledge of these trials (χ2 = 3.943; p = 0.047; O.R. = 2.11; 95% C.I. = 1.0-4.48. Regarding psychotherapy, cognitive behavioural therapy (CBT was the most popular choice for self (33.1%; n = 240 and patient (30.9%; n = 224. Trainees were significantly more likely to prefer some form of psychotherapy for themselves rather than patients (χ2 = 9.98; p Conclusions Trainees are more likely to choose second-generation antipsychotic medication for patients and themselves. Despite being aware of evidence that suggests otherwise, they predominantly base these choices on perceived efficacy.
The 35 participants, representing 7 Member States and one International Organization discussed recent investigations on leak development and propagation in LMFBR steam generators. The meeting was divided into three technical sessions: review of national status on studies of failure propagation (8 papers); propagation experience on reactor steam generators (4 papers); studies of failure propagation: codes, hydrogen detection, tests (11 papers). A separate abstract was prepared for each of these papers
Allan, Catherine K; Tannous, Paul; DeWitt, Elizabeth; Farias, Michael; Mansfield, Laura; Ronai, Christina; Schidlow, David; Sanders, Stephen P; Lock, James E; Newburger, Jane W; Brown, David W
Introduction New paediatric cardiology trainees are required to rapidly assimilate knowledge and gain clinical skills to which they have limited or no exposure during residency. The Pediatric Cardiology Fellowship Boot Camp (PCBC) at Boston Children's Hospital was designed to provide incoming fellows with an intensive exposure to congenital cardiac pathology and a broad overview of major areas of paediatric cardiology practice. The PCBC curriculum was designed by core faculty in cardiac pathology, echocardiography, electrophysiology, interventional cardiology, exercise physiology, and cardiac intensive care. Individual faculty contributed learning objectives, which were refined by fellowship directors and used to build a programme of didactics, hands-on/simulation-based activities, and self-guided learning opportunities. A total of 16 incoming fellows participated in the 4-week boot camp, with no concurrent clinical responsibilities, over 2 years. On the basis of pre- and post-PCBC surveys, 80% of trainees strongly agreed that they felt more prepared for clinical responsibilities, and a similar percentage felt that PCBC should be offered to future incoming fellows. Fellows showed significant increase in their confidence in all specific knowledge and skills related to the learning objectives. Fellows rated hands-on learning experiences and simulation-based exercises most highly. We describe a novel 4-week-long boot camp designed to expose incoming paediatric cardiology fellows to the broad spectrum of knowledge and skills required for the practice of paediatric cardiology. The experience increased trainee confidence and sense of preparedness to begin fellowship-related responsibilities. Given that highly interactive activities were rated most highly, boot camps in paediatric cardiology should strongly emphasise these elements.
Gough, Jenny K; Frydenberg, Alexis R; Donath, Susan K; Marks, Michael M
In curriculum documents for medicine in undergraduate, post-graduate and continuing professional development, there is now a focus on communication skills. The challenges are to place communication skills in the crowded curriculum and then to construct and sustain a programme that uses an evidence-based approach to the teaching and learning of communication skills. For 6 years, we have conducted a programme that involves simulated parents supporting junior medical staff to refine their skills in communication, particularly in giving parents bad news. The aim of our study was to obtain a better understanding of the trainees' experiences of the programme. Nine junior residents individually worked through two scenarios and received feedback from the simulated parent. They gave bad news to a simulated parent/actor who then gave feedback. A recording of the simulation was provided for discussion with a designated colleague at an arranged time. The tapes were then separately appraised by two independent raters - another actor and a paediatrician. Brief written reports and conducted semi-structured interviews provided more insights into the trainees' experience of the simulation. Other participating medical/medical education staff were interviewed about the simulation programme. Five themes emerged from the qualitative data: timeliness, emotional safety, the complexity of communication, practical usefulness and the challenge of effecting change. In addition, the ratings of the videos helped to clarify those 'parent-centred' communication skills that trainees may neglect in difficult conversations: 'ask about support', 'encourage the parent to ask questions' and 'repeat key messages'. The evaluation highlighted the value of an early-career experiential programme to highlight the importance of communication skills in post-graduate paediatrics practice.
Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer
As doctors in all specialties are expected to undertake leadership within health care organisations, leadership development has become an inherent part of medical education. Whereas the leadership literature within medical education remains mostly focused on individual, hierarchical leadership, contemporary theory posits leadership as a group process, which should be distributed across all levels of health care organisation. This gap between theory and practice indicates that there is a need to understand what leadership and followership mean to medical trainees working in today's interprofessional health care workplace. Epistemologically grounded in social constructionism, this research involved 19 individual and 11 group interviews with 65 UK medical trainees across all stages of training and a range of specialties. Semi-structured interviewing techniques were employed to capture medical trainees' conceptualisations of leadership and followership. Interviews were audiotaped, transcribed verbatim and analysed using thematic framework analysis to identify leadership and followership dimensions which were subsequently mapped onto leadership discourses found in the literature. Although diversity existed in terms of medical trainees' understandings of leadership and followership, unsophisticated conceptualisations focusing on individual behaviours, hierarchy and personality were commonplace in trainees' understandings. This indicated the dominance of an individualist discourse. Patterns in understandings across all stages of training and specialties, and whether definitions were solicited or unsolicited, illustrated that context heavily influenced trainees' conceptualisations of leadership and followership. Our findings suggest that UK trainees typically hold traditional understandings of leadership and followership, which are clearly influenced by the organisational structures in which they work. Although education may change these understandings to some extent
White, Mary T; Satterfield, Caley A; Blackard, Jason T
Participation in short-term educational experiences in global health (STEGHs) among medical trainees is increasingly accompanied by interest in conducting research while abroad. Because formal training in both global health and research methods is currently under-represented in most medical curricula, trainees are often unfamiliar with the knowledge, attitudes, and skills necessary to design and conduct research successfully. This narrative review identifies essential global health research competencies for medical trainees engaged in STEGHs. The authors searched the literature using the terms global health, competency, research, research methods/process/training, scholarly project, medical student, and medical education/education. Because articles directly addressing global health research competencies for medical trainees were limited, the authors additionally drew on the broader literature addressing general research competencies and global health competencies. Articles yielded by the literature search, combined with established guidelines in research ethics and global health ethics, were used to identify six core domains and twenty discrete competencies fundamental to global health research at a level appropriate for medical trainees enrolled in STEGHs. Consideration was given to diverse research modalities, varying levels of training, and the availability of mentoring and on-site support. Research may provide important benefits to medical trainees and host partners. These competencies provide a starting point; however, circumstances at any host site may necessitate additional competencies specific to that setting. These competencies are also limited by the methodology employed in their development and the need for additional perspectives from host partners. The competencies identified outline basic knowledge, attitudes, and skills necessary for medical trainees to conduct limited global health research while participating in STEGHS. They may also be used as a
Morgan, Simon; Henderson, Kim M; Tapley, Amanda; Scott, John; van Driel, Mieke L; Spike, Neil A; McArthur, Lawrie A; Davey, Andrew R; Catzikiris, Nigel F; Magin, Parker J
Travel medicine is a common and challenging area of clinical practice and practitioners need up-to-date knowledge and experience in a range of areas. Australian general practitioners (GPs) play a significant role in the delivery of travel medicine advice. We aimed to describe the rate and nature of travel medicine consultations, including both the clinical and educational aspects of the consultations. A cross-sectional analysis from an ongoing cohort study of GP trainees' clinical consultations was performed. Trainees contemporaneously recorded demographic, clinical, and educational details of consecutive patient consultations. Proportions of all problems/diagnoses managed in these consultations that were coded "travel-related" and "travel advice" were both calculated with 95% confidence intervals (CIs). Associations of a problem/diagnosis being "travel-related" or "travel advice" were tested using simple logistic regression within the generalized estimating equations (GEE) framework. A total of 856 trainees contributed data on 169,307 problems from 108,759 consultations (2010-2014). Travel-related and travel advice problems were managed at a rate of 1.1 and 0.5 problems per 100 encounters, respectively. Significant positive associations of travel-related problems were younger trainee and patient age; new patient to the trainee and practice; privately billing, larger, urban, and higher socioeconomic status practices; and involvement of the practice nurse. Trainees sought in-consultation information and generated learning goals in 34.7 and 20.8% of travel advice problems, respectively, significantly more than in non-travel advice problems. Significant positive associations of travel advice problems were seeking in-consultation information, generation of learning goals, longer consultation duration, and more problems managed. Our findings reinforce the importance of focused training in travel medicine for GP trainees and adequate exposure to patients in the practice
Cooke, Georga; Tapley, Amanda; Holliday, Elizabeth; Morgan, Simon; Henderson, Kim; Ball, Jean; van Driel, Mieke; Spike, Neil; Kerr, Rohan; Magin, Parker
Tolerance for ambiguity is essential for optimal learning and professional competence. General practice trainees must be, or must learn to be, adept at managing clinical uncertainty. However, few studies have examined associations of intolerance of uncertainty in this group. The aim of this study was to establish levels of tolerance of uncertainty in Australian general practice trainees and associations of uncertainty with demographic, educational and training practice factors. A cross-sectional analysis was performed on the Registrar Clinical Encounters in Training (ReCEnT) project, an ongoing multi-site cohort study. Scores on three of the four independent subscales of the Physicians' Reaction to Uncertainty (PRU) instrument were analysed as outcome variables in linear regression models with trainee and practice factors as independent variables. A total of 594 trainees contributed data on a total of 1209 occasions. Trainees in earlier training terms had higher scores for 'Anxiety due to uncertainty', 'Concern about bad outcomes' and 'Reluctance to disclose diagnosis/treatment uncertainty to patients'. Beyond this, findings suggest two distinct sets of associations regarding reaction to uncertainty. Firstly, affective aspects of uncertainty (the 'Anxiety' and 'Concern' subscales) were associated with female gender, less experience in hospital prior to commencing general practice training, and graduation overseas. Secondly, a maladaptive response to uncertainty (the 'Reluctance to disclose' subscale) was associated with urban practice, health qualifications prior to studying medicine, practice in an area of higher socio-economic status, and being Australian-trained. This study has established levels of three measures of trainees' responses to uncertainty and associations with these responses. The current findings suggest differing 'phenotypes' of trainees with high 'affective' responses to uncertainty and those reluctant to disclose uncertainty to patients. More
Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith
Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated
Jenkins, Sarah; Mikhael, Joseph; Gitlin, Scott D.
Nonmalignant hematologic conditions are extremely prevalent and contribute significantly to the global burden of disease. The US health care system may soon face a shortage of specialists in nonmalignant hematology. We sought to identify factors that lead hematology-oncology fellows to pursue (or not to pursue) careers in nonmalignant hematology. Cross-sectional, web-based survey distributed to 149 graduates of a hematology-oncology fellowship program at a large academic medical center between 1998 and 2016. Eighty-six out of 149 graduates responded (57.7%); most (59 [68.6%]) practice at an academic medical center. Respondents spend a mean of 61% of their time in clinical practice, 23.7% conducting research, 5.2% in education, and 5.2% in administration. Those in clinical practice spend a mean of 52.1% of their time in solid tumor oncology, 37.5% in hematologic malignancies, and 10% in nonmalignant hematology; only 1 spent >50% of time practicing nonmalignant hematology. Factors most significantly affecting choice of patient population included clinical experience during fellowship and intellectual stimulation of the patient population/disease type. Factors that could have most significantly influenced a decision to spend more time in nonmalignant hematology included increased exposure/access to role models and mentors and opportunities for better career growth/advancement. Fellowship graduates spend >50% of their time in clinical practice, but almost none spend a significant amount of time practicing nonmalignant hematology. Given the growing number of patients with nonmalignant hematologic conditions and a possible future provider shortage, medical trainees should be encouraged to pursue careers in nonmalignant hematology. PMID:29463548
de Jong, Jip; Visser, Mechteld R. M.; Mohrs, Jacob; Wieringa-de Waard, Margreet
The variety of health problems (patient mix) that medical trainees encounter is presumed to be sufficient to master the required competencies. To describe the patient mix of GP trainees, to study differences in patient mix between first-year and third-year GP trainees, and to investigate differences
Nikandrou, Irene; Brinia, Vassiliki; Bereri, Elissavet
Purpose: The purpose of the paper is to present an empirical study based on a trainee-oriented systemic model for training transfer. The paper examines trainee characteristics which affect the motivation to learn and transfer and determine the trainees entry behavior. Then, during the training process, the complex interactions among the trainer,…
Gold, Joshua M.
Entry-level counseling students (n=74) were surveyed to investigate the relationship between resolution of Erikson's psychosocial stage of intimacy/isolation and counselor trainee empathy. Results revealed a significant positive relationship between measures of psychosocial stage resolution and counselor empathy and a significant main effect for…
Weeda, G; Hutter, AW; Groenier, KH; Schuling, J
During their first training period in general practice the authors felt that they did not encounter the balanced workload which is the foundation for learning to be a GP. Previous studies confirmed the existence of differences in overall and specific workload between trainees and trainers. From
Yesim Cokay Abut
Full Text Available Background: Anesthesiology may be stressful and most anesthesiologists develop mechanisms for coping. However, inexperienced trainee anesthesiologists seem to be vulnerable. We studied stress perception and job burnout in trainee anesthesiologists. Methods: Responses to perceived stress scale (PSS and Maslach Burnout Inventory (MBI were evaluated in 159 trainee anesthesiologists. Results: In our results, when perceived stress was increased, emotional exhaustion and depersonalization increased but personal accomplishment decreased, as expected. Perceived stress was very high in the early years of training. There was a negative correlation between age and emotional exhaustion and depersonalization, but positive correlation with personal accomplishment. Female anesthesiologists had higher personal accomplishment, but lower depersonalization points than male anesthesiologists in our study. There was no statistical association between marital status, PSS, and MBI; ≥2 children group had a significant high personal accomplishment but low depersonalization and emotional exhaustion scores. Line regression analysis showed a statistically significant relationship between PSS and emotional exhaustion and between age and depersonalization. Conclusions: Social factors such as gender and number of children affect the work life of our trainees.
Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa.
..., constitutes engagement in activities under section 7(k) only when the employee meets all the applicable tests... FAIR LABOR STANDARDS ACT TO EMPLOYEES OF STATE AND LOCAL GOVERNMENTS Fire Protection and Law Enforcement Employees of Public Agencies Exemption Requirements § 553.214 Trainees. The attendance at a bona...
Yaacob, Aizan; Walters, Lynne Masel; Ali, Ruzlan Md; Abdullah, Sarimah Shaik; Walters, Timothy
Purpose: In this study, 37 English Language Teaching (ELT) teacher trainees from a Malaysian university conducted an action-research project to determine whether journals kept during their fieldwork in primary schools located in an area close to the university allowed them to reflect on their beliefs and behaviors in the classroom. Methodology:…
Langhoff, Peter Koch; Schultz, Martin; Harvald, Thomas
Laparoscopic surgery for colorectal cancer is safe, but there have been hesitations to implement the technique in all departments. One of the reasons for this may be suboptimal learning possibilities since supervised trainees have not been allowed to do the operations to an adequate extent...
Rele, Kiran; Tarrant, C. Jane
Objective: The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). Methods: A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors…
Valdemar Donizeti de Sousa
Full Text Available Trata-se de uma pesquisa qualitativa de inspiração teórica humanista acerca das vivências de estagiários do curso de graduação em psicologia da PUC-Campinas na área da Saúde/Clínica, na atenção básica em saúde pública, como participantes de equipes de saúde da família. Participaram seis estagiários do último ano do curso, alocados em dois Centros de Saúde-Escola da região Noroeste de Campinas. A metodologia utilizada foi de cunho etnográfico. O processo para composição dos dados foi produzido em dois momentos: a registro semanal em diário pessoal de cada estagiário, durante cinco meses; b entrevistas individuais, semidirigidas, ao final do período letivo. Estes dados foram analisados a partir de uma leitura fenomenológica. Encontraram-se fases evolutivas no processo de formação do estagiário. Inicialmente, a experiência foi vivenciada com surpresa e estranhamento, gerando sentimentos contraditórios de inadequação frente à inexperiência para o trabalho em equipe. No entanto, por terem sido acolhidos e compreendidos pela equipe, ocorreu uma transformação de natureza pessoal e formativa, considerada muito enriquecedora, simbolizada como vivência singular de pertencimento, motivando esforços para prática clínica integradora e criativa.This study shows a qualitative research based on a humanist theory in relation to the experiences of trainees from the psychology course of PUC-Campinas, that are participating in family health teams in the areas of Health/Clinic and basic attention in public health. The participants were six trainees in the last year of the course and located in two Health-School Centers in the Northwest region of Campinas. The methodology used was an ethnographic view. The processes of data composition were produced in two different moments: a by weekly register on the trainee's personal diary during five months; b semi-directed individual interviews at the end of the term. These data were
Ferris, Maria; Iglesia, Edward; Ko, Zion; Amamoo, Ahinee; Mahan, John; Desai, Tejas; Gibson, Keisha; Jhaveri, Kenar; Primack, William
A workforce crisis for many pediatric specialties, particularly nephrology, is due to growing retirement rates, attrition during training, and retention difficulties. To obtain specific information regarding pediatric nephrology trainee shortages, we administered two cross-sectional surveys to non-renal pediatric subspecialty fellows and pediatric nephrology program directors. We characterized the fellows' experiences with nephrology and the program directors' experiences with their fellows as well as their outcomes in the last 10 years. We analyzed responses from 531 non-renal fellows (14.4% response rate). Overall, 317 (60%) fellows rated nephrology as difficult, particularly women (65.4% vs. 49.5%, p nephrology as more difficult compared to all others (p = 0.001). More men than women (24% vs. 8%, p nephrology workforce. These findings support our belief that a strong effort needs to be made by the academic community to teach nephrology in more interesting and understandable formats. While these are national samples, we were unable to contact non-nephrology fellows directly and program directors from larger programs were underrepresented. Difficulties in attracting/retaining trainees (particularly women) to nephrology must be addressed systematically, identifying incentives to practice in this field. Bold concerted efforts are required and we propose seven steps to achieve this goal.
Pancreatoduodenectomy (PD) has always been regarded as one of the most technically demanding abdominal procedures, even when carried out in high-volume centers by experienced surgeons. The reduction in higher surgical trainees working hours has led to reduced exposure, and consequently less experience in operative procedures. Furthermore, trainees have also become victims as health care systems striving for operating room efficiency, have attempted to reduce procedure duration by encouraging consultant led procedures at the expense of training. A strategy therefore needs to be developed to match the ability of the trainee with the complexity of the surgical procedure. As a PD can be deconstructed into a number of different steps, it may indeed be an ideal training operation for varying levels of ability.
Vladimir A. Romanov
Full Text Available The aim of the investigation is development of innovative strategy of quality control training of engineers and skilled workers (hereinafter – future specialists in educational professional organizations on the principles of social partnership.Methods. Theoretic: theoretic and methodological analysis, polytheoretic synthesis, modeling. Empirical: research and generalization of the system, process and competence – based approaches experience, experiment, observation, surveys, expert evaluation, SWOT-analysis as a method of strategic planning which is to identify the internal and external factors (socio-cultural of the organization surrounding.Results. The strategy of the development of the process of quality control training in educational professional organizations and a predictive model of the system of quality control training for future engineers and workers have been created on the analysis and synthesis of a quantitative specification of the quality, the obtained experience and success in control training of future specialists in educational professional organizations in recent economic and educational conditions.Scientific novelty. There has been built a predicative model of quality control training of future specialists to meet modern standards and the principles of social partnership; the control algorithm of the learning process, developed in accordance with the standards (international of quality ISO in the implementation of the quality control systems of the process approach (matrix-based responsibility, competence and remit of those responsible for the education process in the educational organization, the «problem» terms and diagnostic tools for assessing the quality of professional training of future specialists. The perspective directions of innovation in the control of the quality of future professionals training have been determined; the parameters of a comprehensive analysis of the state of the system to ensure the
Hauer, Karen E; Oza, Sandra K; Kogan, Jennifer R; Stankiewicz, Corrie A; Stenfors-Hayes, Terese; Cate, Olle Ten; Batt, Joanne; O'Sullivan, Patricia S
Clinical supervisors oversee trainees' performance while granting them increasing opportunities to work independently. Although the factors contributing to supervisors' trust in their trainees to conduct clinical work have been identified, how the development of trust is shaped by these factors remains less clear. This study was designed to determine how supervisors develop and experience trust in resident (postgraduate years 2 and 3) trainees in the clinical workplace. Internal medicine in-patient supervisors at two institutions were interviewed about the meaning and experience of developing trust in resident trainees. Transcribed data were coded and analysed using a phenomenographic approach. Forty-three supervisors participated. Supervisors characterised the meaning of trust from the perspectives of trainee competence and leadership or from their own perspective of needing to provide more or less supervision. Supervisors initially considered trust to be usually independent of prior knowledge of the resident, and then used sources of information about trust to develop their judgements of trust. Sources, which incorporated inference, included supervisors' comparisons with a standard, direct observation of the trainee as a team leader or care provider, and stakeholder input from team members, patients and families. Barriers against and accelerators to trust formation related to the resident, supervisor, resident-supervisor relationship, context and task. Trust formation had implications for supervisors' roles, residents' increasingly independent provision of care, and team functioning. From a general starting point, supervisors develop trust in residents informed by observation, inference and information gathered from the team and patients. Judgements of trust yield outcomes defined by supervisors' changing roles, the increasingly independent provision of care by residents, and team functioning. The implications of these findings for graded resident autonomy
Nasim Amarabit Taqwa Zun
Full Text Available Abstract - Novotel Hotel Bandung has a uniqueness in presentation at breakfast and omlette played by a trainee. Not only that, besides being a man of a trainee omlette also believed to make a food product. The existenceof the uniqueness of the writer very interested to examine and make a final project with the title “Trainee job description at kitchen Novotel Hotel Bandung”. Based on the research and discussion section conducted kitchen Novotel Hotel Bandung, the conclusion by the authors includes explanations, knowledge and preparation responsibilities trainee to support quality improvement kitchen product and follow the duties and responsibilities of an operations trainee at Novotel Hotel Bandung well so that the problem can solved. Keywords :Unique, Trainee, Duty Asbtrak - Hotel Novotel Bandung memiliki suatu keunikan dalam penyajian pada saat breakfast dan omeltte yang diperankan oleh seorang trainee.Bukan itu saja, selain menjadi seorang omeletteman, seorang trainee juga sudah dipercaya membuat suatu product makanan di setiap sectionnya. Adanya keunikan tersebut menjadi suatu ketertarikan untuk meneliti dengan judul “tugas trainee di kitchen Hotel Novotel Bandung”. Berdasarkan hasil penelitian dan pembahasan yang dilakukan di bagian kitchen hotel Novotel Bandung, memuat kesimpulan dengan adanya penjelasan-penjelasan, pengetahuan mengenai tanggung jawab trainee dan preparation untuk mendukung peningkatan kualitas product kitchen dan mengikuti tugas serta tanggung jawab operasional di Hotel Novotel Bandung dengan baik sehingga masalah tersebut bisa diatasi. Kata kunci :Unik, Trainee, Tugas
von Websky, Martin W; Oberkofler, Christian E; Rufibach, Kaspar; Raptis, Dimitri A; Lehmann, Kuno; Hahnloser, Dieter; Clavien, Pierre-Alain
To assess trainee satisfaction in their surgery residency with a validated instrument and identify the contributing factors. Currently, surgery is deemed unattractive by medical students and ignored by many candidates planning to enter an academic career. New insights on the rational for such lack of interest are needed. Job satisfaction is a central concept in organizational and behavioral research that is well understood by large companies such as Google, IBM, and Toyota. Similar assessment can likewise be used to improve trainee satisfaction in surgery residency. A survey among 2039 surgery residents was conducted in three European countries analyzing satisfaction at work using the Global Job Satisfaction Instrument (validated in Emergency Room physicians). Crucial factors covering different aspects of surgery residency where identified using the GJS instrument combined with multiple logistic regression analysis. With an overall response rate of 23%, we identified trainee dissatisfaction in one third of residents. Factors affecting satisfaction related almost exclusively to training issues, such as assignment of surgery procedures according to skills (OR 4.2), training courses (OR 2.7), availability of a structured training curriculum (OR 2.4), bedside teaching, and availability of morbidity-mortality conferences (OR 2.3). A good working climate among residents (OR 3.7) and the option for part time work (OR 2.1) were also significant factors for trainee satisfaction. Increased working hours had a modest (OR 0.98)-though cumulative- negative effect. The sex of the trainee was not related to trainee satisfaction. Validated measurement of job satisfaction as used in the industry appears to be an efficient tool to assess trainee satisfaction in surgery residency and thereby identify the key contributing factors. Improvement of conceptual training structures and working conditions might facilitate recruitment, decrease drop-out, and attract motivated candidates with
al-Suliman, N N; Ryttov, N F; Qvist, N
OBJECTIVE: To present a demographic study of thyroid diseases and thyroid surgical activity, to analyse the results of one department that has specialised in thyroid surgery during an 11-year period, and to try to define those groups of patients at increased risk of complications and untoward...... catchment area composed of five municipalities. MAIN OUTCOME MEASURES: Annual number of operations for goitre, waiting time to operation, incidence of complications, and sequelae. RESULTS: In the demographic study the number of patients operated on for benign thyroid diseases declined from about 50 cases...
Kalkani, M; Balmer, R C; Homer, R M; Day, P F; Duggal, M S
To assess the views and experience of the UK dentists specialising in paediatric dentistry (trainees) about molar incisor hypomineralisation (MIH) and compare the findings with the responses from a group of UK general dental practitioners. A web-based questionnaire was sent to dentists undergoing specialist training in paediatric dentistry. The same questionnaire was completed by a group of general dentists who stated an interest in treating children, with various levels of experience. The questionnaire sought information on clinical experience and the views of the dentists on the impact of MIH on children and families. Specialty trainees (37) from different paediatric dental departments in the UK completed the online survey, giving a total response rate of 71%. The questionnaire was also completed by 31 general dental practitioners. There was difficulty in distinguishing MIH from other conditions for both groups. Increased sensitivity of affected teeth was the most frequently encountered problem with 51% of the trainees and 76% of the dentists saying this was often or always a challenge. The trainees were particularly concerned about the pain children experienced and about the appearance of the condition. Both groups felt that parental anxiety occurred in almost all cases. Both groups felt that MIH presents several clinical challenges and has a negative effect on the quality of life of the affected children and their families. There were significant differences in the views and perceptions between the two groups.
Full Text Available Nowadays foreign language competence is one of the main professional skills of mining engineers. Modern competitive conditions require the ability for meeting production challenges in a foreign language from specialists and managers of mining enterprises. This is the reason of high demand on foreign language training/retraining courses. Language training of adult learners fundamentally differs from children and adolescent education. The article describes the features of andragogical learning model. The authors conclude that distance learning is the most productive education form having a number of obvious advantages over traditional (in-class one. Interactive learning method that involves active engagement of adult trainees appears to be of the greatest interest due to introduction of modern information and communication technologies for distance learning.
Bondareva, Evgeniya; Chistyakova, Galina; Kleshevskyi, Yury; Sergeev, Sergey; Stepanov, Aleksey
Nowadays foreign language competence is one of the main professional skills of mining engineers. Modern competitive conditions require the ability for meeting production challenges in a foreign language from specialists and managers of mining enterprises. This is the reason of high demand on foreign language training/retraining courses. Language training of adult learners fundamentally differs from children and adolescent education. The article describes the features of andragogical learning model. The authors conclude that distance learning is the most productive education form having a number of obvious advantages over traditional (in-class) one. Interactive learning method that involves active engagement of adult trainees appears to be of the greatest interest due to introduction of modern information and communication technologies for distance learning.
... Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If your child ... teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists are medical ...
Wildan, T; Amin, J; Bowe, D; Gerber, B; Saeed, N R
Most dental foundation year 2 (DF2) training takes place in oral and maxillofacial surgery (OMFS) units. We did a survey of DF2 trainees in these units by telephone interviews and an online questionnaire to find out about their experience of training and their career aspirations. A total of 123 responded, which is roughly 41% of the total estimated number of trainees. Trainees applied for these posts mainly to improve their dentoalveolar skills (50%), and this was cited as the best aspect of the training. Most (81%) were on-call at night and this was generally thought to be a valuable training experience (77%), but 20% thought that it was the worst aspect of the job. Most did not regret taking up the post although the experience had caused 75% to alter their intentions about their future career; general dental practice was the commonest choice. In conclusion, trainees are generally satisfied with their training and these positions have guided their choices about future careers. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Kaito, Akio; Kinoshita, Takahiro
The feasibility of laparoscopic gastrectomy (LG) has been gradually proven by several scientific works, however, proper training method for this kind of surgery are still under investigation and debate. Here we report our educational system of LG to enhance the skill of young surgeons in our hospital. Our training program for trainee consists of 3 years of junior residency and 2 years of senior residency programs, requiring 5 years in total. In order to master LG, three following factors seem to be essential: learning, practice and experience. Learning means that trainee study techniques and concepts by educational materials, such as operative videos, lectures, or textbook. Practice means animal laboratory training or dry box training to acquire hand-eye coordination or bi-hand coordination, leading to precise movement of surgical devices. Experience means actual on-site training, participating in clinical LG as scopist, assistant or operator. In the actual surgery, we have some common principles for scopist, assistant and operator, respectively, and these principles are shared by entire surgical team. These principles are transmitted from trainer to trainee using simple keywords repeatedly. In conclusion, combination and balance of the three factors, learning, practice and experience are necessary to efficiently advance education of LG for trainee and may leads to benefits for gastric cancer patients.
Shaw, Ben N J; Stenson, Ben J; Fenton, Alan C; Morrow, Gillian; Brown, Jeremy
Higher specialist training offers an opportunity to focus on non-clinical skills as well as clinical issues. The authors wished to determine whether doctors who complete neonatal higher specialist training in the UK feel prepared for the consultant role with respect to management, research and teaching, as well as clinical activities. A questionnaire related to the preparedness of the consultant to carry out a range of activities was sent to all doctors who were appointed to the UK higher specialist training programme in neonatology from 2002 to 2008 who were currently working as consultants. Seventy-one of the 83 eligible participants completed the questionnaire. Roles that consultants felt extremely well prepared for related to clinical care, communication, team-working, prioritising tasks, teaching and audit. Trainees reported that roles that they had been not at all well prepared for were related to roles in management and service delivery, medicolegal issues and complaints, job planning and personal development, supporting doctors in difficulty and chairing meetings. Four key themes emerged from the analysis of free-text responses regarding specialty training: the influence of shift patterns/service provision, the lack of non-clinical preparation, learning on the job as a consultant later on and problems with grid training itself. This study showed that for neonatal paediatrics in the UK, new consultants feel confident about managing ill babies but are unprepared for other aspects of the consultant's role. Neonatal higher specialist training needs to allow opportunities for non-clinical training.
Hallock, Abhirami; Read, Nancy; D'Souza, David
The objective of this study was to develop and assess the feasibility of utilizing consensus-based penalty metrics for the purpose of critical structure and organ at risk (OAR) contouring quality assurance and improvement. A Delphi study was conducted to obtain consensus on contouring penalty metrics to assess trainee-generated OAR contours. Voxel-based penalty metric equations were used to score regions of discordance between trainee and expert contour sets. The utility of these penalty metric scores for objective feedback on contouring quality was assessed by using cases prepared for weekly radiation oncology radiation oncology trainee treatment planning rounds. In two Delphi rounds, six radiation oncology specialists reached agreement on clinical importance/impact and organ radiosensitivity as the two primary criteria for the creation of the Critical Structure Inter-comparison of Segmentation (CriSIS) penalty functions. Linear/quadratic penalty scoring functions (for over- and under-contouring) with one of four levels of severity (none, low, moderate and high) were assigned for each of 20 OARs in order to generate a CriSIS score when new OAR contours are compared with reference/expert standards. Six cases (central nervous system, head and neck, gastrointestinal, genitourinary, gynaecological and thoracic) then were used to validate 18 OAR metrics through comparison of trainee and expert contour sets using the consensus derived CriSIS functions. For 14 OARs, there was an improvement in CriSIS score post-educational intervention. The use of consensus-based contouring penalty metrics to provide quantitative information for contouring improvement is feasible.
Ferguson, H J M; Fitzgerald, J E F; Reilly, J; Beamish, A J; Gokani, V J
Increasing numbers of minor surgical procedures are being performed in the community. In the UK, general practitioners (family medicine physicians) with a specialist interest (GPwSI) in surgery frequently undertake them. This shift has caused decreases in available cases for junior surgeons to gain and consolidate operative skills. This study evaluated GPwSI's case-load, procedural training and perceptions of offering formalised operative training experience to surgical trainees. Prospective, questionnaire-based cross-sectional study. A novel, 13-item, self-administered questionnaire was distributed to members of the Association of Surgeons in Primary Care (ASPC). A total 113 of 120 ASPC members completed the questionnaire, representing a 94% response rate. Respondents were general practitioners practising or intending to practice surgery in the community. Respondents performed a mean of 38 (range 5-150) surgical procedures per month in primary care. 37% (42/113) of respondents had previously been awarded Membership or Fellowship of a Surgical Royal College; 22% (25/113) had completed a surgical certificate or diploma or undertaken a course of less than 1 year duration. 41% (46/113) had no formal British surgical qualifications. All respondents believed that surgical training in primary care could be valuable for surgical trainees, and the majority (71/113, 63%) felt that both general practice and surgical trainees could benefit equally from such training. There is a significant volume of surgical procedures being undertaken in the community by general practitioners, with the capacity and appetite for training of prospective surgeons in this setting, providing appropriate standards are achieved and maintained, commensurate with current standards in secondary care. Surgical experience and training of GPwSI's in surgery is highly varied, and does not yet benefit from the quality assurance secondary care surgical training in the UK undergoes. The Royal Colleges of
Akpınar, Kadriye Dilek
Higher Education Council of Turkey has added a one term course named as “Effective Communication Skills” to the curriculum since 2006 in Foreign Language Education Departments because of the crucial importance of communication in the information society. In order to test the effectiveness of this course, a research project was developed by looking at the pre-and post course interviews conducted with first year teacher trainees about communication skills compared with the fourth year students’...
Atkinson, Kaye; Ajjawi, Rola; Cooling, Nick
Clinical reasoning requires knowledge, cognition and metacognition, and is contextually bound. Clinical teachers can and should play a key role in explicitly promoting clinical reasoning. The aim of this article is to relate the clinical reasoning literature to the general practice or family medicine context, and to provide clinical teachers with strategies to promote clinical reasoning. It is important that the clinical teacher teaches trainees the specific skills sets of the expert general practitioner (e.g. synthesising skills, recognising prototypes, focusing on cues and clues, using community resources and dealing with uncertainty) in order to promote clinical reasoning in the context of general practice or family medicine. Clinical teachers need to understand their own reasoning processes as well as be able to convey that knowledge to their trainees. They also need to understand the developmental stages of clinical reasoning and be able to nurture each trainee's own expertise. Strategies for facilitating effective clinical reasoning in trainees include adequate exposure to patients, offering the trainees opportunity for reflection and feedback, and coaching on the techniques of reasoning in the general practice context. The journey to expertise in clinical reasoning is unique to each clinician, with different skills developing at different rates, depending on content, context and past experience. Doctors enter into general practice training with the building blocks of biomedical and clinical knowledge and a desire to learn how to be a general practitioner. Clinical teachers are integral in the process of helping trainees learn how to 'think like a general practitioner'. © Blackwell Publishing Ltd 2011.
Jamjoom, Aimun A B; Phan, Pho N H; Hutchinson, Peter J; Kolias, Angelos G
To analyse the research activity and publication output of surgical trainee research collaboratives in the UK. Surgical trainee research collaboratives in the UK. A total of 24 collaboratives were included in this study from 33 identified organisations. We excluded one group that focused purely on systematic review of the literature and eight groups for which we could not identify suitable data sources (website or trainee committee contact). Primary data-points were identified for each collaborative including surgical subspeciality, numbers and types of projects. For published articles, secondary outcomes including study population size, journal impact factor, number of citations and evidence level were collected. A total of 24 collaboratives met our inclusion criteria with a portfolio of 80 projects. The project types included audit (46%), randomised clinical trial (16%), surveys (16%), cohort studies (10%), systematic reviews (2.5%) and other or unidentifiable (9.5%). A total of 35 publications were identified of which just over half (54%) were original research articles. The median size of studied population was 540 patients with a range from 108 to 3138. The published works provided a varied compilation of evidence levels ranging from 1b (individual RCT) to 5 (expert opinion) with a median level of 2b (individual cohort study). The West Midlands Research Collaborative had the highest number of publications (13), citations (130) and h-index (5). The experience of UK-based trainee research collaboratives provides useful insights for trainees and policymakers in global healthcare systems on the value and feasibility of trainee-driven high quality surgical research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna; Goodyear, Helen M
Leading a ward round is an essential skill for hospital consultants and senior trainees but is rarely assessed during training. To investigate the key attributes for ward round leadership and to use these results to develop a multisource feedback (MSF) tool to assess the ward round leadership skills of senior specialist trainees. A panel of experts comprising four senior paediatric consultants and two nurse managers were interviewed from May to August 2009. From analysis of the interview transcripts, 10 key themes emerged. A structured questionnaire based on the key themes was designed and sent electronically to paediatric consultants, nurses and trainees at a large university hospital (June-October 2010). 81 consultants, nurses and trainees responded to the survey. The internal consistency of this tool was high (Cronbach's α 0.95). Factor analysis showed that five factors accounted for 72% of variance. The five key areas for ward round leadership were communication skills, preparation and organisation, teaching and enthusiasm, team working and punctuality; communication was the most important key theme. A MSF tool for ward round leadership skills was developed with these areas as five domains. We believe that this tool will add to the current assessment tools available by providing feedback about ward round leadership skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Sgroi, Joseph; Abbott, Jason
The aim of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Integrated and Elective Training Program is to ensure trainees have both clinical and surgical competence. The capacity to recognise important anatomical structures underpins this aim; however, quantification of RANZCOG trainees' anatomical knowledge and their training and assessment is not available. To survey trainees at all levels relating to applied anatomy, training and assessment within the RANZCOG training program. All accredited RANZCOG trainees were invited to participate in an online survey relating to anatomy knowledge, application, assessment and means of improving anatomical training. At the commencement of training, 11% of trainees perceived their anatomical knowledge as adequate and this increased to 77% by the final year of training. For final-year trainees, 78% perceived their anatomy knowledge as sufficient to perform a total abdominal hysterectomy and 87% an ovarian cystectomy or salpingectomy. Eighty-four per cent of trainees perceived the RANZCOG training programme as providing inadequate anatomy teaching. 100% of respondents supported a RANZCOG approved anatomy training course. This is a survey-based study and therefore subjective. Consequently, accurate determination of anatomical knowledge for RANZCOG trainees is inexact. Trainees perceive limitations in their anatomical knowledge. A formalised RANZCOG anatomy course would be of value in providing structured education and assessment of trainees' knowledge and establishing whether there are improvements in surgical competencies. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Jovanović, N; Podlesek, A; Volpe, U; Barrett, E; Ferrari, S; Rojnic Kuzman, M; Wuyts, P; Papp, S; Nawka, A; Vaida, A; Moscoso, A; Andlauer, O; Tateno, M; Lydall, G; Wong, V; Rujevic, J; Platz Clausen, N; Psaras, R; Delic, A; Losevich, M A; Flegar, S; Crépin, P; Shmunk, E; Kuvshinov, I; Loibl-Weiß, E; Beezhold, J
Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout. In an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout. This is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8-65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (Pburnout, severe burnout remained associated with long working hours (Pburnout. Copyright © 2016. Published by Elsevier Masson SAS.
Knoedler, Margaret; Feibus, Allison H; Lange, Andrew; Maddox, Michael M; Ledet, Elisa; Thomas, Raju; Silberstein, Jonathan L
To evaluate the effect of 3-dimensionally (3D) printed physical renal models with enhancing masses on medical trainee characterization, localization, and understanding of renal malignancy. Proprietary software was used to import standard computed tomography (CT) cross-sectional imaging into 3D printers to create physical models of renal units with enhancing renal lesions in situ. Six different models were printed from a transparent plastic resin; the normal parenchyma was printed in a clear, translucent plastic, with a red hue delineating the suspicious renal lesion. Medical students, who had completed their first year of training, were given an overview and tasked with completion of RENAL nephrometry scores, separately using CT imaging and 3D models. Trainees were also asked to complete a questionnaire about their experience. Variability between trainees was assessed by intraclass correlation coefficients (ICCs), and kappa statistics were used to compare the trainee to experts. Overall trainee nephrometry score accuracy was significantly improved with the 3D model vs CT scan (P <.01). Furthermore, 3 of the 4 components of the nephrometry score (radius, nearness to collecting system, and location) showed significant improvement (P <.001) using the models. There was also more consistent agreement among trainees when using the 3D models compared with CT scans to assess the nephrometry score (intraclass correlation coefficient, 0.28 for CT scan vs 0.72 for 3D models). Qualitative evaluation with questionnaires filled out by the trainees further confirmed that the 3D models improved their ability to understand and conceptualize the renal mass. Physical 3D models using readily available printing techniques improve trainees' understanding and characterization of individual patients' enhancing renal lesions. Published by Elsevier Inc.
Ferrah, Noha; Stephan, Karen; Lovell, Janaka; Ibrahim, Joseph; Beiles, Barry
Adequate surgical care of patients and concurrent training of residents is achieved in elective procedures through careful case selection and adequate supervision. Whether this applies when trainees are involved in emergency operations remains equivocal. The aim of this study was therefore to compare the risk of post-operative complications following emergency procedures performed by senior operators compared with supervised trainees. This is a retrospective cohort study examining in-hospital deaths of patients across all surgical specialties who underwent emergency surgery in Australian public hospitals reported to the national surgical mortality audit between 2009 and 2015. Multivariable logistic regression was used to explore whether there was an association between the level of operator experience (senior operator vs trainee) and the occurrence of post-operative surgical complications following an emergency procedure. Our population consisted of 6920 patients. There were notable differences between the trainees and senior operator groups; trainees more often operated on patients aged over 80 years, with cardiovascular and neurological risk factors. Senior operators more often operated on very young and obese patients with advanced malignancy and hepatic disease. Supervised trainees had a lower rate of post-operative complications compared with senior operators; 18% (n = 396) and 25% (n = 1210), respectively (p emergency operations, provided that cases are judiciously selected.
Beer, Amanda M; Spanierman, Lisa B; Greene, Jennifer C; Todd, Nathan R
This mixed methods study examined social justice commitments of counseling psychology graduate trainees. In the quantitative portion of the study, a national sample of trainees (n = 260) completed a web-based survey assessing their commitments to social justice and related personal and training variables. Results suggested that students desired greater social justice training than what they experienced in their programs. In the qualitative portion, we used a phenomenological approach to expand and elaborate upon quantitative results. A subsample (n = 7) of trainees who identified as strong social justice activists were interviewed regarding their personal, professional, and training experiences. Eleven themes related to participants' meanings of and experiences with social justice emerged within 4 broad categories: nature of social justice, motivation for activism, role of training, and personal and professional integration. Thematic findings as well as descriptive statistics informed the selection and ordering of variables in a hierarchical regression analysis that examined predictors of social justice commitment. Results indicated that trainees' perceptions of training environment significantly predicted their social justice commitment over and above their general activist orientation and spirituality. Findings are discussed collectively, and implications for training and future research are provided. (c) 2012 APA, all rights reserved.
Dunstan, Debra A; Tooth, Susan M
This pilot study explored the outcomes of clinical psychology trainees delivering treatments via videoconferencing. A noncurrent, multiple baseline across subjects and settings. University outpatient psychology clinic. Six clients (two men and four women) with an anxiety or depressive disorder were randomly assigned to received six sessions of individual therapy (either via videoconferencing or face to face) from a male or female clinical psychology trainee. Participants provided daily ratings (0-10) of subjective distress/well-being via text messaging, and at pre-, post-, and 1 month follow-up of treatment, completed the Depression Anxiety Stress Scales and the Outcome Questionnaire-45. Along with the trainees, participants also provided feedback on the therapy experience. The subjective well-being of all participants improved, and all videoconferencing participants showed a statistically and clinically significant reduction in symptomology and gains in general life functioning. Feedback comments were positive. This study suggests that there is value in clinical psychology trainees gaining experience in the delivery of treatments via videoconferencing. Further study is needed to demonstrate the potential for university clinics to deliver mental health services, via this modality, to rural and remote areas. © 2012 The Authors. Australian Journal of Rural Health © 2012 National Rural Health Alliance Inc.
Biaggio, Alfredo L.; Nasazzi, Nora B.; Arias, Cesar
Argentina has a long experience in Radiation Protection training since 25 years ago. In the present work we analyse those variable and non variable training aspects according to scientific development, increasing radiation source diversity (including new concepts like orphan sources and security), mayor concern about patient in Radiation Protection, previous exposures, etc. We comment what we consider the main steps in the training of Radiation Protection specialists, like university degree, post graduate education distinguishing between formative and informative contents and on the job training. Moreover, we point out the trainees aptitudes and attitudes to be developed in order to work properly in this interdisciplinary field. (author)
Leung, John; Le, Hien; Turner, Sandra; Munro, Philip; Vukolova, Natalia
This paper reports the key findings of the first Faculty of Radiation Oncology survey of trainees dealing with experiences and perceptions on work practices and choice of specialty. The survey was conducted in mid 2012 using a 37-question instrument. This was distributed by email to 159 current trainees and advertised through the Radiation Oncology Trainees Committee and other channels. There were six email reminders. Respondents were reassured that their responses were anonymous. The overall response rate was 82.8%. Gender was balanced among respondents with 67 (51.5%) being male and 63 (48.5%) being female. The most common age bracket was the 31 to 35 years range. There were similar proportions of trainee responders in each of the five years of training. A substantial number of trainees held other degrees besides medical degrees. The large majority were satisfied with radiation oncology as a career choice and with the Training Network within which they were training. Interest in oncology patients, lifestyle after training and work hours were given as the major reasons for choosing radiation oncology as a career. Nearly half of trainees were interested in undertaking some of their training in a part-time capacity and working part time as a radiation oncologist in the future. Over 70% of trainees stated they were working 36–55 clinical hours per week with additional non-clinical tasks, after-hours work and on-call duties. Nearly half of all trainees reported having one or less hours of protected time per week. Nonetheless, 40% of respondents indicated they had enough time to pursue outside interests. Radiation treatment planning and maintaining currency in general medicine were considered the most difficult aspects of training in radiation oncology. Most respondents were keen on the concept of fostering a research mentor. In terms of views on practice after completion of training, the majority were interested in pursuing a fellowship, and nearly all expressed an
Preece, Ryan A; Cope, Alexandra C
Medical students and surgical trainees differ considerably in both their preferential learning styles and personality traits. This study compares the personality profiles and learning styles of surgical trainees with a cohort of medical students specifically intent on pursuing a surgical career. A cross-sectional study was conducted contrasting surgical trainees with medical students specifying surgical career intent. The 50-item International Personality Item Pool Big-Five Factor Marker (FFM) questionnaire was used to score 5 personality domains (extraversion, conscientiousness, agreeableness, openness to experience, and neuroticism). The 24-item Learning Style Inventory (LSI) Questionnaire was used to determine the preferential learning styles (visual, auditory, or tactile). χ(2) Analysis and independent samples t-test were used to compare LSI and FFM scores, respectively. Surgical trainees from several UK surgical centers were contrasted to undergraduate medical students. A total of 53 medical students who had specifically declared desire to pursue a surgical career and were currently undertaking an undergraduate intercalated degree in surgical sciences were included and contrasted to 37 UK core surgical trainees (postgraduate years 3-4). The LSI questionnaire was completed by 53 students and 37 trainees. FFM questionnaire was completed by 29 medical students and 34 trainees. No significant difference for learning styles preference was detected between the 2 groups (p = 0.139), with the visual modality being the preferred learning style for both students and trainees (69.8% and 54.1%, respectively). Neuroticism was the only personality trait to differ significantly between the 2 groups, with medical students scoring significantly higher than trainees (2.9 vs. 2.6, p = 0.03). Medical students intent on pursuing a surgical career exhibit similar personality traits and learning styles to surgical trainees, with both groups preferring the visual learning modality
Harewood, G C
BACKGROUND: Occupational psychologists have identified three factors important in motivating physicians: financial reward, academic recognition, time off. AIM: To assess motivators among gastroenterology (GI) trainees. METHODS: A questionnaire was distributed to GI trainees to assess their motivators: (1) work fewer hours for less lucrative rate, (2) reduction in salary\\/increase in hours for academic protected time, and (3) work longer hours for higher total salary, but less lucrative hourly rate. RESULTS: Overall, 61 trainees responded; 52% of trainees would work shorter hours for less lucrative rate; 60% would accept a disproportionate reduction in salary\\/increase in hours for academic protected time; 54% would work longer hours for more money but less lucrative rate. Most trainees (93%) accepted at least one scenario. CONCLUSIONS: Most GI trainees are willing to modify their job description to align with their personal values. Tailoring job descriptions according to these values can yield economic benefits to GI Divisions.
Harewood, G C
BACKGROUND: Occupational psychologists have identified three factors important in motivating physicians: financial reward, academic recognition, time off. AIM: To assess motivators among gastroenterology (GI) trainees. METHODS: A questionnaire was distributed to GI trainees to assess their motivators: (1) work fewer hours for less lucrative rate, (2) reduction in salary\\/increase in hours for academic protected time, and (3) work longer hours for higher total salary, but less lucrative hourly rate. RESULTS: Overall, 61 trainees responded; 52% of trainees would work shorter hours for less lucrative rate; 60% would accept a disproportionate reduction in salary\\/increase in hours for academic protected time; 54% would work longer hours for more money but less lucrative rate. Most trainees (93%) accepted at least one scenario. CONCLUSIONS: Most GI trainees are willing to modify their job description to align with their personal values. Tailoring job descriptions according to these values can yield economic benefits to GI Divisions.
Spanager, Lene; Dieckmann, Peter; Beier-Holgersen, Randi
OBJECTIVE: This study aimed to explore the content of conversations, feedback style, and perceived usefulness of feedback to trainee surgeons when conversations were stimulated by a tool for assessing surgeons' non-technical skills. METHODS: Trainee surgeons and their supervisors used the Non......-Technical Skills for Surgeons in Denmark tool to stimulate feedback conversations. Audio recordings of post-operation feedback conversations were collected. Trainees and supervisors provided questionnaire responses on the usefulness and comprehensiveness of the feedback. The feedback conversations were...
Full Text Available Abstract Background In 1997, regional specialist training was established in Fiji, consisting of one-year Postgraduate Diplomas followed by three-year master’s degree programs in anesthesia, internal medicine, obstetrics/gynecology, pediatrics and surgery. The evolution of these programs during the first 12 years is presented. Case description A case study utilizing mixed methods was carried out, including a prospective collection of enrolment and employment data, supplemented by semi-structured interviews. Between 1997 and 2009, 207 doctors (113 from Fiji and 94 from 13 other countries or territories in the Pacific trained to at least the Postgraduate Diploma level. For Fiji graduates, 29.2% migrated permanently to developed countries, compared to only 8.5% for regional graduates (P coup d’etat in 2000. By 2005, interviews suggested a dynamic of political instability initially leading to resignations, leading to even heavier workloads, compounded by academic studies that seemed unlikely to lead to career benefit. This was associated with loss of hope and downward spirals of further resignations. After 2006, however, Master’s graduates generally returned from overseas placements, had variable success in career progression, and were able to engage in limited private practice. Enrolments and retention stabilized and increased. Discussion and evaluation Over time, all specialties have had years when the viability and future of the programs were in question, but all have recovered to varying degrees, and the programs continue to evolve and strengthen. Prospective clarification of expected career outcomes for graduates, establishment of career pathways for diploma-only graduates, and balancing desires for academic excellence with workloads that trainees were able to bear may have lessened ongoing losses of trainees and graduates. Conclusions Despite early losses of trainees, the establishment of regional postgraduate training in Fiji is
Sharp, Michelle; Burkart, Kristin M
Wellness is critical to physicians in training and the general physician workforce. At present, physicians in general and especially intensive care unit physicians are experiencing high rates of depression and burnout. The prevalence of burnout is greatest in resident and fellow trainees. The Accreditation Council for Graduate Medical Education has recognized the importance of physician wellness by proposing Common Program Requirements that pertain to trainee and faculty well-being. Several individual-focused, organizational, and structural strategies have been described in the literature as helpful in decreasing burnout. Successful implementation of a trainee wellness program requires institutional resources and collaborative efforts between the institution, leadership, faculty, and trainees. To ensure the greatest effect in reducing burnout, training programs and institutions should create programs that intervene at both the organizational and individual levels. Additional steps to implement a trainee wellness program include the following: (1) establish support from institutional and divisional leadership; (2) create a wellness committee; (3) perform a needs assessment; (4) assess trainee wellness and burnout; (5) perform targeted interventions; and (6) routinely reassess trainee wellness and burnout. More research is needed to identify and refine strategies that improve wellness and decrease burnout among physicians and trainees. As a community, we must take on the challenge of improving wellness among physicians for the benefit of our trainees, ourselves, and our patients.
Spanager, Lene; Dieckmann, Peter; Beier-Holgersen, Randi; Rosenberg, Jacob; Oestergaard, Doris
This study aimed to explore the content of conversations, feedback style, and perceived usefulness of feedback to trainee surgeons when conversations were stimulated by a tool for assessing surgeons' non-technical skills. Trainee surgeons and their supervisors used the Non-Technical Skills for Surgeons in Denmark tool to stimulate feedback conversations. Audio recordings of post-operation feedback conversations were collected. Trainees and supervisors provided questionnaire responses on the usefulness and comprehensiveness of the feedback. The feedback conversations were qualitatively analyzed for content and feedback style. Usefulness was investigated using a scale from 1 to 5 and written comments were qualitatively analyzed. Six trainees and six supervisors participated in eight feedback conversations. Eighty questionnaires (response rate 83 percent) were collected from 13 trainees and 12 supervisors. Conversations lasted median eight (2-15) minutes. Supervisors used the elements and categories in the tool to structure the content of the conversations. Supervisors tended to talk about the trainees' actions and their own frames rather than attempting to understand the trainees' perceptions. Supervisors and trainees welcomed the feedback opportunity and agreed that the conversations were useful and comprehensive. The content of the feedback conversations reflected the contents of the tool and the feedback was considered useful and comprehensive. However, supervisors talked primarily about their own frames, so in order for the feedback to reach its full potential, supervisors may benefit from training techniques to stimulate a deeper reflection among trainees.
Robbins, Riann; Sullivan, Sarah; Smith, Brigitte
The Accreditation Council for Graduate Medical Education mandates scheduled didactics for residency programs but allows flexibility in implementation. Work-hour restrictions, patient care duties, and operative schedules create barriers to attendance for surgical trainees. We explored vascular surgery trainees and faculty perceptions on trainees operative preparation and participation, and overall fund of knowledge after implementing an academic half day conference (AHD) schedule. The vascular surgery conference at a single academic institution was changed from three 1-hour conferences weekly, to a single protected, 3-hour conference once weekly. Faculty and trainees were surveyed before and 5 months after implementing the new AHD schedule. Overall satisfaction improved after initiating the AHD (4 of 4 trainees, 3 of 4 faculty). All trainees (n = 4) and faculty (n = 4) believed the AHD conference format was worthwhile. Most trainees believed the AHD format improved their Vascular Surgery in Service Training Exam preparation (3 of 4), fund of knowledge (4 of 4), and operative preparation (3 of 4). More trainees than faculty tended to feel that the AHD interfered with operative participation (3 of 4 trainees vs 1 of 4 faculty). Neither group agreed that the conference was optimally scheduled. This single-institution, pilot study suggests a positive association in the attitudes of most vascular surgery trainees and faculty regarding preparation for the Vascular Surgery In-Training Exam and overall fund of knowledge after implementing a protected AHD schedule. Further research is needed to understand the impact of the AHD conference on operative experience and training exam scores. Copyright © 2018 Elsevier Inc. All rights reserved.
Gostlow, H; Marlow, N; Thomas, M J W; Hewett, P J; Kiermeier, A; Babidge, W; Altree, M; Pena, G; Maddern, G
In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.
Craig, Simon; Naidoo, Parmanand
Emergencies in radiology are infrequent but potentially lethal. Australian and New Zealand radiologists are advised to undergo resuscitation training at least every three years; however, little is known about their experience and confidence in managing common emergencies relevant to their clinical practice. This paper describes the current experience and confidence of radiologists and radiology trainees in Australia and New Zealand in the management of common medical emergencies. A cross-sectional online survey of trainees and fellows of the Royal Australian and New Zealand College of Radiology collected data on training and learning preferences relating to resuscitation and life-support skills, access to emergency medical care, and knowledge, confidence and ability in managing a variety of medical emergencies. There were 602 responses to the survey (response rate 23.4%). The majority of respondents were interested in learning more about the management of contrast reactions, cardiac arrest, ischaemic chest pain and basic life support. Self-rated knowledge, confidence and ability were higher in respondents who had completed life-support training within the previous three years. In this group, however, more than 40% rated their ability at managing contrast reactions as poor or fair, while more than 60% rated their ability as poor or fair for management of cardiac arrest, basic life support, advanced life support and dosing of adrenaline. Preferred resuscitation training modalities included simulation, small-group tutorials and workshops. Self-reported level of skill and expertise in the management of potential emergencies in radiology is suboptimal among a large number of respondents. Consideration should be given to addressing this by improving access to specific training.
Hamdan, M F; Day, A; Millar, J; Carter, F J C; Coleman, M G; Francis, N K
The aim of this study was to explore the feasibility and safety of an outreach model of laparoscopic colorectal training of accredited specialists in advanced laparoscopic techniques and to explore the challenges of this model from the perspective of a National Training Programme (NTP) trainer. Prospective data were collected for unselected laparoscopic colorectal training procedures performed by five laparoscopic colorectal NTP trainees supervised by a single NTP trainer with an outreach model between 2009 and 2012. The operative and postoperative outcomes were compared with standard laparoscopic colorectal training procedures performed by six senior colorectal trainees under the supervision of the same NTP trainer within the same study period. The primary outcome was 30-day mortality. The Mann-Whitney test was used to compare continuous variables and the Chi squared or Fisher's exact tests were applied for the analysis of categorical variables. The level of statistical significance was set at P groups. Seventy-eight per cent of the patients operated on by the NTP trainees had had no previous abdominal surgery, compared with 50% in the supervised trainees' group (P = 0.0005). There were no significant differences in 30-day mortality or the operative and postoperative outcome between both groups. There were, however, difficulties in training an already established consultant in his or her own hospital and these were overcome by certain adjustments to the programme. Outreach laparoscopic training of colorectal surgeons is a feasible and safe model of training accredited specialists and does not compromise patient care. The challenges encountered can be overcome with optimum training and preparation. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.
Full Text Available It is suggested that certain psychological attributes of accounting graduates are significant predictors of the later success of trainee accountants in the work environment. Since selection is a key human resources function in public accounting firms the present study investigated the relationship between academic performance, specific personality traits, examination pass rate and the work performance of a sample (N = 77 of trainee accountants from an international, mid-sized firm. The results indicate that the majority of cases could be correctly predicted as successful or not by a verbal ability variable and that the criterion measure developed for this study (Cronbach alpha = 0,95 can be used successfully to measure the work performance of trainee accountants. The importance of academic performance as well as the pass rate in the qualifying examinations are also discussed. Opsomming Daar word gesuggereer dat sekere sielkundige eienskappe van rekeningkunde gegradueerdes as voorspellers van hul latere sukses in die werkomgewing kan dien. Aangesien keuring ’n kernfunksie van die menslikehulpbronaktiwiteite binne openbare ouditeursfirmas is, het hierdie studie die verhouding tussen akademiese prestasie, spesifieke persoonlikheidstrekke, die eksamenslaagsyfer en die werkprestasie van ’n steekproef (N = 77 kwekelinggeoktrooieerde-rekenmeesters binne ’n internasionale, gemiddelde grootte firma ondersoek. Die resultate dui daarop dat die meerderheid gevalle korrek as suksesvol aldan nie voorspel kan word deur ’n verbale vermoëveranderlike en dat die kriteriuminstrument wat vir hierdie studie ontwikkel is (Cronbach alfa = 0,95, gebruik kan word om die werkprestasie van hierdie kwekelinge te meet. Die belangrikheid van akademiese prestasie en die slaagsyfer in die kwalifiserende eksamens word ook bespreek.
Jane, Beverley; Martin, Marjory-Dore; Tytler, Russell
A study of primary teacher trainees' perceptions and attitudes to science in 1990, has been useful in designing a semester unit aimed at increasing the confidence and interest of first year students at Victoria College. This paper outlines the background survey and discusses some, of the results and how they were used to develop the Professional Readiness Study-Understanding Science. This unit attempts to change attitudes by focussing on metacognition and encourages students to understand and control their own learning. Discussion involves teaching and learning strategies and alternative assessment approaches including the student's journal-the Personal Record.
Waugh, Jeff L
The objective of residency training is to produce physicians who can function independently within their chosen subspecialty and practice environment. Skills in the business of medicine, such as clinical billing, are widely applicable in academic and private practices but are not commonly addressed during formal medical education. Residency and fellowship training include limited exposure to medical billing, but our academic department's performance of these skills was inadequate: in 56% of trainee-generated outpatient notes, documentation was insufficient to sustain the chosen billing level. We developed a curriculum to improve the accuracy of documentation and coding and introduced practice changes to address our largest sources of error. In parallel, we developed tools that increased the speed and efficiency of documentation. Over 15 months, we progressively eliminated note devaluation, increased the mean level billed by trainees to nearly match that of attending physicians, and increased outpatient revenue by $34,313/trainee/year. Our experience suggests that inclusion of billing education topics into the formal medical curriculum benefits both academic medical centers and trainees. © 2014 American Academy of Neurology.
Nestel, Debra; Harlim, Jennifer; Bryant, Melanie; Rampersad, Rajay; Hunter-Smith, David; Spychal, Bob
The landscape of surgical training is changing. The anticipated increase in the numbers of surgical trainees and the shift to competency-based surgical training places pressures on an already stretched health service. With these pressures in mind, we explored trainers' and trainees' experiences of surgical training in a less traditional rotation, an outer metropolitan hospital. We considered practice-based learning theories to make meaning of surgical training in this setting, in particular Actor-network theory. We adopted a qualitative approach and purposively sampled surgical trainers and trainees to participate in individual interviews and focus groups respectively. Transcripts were made and thematically analysed. Institutional human research ethics approval was obtained. Four surgical trainers and fourteen trainees participated. Almost without exception, participants' report training needs to be well met. Emergent inter-related themes were: learning as social activity; learning and programmatic factors; learning and physical infrastructure; and, learning and organizational structure. This outer metropolitan hospital is suited to the provision of surgical training with the current rotational system for trainees. The setting offers experiences that enable consolidation of learning providing a rich and varied overall surgical training program. Although relational elements of learning were paramount they occurred within a complex environment. Actor-network theory was used to give meaning to emergent themes acknowledging that actors (both people and objects) and their interactions combine to influence training quality, shifting the focus of responsibility for learning away from individuals to the complex interactions in which they work and learn.
Nagendran, Myura; Gurusamy, Kurinchi Selvan; Aggarwal, Rajesh; Loizidou, Marilena; Davidson, Brian R
Standard surgical training has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time-consuming, costly, and of variable effectiveness. Training using a virtual reality simulator is an option to supplement standard training. Virtual reality training improves the technical skills of surgical trainees such as decreased time for suturing and improved accuracy. The clinical impact of virtual reality training is not known. To assess the benefits (increased surgical proficiency and improved patient outcomes) and harms (potentially worse patient outcomes) of supplementary virtual reality training of surgical trainees with limited laparoscopic experience. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE and Science Citation Index Expanded until July 2012. We included all randomised clinical trials comparing virtual reality training versus other forms of training including box-trainer training, no training, or standard laparoscopic training in surgical trainees with little laparoscopic experience. We also planned to include trials comparing different methods of virtual reality training. We included only trials that assessed the outcomes in people undergoing laparoscopic surgery. Two authors independently identified trials and collected data. We analysed the data with both the fixed-effect and the random-effects models using Review Manager 5 analysis. For each outcome we calculated the mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals based on intention-to-treat analysis. We included eight trials covering 109 surgical trainees with limited laparoscopic experience. Of the eight trials, six compared virtual reality versus no supplementary training. One trial compared virtual reality training versus box-trainer training and versus no supplementary training, and one trial compared
Objective: To know the opinions of trainee ophthalmologists on ways to improve cataract surgical rate (CSR) with a view to having insight into actions that should be of high priority for achieving this improvement. Methods: A survey of 27 trainee ophthalmologists using structured self-administered questionnaire. Results: ...
Busacca, Louis A.; Beebe, Ronald S.; Toman, Sarah M.
This national web-based study used the Schwartz Value Survey (Schwartz, 1994) and Super's Work Values Inventory-Revised (Zytowski, n.d.) to identify general life and work value orientations of 674 female and male entry-level counselor trainees residing in 27 states. In general, trainees emphasized benevolence, self-direction, and achievement and…
The purpose of this study is to investigate history teacher trainees' views and perceptions of the functions of history education. 36 teacher trainees participated in the study. All of the participants were registered to the History Education masters degree (without dissertation), within the Secondary Education Social Sciences discipline at…
Objective: To determine the effect of a health education intervention on trainee teachers' knowledge, attitude and first aid management of epilepsy. Methods: The effect of a health education intervention in first aid management of epilepsy was assessed among 226 trainee teachers, attending the Federal College of ...
Ross, Paula T; McMyler, Eileen T; Anderson, Susan G; Saran, Kelly A; Urteaga-Fuentes, Anabel; Boothman, Richard C; Lypson, Monica L
Ensuring that trainees receive appropriate clinical supervision is one proven method for improving patient safety outcomes. Yet, supervision is difficult to monitor, even more so during advanced levels of training. The manner in which trainees' perceived failures of supervision influenced patient safety practices across disciplines and various levels of training was investigated. A brief, open-ended questionnaire, administered to 334 newly hired interns, residents, and fellows, asked for descriptions of situations in which they witnessed a failure of supervision and their corresponding response. Of the 265 trainees completing the survey, 73 (27.5%) indicated having witnessed a failure of supervision. The analysis of these responses revealed three types of supervision failures-monitoring, guidance, and feedback. The necessity of adequate supervision and its accompanying consequences were also highlighted in the participants responses. The findings of this study identify two primary sources of failures of supervision: supervisors' failure to respond to trainees' seeking of guidance or clinical support and trainees' failure to seek such support. The findings suggest that the learning environment's influence was sufficient to cause trainees to value their appearance to superiors more than safe patient care, suggesting that trainees' feelings may supersede patients' needs and jeopardize optimal treatment. The literature on the impact of disruptive behavior on patient care may also improve understanding of how intimidating and abusive behavior stifles effective communication and trainees' ability to provide optimal patient care. Improved supervision and communication within the medical hierarchy should not only create more productive learning environments but also improve patient safety.
paper reports on how to improve recruitment of surgical trainees and training of surgeons in Uganda, focusing on perceptions of potential trainees, trainers, and medical administrators. Methods: This was cross sectional, descriptive study sampled at least 50% of each of the relevant category of interviewees.
Xu, G.; Zhao, W.; Zheng, L.; Fan, X.; Yin, Q.; Liu, X.
Digital subtraction angiography (DSA) performed by trainees may be related to increased radiation exposure. This study was aimed to investigate and quantify this learning effect, with fluoroscopy time and dose-area product (DAP) as parameters. We collected procedure data of the first to the fortieth cerebral DSA consecutively performed by 13 trainees in a training centre. DAP, procedure time, fluoroscopy time, number of cine-frames of the first 20 DSA procedures performed by these trainees were compared with that of the second 20 procedures. There was no significant difference concerning the procedure time between the first and the second 20 procedures (56.3 ±29.5 vs 51.5±20.2 min, p = 0.113). Numbers of cine-frames were very similar between the first and the second 20 procedures (750.7 ±290.3 vs 744.5 ±188.7, p = 0.830). Fluoroscopy time of the first 20 procedures was significantly longer than that of the second 20 procedures (17.8 ±15.4 vs 12.6 ±9.0, p = 0.001). DAP of the first 20 procedures was significantly higher than that of the second 20 procedures (6.4 ±4.9 vs 3.8 ±1.8, p < 0.001). DAP was correlated significantly with the performer's experience (R = -0.288, p < 0.001). There exists a learning effect of radiation exposure during cerebral DSA procedures performed by trainees. The learning effect is significant during the first 20 procedures, and becomes insignificant after 20 procedures. Insufficient catheter skills in novice trainees may be one reason for this effect. (authors)
Hansen, Tom G
There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...
Mackenzie, Hugh; Miskovic, Danilo; Ni, Melody; Parvaiz, Amjad; Acheson, Austin G; Jenkins, John T; Griffith, John; Coleman, Mark G; Hanna, George B
The self-taught learning curve in laparoscopic colorectal surgery (LCS) is between 100 and 150 cases. Supervised training has been shown to shorten the proficiency gain curve of senior specialist surgeons. Little is known about the learning curve of LCS trainees undergoing mentored training. The aim of this study was to analyze the proficiency gain curve and clinical outcomes of English surgical trainees during laparoscopic colorectal surgery fellowships. In 2010 the educational, Web-based platform from the National Training Program in Laparoscopic Colorectal Surgery in England was newly available to surgical trainees undertaking a laparoscopic colorectal fellowship. These fellows were asked to submit clinical outcomes, including patient demographics and case specifications. In addition, self-perceived performance was evaluated using a validated task-specific self-assessment form [global assessment scale (GAS) range 1-6]. Proficiency gain curves and learning rates were evaluated using risk-adjusted (RA) cumulative sum (CUSUM) curves. Of 654 cases 608 were included for analysis. The clinical outcomes included 9.2 % conversions, 16.9 % complications, 4 % reoperations, 2.6 % readmissions and a 0.8 % in-hospital mortality rate. RA CUSUM curves for complications and reoperation do not show a learning effect. However, the RA CUSUM curve for conversion has an inflection point at 24 cases. The GAS CUSUM curves for 'setup' and 'exposure' have inflection points at case 15 and case 29 respectively. The curves for 'mobilization of colon,' 'vascular pedicle' and 'anastomosis' plateau towards the end of the training period. 'Flexure' and 'mesorectum' do not of reach a plateau by case 40. Supervised fellowships provide training in LCS without compromising patient safety. Forty cases are required for the fellows to feel confident to perform the majority of tasks except dissection of the mesorectum and flexure, which will require further training.
... 18-21yrs. Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & ... Overuse injuries Cartilage injuries Exercise-induced asthma Concussions ... Pediatric Sports Medicine Specialist? Pediatric sports medicine specialists practice in ...
Stoffels, Antoinette Marie-Rose Renée
This thesis investigates the cooperation among medical specialists in multidisciplinary teams as well as its antecedents and consequences. During meetings, medical specialists combine their knowledge and expertise, discuss the health problems of patients, weigh possible treatment options and decide
Kadriye Dilek Akpınar
Full Text Available Higher Education Council of Turkey has added a one term course named as “Effective Communication Skills” to the curriculum since 2006 in Foreign Language Education Departments because of the crucial importance of communication in the information society. In order to test the effectiveness of this course, a research project was developed by looking at the pre-and post course interviews conducted with first year teacher trainees about communication skills compared with the fourth year students’ ideas who did not take the course. This paper describes both the significance of effective communication skills and the benefits of the course for developing teacher trainees’ effective communication skills. The implementations and suggestions for teacher education has also been discussed.
Provider Perspectives on Advance Care Planning Documentation in the Electronic Health Record: The Experience of Primary Care Providers and Specialists Using Advance Health-Care Directives and Physician Orders for Life-Sustaining Treatment.
Dillon, Ellis; Chuang, Judith; Gupta, Atul; Tapper, Sharon; Lai, Steve; Yu, Peter; Ritchie, Christine; Tai-Seale, Ming
Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice. Structured interviews were conducted with 13 providers with high and low rates of ACP documentation in primary care, oncology, pulmonology, and cardiology departments. The EHR problem list data on Advance Health Care Directives (AHCDs) and Physician Orders for Life-Sustaining Treatment (POLST) were used to calculate ACP documentation rates. Examining seriously ill patients ≥65 years with no preexisting ACP documentation seen by providers during 2013 to 2014, 88.6% (AHCD) and 91.1% (POLST) of 79 specialists had zero ACP documentations. Of 358 PCPs, 29.1% (AHCD) and 62.3% (POLST) had zero ACP documentations. Interviewed PCPs often believed ACP documentation was beneficial and accessible, while specialists more often did not. Specialists expressed more confusion about documenting ACP, whereas PCPs reported standard clinic workflows. Problems with interoperability between outpatient and inpatient EHR systems and lack of consensus about who should document ACP were sources of variations in practices. Results suggest that providers desire standardized workflows for ACP discussion and documentation. New Medicare reimbursement for ACP and an increasing number of quality metrics for ACP are incentives for health-care systems to address barriers to ACP documentation.
Duran, Cassidy A; Shames, Murray; Bismuth, Jean; Lee, Jason T
Simulation modules allow for the safe practice of certain techniques and are becoming increasingly important in the shift toward education for integrated vascular residents. There is an unquestionable need to standardize the evaluation of trainees on these simulation models to assure their impact and effectiveness. We sought to validate such an assessment tool for a basic open vascular technique. Vascular fellows, integrated vascular residents, and general surgery residents attending Society for Clinical Vascular Surgery, Introduction to Academic Vascular Surgery, and Methodist Boot Camp in 2012 were asked to participate in an assessment model using multiple anastomotic models and given 20 minutes to complete an end-to-side anastomosis. Trained vascular faculty evaluated subjects using an assessment tool that included a 25-point checklist and a graded overall global rating scale (GRS) on a 5-point Likert scale with 8 parameters. Self-assessment using the GRS was performed by 20 trainees. Reliability and construct validity were evaluated. Ninety-two trainees were assessed. There was excellent agreement between assessors on 21 of the 25 items, with 2 items found not to be relevant for the bench-top model. Graders agreed that the checklist was prohibitively cumbersome to use. Scores on the global assessments correlated with experience and were higher for the senior trainees, with median global summary scores increasing by postgraduate year. Reliability was confirmed through interrater correlation and internal consistency. Internal consistency was 0.92 for the GRS. There was poor correlation between grades given by the expert observers and the self-assessment from the trainee, but good correlation between scores assigned by faculty. Assessment of appropriate hemostasis was poor, which likely reflects the difficulty of evaluating this parameter in the current inanimate model. Performance on an open simulation model evaluated by a standardized global rating scale
Hawley, Jeffrey R; Taylor, Clayton R; Cubbison, Alyssa M; Erdal, B Selnur; Yildiz, Vedat O; Carkaci, Selin
Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes. Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded. A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Dieckmann, Peter; Beier-Holgersen, Randi; Rosenberg, Jacob; Oestergaard, Doris
Objectives This study aimed to explore the content of conversations, feedback style, and perceived usefulness of feedback to trainee surgeons when conversations were stimulated by a tool for assessing surgeons’ non-technical skills. Methods Trainee surgeons and their supervisors used the Non-Technical Skills for Surgeons in Denmark tool to stimulate feedback conversations. Audio recordings of post-operation feedback conversations were collected. Trainees and supervisors provided questionnaire responses on the usefulness and comprehensiveness of the feedback. The feedback conversations were qualitatively analyzed for content and feedback style. Usefulness was investigated using a scale from 1 to 5 and written comments were qualitatively analyzed. Results Six trainees and six supervisors participated in eight feedback conversations. Eighty questionnaires (response rate 83 percent) were collected from 13 trainees and 12 supervisors. Conversations lasted median eight (2-15) minutes. Supervisors used the elements and categories in the tool to structure the content of the conversations. Supervisors tended to talk about the trainees’ actions and their own frames rather than attempting to understand the trainees’ perceptions. Supervisors and trainees welcomed the feedback opportunity and agreed that the conversations were useful and comprehensive. Conclusions The content of the feedback conversations reflected the contents of the tool and the feedback was considered useful and comprehensive. However, supervisors talked primarily about their own frames, so in order for the feedback to reach its full potential, supervisors may benefit from training techniques to stimulate a deeper reflection among trainees. PMID:25602262
Heitman, Elizabeth; Litewka, Sergio
In the increasingly global community of biomedical science and graduate science education, many US academic researchers work with international trainees whose views on scientific writing and plagiarism can be strikingly different from US norms. Although a growing number of countries and international professional organizations identify plagiarism as research misconduct, many international trainees come from research environments where plagiarism is ill-defined and even commonly practiced. Two research-ethics educators consider current perspectives on plagiarism around the world and contend that US research-training programs should focus on trainees' scientific writing skills and acculturation, not simply on preventing plagiarism. Copyright © 2011 Elsevier Inc. All rights reserved.
Dayal, Helena; Weaver, Kathryn; Domene, José F
Using narrative analysis, the experiences of 7 Canadian counselor trainees with eating issues were explored for meanings of shame and resilience. Shame was experienced as layers of discounting and disconnection from self and others, which served as barriers to help seeking and recovery. Trainees' attempts to overcome shame were characterized by a dialectic conflict of protecting shame vs. prioritizing recovery. Finding a culture of safety and belonging, invalidating perfection, and redefining ideals emerged as elements that fostered resilience from the layers of shame. Recommendations for future research include exploring the important features of social support and examining how safe disclosure contributes to overcoming shame. Potential implications for counselor education programs include introducing self-care initiatives, discussions about counselor wellness and ethical practice, and education on eating issues. © The Author(s) 2014.
Foster, Cortney B; Simone, Shari; Bagdure, Dayanand; Garber, Nan A; Bhutta, Adnan
The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. PubMed, CINAHL, OVID MEDLINE, and Cochrane Review from 2002 to 2015. Experimental study designs conducted in an ICU setting. Two reviewers screened articles for eligibility and independently abstracted data using the identified search terms. We found 21 articles describing ICU team structure and outcomes. Four articles were found describing the impact of advanced practice providers on resident or fellow education. Two articles were found discussing strategies to promote collaboration between advanced practice providers and critical care fellows or residents. Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.
School media specialists must be teachers, leaders, and advocates for reading, inquiry, and learning. Partnering with classroom teachers, they must design and implement curriculum and instruction that prepare young citizens for a life that requires thinking, inquiry, problem-solving and ethical behavior. These experiences provide the foundation…
Objective: To analyse and document our experiences with maternal mortality with the view of finding the trends over the last seven years, common causes and attributing socio-demographic factors. Design: A prospective analysis of maternal mortality. Setting: State Specialists Hospital Bauchi, Bauchi Northeastern Nigeria.
Polish experience in training specialists in international marketing in the context of globalization and integration processes has been studied. A range of theoretical resources, namely Market Entry Strategy for Poland; the articles dedicated to international marketing and economy development (W. Grzegorczyk, M. Viachevskyi, M. Urbanetst); program…
Messina, Irene; Gelo, Omar C G; Sambin, Marco; Bianco, Francesca; Mosconi, Andrea; Fenelli, Antonio; Curto, Marcello; Gullo, Salvo; Orlinsky, David
This study presents a pilot contribution to the new collaborative, multinational study of psychotherapy trainee development that was undertaken by the Society for Psychotherapy Research Interest Section on Therapist Training and Development (see Orlinsky, Strauss, Rønnestad, et al., ). Although the main project is longitudinal in design, this preliminary study investigated cross-sectional differences between trainees in different years of training and explored the influence of core training experiences-including supervision and personal therapy-on their perceived development as therapists. Using the trainee current-progress report that was designed for the Society for Psychotherapy Research Interest Section on Therapist Training and Development project, 90 trainees at 4 different 4-year training programs in Italy provided self-evaluations of their development and of their therapeutic work experiences. Perceived development included overall change, progress, deterioration, overcoming past limitations, and realization of potential as a therapist. Therapeutic work experiences were assessed using scales of healing and stressful involvement (Orlinsky & Rønnestad, ). Year in training and support in supervision predicted perceived development and healing involvement, whereas experiencing criticism in supervision was associated with stressful involvement. Having had personal therapy, and especially ratings of benefit from personal therapy, was also associated with perceived development and healing involvement. Results are discussed with regard of their implications for psychotherapy training. Copyright © 2017 John Wiley & Sons, Ltd.
Badawy, Sherif M
Publishing and securing funding are considered our "academic currency", and therefore, both should be emphasized during training, both residency and fellowship. Trainees should make an effort to find funding opportunities at or outside of their institutions and try to identify their short- and long-term goals. Establishing a track record of publications can help trainees get hired, funded, and promoted as junior faculty, and effective networking and mentorship are critical determinants of academic success. Given the positive effects of mentorship, trainees should understand what comprises a good mentor-mentee relationship and how to optimize the mentoring process. The objective of this article is to discuss few key considerations for trainees in residency or fellowship regarding mentorship and career planning in academic medicine.
Fluoroscopy is frequently used in orthopaedic surgery, particularly in a trauma setting. Exposure of patients and staff to ionising radiation has been studied extensively; however, little work has been done to evaluate current knowledge and practices among orthopaedic trainees.
Triage capabilities of medical trainees in Ghana using the South African triage scale: an opportunity to improve emergency care. Adam Gyedu, Kwabena Agbedinu, Mohammed Dalwai, Maxwell Osei-Ampofo, Emmanuel Kweku Nakua, Rockefeller Oteng, Barclay Stewart ...
Neelam, Kishen; Duddu, Venugopal; Chaudhry, Imran Bashir; Antonysamy, A S; Husain, Nusrat
The authors explored the ethnocultural values of a group of senior psychiatry trainees in the northwest region of England. The authors surveyed senior psychiatry trainees using the Personal Values Questionnaire and analyzed responses under the headings of ethnic stereotypes, ethnocultural service issues, and perceptions of racism. They also explored training requirements on cultural issues in a subsample of trainees. The majority of the trainees disagreed with certain commonly held ethnic stereotypes and acknowledged the role of culture in mental health. However, they had contrasting views on the need for culture-specific services and on perceptions of racism. They expressed interest in training programs on cultural issues in psychiatric practice. In multicultural settings, personal beliefs, perceptions, and values are likely to influence psychiatric practice. A training program on cultural aspects of mental health could help improve awareness and sensitivity of these issues and the quality of care.
Schomburg, Allison M; Prieto, Loreto R
Previous literature on the assessment of multicultural counseling competence has been concerned only with counselors' abilities when working with individual clients. We expanded this line of research by investigating trainees' multicultural case conceptualization ability in the context of working with couples. Despite the fact that trainees self-reported a high level of multicultural competency, trainees were largely inattentive to racial factors in their case conceptualization responses to vignettes involving both African American and European American clients presenting for couples therapy. On the whole, despite didactic, clinical, and extracurricular training in multiculturalism, marriage and family therapy trainees did not sufficiently incorporate cultural factors into their clinical case conceptualizations. We discuss implications for teaching, practice, and future research. © 2009 American Association for Marriage and Family Therapy.
Full Text Available To meet a critical and growing need for emergency physicians and emergency medicine resources worldwide, physicians must be trained to deliver time-sensitive interventions and lifesaving emergency care. Currently, there is no globally recognized, standard curriculum that defines the basic minimum standards for specialist trainees in emergency medicine. To address this deficit, the International Federation for Emergency Medicine (IFEM convened a committee of international physicians, health professionals, and other experts in emergency medicine and international emergency medicine development to outline a curriculum for training of specialists in emergency medicine. This curriculum document represents the consensus of recommendations by this committee. The curriculum is designed to provide a framework for educational programs in emergency medicine. The focus is on the basic minimum emergency medicine educational content that any emergency medicine physician specialist should be prepared to deliver on completion of a training program. It is designed not to be prescriptive but to assist educators and emergency medicine leadership to advance physician education in basic emergency medicine no matter the training venue. The content of this curriculum is relevant not just for communities with mature emergency medicine systems but in particular for developing nations or for nations seeking to expand emergency medicine within the current educational structure. We anticipate that there will be wide variability in how this curriculum is implemented and taught. This variability will reflect the existing educational milieu, the resources available, and the goals of the institutions’ educational leadership with regard to the training of emergency medicine specialists.
Rodríguez-Antigüedad, A; Matías-Guiu, J; Hernández-Pérez, M A; Jiménez Hernández, M D; Martín González, M R; Morales Ortiz, A; Delgado, G; Frank, A; López de Silanes, C; Martínez-Vila, E
The training period in neurophysiology is a substantial part of the Neurology Specialist Program in Spain. The National Neurology Committee (La Comisión Nacional de Neurología (CNN), which is the body reporting to the Ministries of Health and Education, must ensure compliance to the Program. During the first trimester of 2008, the CNN sent a questionnaire, in which there was a question asking about this training period, to each of the managers of the 69 teaching units accredited for neurology training in Spain, for them to answer. Of the 69 questionnaires issued, 49 were received completed, which was a response rate of 71%. The neurophysiology training period of the neurology specialist program in Spain was carried out in the same hospital in 44 teaching unit (90%): the remaining 5 sent their neurology trainees to 4 different hospitals. The Unit that carried out the neurophysiology training period was incorporated into the Neurology Department in 27 (55%) cases, and the formula was mixed in 3 (6%). A total of 69% of tutors were satisfied with the training, but was 90% in the hospitals where the unit was integrated into Neurology, and was 65% where this relationship did not exist. The neurologists in training were informed about EEG in 49% of education units, performed EMG/ENG 57%, and informed about evoked potentials in 35% after their training period. Although the level of satisfaction is high, the level of responsibility assumed by the neurologists in training during their rotation into neurophysiology does not appear to comply to the demands laid out in the training program, particularly in these units not integrated into Neurology Departments. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.
Hooreman, RW Ralph; Kommers, PAM; Jochems, WMG Wim
The need to make trainee teachers more prepared to coach collaborative learning effectively is increasing, as collaborative learning is becoming more important. One complication in this training process is that it is hard for the teacher trainer to hear and understand the students’ utterances and those of the coaching trainee teacher. Besides, it is essential that the teacher trainer does not intervene with the students directly. This constraint is a strong plea for facilitating the direct wh...
Giangreco, Antonio; Carugati, Andrea; Sebastiano, Antonio
The extensive use of training demands more extensive evaluations of its real effects. Human resource scholars attempt to develop multi-dimensional training evaluation models, often ignored by practitioners, whereas training managers tend to evaluate only reaction evaluations, the first dimension....... Structured survey data from a sample of 13,753 trainees, grouped in 1230 courses, involving 3047 companies, and financed by an Italian inter-professional fund, confirm the role of all three antecedents of OST. Moreover, of the five course- and participantrelated variables, participation of female workers...
The \\'accuracy\\' of age, blood pressure, clinical features, duration and diabetes (ABCD(2)) scoring by non-stroke specialists referring patients to a daily Rapid Access Stroke Prevention (RASP) service is unclear, as is the accuracy of ABCD(2) scoring by trainee residents. In this prospective study, referrals were classified as \\'confirmed TIAs\\' if the stroke specialist confirmed a clinical diagnosis of possible, probable or definite TIA, and \\'non-TIAs\\' if patients had a TIA mimic or completed stroke. ABCD(2) scores from referring physicians were compared with scores by experienced stroke specialists and neurology\\/geriatric medicine residents at a daily RASP clinic; inter-observer agreement was examined. Data from 101 referrals were analysed (mean age=60.0years, 58% male). The median interval between referral and clinic assessment was 1day. Of 101 referrals, 52 (52%) were \\'non-TIAs\\': 45 (86%) of 52 were \\'TIA mimics\\' and 7 (14%) of 52 were completed strokes. There was only \\'fair\\' agreement in total ABCD(2) scoring between referring physicians and stroke specialists (κ=0.37). Agreement was \\'excellent\\' between residents and stroke specialists (κ=0.91). Twenty of 29 patients scored as \\'moderate to high risk\\' (score 4-6) by stroke specialists were scored \\'low risk\\' (score 0-3) by referring physicians. ABCD(2) scoring by referring doctors is frequently inaccurate, with a tendency to underestimate stroke risk. These findings emphasise the importance of urgent specialist assessment of suspected TIA patients, and that ABCD(2) scores by non-stroke specialists cannot be relied upon in isolation to risk-stratify patients. Inter-observer agreement in ABCD(2) scoring was \\'excellent\\' between residents and stroke specialists, indicating short-term training may improve accuracy.
Pam Wright highlights the role of technology in providing situated learning opportunities for preservice teachers to explore the role commercial computer games may have in primary education. In a study designed to assess the effectiveness of an online unit on gaming incorporated into a course on learning technologies, Wright found that thoughtful…
Windsor, J A; Zoha, F
It has been suggested that virtual reality (VR) might be useful for the selection of surgical trainees and the measurement of technical performance during preoperative training and retraining. This study was designed to determine whether it is possible to define and measure the acquisition, loss, and reacquisition of psychomotor skills in novice surgical trainees. Novice surgical trainees (NSTs n = 10, junior surgical registrars with little or no prior experience with laparoscopic surgery) were tested and retested after 1 month using the Minimally Invasive Surgical Trainer-Virtual Reality. Two tasks were used: the simple task [stretch diathermy (SD)] and the more complex task [manipulation diathermy (MD)]. The score was derived from the time taken to complete the task and the number of errors that occurred. Acquisition is the difference between the first and last score of the first training session, loss is the difference in score that occurs between the last score of the first training session and the first score of the second training session, and reacquisition is the difference in the first and last scores of the second training session. A performance criterion level was defined for each task by testing a group of experienced laparoscopic surgeons (n = 10). Groups were compared using the nonparametric Wilcoxon signed rank test, with p psychomotor skills in individual NSTs and to compare them with a predefined performance criterion level. This study defines parameters that will be useful in repeated training sessions of NSTs in the preoperative phase of training and during retraining.
Olaussen, Alexander; Jennings, Paul A; O'Reilly, Gerard; Mitra, Biswadev; Cameron, Peter A
Research underpins evidence-based practice, but there are significant barriers to conducting research relevant to each clinical discipline. Understanding these barriers could allow strategies to reduce their impact. The present study was undertaken to understand specific barriers to research for emergency medicine (EM) trainees. EM trainees attending research short courses were surveyed. Free-text responses were classified into themes and a list of pre-specified potential barriers was used for ranking purposes. The responders (n = 61/90; 67.8%) were young, mostly male with low confidence in leading a research project and limited previous research experience. There were 155 unique barriers identified from 55 respondents, which fitted into nine categories. The most frequently perceived barrier was time (29%), followed by skills (22.6%) and cultural factors (19.4%). Most trainees (n = 54/56, 96.4%) believed that the barriers could be overcome. Strategies suggested included protection of time, mentoring and education, as well as top-down improved research culture. Barriers to research in EM are similar to other specialities and were perceived to be manageable. Reorganisation and refocus of the Australasian College for Emergency Medicine training curriculum may be an option to foster an environment to promote research. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Martinez, William; Hickson, Gerald B; Miller, Bonnie M; Doukas, David J; Buckley, John D; Song, John; Sehgal, Niraj L; Deitz, Jennifer; Braddock, Clarence H; Lehmann, Lisa Soleymani
To measure trainees' exposure to negative and positive role-modeling for responding to medical errors and to examine the association between that exposure and trainees' attitudes and behaviors regarding error disclosure. Between May 2011 and June 2012, 435 residents at two large academic medical centers and 1,187 medical students from seven U.S. medical schools received anonymous, electronic questionnaires. The questionnaire asked respondents about (1) experiences with errors, (2) training for responding to errors, (3) behaviors related to error disclosure, (4) exposure to role-modeling for responding to errors, and (5) attitudes regarding disclosure. Using multivariate regression, the authors analyzed whether frequency of exposure to negative and positive role-modeling independently predicted two primary outcomes: (1) attitudes regarding disclosure and (2) nontransparent behavior in response to a harmful error. The response rate was 55% (884/1,622). Training on how to respond to errors had the largest independent, positive effect on attitudes (standardized effect estimate, 0.32, P error (OR 1.37, 95% CI 1.15-1.64; P errors. Negative role models may be a significant impediment to disclosure among trainees.
Murphy, Michael J; Shahriari, Neda; Payette, Michael; Mnayer, Laila; Elaba, Zendee
Results of molecular studies are redefining the diagnosis and management of a wide range of skin disorders. Dermatology training programs maintain a relative gap in relevant teaching. To develop a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees at our institution. The aim is to provide trainees with a specialty-appropriate, working knowledge in clinical molecular dermatology. The Departments of Dermatology and Pathology and Laboratory Medicine collaborated on the design and implementation of educational objectives and teaching modalities for the new curriculum. A multidisciplinary curriculum was developed. It comprises: (i) assigned reading from the medical literature and reference textbook; (ii) review of teaching sets; (iii) two 1 hour lectures; (iv) trainee presentations; (v) 1-week rotation in a clinical molecular pathology and cytogenetics laboratory; and (vi) assessments and feedback. Residents who participated in the curriculum to date have found the experience to be of value. Our curriculum provides a framework for other dermatology residency programs to develop their own specific approach to molecular diagnostics education. Such training will provide a foundation for lifelong learning as molecular testing evolves and becomes integral to the practice of dermatology. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Harewood, Gavin C
BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.
Harewood, Gavin C
BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.
Nattres, E.; Barrett, J. A.
HSE's mission is to ensure that risks to people's health and safety from work activities are properly controlled. Radiation Specialist Inspectors make an essential contribution to HSE's objectives through the application of their professional skills and knowledge. The role of the Radiation Specialist Inspector includes inspection work in the field to ensure compliance by employers with the Health and Safety at Work etc Act 1974, Ionising Radiations Regulations 1999 and associated legislation. They also contribute to research, and the development of technical policy, legislation, standards, and guidance on protection against the possible harm from exposure to electromagnetic fields, optical or ionizing radiation. This paper explains how Radiation Specialist Inspectors are trained. It starts with the recruitment process, with an emphasis on recruiting people who have already gained relevant experience from radiation work practices in previous employments. The interview process is explored, which includes both technical and behavioural interviews, making a presentation and completing a personality questionnaire. The initial twelve months training is then discussed in detail, including the six months as a general Health and Safety Inspector where inspector' skills and techniques' are developed by practical involvement in inspection, followed by a challenging six months with a Radiation Specialist group. The programme for this period is designed to broaden and develop skills and knowledge within the radiation protection specialist. After the initial twelve months probationary period, new Inspectors are expected to confirm and establish themselves in their role of Radiation Specialist Inspectors. However, it does not end there, continuing professional development to ensure that Inspectors have cutting edge knowledge of the latest advances within the radiation field and health and safety as a whole is essential and will be discussed in more detail. (Author) 6 refs
Fennessy, B G
Cadaveric temporal bone dissection in a temporal bone laboratory is a vital component in training safe, competent otorhinolaryngologists. Recent controversies pertaining to organ retention have resulted in a more limited supply of temporal bones. Consequently, current trainees are dissecting far fewer bones than their consultants. We discuss the establishment of a temporal bone laboratory in the Department of Anatomy in the University College Cork, from the timely preparation and preservation of the tissue to its disposal. Comparisons are drawn between our experience and that of the United States training schemes. The temporal bone laboratory in Cork is the only one in existence in Ireland. The exposure and experience obtained by registrars rotating through Cork, has resulted in noticeable improvements in their operative abilities. The temporal bone laboratory remains a core component to training. It is hoped that this article may facilitate other units overcoming obstacles to establish a temporal bone laboratory.
Johnson, Steven T; Cornish, Stephen M; Lytvyak, Ellina; Taylor, Lorian M; Bell, Gordon; Vallance, Jeff; Fraser, Shawn; Murray, Terra
The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P healthy eating (P healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.
Full Text Available The English Education Department students as teacher trainees still have limited experience in managing the lesson; however they have to practice handling real classroom in the Teaching Practice Program. This teaching experience can be a significant process for the students in applying their knowledge about teaching and learning English. It is also very important in developing students’ competence as the next professional teachers in the future. Therefore the students need to be assisted in order to improve their ability, not only in giving the learning material but also in managing the class. Teaching Practice (PPL as one of English Education Department subjects needs to be assessed. There are two kinds of assessments that are used, one is by direct observation and the other is by observing the video. In this paper I would like to emphasize on the use of video recording as one of the assessment models. There are several aspects that are assessed, including students’ and teachers’ interaction, teachers’ attitude, the use of English in the classroom, teachers’ rapport with students, students’ participation and the use of class equipments. One of the advantages of using this type of assessment is that the video recording can be played several times so there will be less chance of missing the aspects. Moreover it also can be used as teacher’s reflective teaching media, in order to find out the strengths and weaknesses of the teacher trainees’ way of teaching to improve the quality of teaching and learning processes in Teaching Practice Program (PPL.
Newton, Jennifer W.
To address the varying needs of media specialists, area Educational Technology Training Centers, Regional Educational Service Agencies (RESA), and larger school systems are forming professional development communities or consortia that cater specifically to the continuing education needs of library media specialists. In addition to academic and…
Galey, Minaruth; Grady, William F.
This certification model, which is a refined version of the 1974 AECT Certification Model, is directed to the needs of educational media specialists, their employers and educators, and to certifying and accrediting agencies that approve programs preparing educational media specialists. Included in the document are reports on accreditation and…
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 536.570-3 Section 536.570-3 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-3 Specialist...
Nason, G J; Burke, M J; Aslam, A; Kelly, M E; Akram, C M; Giri, S K; Flood, H D
Mobile phone technology is continuously advancing- the smartphone allows users instant access to information via the internet. Downloadable applications (apps) are becoming widespread across medical specialities. The aim of this study was to assess the use of smartphone apps among urology trainees in Ireland. An anonymous electronic survey was distributed via Survey Monkey(®) to all urology trainees in Ireland assessing their ownership and use of smartphones and downloadable apps. A search of urology apps was performed using the Apple App Store and the Android Market. 36 (81.8%) of trainees responded with 100% ownership of smartphones. 28 (77%) report downloading apps with 11 (30.6%) reporting paying for them. The mean number of apps downloaded was 4 (Range 1-12). 16 (44.4%) trainees think apps for smartphones are very useful in clinical practice, 14 (42.4%) think they are useful. A total of 126 urology apps were available. 76 (60.3%) were designed for physicians, 46 (36.5%) for patients, 2 (1.6%) for students and 2 (1.6%) for urological nurses. There are an ever increasing number of urology apps available. Urology trainees are using smartphones as an educational and reference tool and find them a useful aide in clinical practice. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.
AIM: To determine if the assessment of radiology trainees can be improved by modifying the in-training assessment form issued by the Royal College of Radiologists (RCR). MATERIALS AND METHODS: A qualitative study comparing the RCR assessment form with other alternative forms in use in the U.K. Individual semi-structured interviews were conducted with trainees (21) and trainers (18) in Sheffield to collect their views on the RCR form and an alternative form introduced on the North Trent Training Scheme. A postal questionnaire was sent to Heads of Training (24) to find out what assessment forms were in use at other centres and collect their views on the different forms. RESULTS: Trainees and trainers in Sheffield were virtually unanimous in their support of the new North Trent assessment form. The main advantages perceived were the encouragement of appraisal, setting of objectives and feedback from the trainees. Six other radiology training centres were using alternative assessment forms and all believed their forms had advantages over the RCR in-training assessment form. CONCLUSION: The results of this study suggest that the assessment process for radiology trainees can be improved by modifications to the RCR in-training assessment form and allows various recommendations to be made. Long, G. (2001)
Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina
This study was designed to examine the impact of role clarity and job training on job satisfaction among peer specialists. A 3-part survey assessing job training, job satisfaction, and role clarity was administered online to 195 peer specialists who are members of the International Association of Peer Specialists. Data was analyzed using descriptive statistics, correlational analyses to include multiple linear regressions and analysis of variance. Self-study and online training methods were negatively correlated with job satisfaction while job shadowing was positively correlated with job satisfaction. Role clarity was positively correlated with job satisfaction and job training satisfaction as well as job shadowing and one-on-one training. The use of self-study and online training for peer specialists is contraindicated by current findings, which suggest the need to utilize job shadowing or training methods that allow for personal interaction between peer specialists and their colleagues. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
STS-95 Mission Specialist Scott E. Parazynski notes the time on his watch upon his late arrival aboard a T-38 jet at the Shuttle Landing Facility. Parazynski's first plane experienced problems at the stop at Tyndall AFB and he had to wait for another jet and pilot to finish the flight to KSC. He joined other crewmembers Mission Commander Curtis L. Brown Jr., Pilot Steven W. Lindsey, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, Mission Specialist Pedro Duque, with the European Space Agency (ESA), and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA), for final pre-launch preparations. STS-95 is expected to launch at 2 p.m. EST on Oct. 29, last 8 days, 21 hours and 49 minutes, and land at 11:49 a.m. EST on Nov. 7.
Zambrano, Sofia Carolina; Chur-Hansen, Anna; Crawford, Gregory B
This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. Thirty-three semi-structured individual interviews were analysed using thematic analysis. One of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies. Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.
Bastings, L; Baysal, Ö; Beerendonk, C C M; IntHout, J; Traas, M A F; Verhaak, C M; Braat, D D M; Nelen, W L D M
How do female patients experience fertility preservation (FP) consultation (FPC) with a specialist in reproductive medicine and subsequent decision-making on FP? Most patients had positive experiences with FPC, but negative experiences were found to be associated with decisional conflict and decision regret. When confronted with a need for gonadotoxic treatment, girls and young women will have to make an irreversible decision with regard to FP. Patients may experience decisional conflict and develop regret about their decision during follow-up. Patients' opportunities to ask questions during FPC and their knowledge about FP have been inversely related to decisional conflict. A questionnaire on experiences with FPC, designed after qualitative research, was retrospectively distributed to 108 patients to whom FP was offered after FPC between July 2008 and July 2013. Aiming to minimize recall bias, we defined a subgroup of patients counselled since 2011 who had not yet tried to conceive after FPC. Patients were aged ≥16 years and had either cancer or a benign disease that required gonadotoxic therapy. They received FPC in a single university hospital in the Netherlands. Apart from patients' experiences, patients' characteristics, decisional conflict and decision regret were assessed. A total of 64 patients (59.3%) responded to the questionnaire. Patients generally had positive experiences with FPC, but indicated room for improvement. Negative experiences were associated with decisional conflict regarding the FP decision (not enough time for counselling: P conflict was correlated to decision regret (P conflict. Given our retrospective design, we were not informed about the causality of the associations observed. We studied Dutch patients who were counselled in a single centre and were at least 16 years old when filling in the questionnaire. This may limit the generalizability of our data to other settings and populations. More attention should be paid to improving FPC
Clarke, Nicholas; Crowe, Sophie; Humphries, Niamh; Conroy, Ronan; O'Hare, Simon; Kavanagh, Paul; Brugha, Ruairi
The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. Using a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey. Of the 523 who responded (58.6% response rate), 423 were still in Ireland and responded to questions on factors influencing intention to practice medicine abroad and are the subjects of this study. Explanatory factors for intention to practice medicine in Ireland in the foreseeable future, the primary outcome, included demographic variables and experiences of working within the Irish health system. Associations were examined using univariable and multivariable logistic regression to estimate odds ratios for factors influencing the primary outcome. Qualitative interviews were conducted with 50 trainee doctors and analysed thematically, exploring issues associated with intention to practice medicine abroad. There were high levels of dissatisfaction among trainee doctors around working conditions, training and career progression opportunities in Ireland. However, most factors did not discriminate between intention to leave or stay. Factors that did predict intention to leave included dissatisfaction with one's work-life balance (odds ratio (OR) 2.51; 95% confidence interval (CI) 1.53-4.10; P < 0.001); feeling that the quality of training in Ireland was poor (OR 1.82; 95% CI 1.09-3.05; P = 0.002) and leaving for family or personal reasons (OR 1.85; 95% CI 1.08-3.17; P = 0.027). Qualitative findings illustrated the stress of doing postgraduate
Jairo Antônio da Cruz
Full Text Available O artigo busca problematizar as transformações do trabalho na passagem da Modernidade para a Contemporaneidade, e alguns de seus efeitos nos domínios educacionais. Para tanto, mostramos o deslocamento de ênfase de um trabalho fabril para um trabalho que vem sendo chamado imaterial, que já não prioriza um sistema baseado na obediência a regulamentos e na vigilância do corpo. Sua organização lança mão de formas muito mais sutis de poder, apoiando-se em formas mais sofisticadas e complexas de atuar sobre os sujeitos. Esse quadro teórico serve de suporte para a análise de três programas trainees corporativos, que buscam capturar "grandes talentos" egressos de cursos superiores e torná-los fiéis colaboradores das organizações empresariais, fazendo com que desejem e passem a agir como autoem-presários prestadores de serviços.The article attempts to discuss changes in work in the passage from Modernity to Contemporary and some of its effects in education. For this, we show the displacement in emphasis from a factory work, guided by a disciplinary organization, to a work that is being called immaterial. This is no longer a priority a system based on obedience to rules and surveillance of the body. Its organization makes use of more subtle forms of power, relying on more sophisticated and complex ways of acting on the subject. This theoretical framework supports the analysis of three trainees corporate programs, whose purpose is capturing "great talents" graduates from colleges and making them loyal employees of business organizations, making they wish and start to act as self-entrepreneurs service providers.
Full Text Available Digital illiteracy is one of the great challenges of education. In our information society, an adequate level of digital proficiency is an important requirement and teachers’ skills, personality, competence and professional experience are important factors in determining the efficiency of the teaching-learning process. This research has two goals. First, we tried to find out what characteristics a “good” and a “bad” teacher would have based on the trainee teachers’ own experience as secondary school students. We also wanted to know what they think about the social roles of teachers; about the importance of native language in education; what expectations they have regarding the computer skills and competences of secondary school teachers; and what experience they have regarding the use of ICT equipment in the education process. The answers to the open questions about teachers were grouped into four categories: professional expectations, preparedness, teaching skills, personality traits and behaviour. We developed four statistically relevant factors to determine the level of teachers’ computer skills and we used a set of questions containing 10 items to examine the experience of trainee teachers regarding the use of ICT in education. Our study reveals the situation of Hungarian vocational training from Romania, which is a key factor for high-quality teacher training.
M Hajjaji Darouiche
Full Text Available Blood and body fluid Exposure is a major occupational safety problems for health care workers. Therefore, we conducted a descriptive and retrospective study to identify the characteristics of blood exposure accidents in health care settings which lasted five years (2005-2009 at the two university hospitals of Sfax. We have 593 blood exposure accidents in health care settings 152 (25.6% health personnel and 441 (74.4% trainees' doctors, nurses and health technicians. The mechanism of blood and body fluid exposure was accidental needle-stick injury in 78.9% of health staff, and 81% of trainees, accidental cut in 14.7% of health workers and 10.2% of trainees. The increasing severity of blood exposure accidents is linked to the lack of safe behavior against this risk.
Dana K Bagwell
Full Text Available Dana K Bagwell, Robin L WestDepartment of Psychology, University of Florida, Gainesville, FL, USAAbstract: Extensive research on memory interventions has confirmed their success with older adults, but the individual difference factors that predict successful training outcomes remain relatively unexplored. In the current intervention, trainees were identified as active (compliant with training regimens or inactive using trainer ratings based on attendance, homework completion, and class participation. The active group showed significantly greater training-related gains than the inactive group and the control group on most measures. Compliance was predicted by health, education, and self-efficacy. Specifically, active trainees were more likely to have advanced degrees and somewhat higher self-efficacy, and to have higher vitality and fewer functional limitations than the inactive trainees. This research may assist future investigators to target interventions to those who will show the most benefit.Keywords: compliance, memory training, aging, intervention
Kostick, Kristin M; Whitley, Rob; Bush, Philip W
This article examines the notion of client-centeredness from the perspective of supported employment specialists and supervisors, identifying barriers and facilitators to implementation in the field. Though by definition client-centered practices give precedence to clients' wishes, in a realistic setting client-centeredness is adapted to account for negotiations among clients, specialists, employers, and mental health service agencies. Qualitative interviews (n = 22) were conducted with employment specialists and supervisors to elicit facilitators and barriers to successful supported employment outcomes. Data were analyzed inductively using ATLAS.ti 5.0 software. Principal factors influencing implementation of client-centeredness include (1) clients' anxieties about their interests and abilities, (2) difficulties interpreting and negotiating clients' preferences in realistic contexts, (3) quality of supervision and guidance in implementing client-centered practices and upholding morale when facing challenges in the field, and (4) managing discrepancies across resource-sharing agencies in what it means to be "client-centered". These factors suggest the need for (1) focused training among employment specialists to better understand and negotiate clients' wishes, (2) more integration and communication between members of the treatment team, (3) hiring supervisors with first-hand supported employment experience, and (4) spreading awareness of the IPS model across resource-sharing agencies.
Full Text Available There has been much recent attention on increasing the diversity of teachers in the Lifelong Learning Sector (LLS in order to provide a more representative workforce. This is seen as vital not only in engaging learners from minorities but also in increasing the experience of others in working with underrepresented groups. There has been less attention on how to support and sustain teachers from minorities once in post. This study profiles six pioneering teachers/trainees, looking at how they came into their chosen profession and subsequently into teaching, and what processes and attitudes help or hinder them in their work.
Polish experience in training specialists in international marketing in the context of globalization and integration processes has been studied. A range of theoretical resources, namely Market Entry Strategy for Poland; the articles dedicated to international marketing and economy development (W. Grzegorczyk, M. Viachevskyi, M. Urbanetst); program specifications and structures at Polish universities, namely University of Lodz and Collegium Civitas, have been analyzed. It has been defined that...
Győrffy, Zsuzsa; Kalabay, László; Mohos, András; Márkus, Bernadett; Nánási, Anna; Rinfel, József; Girasek, Edmond; Torzsa, Péter
The issue of gratuity is one of the most important health policy issues in Hungary. The authors' aim is to investigate the attitude of Hungarian family medicine trainees towards gratitude payment. Quantitative, paper-based survey among trainees from four Departments of Family Medicine in Hungary (n = 152). More than 50 percent of the residents do not approve of accepting gratitude money. Men (pcorruption, and it's humiliating for doctors (80-80%). Family medicine residents approve of gratitude money even less as compared to the results of previous studies, but related to other gratitude payment issues we have found similar opinions. Orv Hetil. 2017; 158(26): 1028-1035.
Meyer, Bente; Levinsen, Karin
Interviews with trainees were conducted after the Action Research period (November-December 2006), when LBs 1-4 were tested on trainees. The aim of the interviews was to understand how teachers learn to teach and to relate to the online environment through the specific context of the Lancelot live...... online course. The focus of the interviews was on the one hand the ability of the course to support this learning process and on the other hand the correction and adjustment of the syllabus for the spring pilot testing phase (beginning March 2007)....
Liang, Tiffany W; Feliciano, David V; Koniaris, Leonidas G
Publishing clinical and research work for dissemination is a critical part of the academic process. Learning how to write an effective manuscript should be a goal for medical students and residents who hope to participate in publishing. While there are a number of existing texts that address how to write a manuscript, there are fewer guides that are specifically targeted towards surgery trainees. This review aims to direct and hopefully encourage surgery trainees to successfully navigate the process of converting ideas into a publication that ultimately helps understanding and improves the care of patients. Copyright © 2016 Elsevier Inc. All rights reserved.
McNab, Duncan; McKay, John; Bowie, Paul
Small-scale quality improvement projects are expected to make a significant contribution towards improving the quality of healthcare. Enabling doctors-in-training to design and lead quality improvement projects is important preparation for independent practice. Participation is mandatory in speciality training curricula. However, provision of training and ongoing support in quality improvement methods and practice is variable. We aimed to design and deliver a quality improvement training package to core medical and general practice specialty trainees and evaluate impact in terms of project participation, completion and publication in a healthcare journal. A quality improvement training package was developed and delivered to core medical trainees and general practice specialty trainees in the west of Scotland encompassing a 1-day workshop and mentoring during completion of a quality improvement project over 3 months. A mixed methods evaluation was undertaken and data collected via questionnaire surveys, knowledge assessment, and formative assessment of project proposals, completed quality improvement projects and publication success. Twenty-three participants attended the training day with 20 submitting a project proposal (87%). Ten completed quality improvement projects (43%), eight were judged as satisfactory (35%), and four were submitted and accepted for journal publication (17%). Knowledge and confidence in aspects of quality improvement improved during the pilot, while early feedback on project proposals was valued (85.7%). This small study reports modest success in training core medical trainees and general practice specialty trainees in quality improvement. Many gained knowledge of, confidence in and experience of quality improvement, while journal publication was shown to be possible. The development of educational resources to aid quality improvement project completion and mentoring support is necessary if expectations for quality improvement are to be
Tolsgaard, Martin Grønnebæk; Rasmussen, Morten; Tappert, C
To explore the association between clinical training characteristics and trainees' level of confidence in performing ultrasound scans independently.......To explore the association between clinical training characteristics and trainees' level of confidence in performing ultrasound scans independently....
... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE VISTA TRAINEE DESELECTION AND VOLUNTEER EARLY... Volunteers with the following exceptions: (a) For Trainees, the deselection procedure, [See § 1210.2-2] will...
Wagner, Anne C; Girard, Todd; McShane, Kelly E; Margolese, Shari; Hart, Trevor A
HIV continues to be a stigmatized disease, despite significant advances in care and concerted effort to reduce discrimination, stereotypes, and prejudice. Living with HIV is often associated with a multitude of overlapping and intersecting experiences which can, in and of themselves, also be stigmatized, and which may exacerbate HIV-related stigma. The consequences of these stigmatizing experiences are particularly impactful when the stigmatizing individual is a health care provider, as this can influence access to and quality of care. The current study empirically investigates a model of overlapping stigmas (homophobia, racism, sexism, stigma against injection drug use and stigma against sex work) potentially held by health care provider trainees in Canada to determine how these constructs overlap and intersect, and to assess whether HIV-related stigma may have unique attributes. Understanding overlapping stigmas can help inform targeted, stigma-informed training for health care trainees in order to provide effective, compassionate care for people living with HIV.
De Silva, M D
The Ministry of Health is the largest health care provider in Sri Lanka in terms of funding, coverage and human resources. Long duration and high training cost of a medical specialist highlights the importance of health human resource planning. Ministry of Health, Sri Lanka has no scientific cadre planning for medical specialists. System dynamics, an analytical modelling approach and a methodology for studying complex feedback systems was used. Two sub models of “need” and “supply” were developed and simulated over a period of 10 years from 2016 to 2025. By December 2015 there were 1860 clinician medical specialists with an average age of 46.8 years, in the government hospitals in Sri Lanka. In the surgical group of specialties the Proposed Training Rate is more than Current Training Rate while in Medical and Paediatric groups and in Radiology, Anaesthesiology, Psychiatry, Dermatology and Hematology Proposed Training Rate is less than the Current Training Rate. In Surgical specilities the number of trainees enrolled in the Pre-MD programme should be increased from 55 to 71 and while in Medical specilaities the number of trainees enrolled in Pre- MD programmes should be reduced from 107 to 68 and in the Paediatric specialities from 47 to 39. During the 2016-2025 period, 765 specialists will be lost to the Ministry of Health costing nearly Rs 7.6 billion and there will be 4050 consultants by 2025, which is a 120% increase.
This study focuses on the need for specialist training for mountain warfare. It analyzes the special characteristics of mountain and high altitude terrain which affect conduct of military operations...
Singh, Gaurav; Kumar, Girijesh
In the personality of a teacher, his emotional creativity is an important counterpart. In current study, researchers have carried out an investigation of emotional creativity of trainee teachers of pre-service and in-service trainee teachers. The objectives were to compare the emotional creativity of Trainee teachers of Pre-service Courses and…
Petrie, Kimberly A.; Carnahan, Robert H.; Brown, Abigail M.; Gould, Kathleen L.
Many biomedical PhD trainees lack exposure to business principles, which limits their competitiveness and effectiveness in academic and industry careers. To fill this training gap, we developed Business and Management Principles for Scientists, a semester-long program that combined didactic exposure to business fundamentals with practical…
Most procedures used to obtain information about student learning are subsumed under assessment. This study appraised in-service trainee teachers' competency on applications of principles of test items writing. One Study Centre was purposively drawn from the National Teachers' Institute for the study. A sample of 33 ...
Dunsmuir, Sandra; Atkinson, Cathy; Lang, Jane; Warhurst, Amy; Wright, Sarah
Objective Structured Professional Assessments (OSPAs) were developed and evaluated at three universities in the United Kingdom, to supplement supervisor assessments of trainee educational psychologists' placement practice. Participating second year students on three educational psychology doctoral programmes (n = 31) and tutors (n = 12) were…
Alvarez, Ibis M.; Weise, Crista; Vall, Berta; González, Montserrat; Morodo, Andy
Educational Psychology makes a significant contribution to the development of skills to research the effectivity of teacher practices in class. However, there is little agreement on what educational psychology concepts are most relevant for teacher training. This paper reports on trainee teachers' self-perceived mastery of, and attributed…
Gutierrez, Daniel; Mullen, Patrick R.; Fox, Jesse
The authors explored the relationship between counseling trainees' emotional intelligence (EI), empathy, stress, distress, and demographics. Results indicated that higher levels of EI were associated with lower stress and distress, higher affective and cognitive empathy, and age. These findings suggest curricular integration of EI and potential…
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Trainees and interns. 62.22 Section 62.22 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific...; (vii) Hospitality and Tourism; (viii) Information Media and Communications; (iv) Management, Business...
Menke, Kristen Ann
Counseling psychology doctoral trainees' satisfaction with their clinical methods training is an important predictor of their self-efficacy as counselors, persistence in graduate programs, and probability of practicing psychotherapy in their careers (Fernando & Hulse-Killacky, 2005; Hadjipavlou & Ogrodniczuk, 2007; Morton & Worthley,…
Davis, Sharon J.; Sneed, Zachery B.; Koch, D. Shane
Using the Counselor Trainee Attitudes Measure (CTAM) to assess student attitudes toward alcohol and other drug abuse (AODA), results indicated that students had more positive attitudes toward AODA when they were in recovery or had a family member in recovery. Furthermore, completion of AODA related courses predicted more positive attitudes toward…
Illinois State Board of Education, Springfield.
This trainee guide contains six units of materials for use by those studying to become school bus drivers in the State of Illinois. Covered in the units are the following topics: school bus driver role and responsibility, passenger control, first aid, driving fundamentals, accidents and emergencies, and detecting hazards. Each unit contains a…
Panter, A. T.; Huba, G. J.; Melchior, Lisa A.; Anderson, Donna; Driscoll, Mary; German, Victor F.; Henderson, Harold; Henderson, Ron; Lalonde, Bernadette; Uldall, Karnina K.; Zalumas, Jacqueline
Reports findings from 7 HIV/AIDS education and training projects involving more than 600 training sessions. Trainee characteristics were related to their assessments of training quality, using a regression decision-tree analytic approach. Discusses implications for curriculum development. (SLD)
The results show that over 90% of the trainees agreed the objectives of he social studies curriculum are valid and very necessary for the programme; they were very much aware that the purpose of Social Studies education is to train them to teach at the basic level; and agreed that the subject equips them with skills to teach ...
Boyes, Edward; And Others
Survey results reveal trainee primary teachers are well informed about the nature and location of the ozone layer and appreciated that it screens the earth from ultraviolet (UV) rays, although some thought that it protects the earth from acid rain. Identifies themes in students' thinking and groups of students with different concepts. (LZ)
Stojan, Jennifer N; Schiller, Jocelyn Huang; Mullan, Patricia; Fitzgerald, James T; Christner, Jennifer; Ross, Paula T; Middlemas, Sarah; Haftel, Hillary; Stansfield, R Brent; Lypson, Monica L
Determine postgraduate first-year (PGY-1) trainees ability to perform patient care handoffs and associated medical school training. About 173 incoming PGY-1 trainees completed an OSCE handoff station and a survey eliciting their training and confidence in conducting handoffs. Independent t-tests compared OSCE performance of trainees who reported receiving handoff training to those who had not. Analysis of variance examined differences in performance based on prior handoff instruction and across levels of self-assessed abilities, with significance set at pperformance in medical school. Mean handoff performance score was 69.5%. Trainees who received instruction or feedback during medical school had higher total and component handoff performance scores (pconfident in their handoff abilities (pperformed better on the OSCE (pperform handoffs. However, those who received instruction during medical school perform better and are more confident on standardized performance assessments. Given communication failures lead to uncertainty in patient care and increases in medical errors, medical schools should incorporate handoff training as required instruction.
Hamade, Ramsey F.; Artail, Hassan A.; Sikstrom, Sverker
Purpose: The purpose of this exploratory study is to identify trainee attributes relevant for development of skills in 3D computer-aided design (CAD). Design/methodology/approach: Participants were trained to perform cognitive tasks of comparable complexity over time. Performance data were collected on the time needed to construct test models, and…
Castanelli, D J; Wickramaarachchi, S A; Wallis, S
Burnout has a high prevalence among healthcare workers and is increasingly recognised as an environmental problem rather than reflecting a personal inability to cope with work stress. We distributed an electronic survey, which included the Maslach Burnout Inventory Health Services Survey and a previously validated learning environment instrument, to 281 Victorian anaesthetic trainees. The response rate was 50%. We found significantly raised rates of burnout in two of three subscales. Ninety-one respondents (67%) displayed evidence of burnout in at least one domain, with 67 (49%) reporting high emotional exhaustion and 57 (42%) reporting high depersonalisation. The clinical learning environment tool demonstrated a significant negative correlation with burnout (r=-0.56, P Burnout was significantly more common than when previously measured in Victoria in 2008 (62% versus 38%). Trainees rated examination preparation the most stressful aspect of the training program. There is a high prevalence of burnout among Victorian anaesthetic trainees. We have shown a significant correlation exists between the clinical learning environment measure and the presence of burnout. This correlation supports the development of interventions to improve the clinical learning environment, as a means to improve trainee wellbeing and address the high prevalence of burnout.
Feb 8, 2010 ... (74.1%), effective primary eye care- 25 (92.6%) and marketing of cataract surgical services- 23 (85.2%). However, only 16 (59.3%) trainees ... rate (CSR) falls below 500, compared to India and affluent economies, where CSR is ..... College of Nigeria (NPMCN); Friday August 17, 2001. p. 8-9. 3. Faal H. The ...
McKenzie, Karen; Cossar, Jill A.; Fawns, Tim; Murray, Aja L.
The study explored the ways in which qualified and trainee clinical psychologists perceived professional behaviour, as illustrated in a series of short vignettes, in student and clinical practice contexts. Comparisons were made to identify the extent to which ideas of professionalism differed across different learning contexts and between…
Chaplain, Roland P.
The relationships between stress and psychological distress were investigated among a cohort of trainee secondary school teachers in England. Specifically, the study examined the structure of a Teacher Stress Scale and its relationship to mental health as measured by the 12-item General Health Questionnaire. Three factors were identified:…
Hooreman, Ralph W.; Kommers, Petrus A.M.; Jochems, Wim M.G.
The need to make trainee teachers more prepared to coach collaborative learning effectively is increasing, as collaborative learning is becoming more important. One complication in this training process is that it is hard for the teacher trainer to hear and understand the students’ utterances and
Goktalay, Sehnaz Baltaci
Prompt feedback is one of the critical components of teacher education programs. To reap the greatest benefit from the teaching practicum process, the quality of feedback as well as its implementation by stakeholders, supervisors, cooperating teachers, and teacher trainees, takes on great importance. The purpose of this study is to examine how Web…
Briefly described is the activity of the Centre for the Research of Instruction Methods and Aids and experiences gained by the centre presented. The Centre is oriented to the research and testing of instruction and training objectives and content (curricula, programmes, professiograms), new methods (methodologies of individual subjects) and educational technologies (teaching aids, simulators, microcomputer Hvezda 1). Research works are carried out also Dukovany nuclear power plant training centre. (B.S.)
Price, Sophie; Lusznat, Rosie
Postgraduate medical education has undergone significant reorganisation in recent years, with changes to the traditional apprenticeship model and an increasing reliance on shift working. The importance of teamwork in clinical care is well established; however, there is little literature on the extent to which trainees actually feel part of a team in the context of current working patterns. This is a qualitative study using semi-structured interviews of medical and surgical trainees. Data were analysed thematically using an inductive qualitative approach. Fifteen trainees who had worked in a range of hospitals across the UK participated. Emerging themes fell into several categories: what constitutes the team; the effect of shift patterns on the team; the role of the team in education, support and well-being; and influences on team rapport. Whilst in general interviewees felt part of a team, this was not true for all posts. The nature of the team was also highly variable, and had evolved from the traditional 'Firm' structure to a more nebulous concept. Shift-working patterns could result in the fragmentation of the team, which had implications for patient care as well as for training. The team played an important role in both education and well-being for trainees, and several factors were identified that could engender a more supportive team. With an ageing population and with increasing demands on limited resources, the requirement for shift work is likely to increase, and there is a fundamental need to maintain support for the next generation of doctors. There is little literature on the extent to which trainees actually feel part of a team. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Liness, Sheena; Lea, Susan; Nestler, Steffen; Parker, Hannah; Clark, David M
The UK Department of Health Improving Access to Psychological Therapies (IAPT) initiative set out to train a large number of therapists in cognitive behaviour therapies (CBT) for depression and anxiety disorders. Little is currently known about the retention of IAPT CBT trainees, or the use of CBT skills acquired on the course in the workplace after training has finished. This study set out to conduct a follow-up survey of past CBT trainees on the IAPT High Intensity CBT Course at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), one of the largest IAPT High Intensity courses in the UK. Past trainees (n = 212) across 6 cohorts (2008-2014 intakes) were contacted and invited to participate in a follow-up survey. A response rate of 92.5% (n = 196) was achieved. The vast majority of IAPT trainees continue to work in IAPT services posttraining (79%) and to practise CBT as their main therapy modality (94%); 61% have become CBT supervisors. A minority (23%) have progressed to other senior roles in the services. Shortcomings are reported in the use of out-of-office CBT interventions, the use of disorder-specific outcome measures and therapy recordings to inform therapy and supervision. Past trainees stay working in IAPT services and continue to use CBT methods taught on the course. Some NICE recommended treatment procedures that are likely to facilitate patients' recovery are not being routinely implemented across IAPT services. The results have implications for the continued roll out of the IAPT programme, and other future large scale training initiatives.
Cherniak, William; Latham, Emily; Astle, Barbara; Anguyo, Geoffrey; Beaunoir, Tessa; Buenaventura, Joel; DeCamp, Matthew; Diaz, Karla; Eichbaum, Quentin; Hedimbi, Marius; Myser, Cat; Nwobu, Charles; Standish, Katherine; Evert, Jessica
Current competencies in global health education largely reflect perspectives from high-income countries (HICs). Consequently, there has been underrepresentation of the voices and perspectives of partners in low- and middle-income countries (LMICs) who supervise and mentor trainees engaged in short-term experiences in global health (STEGH). The objective of this study was to better understand the competencies and learning objectives that are considered a priority from the perspective of partners in LMICs. A review of current interprofessional global health competencies was performed to design a web-based survey instrument in English and Spanish. Survey data were collected from a global convenience sample. Data underwent descriptive statistical analysis and logistic regression. The survey was completed by 170 individuals; 132 in English and 38 in Spanish. More than 85% of respondents rated cultural awareness and respectful conduct while on a STEGH as important. None of the respondents said trainees arrive as independent practitioners to fill health care gaps. Of 109 respondents, 65 (60%) reported that trainees gaining fluency in the local language was not important. This study found different levels of agreement between partners across economic regions of the world when compared with existing global health competencies. By gaining insight into host partners' perceptions of desired competencies, global health education programs in LMICs can be more collaboratively and ethically designed to meet the priorities, needs, and expectations of those stakeholders. This study begins to shift the paradigm of global health education program design by encouraging North-South/East-West shared agenda setting, mutual respect, empowerment, and true collaboration. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.
Yamada, Kiyoshi; Yamashita, Shuji; Sugiyama, Narushi; Tokuyama, Eijiro; Matsumoto, Kumiko; Takara, Ayumi; Kimata, Yoshihiro
Background We established the Microvascular Research Center Training Program (MRCP) to help trainee surgeons acquire and develop microsurgical skills. Medical students were recruited to undergo the MRCP to assess the effectiveness of the MRCP for trainee surgeons. Methods Twenty-two medical students with no prior microsurgical experience, who completed the course from 2005 to 2012, were included. The MRCP comprises 5 stages of training, each with specific passing requirements. Stages 1 and 2 involve anastomosing silicone tubes and blood vessels of chicken carcasses, respectively, within 20 minutes. Stage 3 involves anastomosing the femoral artery and vein of live rats with a 1-day patency rate of >80%. Stage 4 requires replantation of free superficial inferior epigastric artery flaps in rats with a 7-day success rate of >80%. Stage 5 involves successful completion of one case of rat replantation/transplantation. We calculated the passing rate for each stage and recorded the number of anastomoses required to pass stages 3 and 4. Results The passing rates were 100% (22/22) for stages 1 and 2, 86.4% (19/22) for stage 3, 59.1% (13/22) for stage 4, and 55.0% (11/20) for stage 5. The number of anastomoses performed was 17.2±12.2 in stage 3 and 11.3±8.1 in stage 4. Conclusions Majority of the medical students who undertook the MRCP acquired basic microsurgical skills. Thus, we conclude that the MRCP is an effective microsurgery training program for trainee surgeons. PMID:23730596
Full Text Available BackgroundWe established the Microvascular Research Center Training Program (MRCP to help trainee surgeons acquire and develop microsurgical skills. Medical students were recruited to undergo the MRCP to assess the effectiveness of the MRCP for trainee surgeons.MethodsTwenty-two medical students with no prior microsurgical experience, who completed the course from 2005 to 2012, were included. The MRCP comprises 5 stages of training, each with specific passing requirements. Stages 1 and 2 involve anastomosing silicone tubes and blood vessels of chicken carcasses, respectively, within 20 minutes. Stage 3 involves anastomosing the femoral artery and vein of live rats with a 1-day patency rate of >80%. Stage 4 requires replantation of free superficial inferior epigastric artery flaps in rats with a 7-day success rate of >80%. Stage 5 involves successful completion of one case of rat replantation/transplantation. We calculated the passing rate for each stage and recorded the number of anastomoses required to pass stages 3 and 4.ResultsThe passing rates were 100% (22/22 for stages 1 and 2, 86.4% (19/22 for stage 3, 59.1% (13/22 for stage 4, and 55.0% (11/20 for stage 5. The number of anastomoses performed was 17.2±12.2 in stage 3 and 11.3±8.1 in stage 4.ConclusionsMajority of the medical students who undertook the MRCP acquired basic microsurgical skills. Thus, we conclude that the MRCP is an effective microsurgery training program for trainee surgeons.
Morris, S; Yudin, M H; Callum, J; Alam, A; Herold, J; Lin, Y
To evaluate the current state of transfusion medicine (TM) knowledge among obstetricians using a valid assessment tool. Transfusion issues are common in obstetrical patients. Knowledge topics were identified and rated by experts in obstetrics, anaesthesia, haematology and TM using a modified Delphi method. A knowledge assessment tool was developed and validated during pilot testing. The assessment tool, consisting of 15 multiple choice questions, was administered electronically to members of the Society of Obstetricians and Gynaecologists of Canada (SOGC). A total of 192 SOGC members completed the assessment tool: 121 faculty obstetricians and 71 trainees. The average score was 65·8% ± 15·5. Scores for faculty were higher than trainees (68·9% ± 13·5 vs 60·6% ± 17·2; P blood cell (RBC) transfusion and anaemia management but had lower scores on questions related to non-RBC transfusion and management of alloantibodies and fetomaternal haemorrhage (FMH) testing. There was no improvement in scores with increasing trainee level, years of practice, hours of formal TM training or experience with massive haemorrhage. Only self-rated knowledge was associated with scores ['no knowledge' or 'beginner' 63·1% ± 15 vs 'intermediate' or 'advanced' 68·9% ± 13·3 (P = 0·007)]. Of the respondents, 93·8% felt additional training in TM would be helpful. Overall knowledge assessment scores indicate the need for educational intervention, particularly with respect to non-RBC blood product use, management of FMH and management of pregnancies complicated by alloantibodies. The study also demonstrated a desire for additional TM training. © 2016 British Blood Transfusion Society.
The purpose of this study was to define the self-efficacy perception of Turkish ELT students and examine the relationship between their self-efficacy and such variables as grade level, computer ownership, first time computer use, and frequency of internet and computer use. The participants are 305 Turkish ELT trainees at Dokuz Eylul University,…
Leyden, J E
Cecal intubation and polyp detection rates are objective measures of colonoscopy performance. Minimum cecal intubation rates greater than 90% have been endorsed by the American Society for Gastrointestinal Endoscopy (ASGE) and the Joint Advisory Group (JAG) UK. Performance data for medical and surgical trainee endoscopists are limited, and we used endoscopy quality parameters to compare these two groups.
Hobgood, Cherri; Anantharaman, Venkataraman; Bandiera, Glen; Cameron, Peter; Halpern, Pinchas; Holliman, C James; Jouriles, Nicholas; Kilroy, Darren; Mulligan, Terrence; Singer, Andrew
To meet a critical and growing need for emergency physicians and emergency medicine resources worldwide, physicians must be trained to deliver time-sensitive interventions and lifesaving emergency care. Currently, there is no globally recognized, standard curriculum that defines the basic minimum standards for specialist trainees in emergency medicine. To address this deficit, the International Federation for Emergency Medicine convened a committee of international physicians, health professionals and other experts in emergency medicine and international emergency medicine development to outline a curriculum for training of specialists in emergency medicine. This curriculum document represents the consensus of recommendations by this committee. The curriculum is designed to provide a framework for educational programmes in emergency medicine. The focus is on the basic minimum emergency medicine educational content that any emergency medicine physician specialist should be prepared to deliver on completion of a training programme. It is designed not to be prescriptive but to assist educators and emergency medicine leadership to advance physician education in basic emergency medicine no matter the training venue. The content of this curriculum is relevant not just for communities with mature emergency medicine systems, but in particular for developing nations or for nations seeking to expand emergency medicine within the current educational structure. We anticipate that there will be wide variability in how this curriculum is implemented and taught. This variability will reflect the existing educational milieu, the resources available, and the goals of the institutions' educational leadership with regard to the training of emergency medicine specialists. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Hanley, Judy; Adams, Jane
This article describes the initial development and subsequent evolution of a simple referral assessment tool for stoma care. The first author's personal experience identified that there was widespread inconsistency in perceptions of local multidisciplinary teams as to when it was appropriate to refer to specific specialist nursing teams. This resulted in both inappropriate and delayed referrals. A 'Think Specialist Nurse' initiative was developed across the author's trust, building on the traffic light template from the 'ThinkGlucose' tool, to facilitate referrals to clinical nurse specialists. The stoma-care specific tool, 'Think Stoma Nurse', has subsequently evolved beyond its initial audience, and has been adapted into materials aimed at patients and carers.
Kit, Phey Ling; Garces-Bacsal, Rhoda Myra; Burgetova, Kristina
This study focused on the experiential learning experiences of eight trainee educational psychologists (school psychologists in the United States) from Singapore who participated in three role-play sessions during a two-day Basic Counseling Skills Training Program. Data collected from transcriptions of video-recorded sessions, a focus group…
Svetlana N Dvoryatkina
monitoring of knowledge the fact that individual evaluation test of tutoring of students is carried out on the basis of two parameters depths of assimilation of a concept, its interrelation with other concepts and assessment of size of the synergetic effect of integration of knowledge and activity of trainees is new. Experience of introduction and operation of the automated system of pedagogical monitoring and assessment of the level of knowledge on the basis of integration of fractal model operation and neural network technologies allowed to increase the level of objectivity of estimation of trainees, quality of management of the educational process, its effectiveness in general.
French, James R.
The X-37 is a technology demonstrator sponsored by NASA. It includes a number of experiments both imbedded (i.e., essential aspects of the vehicle) and separate. The technologies demonstrated will be useful in future operational versions as well as having broad applications to other programs. Mr. James R. French, of JRF Engineering Services and as a consultant to SAIC, has provided technical support to the X-37 NASA Program office since the beginning of the program. In providing this service, Mr. French has maintained close contact with the Boeing Seal Beach and Rocketdyne technical teams via telephone, e-mail, and periodic visits. His interfaces were primarily with the working engineers in order to provide NASA sponsors with a different view than that achieved through management channels. Mr. French's periodic and highly detailed technical reports were submitted to NASA and SAIC (Science Applications International Corporation) on a weekly/monthly basis. These reports addressed a wide spectrum of programmatic and technical interests related to the X-37 Program including vehicle design, flight sciences, propulsion, thermal protection, Guidance Navigation & Control (GN&C), structures, and operations. This deliverable is presented as a consolidation of the twelve monthly reports submitted during the Contract's Option Year,
Long, Jennifer; Long, Airdrie
Ergonomics is a holistic discipline encompassing a wide range of special interest groups. The role of an ergonomics consultant is to provide integrated solutions to improve comfort, safety and productivity. In Australia, there are two types of consultants--generalists and specialists. Both have training in ergonomics but specialist knowledge may be the result of previous education or work experience. This paper presents three projects illustrating generalist and specialist (visual ergonomics) consultancy: development of a vision screening protocol, solving visual discomfort in an office environment and solving postural discomfort in heavy industry. These case studies demonstrate how multiple ergonomics consultants may work together to solve ergonomics problems. It also describes some of the challenges for consultants, for those engaging their services and for the ergonomics profession, e.g. recognizing the boundaries of expertise, sharing information with business competitors, the costs-benefits of engaging multiple consultants and the risk of fragmentation of ergonomics knowledge and solutions. Since ergonomics problems are often multifaceted, ergonomics consultants should have a solid grounding in all domains of ergonomics, even if they ultimately only practice in one specialty or domain. This will benefit the profession and ensure that ergonomics remains a holistic discipline.
Mulder, Hanneke; Ter Braak, Edith; Chen, H Carrie; Ten Cate, Olle
The hidden curriculum, commonly described in negative terms, is considered highly influential in medical education, especially in the clinical workplace. Structured approaches to address it are limited in number and scope. This paper presents a practical, value-neutral method called REVIEW (Reflecting & Evaluating Values Implicit in Education in the Workplace), to facilitate reflection and discussion on the hidden curriculum by faculty members and trainees. REVIEW approaches the hidden curriculum as a reflection of the professional microculture of a clinical team. This microculture results from collective problem solving and mutual negotiation when facing different, often conflicting, demands and interests, and their underlying values in daily clinical practice. Using this nonjudgmental conceptual framework, REVIEW employs a series of 50 culture statements that must be prioritized using Q-sort methodology, reflecting how the culture in a particular clinical context (e.g. ward or department) is perceived by faculty members and trainees. This procedure can be done individually or in groups. Most important is the resulting team discussion after the exercise - a discussion about perceptions of actual team culture and the culture desired by the team. Our early experiences suggest that REVIEW can be a useful tool for addressing the hidden curriculum.
Grierson, Lawrence; Dubrowski, Adam; So, Steph; Kistner, Nicole; Carnahan, Heather
Technical and communicative skills are both important features for one's perception of practitioner competence. This research examines how trainees' perceptions of practitioner competence change as they view health care practitioners who vary in their technical and communicative skill proficiencies. Occupational therapy students watched standardized encounters of a practitioner performing a patient transfer in combinations of low and high technical and communicative proficiency and then reported their perceptions of practitioner competence. The reports indicate that technical and communicative skills have independently identifiable impacts on the perceptions of practitioner competency, but technical proficiency has a special impact on the students' perceptions of practitioner communicative competence. The results are discussed with respect to the way in which students may evaluate their own competence on the basis of either technical or communicative skill. The issue of how this may lead trainees to dedicate their independent learning efforts to an incomplete set of features needed for the development of practitioner competency is raised.
Prof. Dr. Mehmet Demirezen
Full Text Available In the field of teacher training, there is a scarcity of teaching pronunciation teachingmethodology to cure the fossilized mistakes of teacher trainees and foreign language teacherson-the-job. A case study pertaining to this situation is handled for the first time in this articleunder the title of “Audio-articulation Method” (Demirezen, 2003; Hişmanoğlu, 2004. Thismethod takes up a fossilized mistake of teacher trainees or teachers on-the-job in fifty minutesand brings in pronunciation correction by using tongue-twisters, idioms, proverbs, and thelike. Thus, it cures the fossilized mistake to a grater extent by creating a higher awareness andimproving communicative fluency. This method through task-based point of view removesthe related fossilized mistake and brings in pronunciation betterment to the teacher traineesand the teachers on-the-job.
Fletcher, Ian; McCallum, Rachel; Peters, Sarah
To investigate the relationship between trainee doctors' attachment style and their performance in qualifying clinical and communication skills assessments. Participants were 190 undergraduate medical students whose performance was assessed by examiners across two areas (communication and clinical skills) during their qualifying Objective Structured Clinical Examination (OSCE). Simulated patients also rated communication skills. Participants' attachment style was rated across two dimensions, avoidance and anxiety, using the Relationship Questionnaire (RQ). Lower levels of attachment avoidance and anxiety significantly predicted higher performance in both communication and clinical skills. Trainee doctors' attachment styles are associated with patient communication and clinical performance. Further research is needed to investigate the impact of attachment on consultations between doctors and patients within clinical settings. Attachment theory can inform our understanding why, for some student doctors, interacting with patients may be particularly challenging and require additional support by medical educators. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
between the teacher training college, the trainee jobs and the learning processes of the students. The results of the study are important for rethinking teacher education, but also for future discussions on the possible directions for the renewal of university colleges. It contributes to an understanding...... differs from other ways that are well-known in western countries, of organising teacher education as school-based, with a strong workplace focus, as well as from the use of the teacher assistant as support staff in schools, or later in-service teacher education. This paper will discuss key findings...... of how this and similar ways of doing teacher training simultaneously contribute simultaneously to new competencies and engagement among the participants (trainees, teacher teams, schools, local authorities and, to some extent, also the university colleges) and to new forms of self-regulation processes...
Marta Rodrigues Barreto Neta
Full Text Available To determine musculoskeletal disorders presented in algic way of undergraduates supervised I and II of the physiotherapy course at the State University of Southwest Bahia, Jequié campus. The study of descriptive, transversal and quantitative character, with a sample of 35 trainees of the physiotherapy course at the State University of Southwest Bahia. Data were obtained through questionnaires demographic social, Nordic and Mc Gill. Of the participants 20% were male and 80% female, aged between 20-29 years (23 ± 2. The regions most affected by musculoskeletal disorders in the current period, 7 days and 12 months were the lower back (40%, shoulder (28,6%, neck and upper back (25.7%. Regarding the classification of pain, trainees described as tiring (60%; thin (40%; sharp and stabbing (34%. This study concluded that physiotherapy graduates have high musculoskeletal pain complaints, before entering the labor market.
I. I. Leonovich
Full Text Available Complicated conditions, under which road enterprises of the Republic are forced to operate, put forward and reveal the necessity to innovative way of development. In order to fulfill this task it is necessary to have specialists who are capable and ready to realize this endeavour. The most acceptable variant is to train specialists who will be able to introduce innovations and who are presently involved in the production process. Such training should be carried out within the framework of post-graduate education. Authors have provide a number of reasons in favour of quick development of such education.
Full Text Available The issue of whether to establish Specialist Chambers within the Kosovo justice system for alleged war crimes committed in Kosovo has been, arguably, one of the most heated debates not only from a political and social point of view, but also from a legal one. While the required amendments in the Constitution and several laws of Kosovo necessary to establish the Specialist Chambers in furtherance of the agreement dated 14 April 2014 between the Republic of Kosovo and the European Union on the Mission of the European Union Rule of Law Mission in Kosovo (“EULEX” will certainly create heated debates in the political level, one may argue that the legal issues that are expected to be encountered when the Specialist Chambers will be operational, may be even more pressing. This is in consideration of the peculiar nature of the Specialist Chambers, which are meant to have their basis within the laws of Kosovo, but at the same time, be independent from them and from control of Kosovo authorities. The purpose of this article is to delineate the possible legal issues that might confront the Specialist Chambers of Kosovo. Its main argument is that, while the Specialist Chambers seem to follow the experience of other hybrid internationalised courts, it still differs from them in some aspects. The challenges that the new Specialist Chambers may need to tackle deal with its jurisdiction and position within the Kosovo Judicial system, and its legitimacy and legal basis.
Gilson Luís Voloski
Full Text Available The text reflects on essay’s contributions as an instructional practice of the philosophy's teaching trainee. Its objective is to show the essay’s potentialities in the relation theory and practice as formation to the docent autonomy. The reflection has as concrete reference an experience of internships’ monitoring done by the author, who acted as adviser teacher, in schools of the city of Florianópolis. Based on Theodor Adorno's conceptual references, the essay's modality presents itself as a critical pedagogical approach that orientates to the teaching practice and, at the same time, as an exercise of textual elaboration about the teaching experience. The writing systematization as a reflexive conceptual activity about the pedagogical practice, is a self-knowledge process. It is on this activity of thinking the own action that the intern also self-constitutes himself as a teacher.
Coughlan, J; Brinkman, W-P
Copyright © 2011, IGI Global. Distributed with permission. Challenges remain in leveraging e-health technologies for continuous medical education/professional development. This study examines the interface design and learning process features related to the use of multimedia in providing effective support for the knowledge and practice of surgical skills. Twenty-one surgical trainees evaluated surgical content on a CD-ROM format based on 14 interface design and 11 learning process features...
Hauer, Karen E.; Carney, Patricia A.; Chang, Anna; Satterfield, Jason
Purpose Unhealthy behaviors contribute to half of U.S. deaths. However, physicians lack sufficient skill in counseling patients to change behaviors. Characterizing effective published curricular interventions for behavior-change counseling for medical trainees would inform educators toward improved training. Method The authors conducted a systematic literature search of studies published 1965–2011 evaluating curricula on behavior change counseling for medical trainees. Included studies described: (1) behavior change counseling, (2) teaching interventions for medical trainees, and (3) assessment of interventions. The authors extracted eligible articles, rated outcomes for learners and patients using Kirkpatrick’s hierarchy, and determined study quality. Results Of 2,788 identified citations, 109 met inclusion criteria. Most studies were performed in the United States (98), 93 at a single institution, and 81 in primary care settings. Curricular topics for counseling included smoking (67 studies), nutrition (30), alcohol/drug use (26), and exercise (22). Although most studies did not include theoretical frameworks, 39 used the Transtheoretical Model of Change. Sixty-two studies involved eight or fewer hours of curricular time, and 51 spanned four or fewer weeks. The studies with highest-level outcomes and quality employed multiple curricular techniques and included practice of counseling techniques in either simulated or actual clinical settings. Conclusions Existing literature suggests that trainees learn behavior change counseling through active, realistic practice and implementation of reminder and feedback systems within actual clinical practice settings. Multi-institutional medical education research on methods of teaching behavior-change counseling that influence patients’ health outcomes are needed to ensure trainees’ clinical competence and improve patient care. PMID:22622220
AFRL-SA-WP-SR-2016-0004 Serotonin as a Biomarker: Stress Resilience among Battlefield Airmen Trainees Sky J. Wolf, Maj, USAF...Report 3. DATES COVERED (From – To) January 2015 – May 2016 4. TITLE AND SUBTITLE Serotonin as a Biomarker: Stress Resilience among Battlefield...determine whether serotonin levels measured during Battlefield Airmen training were associated with stress resilience . We measured serotonin in blood
Shah, Sweta; Desouches, Stephane L.; Lowe, Lisa H.; Kasraie, Nima; Reading, Brenton
Fluoroscopy is an important tool for diagnosis in the pediatric population, but it carries the risk of radiation exposure. Because radiology resident education and experience in the use of fluoroscopy equipment in children vary, we implemented an intervention to standardize fluoroscopy training. The purpose of this study is to determine the impact of implementing a fluoroscopy competency check-off for radiology resident trainees aimed at decreasing radiation exposure in three common pediatric fluoroscopic studies. A fluoroscopy competency check-off form was developed for radiology resident trainees performing pediatric procedures. Techniques used to limit radiation exposure for common pediatric radiologic studies were reviewed as part of the check-off process. Pediatric radiologists supervised each trainee until they demonstrated competence to independently perform three specified procedures. Radiation dose was recorded for the three procedures, upper GI (UGI), voiding cystourethrogram (VCUG) and oropharyngeal (OPM) exams, over 6 months preceding and 6 months following implementation of the competency check-off. The mean cumulative dose for each procedure was compared before and after implementation of competency check-off using a Kruskal-Wallis test. During the 12-month study period doses from 909 fluoroscopic procedures were recorded. In the 6 months preceding competency check-off implementation, procedures were performed by 24 radiology resident trainees including 171 UGI, 176 VCUG and 171 OPM exams. In the 6 months following competency check-off, 23 trainees performed 114 UGI, 145 VCUG and 132 OPM exams. After competency check-off implementation, a statistically significant reduction in average radiation dose was found for all three studies (P < 0.001). Median cumulative doses (mGy) were decreased by 33%, 36% and 13% for UGIs, VCUGs and OPMs, respectively. Implementation of a competency check-off for radiology resident trainees can reduce average radiation
Goodman, Thomas Rob; Kelleher, Michael
To determine if fine art perception training improved performance in novice radiology trainees. On the first day of their residency, 15 radiology residents underwent a basic radiology perception test in which they were shown 15 different radiographs that each had a significant abnormality. This was followed by a focused session of interpretation training at a local art gallery where art experts taught the trainees how to thoroughly analyze a painting. After this fine art session, the residents were once again shown 15 different radiographs and asked, in the same manner as before, to identify the location of the abnormality. The results of both radiograph assessments were then compared. The 15 residents correctly identified the areas of abnormality on 35 of 225 cases pre-art training with a mean score of 2.33 and a SD of 1.4. After art training, the figure for correctly identifying the area of abnormality rose to 94 of 225 cases with a mean score of 6.27 and a SD of 1.79 (P art gallery may be a novel, effective transitional starting point for novice radiology trainees. Copyright © 2017. Published by Elsevier Inc.
Ilyas, S.; Beatie, A.; Pettet, G.; Kharay, A.; Hedayati, V.; Hameed, S.; McCleery, M.A.; Papadakos, N.; Chari, B.
Aim: To gather information in order to highlight areas within training that could be improved and share ideas of good practice and, in addition, to compare national results with those of local training schemes. Materials and methods: A request to participate in the survey was emailed to 1158 radiology trainees across 36 UK training schemes in October 2012. The electronic replies were anonymous. The survey remained active for 6 weeks. The data were collated and analysed by members of the JRF. The survey itself was divided into seven sections, covering a diverse range of topics. Results: Six hundred and four trainees from 36 UK training schemes completed the survey, resulting in a response rate of 52%. - Highlights: • First Radiology specific national survey, written by trainees. • Training schemes can benchmark their performance against a national average. • Also can share areas of good practice; and highlight those that need improvement. • Summary of the results, highlighting the most pertinent findings from each section
Awad, Z; Hayden, L; Muthuswamy, K; Ziprin, P; Darzi, A; Tolley, N S
UK surgical trainees are required to undertake work-based assessments each year in order to progress in their training. Direct Observation of Procedural Skills (DOPS) is one of these assessments. We aim to investigate the validity of DOPS in assessing otolaryngology trainees at all levels. A retrospective search of the portfolios of all otolaryngology trainees in North Thames was carried out to identify otolaryngology-specific DOPS. A score (Cs) was calculated for each DOPS based on the percentage of satisfactorily-rated items. The overall performance rating (Ps) was analysed as a separate variable and compared with Cs. The Ps and Cs results were then compared across trainee grades and levels within each grade: Core trainees (CT1-CT2) and specialty trainees (ST3-ST8). Seven hundred and sixty-seven otolaryngology DOPS were completed between August 2008 and September 2013. The tool was found to be reliable and internally consistent. Trainees in ST grade had higher Cs and Ps scores than CT grade (P Otolaryngology DOPS is a useful tool in assessing otolaryngology trainees especially from CT1-ST3 level. DOPS can also differentiate between junior and senior trainees. However, it was not able to demonstrate progress at levels above ST3, most likely due to the simplicity of the procedures which trainees tend to master in the first few years of training. © 2014 John Wiley & Sons Ltd.
Nisar, Pasha J; Scott, Humphrey J
This study identifies key attributes of a modern surgical trainer as defined by individual trainees and consultant training faculty members. Using a collaborative inquiry process, we conducted focus groups and semistructured interviews with 32 trainees and 10 consultant trainers in general surgery. This study was undertaken in a single postgraduate deanery in the United Kingdom. Key trainer attributes were identified and categorized into themes. Key attributes identified by core trainees (CTs) were enthusiasm, giving feedback, setting targets, completing online assessments, and inspiring trainees. From specialty trainees (STs), key attributes were leading in difficult situations, patience, ensuring trainees perform cases, inspiring trainees, and being a role model. Key attributes from consultants were engaging other trainers, awareness of individual needs, ensuring trainees perform cases, discussing problems sympathetically, and patience. Effective communication was the principal trainer theme for CTs and STs identified the principal theme of leadership. These themes were emphasized also by trainers. Trainees and trainers have different beliefs on the attributes a good surgical trainer should possess. These findings may be used to promote understanding between trainees and trainers of the expectations and difficulties faced by surgical consultants. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Gaunt, Anne; Patel, Abhilasha; Rusius, Victoria; Royle, T James; Markham, Deborah H; Pawlikowska, Teresa
Although trainees and trainers find feedback interactions beneficial, difficulties in giving and receiving feedback are reported. Few studies have explored what drives trainees to seek feedback. This study explores how workplace-based assessments (WBAs) influence the ways surgical trainees seek feedback and feedback interactions. Utilising a template analysis approach, we conducted 10 focus groups with 42 surgical trainees from four regions across the UK. Data were independently coded by three researchers, incorporating three a priori themes identified from a previous quantitative study. Further themes emerged from exploration of these data. The final template, agreed by the three researchers, was applied to all focus group transcripts. The themes were linked in a diagrammatical form to allow critical exploration of the data. Trainees' perceptions of the purpose of WBA for learning or an assessment of learning, and their relationship with their trainer impacted upon how trainees chose to use WBA. Perceiving WBA as a test led trainees to 'play the game': seek positive and avoid negative feedback through WBA. Perceiving WBA as a chance to learn led trainees to seek negative feedback. Some trainees sought negative feedback outside WBA. Negative feedback was more important for changing practice compared with positive feedback, which enabled trainees to 'look good' but had less of an effect on changing clinical practice. The timing of feedback relative to WBA was also important, with immediate feedback being more beneficial for learning; however, delayed feedback was still sought using WBA. Trainees' perceptions of the purpose of WBA and their relationship with their trainer informed when they chose to seek feedback. Trainees who perceived WBA as a test were led to 'play the game' by seeking positive and avoiding negative feedback. Outside of WBA, trainees sought negative feedback, which was most important for change in practice. © 2017 John Wiley & Sons Ltd and The
Chrisman-Khawam, Leanne; Abdullah, Neelab; Dhoopar, Arjun
This article describes a novel inter-professional curriculum designed to address the needs of homeless patients in a Midwestern region of the United States which has high rates of poverty. The curriculum is intended for healthcare trainees coming from undergraduate pre-medical programs, nursing, pharmacy, social work, clinical psychology, medical school and post-graduate medical training in family medicine, medicine-pediatrics, and psychiatry. The clinical component is specifically designed to reach destitute patients and the curriculum is structured to reverse commonly held myths about homelessness among the trainees, thereby improving their Homelessness Information Quotient, the ability to more fully understand homelessness. Participants across all disciplines and specialties have shown greater empathy and helper behavior as determined by qualitative measures. Learners have also developed a greater understanding of health-care systems allowing them to more consistently address social determinants of health identified by the authors as their Disparity Information Quotient. This article outlines the process of initiating a homeless service program, a curriculum for addressing common myths about homelessness and the effective use of narrative methods, relational connections, and reflective practice to enable trainees to process their experience and decrease burnout by focusing on the value of altruism and finding meaning in their work.
Mendrinos, Roxanne Baxter
Describes a program designed to integrate new technology into the junior high school curriculum with emphasis on the role of the media specialist. Five steps are detailed: (1) needs assessment; (2) planning with teacher input how to fill student needs; (3) teacher training; (4) implementation; and (5) evaluation. (9 references) (MES)
This study was conducted to determine how preservice media specialists perceive leadership responsibilities and certain tasks associated with the school library media profession. Results indicate that many viewed themselves as support personnel rather than school leaders, thus establishing the need to include leadership development courses in…
Barron, Daniel D.
Suggests library media specialists have a responsibility to make educational funding laws work for their children and communities. Discusses the No Child Left Behind (NCLB) Act; NCLB and libraries, and online resources; Reading First Grants; "VISIONS 2020: Transforming Education and Training through Advanced Technologies" and "Technology in…
Piland, William E.; Rives, W. Steven
Describes a study of the perceptions of 245 human resource development specialists concerning the technical, human relations, problem-solving, and basic skills of Illinois community college vocational/technical graduates. Nursing and allied health program graduates received the highest ratings. Overall, graduates were rated highest in human…
Buerkel, Elaine; Rehling, Joseph H.
The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the textile service occupation. The industry needs properly trained alteration specialists, bushelmen and dressmakers, in the repairing, remodeling, altering or renovating of garments. Their personal…
Full Text Available As we all know, libraries are these years rapidly undergoing change on unparalleled scale. Evidently, this applies to librarians, too, and not the least to that important category of library staff, the subject specialist. As recruiting and education of library workers differ from country to country it is difficult to give a detailed, generally valid description of the subject librarian in libraries, but I believe that you can describe an ideal model of subject librarianship as follows: Within each of the major subject disciplines covered by the library, the library should have a subject specialist preferably with a master degree or at least a bachelor degree in the particular subject discipline. The role of the subject specialist is to perform four basic functions where extensive subject knowledge is considered to be necessary: selecting and classifying books, assisting users with advanced subject inquiries, giving subject-specific courses in information retrieval, and maintaining liaison with relevant academic departments and centres. Personally, I know this system very well since I got employment in the Royal Library in Copenhagen as a subject specialist in psychology in the very month I finished my degree in psychology from the University of Copenhagen, back in 1973. The subject librarian system at the Royal Library in Copenhagen was patterned on the ideal model, as I just described it, and it was closely paralleled in the other academic libraries in Denmark, also the new university libraries which were founded in the seventies.
Mellin, Laurel M.
Presents seven reasons why it is important for health specialist teams to take action supporting the prevention and treatment of childhood obesity. The article offers guidelines to help parents assist their children in maintaining positive eating, exercise, and self-esteem patterns, noting sensitive intervention is preferable to imposed diets. (SM)
Schneller, S; Hoeppner, M
Preceptor orientation is a well identified need. Less often identified is the critical role the staff development specialist plays in the ongoing support and development of preceptors. In this article, the authors explain activities of coaching, facilitating, mentoring, and consulting. These role components are essential in the ongoing development of preceptors. This support also may help retain preceptors.
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Specialists. 62.26 Section 62.26 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program... such areas, for example, as mass media communication, environmental science, youth leadership...
Pfister, Fred C.
A study conducted to determine essential competencies for school media specialists revealed that 21 competencies (in library organization and management, library services, instruction) met Florida Council of Teacher Education criteria for an essential competency and 42 did not (in curriculum planning, research, audiovisual production,…
School librarians can be an important resource for school administrators, provided that the right relationship is in place between them. In this article, the author reports on the critical points emphasized with librarians/media specialists in a recent panel presentation on their changing roles: (1) the importance of building ongoing relationships…
The XIIth national conference of Czechoslovak power specialists was held in Bratislava from October 5 to 7, 1983. Of the total number of 32 papers 12 were incorporated in the INIS system, i.e., such which dealt with the development of the nuclear power complex and the rationalization of sources and the use of heat in the Czechoslovak energy balance. (E.S.)
TTI), and working as a member of the global TTI team, the Senior Program Specialist has a key role in providing strategic direction and support to the outreach capacity of the Initiative at all levels, and thereby strengthening the visibility of TTI.
Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas
Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. © 2014 The Author(s) Published by the Royal Society. All rights reserved.
Sep 15, 2009 ... In this study, the development of a model is regarded as being consistent with middle-range theory generation (George 2002:6), which, in turn, guides the education practice of specialist nurses. According to Smith and Liehr,. [m]iddle range theory can be defined as a set of related ideas that are focused on ...
Job Summary. The Global Compensation Specialist provides advice and guidance regarding compensation and benefits by analysing trends, conducting studies, keeping up-to-date on new legislation, and developing strategies and tools to support corporate global compensation program. The incumbent supports the HR ...
The unit of individualized learning activities is designed to provide training in the job skill, lubrication, for the prospective auto mechanic service specialist. The materials in the unit are divided into two sections. The developmental, or preliminary phase, for use by the instructor, includes brief descriptions of the job and of the student…
Forster, Benjamin C; Proskurin, Helen; Kelly, Brian; Lovell, Melanie R; Ilchef, Ralf; Clayton, Josephine M
People with a life-limiting physical illness experience high rates of significant psychological and psychiatric morbidity. Nevertheless, psychiatrists often report feeling ill-equipped to respond to the psychiatric needs of this population. Our aim was to explore psychiatry trainees' views and educational needs regarding the care of patients with a life-limiting physical illness. Using semistructured interviews, participants' opinions were sought on the role of psychiatrists in the care of patients with a life-limiting illness and their caregivers, the challenges faced within the role, and the educational needs involved in providing care for these patients. Interviews were audiotaped, fully transcribed, and then subjected to thematic analysis. A total of 17 psychiatry trainees were recruited through two large psychiatry training networks in New South Wales, Australia. There were contrasting views on the role of psychiatry in life-limiting illness. Some reported that a humanistic, supportive approach including elements of psychotherapy was helpful, even in the absence of a recognizable mental disorder. Those who reported a more biological and clinical stance (with a reliance on pharmacotherapy) tended to have a nihilistic view of psychiatric intervention in this setting. Trainees generally felt ill-prepared to talk to dying patients and felt there was an educational "famine" in this area of psychiatry. They expressed a desire for more training and thought that increased mentorship and case-based learning, including input from palliative care clinicians, would be most helpful. Participants generally feel unprepared to care for patients with a life-limiting physical illness and have contrasting views on the role of psychiatry in this setting. Targeted education is required for psychiatry trainees in order to equip them to care for these patients.
Rosenkrantz, Andrew B; Ginocchio, Luke A
The aim of the present study was to assess the potential usefulness of written instructional vignettes relating to publication and journalism ethics in radiology via a survey of radiology trainees. A literature review was conducted to guide the development of vignettes, each describing a scenario relating to an ethical issue in research and publication, with subsequent commentary on the underlying ethical issue and potential approaches to its handling. Radiology trainees at a single institution were surveyed regarding the vignettes' perceived usefulness. A total of 21 vignettes were prepared, addressing institutional review board and human subjects protection, authorship issues, usage of previous work, manuscript review, and other miscellaneous topics. Of the solicited trainees, 24.7% (16/65) completed the survey. On average among the vignettes, 94.0% of the participants found the vignette helpful; 19.9 received prior formal instruction on the issue during medical training; 40.0% received prior informal guidance from a research mentor; and 42.0% indicated that the issue had arisen in their own or a peer's prior research experience. The most common previously experienced specific issue was authorship order (93.8%). Free-text responses were largely favorable regarding the value of the vignettes, although also indicated numerous challenges in properly handling the ethical issues: impact of hierarchy, pressure to publish, internal politics, reluctance to conduct sensitive conversations with colleagues, and variability in journal and professional society policies. Radiology trainees overall found the vignettes helpful, addressing commonly encountered topics for which formal and informal guidance were otherwise lacking. The vignettes are publicly available through the Association of University Radiologists (AUR) website and may foster greater insights by investigators into ethical aspects of the publication and journalism process, thus contributing to higher quality
Bamford, R; Langdon, L; Rodd, C A; Eastaugh-Waring, S; Coulston, J E
The transition to surgical training can be a stressful time for trainees and is most evident during national handover periods where new graduates start and senior trainees rotate to new programmes. During this time, patient mortality can increase and Hospital efficiency reduces. This influence is compounded by the impact of working time directives. Intensive, simulation rich training programmes or "Boot Camps" have been postulated as a solution. This article highlights the development of a surgical boot camp for novice surgical trainees and the impact this can have on training. A novel surgical boot camp was developed for all trainees within a surgical training region including nine acute NHS trusts. Participating cohort of trainees completed pre and post course questionnaires to assess technical and non-technical skills. 25 trainees attended and completed the pre and post boot camp questionnaire. Significant improvements were seen with technical skills (p = 0.0429), overall non-technical skills (p skills (p = 0.005) and outpatient skill (p = 0.002). Trainees reported significantly increased ability to assess and manage a critically unwell patient (p = 0.001) and a trauma patient (p = 0.001). 96% of trainees have utilised the skills they learnt on Boot Camp and all trainees would recommend it as an induction programme. Surgical Boot Camps offer a timely chance to develop technical and non-technical skills whilst enhancing a trainee's confidence and knowledge and reduce the patient safety impact of the handover period. Copyright © 2018. Published by Elsevier Ltd.
Emmanuel I. Agaba
Full Text Available Background: Postgraduate training is aimed at equipping the trainee with the necessary skills to practise as an expert. Non-nephrology specialist physicians render the bulk of pre-end-stage renal disease care for patients with chronic kidney disease (CKD. We sought to ascertain the knowledge of CKD amongst non-nephrology specialist physicians who serve as trainers and examiners for a training, accrediting and certifying body in postgraduate medicine in West Africa. We also compared the knowledge of family physicians and non-nephrology internists. Methods: Self-administered questionnaires were distributed to non-nephrology specialist physicians who serve as examiners for the West African College of Physicians.Results: Only 19 (27.5% of the respondents were aware of the Kidney Disease Outcomes Quality Initiatives guidelines for CKD management. Twenty five (36.2% of the respondents had adequate knowledge of CKD. There was no significant difference in the proportion of family physicians and non-nephrology internists who had adequate knowledge of CKD (27.3% vs. 40.4% respectively; p = 0.28. Hypertension and diabetes mellitus were identified by all of the physicians as risk factors for CKD. Non-nephrology internists more frequently identified systemic lupus erythematosus as a risk factor for CKD, urinalysis with microscopy as a laboratory test for CKD evaluation, and bone disease as a complication of CKD than family physicians.Conclusion: There is a lack of adequate CKD knowledge amongst non-nephrology specialist physicians, since many of them are unaware of the CKD management guidelines. Educational efforts are needed to improve the knowledge of CKD amongst non-nephrology specialist physicians. Guidelines on CKD need to be widely disseminated amongst these physicians.
Long, Theodore; Dann, Sarah; Wolff, Marissa Lynn; Brienza, Rebecca S
As the United States faces an impending shortage in the primary care workforce, interprofessional teamwork training to improve clinic efficiency and health outcomes is becoming increasingly important. Currently there is limited integration of interprofessional training in educational models for health professionals. The implementation of Patient Aligned Care Teams at the Department of Veterans Affairs (VA) has provided an opportunity for interprofessional collaboration among trainee and faculty providers within the VA system. However, integration of interprofessional education is also necessary to train future providers in order to provide effective team-based care. We describe a transportable educational model for health professional collaboration from our experience as a VA Center of Excellence in Primary Care Education, including a complementary novel one-year post-Master's adult nurse practitioner interprofessional clinical fellowship. With growing recognition that interprofessional care can improve efficiency and outcomes, there is an increasing need for programs that train future providers in collaboration and team-based care.
Cahill Naomi E
Full Text Available Abstract Background Knowledge translation (KT is a rapidly growing field that is becoming an integral part of research protocols. Methods This meeting report describes one group's experience at the 2009 KT Canada Summer Institute in developing an end-of-grant KT plan for a randomized control trial proposal. Results Included is a discussion of the process, challenges, and recommendations from the trainee's perspective in developing an end-of-grant KT plan. Conclusion New researchers should consider developing an end-of-grant KT plan with strategies that move beyond passive dissemination to incorporate innovative means of collaboration with the end user to craft the message, package the information, and share the research findings with end users.
Bjorklund, Kim; Eismann, Emily A; Cornwall, Roger
The importance of continuity of care in training is widely recognized; however, a broad-spectrum assessment across all specialties has not been performed. We assessed the continuity of care provided by trainees, following patient consultations in the emergency department (ED) across all specialties at a large pediatric tertiary care center. Medical records were reviewed to identify patients seen in consultation by a resident or fellow trainee in the ED over a 1-year period, and to determine if the patient followed up with the same trainee for the same condition during the next 6 months. Resident and fellow trainees from 33 specialties participated in 3400 ED consultations. Approximately 50% (1718 of 3400) of the patients seen in consultation by a trainee in the ED followed up with the same specialty within 6 months, but only 4.1% (70 of 1718) followed up with the same trainee for the same condition. Trainee continuity of care ranged from 0% to 21% among specialties, where specialties with resident clinics (14.4%) have a greater continuity of care than specialties without resident clinics (2.7%, P Continuity of care did not differ between fellows (4.2%) and residents (4.0%, P = .87), but did differ between postgraduate years for residents (P continuity of care for ED consultations was low across all specialties and levels of training. If continuity of care is important for patient well-being and trainee education, efforts to improve continuity for trainees must be undertaken.
Harewood, G C
The medical literature describes disparity in colonoscopy performance. This randomised, controlled study aimed to characterise the impact of feedback on colonoscopy performance among gastroenterology (GI) trainees.
White, Andrew A; Bell, Sigall K; Krauss, Melissa J; Garbutt, Jane; Dunagan, W Claiborne; Fraser, Victoria J; Levinson, Wendy; Larson, Eric B; Gallagher, Thomas H
The disclosure of harmful errors to patients is recommended, but appears to be uncommon. Understanding how trainees disclose errors and how their practices evolve during training could help educators design programmes to address this gap. This study was conducted to determine how trainees would disclose medical errors. We surveyed 758 trainees (488 students and 270 residents) in internal medicine at two academic medical centres. Surveys depicted one of two harmful error scenarios that varied by how apparent the error would be to the patient. We measured attitudes and disclosure content using scripted responses. Trainees reported their intent to disclose the error as 'definitely' (43%), 'probably' (47%), 'only if asked by patient' (9%), and 'definitely not' (1%). Trainees were more likely to disclose obvious errors than errors that patients were unlikely to recognise (55% versus 30%; p error rather than only an adverse event had occurred. Regarding apologies, trainees were split between conveying a general expression of regret (52%) and making an explicit apology (46%). Respondents at higher levels of training were less likely to use explicit apologies (trend p errors (odds ratio 1.40, p = 0.03). Trainees may not be prepared to disclose medical errors to patients and worrisome trends in trainee apology practices were observed across levels of training. Medical educators should intensify efforts to enhance trainees' skills in meeting patients' expectations for the open disclosure of harmful medical errors. © Blackwell Publishing Ltd 2011.
Deluge of conflicting and overwhelming information and media are creating a state of information anxiety. In such a society, an organization is also seeking a variety of information in wide corporate activities. The searcher, looking for information, must determine for him/herself not only which databases to search, but also which database system will deliver a fullest, good and trustworthy information of his needs. Commercial databases here in Japan have been accepted and searched by increased number of searchers as well as end-users. In the 90's, our online specialist's challenge is no longer to find information; we have to aim at professional information specialists to respond with increased educational and consultant role to assist further increasing number of end-users.
Fuel Safety Research Specialists' Meeting, which was organized by Japan Atomic Energy Research Institute, was held on March 4-5, 2002 at JAERI in Tokai Establishment. Purposes of the Meeting are to exchange information and views on LWR fuel safety topics among the specialist participants from domestic and foreign organizations, and to discuss the recent and future fuel research activities in JAERI. In the Meeting, presentations were given and discussions were made on general report of fuel safety research activities, fuel behaviors in normal operation and accident conditions, FP release behaviors in severe accident conditions, and JAERI's ''Advanced LWR Fuel Performance and Safety Research Program''. A poster exhibition was also carried out. The Meeting significantly contributed to planning future program and cooperation in fuel research. This proceeding integrates all the pictures and papers presented in the Meeting. The 10 of the presented papers are indexed individually. (J.P.N.)
Stayko I. Spiridonov
Full Text Available Purpose: In the resent years the healthcare system has moved to inter-professional, cross-disciplinary, multi-person approach where the communications are very important for ensuring patient safety. Communication in health organisations needs to be studied and analysed deeply and comprehensively because the future of an organisation often depends on good communication. The purpose of this study is to investigate and analyse the reasons for ineffective communication between medical specialists in the teams they work in. Materials and Methods: A questionnaire method is used. Through a survey over a period of 12 months (from 01. 12. 2014 to 01. 12. 2015 at the Escullap Hospital in Pazardzhik, DCC 18 - Sofia, St. Mina Hospital in Plovdiv, MHAT – Plovdiv, DCC 1 in Haskovo, UMHAT in Stara Zagora, DCC 3 in Varna and MHAT – Parvomay, was studied and analyzed the opinion of medical specialists on the effectiveness of communication within the team they work in. The survey includes 477 medical specialists. Results and conclusions: According to 41.1% of the respondents, the communication in the team they work in is insufficiently effective. Most of the respondents (39.8% find their colleagues responsible for the ineffective communication, followed by those who seek the cause for poor communication in the management of the health care facility (27.6%. The leading cause of poor communication in the team according to the study participants is the inequality between the characters of the colleagues (41.9%. According to the majority of respondents (28.3%, improvements in facilities and wage increases (27.3% would be essential to improve communication within the team they work in. Recommendations have been formulated to improve communication among medical specialists.
Devasahayam J Christopher
Full Text Available Among healthcare workers in developing countries, nurses spend a large amount of time in direct contact with tuberculosis (TB patients, and are at high risk for acquisition of TB infection and disease. To better understand the epidemiology of nosocomial TB among nurses, we recruited a cohort of young nursing trainees at Christian Medical College, a large, tertiary medical school hospital in Southern India.Among 535 nursing students enrolled in 2007, 468 gave consent to participate, and 436 underwent two-step tuberculin skin testing (TST. A majority (95% were females, and almost 80% were under 22 years of age. Detailed TB exposure information was obtained using interviews and clinical log books. Prevalence of latent TB infection (LTBI was estimated using Bayesian latent class analyses (LCA. Logistic regression analyses were done to determine the association between LTBI prevalence and TB exposure and risk factors. 219 of 436 students (50.2%, 95% CI: 45.4-55.0 were TST positive using the 10 mm or greater cut-off. Based on the LCA, the prevalence of LTBI was 47.8% (95% credible interval 17.8% to 65.6%. In the multivariate analysis, TST positivity was strongly associated with time spent in health care, after adjusting for age at entry into healthcare.Our study showed a high prevalence of LTBI even in young nursing trainees. With the recent TB infection control (TBIC policy guidance from the World Health Organization as the reference, Indian healthcare providers and the Indian Revised National TB Control Programme will need to implement TBIC interventions, and enhance capacity for TBIC at the country level. Young trainees and nurses, in particular, will need to be targeted for TBIC interventions.
Kousgaard, Marius Brostrøm; Thorsen, Thorkil
The use of facilitators for quality improvement in general practice has accelerated during the past decade. As general practitioners (GPs) or pharmacists have typically been used as facilitators, there is a lack of knowledge of how other professionals function as facilitators. This article explores...
Anderson, D; Soo, S S; Towler, H
Acanthamoeba keratitis is an unusual complication of wearing soft contact lenses: a case was diagnosed by culturing corneal scrapings. Acanthamoeba are tolerant of variations in osmolarity in the culture media. Page's saline, recommended for culture agar plates, can easily be substituted with salines which are suitable for cell culture media, thereby avoiding the cumbersome manufacture of special saline. Early diagnosis as a result of successful isolation may avoid the need for keratoplasty. PMID:1890209
Full Text Available The ward round (WR is a complex task and medical teachers are often faced with the challenge of finding a balance between service provision and clinical development of learners. The educational value of WRs is an under-researched area. This short communication aims to evaluate the educational role of WRs for junior trainees and provides insight into current practices. It also identifies obstacles to effective teaching/training in this setting and provides suggestions for improving the quality of WR teaching.
Curry, Nicola; Denney, MeiLing
There is currently a lack of formal training in leadership skills, particularly during GP training. This study aimed to explore the current training and practical opportunities which exist, specifically exploring the views of GP trainees and trainers. An electronic questionnaire was sent to 266 GP trainees and trainers in south-east Scotland. Questions focused on respondents' experience of leadership-specific training and opportunities to engage with leadership roles. There were a total of 76 respondents (28.6% response rate). Response rate was 19.0% in trainees and 34.6% in trainers. A majority of respondents (80.0%) were established GPs. Of those who had received training in leadership, most (72.1%) underwent this after qualifying as a GP. Respondents identified a range of leadership roles within and outside the practice covering clinical and non-clinical areas. Most were interested in future leadership roles (46.7% moderately interested; 28% very interested). More time, training opportunities and the presence of GP role models were motivating factors in terms of participants' readiness to take on future leadership roles. Signposting trainees, trainers and general practitioners to leadership opportunities and training would be relatively easy but addressing a lack of motivating factors at a local level is essential. The effectiveness of such training and opportunities for experiential learning in leadership roles requires further research.
Rajka Bračun Sova
Full Text Available Since Bourdieu, it has been argued that art appreciation requires “knowledge”. The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three adults were recruited and accompanied during their visit to the museum. Participants were requested to “think out loud”, which meant to talk about what they saw, thought, and felt about the artworks. There was a short interview conducted with each participant before entering the museum to gain insight into their art-related and museum-visiting experience. The analysis of the data revealed that some processes of art appreciation were similar within the two groups. Both art specialists and art non-specialists interact with museum objects physically and intellectually; they see contents and formal qualities as a whole; they respond emotionally to artworks; appreciation includes their personal experience; they search museum interpretation/information for their understanding. Some noticeable differences were found. Art specialists respond to artworks with more understanding and are willing to put more effort into art appreciation, whereas art non-specialists respond with less understanding and put less effort into art appreciation. This paper focuses on the differences between the two groups; reflective and spontaneous appreciation of art, objective and subjective appreciation of art and the effort put into art appreciation. The paper ends with a discussion of the implications of the study for the teaching of art and museum education.
Brahmania, Mayur; Young, Madison; Muthiah, Chetty; Ilnyckyj, Alexandra; Duerksen, Donald; Moffatt, Dana C
There is little literature regarding how a gastroenterology trainee affects a patient's interpretation of care during outpatient clinic visits. Improving patient satisfaction is desirable and benefits may include enhanced patient compliance as well as providing trainees with areas for improvement. To evaluate patient satisfaction in an outpatient gastroenterology clinic when seen by a trainee and attending physician versus an attending physician alone. The secondary objective was to evaluate physician characteristics that play a role in creating a positive clinical experience. A randomized prospective survey study was conducted over an 11-month period (July 2012 to June 2013) at St Boniface Hospital (Winnipeg, Manitoba). Two gastroenterology fellows (postgraduate year 4 and 5) and nine internal medicine residents (postgraduate year 1 to 3) comprised the 'trainee' role, while three academic clinicians comprised the 'attending' role. Patients included individuals seen for an initial consultation and were >18 years of age. A total of 211 patients comprised the final study group, with 118 in the attending group and 93 in the trainee group. In univariate analysis, patients more often had a very good experience when seen by an attending physician alone versus a trainee and attending physician (73% versus 56%; P=0.016); however, on multivariate analysis, there was no significant difference in patient satisfaction (OR 0.89; P=0.931). Physician factors found to be associated with high patient satisfaction on multivariate analysis included: addressing all patient concerns (OR 27.56; P=0.021); giving the patient a preliminary diagnosis (OR 78.02; P=0.006); and feeling the physician was thorough (OR 72.53; P=0.029). The present study did not reveal a difference in patient satisfaction if a patient sees an attending physician alone or with a trainee. Moreover, to improve patient satisfaction in a gastroenterology clinic, physicians should address all patient concerns, provide a
Sievers, Beth; Wolf, Sherry
Without formal education, many healthcare professionals fail to develop interdisciplinary team skills; however, when students are socialized to interdisciplinary practice through academic clinical learning experiences, effective collaboration skills can be developed. Increasingly, educational environments are challenged to include clinical experiences for students that teach and model interdisciplinary collaboration. The purpose of this quality improvement initiative was to create an interdisciplinary educational experience for clinical nurse specialist (CNS) students and postgraduate physicians. The interdisciplinary learning experience, supported by an educational grant, provided an interdisciplinary cohort of learners an opportunity to engage in a clinically focused learning experience. The interdisciplinary cohort consisted of CNS students and physicians in various stages of postgraduate training. The clinical experience selected was a quality improvement initiative in which the students were introduced to the concepts and tools of quality improvement. During this 1-month clinical experience, students applied the new skills by implementing a quality improvement project focusing on medication reconciliation in the outpatient setting. The CNS core competencies and outcomes were used to shape the experience for the CNS students. The CNS students exhibited 5 of the 7 essential characteristics of the CNS (leadership, collaboration, consultation skills, ethical conduct, and professional attributes) while demonstrating competencies and fulfilling performance expectations. During this learning experience, the CNS students focused on competencies and outcomes in the organizational sphere of influence. Multiple facilitating factors and barriers were identified. This interdisciplinary clinical experience in a quality improvement initiative provided valuable opportunities for CNS students to develop essential CNS characteristics and to explore practice competencies in the
Full Text Available The difficulties specialized phytophagous insects face in finding habitats with an appropriate host should constrain their dispersal. Within the concept of metacommunities, this leads to the prediction that host-plant specialists should sort into local assemblages according to the local environmental conditions, i.e. habitat conditions, whereas assemblages of host-plant generalists should depend also on regional processes. Our study aimed at ranking the importance of local environmental factors and species composition of the vegetation for predicting the species composition of phytophagous moth assemblages with either a narrow or a broad host range. Our database consists of 351,506 specimens representing 820 species of nocturnal Macrolepidoptera sampled between 1980 and 2006 using light traps in 96 strict forest reserves in southern Germany. Species were grouped as specialists or generalists according to the food plants of the larvae; specialists use host plants belonging to one genus. We used predictive canonical correspondence and co-correspondence analyses to rank the importance of local environmental factors, the species composition of the vegetation and the role of host plants for predicting the species composition of host-plant specialists and generalists. The cross-validatory fit for predicting the species composition of phytophagous moths was higher for host-plant specialists than for host-plant generalists using environmental factors as well as the composition of the vegetation. As expected for host-plant specialists, the species composition of the vegetation was a better predictor of the composition of these assemblages than the environmental variables. But surprisingly, this difference for specialized insects was not due to the occurrence of their host plants. Overall, our study supports the idea that owing to evolutionary constraints in finding a host, host-plant specialists and host-plant generalists follow two different models of
Ahluwalia, Aneeta; Crossman, Tim; Smith, Helen
In the UK the incidence of oral cancers has risen by a third in the last decade, and there have been minimal improvements in survival rates. Moreover, a significant proportion of the population no longer access dental health services regularly, instead presenting their oral health concerns to their General Medical Practitioner. Therefore, General Practitioners (GP) have an important role in the diagnosis of oral health pathologies and the earlier detection of oral cancers. This study aims to understand the current provision of training in oral health and cancer for GP trainees and to identify how unmet training needs could be met. A cross-sectional survey of GP Training Programme Directors using an online questionnaire asking about current oral health education training (hospital placements and structured teaching), the competencies covered with trainees and ways to improve oral health training. Quantitative data were analysed using descriptive statistics and content analysis was undertaken of free text responses. We obtained responses from 132 GP Training Programme Directors (GPTPDs), from 13 of the 16 UK medical deaneries surveyed. The majority of respondents (71.2%) indicated that their programmes did not provide any structured oral health training to GP trainees and that ≤ 10% of their trainees were undertaking hospital posts relevant to oral health. GPTPDs were of the view that the quality of oral health training was poor, relative to the specified competencies, and that teaching on clinical presentations of 'normal' oral anatomy was particularly poor. It was envisaged that oral health training could be improved by access to specialist tutors, e-learning programmes and problem-based-learning sessions. Respondents highlighted the need for training sessions to be relevant to GPs. Barriers to improving training in oral health were time constraints, competing priorities and reluctance to taking on the workload of dentists. This UK-wide survey has identified
Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges
Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of
Full Text Available Abstract Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44 in three heterogeneous districts in Maharashtra state of India. Interviews (42 were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month. The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important
What is a Sports Medicine Specialist? A physician with significant specialized training in both the treatment and prevention of illness and injury. The Sports Medicine Specialist helps patients maximize function and minimize ...
Payload specialist Reinhard Furrer shows evidence of previous blood sampling while Wubbo J. Ockels, Dutch payload specialist (only partially visible), extends his right arm after a sample has been taken. Both men show bruises on their arms.
Wenderlein, F U
To analyse the high level of absenteeism among nursing trainees compared with nursing staff. Unlike previous studies, the present study focussed on work satisfaction and motivation. Specifically, combining satisfaction with absenteeism was a novel approach. For assessing work satisfaction, a standardised form with 73 items in four areas was drafted and checked in a pre-test (n = 150). 861 nurses and 159 trainees were interviewed. The absenteeism data given by the nursing staff were compared with the 'missing' records of the personnel department. In all areas it was found that, in particular, problems of organisation, personnel management and working atmosphere in the hospital were a burden on the employees. In detail, however, there were considerable differences between nurses and trainees in respect of appraisal. Work organisation: Although trainees rated work organisation aspects lower than nurses, direct relationship to work satisfaction was less pronounced. For the trainees, improvements are imperative in respect of active self-responsibility. Leadership/co-operation: Trainees rated supervisor behaviour and working atmosphere lower than their colleagues. There was a direct relation to satisfaction and absenteeism. Workload/stress: Although their responsibility was less, a larger proportion of the trainees felt stressed. This was directly related to work satisfaction and absenteeism. Fluctuation and turnover: 44% of the trainees would be prepared to work up to the age of retirement, but only 25% of the qualified staff. Nevertheless, three-quarters of the trainees and two-thirds of the nurses would choose the same profession again. Hence, unfavourable local (internal) circumstances led to the discontent and not the profession as such. The extremely high absenteeism of nursing trainees calls for action on the part of school and hospital management. There is a need for better information and care before and during professional training, because workload will be
Owen, Jesse; Wampold, Bruce E; Kopta, Mark; Rousmaniere, Tony; Miller, Scott D
There is a paucity of empirical studies that demonstrate psychotherapy trainees improve at assisting their clients' therapy outcomes over time. We examined whether trainees (i.e., practicum, predoctoral interns, and postdoctoral fellows) improved in their clients' therapy outcomes over time. We examined 114 trainees (i.e., who were trainees for the first client in the database) and had over 12 months of client outcome data (M = 45.31 months). At the start of their time in our database, about half of the participants (48.2%) were predoctoral interns, 42.1% were practicum students, and 9.6% were postdoctoral fellows. Collectively, they treated 2,991 clients (M = 26 clients per trainee). Clients completed the Behavioral Health Measure, which assesses general psychological functioning (i.e., well-being, symptom distress, and life functioning), as a measure of therapy outcomes. Trainees demonstrated small-sized growth in their clients' outcomes over time (d = 0.04 per year); however, this growth was moderated by client severity. That is, trainees demonstrated growth over time in working with clients who were less distressed (d = -0.13 to 0.10 over time), but there was no change over time for trainees when working with more distressed clients (d = 0.67 to .65 over time). The results were consistent across trainee level (i.e., practicum, predoctoral intern, postdoctoral fellow), yet trainees varied in their patterns of growth. Psychotherapy training has a small, but positive, effect on trainees' ability to foster positive outcomes with their clients over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Harries, Rhiannon L; Rashid, Mustafa; Smitham, Peter; Vesey, Alex; McGregor, Richard; Scheeres, Karl; Bailey, Jon; Sohaib, Syed Mohammed Afzal; Prior, Matthew; Frost, Jonathan; Al-Deeb, Walid; Kugathasan, Gana; Gokani, Vimal J
The British Government is acting on recommendations to overhaul postgraduate training to meet the needs of the changing population, to produce generalist doctors undergoing shorter broad-based training (Greenaway Review). Only 45 doctors in training were involved in the consultation process. This study aims to obtain a focused perspective on the proposed reforms by doctors in training from across specialities. Prospective, questionnaire-based cross-sectional study. Following validation, a 31-item electronic questionnaire was distributed via trainee organisations and Postgraduate Local Education and Training Board (LETB) mailing lists. Throughout the 10-week study period, the survey was publicised on several social media platforms. Of the 3603 demographically representative respondents, 69% knew about proposed changes. Of the respondents, 73% expressed a desire to specialise, with 54% keen to provide general emergency cover. A small proportion (12%) stated that current training pathway length is too long, although 86% felt that it is impossible to achieve independent practitioner-level proficiency in a shorter period of time than is currently required. Opinions regarding credentialing were mixed, but tended towards disagreement. The vast majority (97%) felt credentialing should not be funded by doctors in training. Respondents preferred longer placement lengths with increasing career progression. Doctors in training value early generalised training (65%), with suggestions for further improvement. This is the first large-scale cross-specialty study regarding the Shape of Training Review. Although there are recommendations which trainees support, it is clear that one size does not fit all. Most trainees are keen to provide a specialist service on an emergency generalist background. Credentialing is a contentious issue; however, we believe removing aspects from curricula into post-Certificate of Completion of Training (CCT) credentialing programmes with shortened
Full Text Available Background: Workplace bullying is an important and serious issue in a healthcare setting because of its potential impact on the welfare of care-providers as well as the consumers. Aims: To gauge the extent of bullying among the medical community in India; as a subsidiary objective, to assess the personality trait of the bullying victims. Settings and Design: A cross-sectional, anonymous, self-reported questionnaire survey was undertaken among a convenient sample of all the trainee doctors at a Government Medical College in Tamil Nadu, India. Materials and Methods: A questionnaire, in English with standard written explanation of bullying was used. Basic information like age, sex, job grade and the specialty in case of Postgraduates (PGs were also collected. Statistical Analysis: The results were subjected to descriptive statistical analysis and Chi-square test for comparison of frequencies. Results: A total of 174 doctors (115 PGs and 59 junior doctors, took part in the study with a cent percent response. Nearly half of the surveyed population reported being subjected to bullying. Nearly 54 (53% of the men and 35 (48% of women were subjected to bullying. Significant proportions ( P < 0.0001 of medical personnel and paramedical staff bullied the PGs and junior doctors, respectively. More than 85 (90% of bullying incidents went unreported. A significant ( P < 0.0001 percentage of PGs and junior doctors revealed a personality trait towards bully. Conclusions: Workplace bullying is common among trainee doctors and usually goes unreported.
Cooper, O. P.; Bray, Marty
The most successful school library media specialists are those who collaborate with teachers as full partners in the instructional process. Without assertive action by the school library media specialist, however, school administrators and teachers are likely to be more aware of the media specialist's administrative role than the roles of teacher,…
Bagot, Kathleen L; Cadilhac, Dominique A; Vu, Michelle; Moss, Karen; Bladin, Christopher F
Telemedicine is a disruptive innovation within health care settings as consultations take place via audio-visual technology rather than traditional face-to-face. Specialist perceptions and experiences of providing audio-visual consultations in emergency situations, however, are not well understood. The aim of this exploratory study was to describe the experience of medical specialists providing acute stroke decision-making support via telemedicine. Data from the Victorian Stroke Telemedicine (VST) programme were used. The experiences of specialists providing an acute clinical telemedicine service to rural emergency departments were explored, drawing on disruptive innovation theory. Document analysis of programme consultation records, meeting minutes and in-depth individual interviews with three neurologists were analysed using triangulation. Since February 2014, 269 stroke telemedicine consultations with 12 neurologists have occurred. Retention on the roster has varied between 1 and >4 years. Overall, neurologists reported benefits of participation, as they were addressing health equity gaps for rural patients. Negative effects were the unpredictability of consultations impacting on their personal life, the mixed level of experience of colleagues initiating the consult and not knowing patient outcomes since follow-up communication was not routine. Insights into workforce experience and satisfaction were identified to inform strategies to support specialists to adapt to the disruptive innovation of telemedicine. © The Author(s) 2015.
Karunanayake, Chandima P; Rennie, Donna C; Hagel, Louise; Lawson, Joshua; Janzen, Bonnie; Pickett, William; Dosman, James A; Pahwa, Punam; The Saskatchewan Rural Health Study Group
The role of place has emerged as an important factor in determining people's health experiences. Rural populations experience an excess in mortality and morbidity compared to those in urban settings. One of the factors thought to contribute to this rural-urban health disparity is access to healthcare. The objective of this analysis was to examine access to specialized medical care services and several possible determinants of access to services in a distinctly rural population in Canada. In winter 2010, we conducted a baseline mail survey of 11,982 households located in rural Saskatchewan, Canada. We obtained 4620 completed household surveys. A key informant for each household responded to questions about access to medical specialists and the exact distance traveled to these services. Correlates of interest included the location of the residence within the province and within each household, socioeconomic status, household smoking status, median age of household residents, number of non-respiratory chronic conditions and number of current respiratory conditions. Analyses were conducted using log binomial regression for the outcome of interest. The overall response rate was 52%. Of households who required a visit to a medical specialist in the past 12 months, 23% reported having difficulty accessing specialist care. The magnitude of risk for encountering difficulty accessing medical specialist care services increased with the greatest distance categories. Accessing specialist care professionals by rural residents was particularly difficult for persons with current respiratory conditions.
The meeting provided the forum for graphite specialists representing operating and research organizations worldwide to exchange information in the following areas: the status of graphite development; operation and safety procedures for existing and future graphite moderated reactors; graphite testing techniques; review of the experiences gained and data acquired on the influence of neutron irradiation and oxidizing conditions on key graphite properties; and to exchange information useful for decommissioning activities. The participants provided twenty-seven papers on behalf of their countries and respective technical organizations. An open discussion followed each of the presentations. A consistently reoccurring theme throughout the specialists meeting was the noticeable reduction in the number of graphite experts remaining the nuclear power industry. Graphite moderated power reactors have provided a significant contribution to the generation of electricity throughout the past forty years and will continue to be a prominent energy source for the future. Yet, many of the renowned experts in the field of nuclear graphites are nearing the end of their careers without apparent replacement. This, coupled with changes in the focus on nuclear power by some industrialized countries, has prompted the IAEA to initiate an evaluation on the feasibility and interest by Member States of establishing a central archive facility for the storage of data on irradiated graphites. Refs, figs, tabs
Moswela, Bernard; Gobagoba, Marina
This paper presents the results of a survey conducted to find out the extent to which teacher trainees understand and observe professional ethics. It also sought the contribution of the Faculty of Education and secondary schools make in promoting teacher ethics among trainees on teaching practice. Data were gathered from randomly chosen 90…
Conclusions: The prevalence of burnout syndrome among family medicine trainees is high and consistent with data from other studies among the physicians worldwide using the same instrument. Family medicine trainees are at risk of burnout regardless of their demographic characteristics. Increased workload affects EE and D.
Fincke, Janna I; Möller, Heidi; Taubner, Svenja
The present study aimed to evaluate the effect of trainees' interpersonal behavior on work involvement (WI) and compared their social behavior within professional and private relationships as well as between different psychotherapeutic orientations. The interpersonal scales of the Intrex short-form questionnaire and the Work Involvement Scale (WIS) were used to evaluate two samples of German psychotherapy trainees in psychoanalytic, psychodynamic, and cognitive behavioral therapy training. Trainees from Sample 1 (N = 184) were asked to describe their interpersonal behavior in relation to their patients when filling out the Intrex, whereas trainees from Sample 2 (N = 135) were asked to describe the private relationship with a significant other. Interpersonal affiliation in professional relationships significantly predicted the level of healing involvement, while stress involvement was predicted by interpersonal affiliation and interdependence in trainees' relationships with their patients. Social behavior within professional relationships provided higher correlations with WI than private interpersonal behavior. Significant differences were found between private and professional relation settings in trainees' interpersonal behavior with higher levels of affiliation and interdependence with significant others. Differences between therapeutic orientation and social behavior could only be found when comparing trainees' level of interdependence with the particular relationship setting. Trainees' interpersonal level of affiliation in professional relationships is a predictor for a successful psychotherapeutic development. Vice versa, controlling behavior in professional settings can be understood as a risk factor against psychotherapeutic growth. Both results strengthen an evidence-based approach for competence development during psychotherapy training.
Ybrandt, H.; Sundin, E. C.; Capone, G.
The shape of alliance in psychotherapy and supervision using growth curve modeling was examined for clinically inexperienced trainee therapists, who were engaged in long-term cognitive behavioral--or psychodynamic individual psychotherapy at a Psychology Clinic in Sweden. Trainee therapists rated their view of the alliance with their clients and…
Teck-Chai, Lau; Kim-Hong, Yeoh; Ching-Ching, Choong
This study reports the usage of three commercial Internet search engines in information seeking among trainee teachers at a teacher training institute in Malaysia. It attempts to investigate the information seeking behavior of the trainees via three Internet search engines (Google, Yahoo and MSN) as gateways to information for research in academic…
Hramiak, Alison; Boulton, Helen; Irwin, Brian
A collaborative research project between Sheffield Hallam University and Nottingham Trent University in the UK investigated the use of blogs with trainee teachers as an alternative to reflective paper-based diaries. An action research case study, involving focus groups of post-graduate (secondary) trainee teachers (one group from each University)…
Learning in the teaching workplace is crucial for the development of all trainee teachers. Workplace learning is particularly important for trainee teachers in the lifelong learning sector (LLS) in the UK, the majority of whom are already working as teachers, tutors, trainers or lecturers while undertaking initial teacher education. However,…
Chari, Aswin; Jamjoom, Aimun A; Edlmann, Ellie; Ahmed, Aminul I; Coulter, Ian C; Ma, Ruichong; May, Paul; Brennan, Paul M; Hutchinson, Peter J A; Kolias, Angelos G
Since its inception in 2012, the British Neurosurgical Trainee Research Collaborative (BNTRC) has established itself as a robust example of a trainee-led research collaborative. This article summarises the work of the collaborative over its first 5 years of existence, outlining the structure, its research projects, impact and future directions.
de Lange, T.
Foreign students and trainees are welcomed by the EU for study purposes. Member States must ensure that during their studies third-country national (TCN) students can legally work for at least ten hours a week, whereas trainees may not. This article deals with these often overlooked TCN students and
Banerjee, Kaustuva; Halder, Santoshi; Guha, Abhijit
The main purpose of this study is to understand the opinion of student trainee teachers towards Microteaching skills. In this study, survey method was adopted. The participants of this study were 130 trainee students from four Teacher Training Colleges of West Bengal, India in 2013-14 sessions. The tools used in the study for data collection was a…
Conclusion: The tool designed to assess bag-mask ventilation and tracheal intubation skills in anesthesia trainees demonstrated excellent inter-rater reliability, fair test-retest reliability, and good construct validity. The authors recommend its use for formative and summative assessment of junior anesthesia trainees.
... coverage for USAID participant trainees. 752.7018 Section 752.7018 Federal Acquisition Regulations System... of USAID Contract Clauses 752.7018 Health and accident coverage for USAID participant trainees. For use in any USAID contract under which USAID participants are trained. Health and Accident Coverage for...
Beer, Amanda M.; Spanierman, Lisa B.; Greene, Jennifer C.; Todd, Nathan R.
This mixed methods study examined social justice commitments of counseling psychology graduate trainees. In the quantitative portion of the study, a national sample of trainees (n = 260) completed a web-based survey assessing their commitments to social justice and related personal and training variables. Results suggested that students desired…
Although spiritual/religious identity development is included within multicultural training on the theoretical level, significant gaps exist in counseling trainees' practical preparation for spiritual/religious competence. This grounded theory study explores counseling trainees' multicultural counseling competence within the…
Lawson, David M.; And Others
Investigated counselor trainee's recollections of early family structure and current intergenerational relationships. Found trainees who remained relatively free from "triangling" patterns with parents reported significantly greater spousal intimacy, more individuation from parents, and less triangulation with children and spouses.…
Kahyalar, Eda; Yazici, lkay Çelik
This article reports on the findings from a study which investigated supervision in language teaching from a supervisor's and her three trainee teachers' perspectives. The data in the study were from three sources: 1) audio recordings of the supervisor's feedback sessions with each trainee teacher, 2) audio recording of an interview between the…
Young Kaelber, Kara A.; Schwartz, Robert C.
This study explored degree of empathy and emotional intelligence among Thai (n?=?48) and American (n?=?53) counsellor trainees to determine if differences in Eastern and Western cultural orientations (e.g., interdependent versus independent self-construals) affect foundational counselling skills. Results indicated that Western trainees showed…
Agius, Steven J; Tack, Gurinder; Murphy, Philip; Holmes, Stuart; Hayden, Jacky
Postgraduate medical trainees may take time out of programme for personal or professional reasons which can delay completion of training. This survey of out of programme trainees in England explores a phenomenon that impacts significantly upon medical careers and workforce planning.
Considering the coping effect and health connections of diary-keeping behaviour, the purpose of the present study was to investigate diary-keeping in relation to happiness and gender among Turkish teacher trainees. A sample of 417 teacher trainees between the ages of 18 and 29 was surveyed. Happiness was considered as consisting of positive and…
AlJamal, Yazan N; Ali, Shahzad M; Ruparel, Raaj K; Brahmbhatt, Rushin D; Yadav, Siddhant; Farley, David R
Surgery interns' training has historically been weighted toward patient care, operative observation, and sleeping when possible. With more protected free time and less clinical time, real educational hours for trainees in 2013 are precious. We created a 20-session (3 hours each) simulation curriculum (with pre- and post-tests) and a 24/7 online audiovisual (AV) curriculum for surgery interns. Friday morning simulation sessions emphasize operative skills and judgment. AV clips (using operating room, whiteboard, and simulation center videos) take learners through 20 different general surgery operations with follow-up quizzes. We report our early experience with this novel setup. Thirty-two surgical interns (2012-2013) attended simulation sessions on 20 separate subjects (hernia, breast, hepatobiliary, endocrine, etc). Post-test scores improved (P 4.5; Likert scale, 1-5). The AV curriculum feedback is similar (mean, >4.3) and usage is available 24/7 preparing learners for both operating room and simulation sessions. Most simulation sessions utilize low-fidelity models to keep costs <$50 per session. Scores on our semiannual Surgical Olympics (mean score of 49.6 in July vs 82.9 in January; P < .05) improved significantly, suggesting that interns are improving their surgical skills and knowledge. Residents enjoy and learn from the step-by-step, in-house, AV curriculum and both appreciate and thrive on the 'hands-on' simulation sessions mimicking operations they see in real operating rooms. The cost of these programs is not prohibitive and the programs offer simulated repetitions for duty-hour-regulated trainees. Copyright © 2014 Mosby, Inc. All rights reserved.
Lee, Jason Y; Andonian, Sero; Pace, Kenneth T; Grober, Ethan
As urology training programs move to a competency based medical education model, iterative assessments with objective standards will be required. To develop a valid set of technical skills standards we initiated a national skills assessment study focusing initially on laparoscopic skills. Between February 2014 and March 2016 the basic laparoscopic skill of Canadian urology trainees and attending urologists was assessed using 4 standardized tasks from the AUA (American Urological Association) BLUS (Basic Laparoscopic Urological Surgery) curriculum, including peg transfer, pattern cutting, suturing and knot tying, and vascular clip applying. All performances were video recorded and assessed using 3 methods, including time and error based scoring, expert global rating scores and C-SATS (Crowd-Sourced Assessments of Technical Skill Global Rating Scale), a novel, crowd sourced assessment platform. Different methods of standard setting were used to develop pass-fail cut points. Six attending urologists and 99 trainees completed testing. Reported laparoscopic experience and training level correlated with performance (p standard setting methods to define pass-fail cut points for all 4 AUA BLUS tasks. The 4 AUA BLUS tasks demonstrated good construct validity evidence for use in assessing basic laparoscopic skill. Performance scores using the novel C-SATS platform correlated well with traditional time-consuming methods of assessment. Various standard setting methods were used to develop pass-fail cut points for educators to use when making formative and summative assessments of basic laparoscopic skill. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Mirkuzie, Alemnesh H; Sisay, Mitike Molla; Bedane, Mulu Muleta
In 2010, the Federal Ministry of Health of Ethiopia (FMOH) has developed standard Basic Emergency Obstetric and Neonatal Care (BEmONC) in-service training curricula to respond to the high demand for competency in EmONC. However, the effectiveness of the training curricula has not been well documented. A collaborative intervention project in Addis Ababa has trained providers using the standard BEmONC curricula where this paper presents Krikpartick level 1 and level 2 evaluation of the training. The project has been conducted in 10 randomly selected public health centers (HC) in Addis Ababa. Providers working in the labour wards of the selected HCs have received the standard BEmONC training between May and July 2013. Using standard tools, trainees' reaction to the course and factual knowledge during the immediate post-course and six months after the training were assessed. Descriptive statistics and t-tests were done. Of the total 82 providers who received the training, 30 (36.6%) were male, 61 (74.4%) were midwives. Providers' work experiences ranged from 1 month to 37 years. Seventy-four (89%) providers reported that the training was appropriate for their work, 95% reported that the training have updated their knowledge & skills, while 27 (32.9%) reported that the training facilities & arrangements were unsatisfactory. The mean immediate post-course knowledge score was 83.5% and 33 (40%) providers did not achieve knowledge-based mastery in their first attempt. The midwives were more likely to achieve knowledge-based mastery than the nurses (p standard in-service BEmONC training curriculum, we have identified an important limitation on the course evaluations of the curriculum, which need urgent consideration. The majority of the trainees has reported favourable reaction to the training, but many of them did not achieve knowledge-based mastery in the immediate post training although the knowledge retention six months post training was encouraging.
Abdulraheem Olarongbe Mahmoud
Full Text Available The current research aimed at collating the views of medical specialists on disease priorities, class and outcomes of health research in Nigeria, and draw appropriate policy implications. Structured questionnaires were distributed to consent 90 randomly selected medical specialists practising in six Nigerian tertiary health institutions. Participants' background information, relative disease priority, research types and class, type and class of publication media, frequency of publications, challenges faced in publishing research, impact of their research on health practice or policy, and inventions made were probed. Fifty-one out of the 90 questionnaires distributed were returned giving a response rate of 63.3%. Sixty-four point six percent indicated that the highest priority should be given to non communicable diseases while still recognizing that considerations should be giving to the others. They were largely “always” involved in simple low budget retrospective studies or cross-sectional and medical education studies (67.8% and over a third (37.5% had never been involved in clinical trials. They largely preferred to “always” publish in PubMed indexed journals that are foreign-based (65.0%. They also indicated that their research works very rarely resulted in inventions (4% and change (4% in clinical practice or health policy. Our study respondents indicated that they were largely involved in simple low budget research works that rarely had significant impacts and outcomes. We recommend that adequate resources and research infrastructures particularly funding be made available to medical specialists in Nigeria. Both undergraduate and postgraduate medical education in Nigeria should emphasize research training in their curricula.
Soran, Handrean; Adam, Safwaan; Mohammad, Jamal B; Ho, Jan H; Schofield, Jonathan D; Kwok, See; Siahmansur, Tarza; Liu, Yifen; Syed, Akheel A; Dhage, Shaishav S; Stefanutti, Claudia; Donn, Rachelle; Malik, Rayaz A; Banach, Maciej; Durrington, Paul N
Hypercholesterolaemia is amongst the most common conditions encountered in the medical profession. It remains one of the key modifiable cardiovascular risk factors and there have been recent advances in the risk stratification methods and treatment options available. In this review, we provide a background into hypercholesterolaemia for non-specialists and consider the merits of the different risk assessment tools available. We also provide detailed considerations as to: i) when to start treatment, ii) what targets to aim for and iii) the role of low density lipoprotein cholesterol.
Dadkhah, Mehdi; Lagzian, Mohammad; Borchardt, Glenn
In this opinion piece, we present a synopsis of our findings from the last 2 years concerning cyber-attacks on web-based academia. We also present some of problems that we have faced and try to resolve any misunderstandings about our work. We are academic information security specialists, not hackers. Finally, we present a brief overview of our methods for detecting cyber fraud in an attempt to present general guidelines for researchers who would like to continue our work. We believe that our work is necessary for protecting the integrity of scholarly publishing against emerging cybercrime.
Increased performance in both areas requires routine assessment of the learning environment to identify components that need attention. Objective. To evaluate the perception of junior doctors undergoing specialist training regarding the learning environment in a teaching hospital. Methods. This was a single-centre, ...
Frioni, Jeannette; Kazemzadeh, Andrea
A survey was conducted of 100 Ohio school library media specialists (79% return) to determine where they received their technology training. Years of experience ranged from 1 to 32 with and average of 16 years. Results indicate that 85% of training has occurred after employment; and 8 figures display the survey results. (AEF)
BROWN, DONALD J.; BROWN, JAMES W.
THE PURPOSE OF THIS EVALUATION WAS TO GATHER DATA FROM 35 EDUCATIONAL MEDIA SPECIALIST INSTITUTES ON (1) PERSONAL AND PROFESSIONAL CHARACTERISTICS OF INSTITUTE PARTICIPANTS, (2) CHARACTERISTICS OF THE INSTITUTES THEMSELVES, (3) THE EFFECTIVENESS OF INSTITUTE PROGRAMS, (4) THE EFFECTIVENESS OF INSTITUTE EXPERIENCES ON PARTICIPANT INTERESTS AND…
Lucas, Rebecca; James, Alana I.
Mentoring is often recommended to universities as a way of supporting students with Autism Spectrum Disorders (ASD) and/or mental health conditions (MHC), but there is little literature on optimising this support. We used mixed-methods to evaluate mentees' and mentors' experiences of a specialist mentoring programme. Mentees experienced academic,…
Homoniuk, Olena; Pokudina, Larysa
The article touches on the peculiarities of future finance and economics specialists' training in educational establishments of Western Europe and Ukraine. The problem of higher economic education has been considered. The experience of higher economic education organization in developed European countries has been generalized. The peculiarities of…
The article deals with the problem of forming social partnership policy in vocational training of service sector specialists in Germany and Austria. The foreign and domestic pedagogical experience in establishing an effective system of social partnership in vocational education has been analyzed. The author has considered main factors of social…
Chew, C H; Chee, Y C
The Singapore Medical School celebrates its Centenary in 2005. This historical review is presented on Singapore's postgraduate medical education and specialist training programmes. The special informal role of the Alumni Association and its members during the early years and soon after World War II is highlighted. Postgraduate education and specialist training was more formalised only during the challenging years when Singapore became more autonomous and politically independent with the establishment of the Academy of Medicine, the School's postgraduate medical studies, the Singapore Medical Association, specialist societies and, more recently, the College of Family Physicians. Specialist training programmes and the process of specialist accreditation are also outlined. While Singapore has gone far towards developing a comprehensive programme of postgraduate medical education and specialist training, the process is still evolving and can be improved upon. As long as we keep pace with relevant and realistic strategies, the future for postgraduate medical training and specialist training should be assured.
Shah, Peter; Cross, Vinette; Sii, Freda
The potential for "discontinuities in care" arising from the turbulent transition from specialist trainee to consultant specialist presents risks to patient safety. But it is easy to lose sight of the affective needs of individuals facing the burden of keeping patients safe. This article describes a 2-day program focused on new and prospective consultant specialist ophthalmic surgeons entitled "Sailing a Safe Ship" (SASS). The purpose was to facilitate understanding and analysis of their personal holistic learning needs and enhance individual agency in optimizing learning during the transition period. The program used gaming, team challenges, meta-planning, role play and professional actors, interactive presentations, and self-analysis tools to portray the real world of consultant specialist practice in terms of ill-defined problems requiring "elite communication" and effective negotiation of value differences and priorities for their resolution. Participants' insights into their individual learning were recorded in scheduled reflective sessions. The immediate impact on their learning was also considered in terms of direct (instructional) and indirect (nurturant) effects. Participants' insights reflected 4 key themes: admitting vulnerability and uncertainty, taking responsibility for managing risk, being self-aware and reflexive, and internalizing authentic leadership. Four instructional and 4 nurturant effects were revealed. Preliminary findings on long-term impact on participants' practice are outlined. Evidence from the evaluation indicated that participants felt empowered to construct a personal strategic response to unfamiliar and unanticipated workplace demands and pressures, adopt a capability mindset that would accelerate their capacity to fulfill an enhanced leadership role, and take a holistic approach to their continuing self-directed development as leaders and educators. Copyright © 2013 The Alliance for Continuing Education in the Health Professions
The Specialists' Meeting on Bellows for Sodium Systems was sponsored by the IAEA on the recommendation of the International Working Group on Fast Reactors (IWGFR) was attended by participants and observers from France, the Federal Republic of Germany, Italy, Japan, the Netherlands, the United Kingdom and the IAEA. The purpose of the meeting was to provide forum for exchanging views on application of bellows for FBR use, problems found in service in sodium systems, design and fabrication of bellows for sodium systems and studies necessary for estimation and improvement of reliability of bellows in long term use under the condition of high temperature sodium. The technical parts of the meeting were divided into five major sessions, as follows: Experience of Bellows Applications for Sodium Systems; Design and Analysis; Fabrication; In-Service Inspection and Repair; Research Work
STS-95 Mission Specialist Scott E. Parazynski gets help with his flight suit in the Operations and Checkout Building from a suit technician George Brittingham. The final fitting takes place prior to the crew walkout and transport to Launch Pad 39B. Targeted for launch at 2 p.m. EST on Oct. 29, the mission is expected to last 8 days, 21 hours and 49 minutes, and return to KSC at 11:49 a.m. EST on Nov. 7. The STS-95 mission includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.
Ares, Terri L
Graduate nursing programs facilitate the transition of RNs to advanced roles through a complex process of professional socialization. The purpose of this study was to explore the professional socialization of clinical nurse specialist (CNS) students. Two hundred twenty-five students, representing 73 CNS programs, responded to an online survey. Both preprogram variables and educational experiences contributed to an adequate level of CNS socialization. Students' self-concept was strong, and they felt prepared to practice in the role, which was highly correlated with their perceptions of how well the program prepared them academically and experientially. Having a CNS mentor was positively associated with readiness to practice. Outcomes did not vary with cohort status, and online instruction did not impede socialization. These findings provide implications for CNS program advisement and design. Copyright 2014, SLACK Incorporated.
Takeda, Tsuyoshi; Itoi, Osamu; Takagi, Hideki; Tsubakimoto, Shozo
The purpose of this study was to clarify factors to perform the hole-entry technique in the backstroke start. A total of 16 well-trained Japanese competitive swimmers were divided into two groups (backstroke specialists and non-specialists) to compare their backstroke start motions. Their backstroke motions were videotaped, and two-dimensional co-ordinates for the swimmers were obtained from the video images using direct linear transformation methods. A non-paired t-test and Mann-Whitney U-test were used to analyse the statistical difference of the kinematic variables between the groups. Backstroke specialists showed a significantly shorter 5 m time (P = 0.009, effect size = -1.54), a significantly higher position of the toe (P = 0.010, effect size = 1.47) at signal and of the hip at toe-off (P = 0.002, effect size = 1.94), a significantly larger hip joint angle at toe-off (P = 0.007, effect size = 1.60) and a significantly higher angular velocities of the hip joints (45-85%; P < 0.05) for the normalised time as compared to that of non-specialists. An earlier initiation of the extension and the maintenance of a higher extension speed at the hip joints were important factors in achieving an arched-back posture, which facilitated and water entrance with a small entry range.
Müller, J.; Stadler, J.; Jarzabek-Müller, A.; Hacker, H.; Braak, ter C.J.F.; Brandl, R.
The difficulties specialized phytophagous insects face in finding habitats with an appropriate host should constrain their dispersal. Within the concept of metacommunities, this leads to the prediction that host-plant specialists should sort into local assemblages according to the local
Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M; Biermann, Martin
While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. To assess the potential of e-learning in specialist education in medical imaging. An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs.
Pimm, Jonathan; Galbraith, Niall
The publishing world is changing rapidly. Innovations include the move to open access, the rise of social media and the transition to digitalisation. In the light of these developments and with ever-increasing pressures on early career psychiatrists and trainees to publish papers in journals with a recognised pedigree, the BJPsych Bulletin is piloting an author mentoring scheme. Mentors will help clinicians and aspiring academics develop articles from a pedestrian manuscript to one that will hopefully provoke important debate and aid changes in current practices. The scheme will run on a trial basis for approximately 12 months and will then be reviewed. Mentoring has been found to have an important effect of research output including publication and grant success; the hope is that this new initiative at the BJPsych Bulletin will result in such dividends to all involved.
Pfeifer, Cory M
Academic radiologists commonly hold multiple simultaneous roles within the landscape of physician training. This paper analyzes theoretical scenarios describing relationships between medical students, residents, and physician educators in radiology. The scenarios presented involve medical student supervision, radiology resident recruitment, and resident termination with respect to relevant ethical, regulatory, and legal considerations. Legal precedents and the medical social contract are addressed. The Family Educational Rights and Privacy Act defines a framework for the privacy practices of medical schools, but it does not confer individual rights. Resident physicians rarely win wrongful termination lawsuits. Physician educators are ethically bound to act in the best interest of society. Courts have ruled that medicine is intended to be a self-regulatory profession. Such a power requires that physicians remain accountable to the public while providing a fair learning environment for medical trainees. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Full Text Available This paper gives an outline of Traineeship at the Department of Translation, University of Ljubljana, designed as a practical, hands-on experience in translation work for students. In the re-design of the study programmes at the Department of Translation in line with the Bologna Reform, compulsory Traineeship was introduced as part of the MA course in Translation/Interpreting, offering students an insight into real-life translation situations while providing employers with an impression of their prospective employees. The main objective of Traineeship is to give an added-value to the MA course, provide job opportunities and offer students a practical experience while workingwith the state-of-the-art translation technologies. The trainees can apply their knowledge obtained at the faculty to real-life translation assignments while gaining new skills and experience which combined contribute to a more efficient integration into the translation market. The paper explores the specific approaches to the implementation of Traineeship at the Department of Translation developed over the last decade, offering a model of good practice to other traineeship organizers.
Fralick, Michael; Haj, Reem; Hirpara, Dhruvin; Wong, Karen; Muller, Matthew; Matukas, Larissa; Bartlett, John; Leung, Elizabeth; Taggart, Linda
To determine whether a smartphone app, containing local bacterial resistance patterns (antibiogram) and treatment guidelines, improved knowledge of prescribing antimicrobials among medical trainees. We conducted a prospective, controlled, pre-post study of medical trainees with access to a smartphone app (app group) containing our hospital's antibiogram and treatment guidelines compared to those without access (control group). Participants completed a survey which included a knowledge assessment test (score range, 0 [lowest possible score] to 12 [highest possible score]) at the start of the study and four weeks later. The primary outcome was change in mean knowledge assessment test scores between week 0 and week 4. Change in knowledge assessment test scores in the app group were compared to the difference in scores in the control group using multivariable linear regression. Sixty-two residents and senior medical students participated in the study. In a multivariable analysis controlling for sex and prior knowledge, app use was associated with a 1.1 point (95% CI: 0.10, 2.1) [β = 1.08, t(1) = 2.08, p = 0.04] higher change in knowledge score compared to the change in knowledge scores in the control group. Among those in the app group, 88% found it easy to navigate, 85% found it useful, and about one- quarter used it daily. An antibiogram and treatment algorithm app increased knowledge of prescribing antimicrobials in the context of local antibiotic resistance patterns. These findings reinforce the notion that smartphone apps can be a useful and innovative means of delivering medical education.
Goulding, J M R; Passi, V
Dermatology specialty trainees (STs) in the United Kingdom (UK) are few in number and will join a thinly spread national consultant body. It is of paramount importance to deliver training programmes of the highest quality for these doctors, central to which is the establishment and maintenance of an educational climate conducive to learning. To conduct a pilot study to evaluate the educational climate for dermatology STs in one UK deanery (West Midlands). Secondary analysis of published data was performed, from the UK's General Medical Council (GMC) national training survey, and the Job Evaluation Survey Tool (JEST) administered by the West Midlands deanery. A modified online version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was circulated among dermatology STs. The GMC's survey data show that UK dermatology STs rated their training highly in comparison with undifferentiated UK postgraduate trainees. West Midlands dermatology STs (n = 22) scored very similarly to UK dermatology STs. The JEST gave broadly encouraging results, with 21/22 (95%) happy to recommend their posts to colleagues. The modified PHEEM yielded a global mean score of 96.5/152, attracting the descriptor 'more positive than negative but room for improvement'. Despite inherent methodological limitations, the GMC, JEST and modified PHEEM surveys have revealed useful comparative triangulated data which allows the conclusion that West Midlands dermatology STs seem to be training in a favourable educational climate. This represents an important facet of the quality assurance process for medical education, and allows insight into areas which may require improvement. © 2015 European Academy of Dermatology and Venereology.
Eze, K C; Marchie, T T; Eze, C U
Proforma information, instructions and procedures of training in radiology are lacking in Nigeria. To describe the errors in ultrasonography performed by unsupervised trainee radiologists. The radiology records of all ultrasound scans (USS) carried out and all reports that came back to the unit of the authors on account of misdiagnosis, doubtful diagnosis, misinformation or error in the reports were studied. The patients with the returned reports were rescanned where available by consultants and the collected data analysed. A total of 4680 patients had ultrasound studies without supervision resulting in 605 (12.93%) queried reports. The USS scans of 235 (5.02%) patients were repeated with consultants in attendance resulting in significant change in reports of 95 (2.03%) patients. Analysis of the request cards of 605 queried reports showed omission of relevant clinical information 463 (76.53%), outright wrong information 65 (10.73%),and unconventional abbreviations 139 (22.98%), while 493 (81.49%) were completed by a nurse, medical student or junior resident. Typographical errors comprised 174 (28.76%) of the 605 queried reports. False negative error was the highest type of error seen in 55 (57.89%) of the 95 patients with significant change in their report after repeat scan as lesions not detected were not documented. Trainee radiologists make significant errors in carrying out and reporting ultrasonography without adequate direct supervision of the study by their training consultants. Majority of the errors originate from lack of accurate filling of the patients request cards by the requesting physicians, lack of adequate preparation for the intended study, and typographical errors in writing reports. False negative reports are by far the greatest cause of errors recorded as lesions not detected were not documented.
Bernson-Leung, Miya E; Urion, David K
Clinical teaching skills programs for resident physicians are increasingly offered. Less attention has been devoted to the unique educational roles of specialty residents and subspecialty fellows, many of whom will become academic faculty physicians. These teaching roles, and therefore a trainee's learning needs and motivation, also change over the course of training. We designed and implemented a two-year longitudinal teaching curriculum for child neurology and neurodevelopmental disabilities residents using adult learning theory principles: experiential learning and immediate applicability to specific roles. Core modules included teaching in clinical settings, adult learning, and giving feedback. Training-year-specific modules for second-year residents (n = 11) and final-year residents (n = 10) included teaching through consultation and promoting clinical reasoning in supervisory roles. Learners completed an 11-item self-assessment before and after intervention. The overall program significantly increased residents' self-assessed knowledge of how to assess the level of a learner (P = 0.02, Cohen d = 0.84) and comfort and skill in giving feedback (P = 0.04, d = 0.64; P = 0.04, d = 0.71). The final-year-specific curriculum additionally increased self-assessed skill in teaching same-specialty residents (P = 0.05, d = 1.07) and in promoting clinical reasoning (P = 0.03, d = 1.14). The program was rated highly by trainees and faculty, and has been adopted as an ongoing part of our training program. Our experience offers a reproducible model and theoretical framework for child neurology, neurodevelopmental disabilities, and other specialty programs to develop customized trainee-as-teacher curricula with specialty- and training-year-specific content. Copyright © 2017 Elsevier Inc. All rights reserved.
Janna Ida Fincke
Full Text Available Aim: The present study aimed to evaluate the effect of trainees' interpersonal behaviour on Work Involvement (WI and compared their social behaviour within professional and private relationships as well as between different psychotherapeutic orientations. Methods: The interpersonal scales of the Intrex short-form questionnaire and the Work Involvement Scale (WIS were used to evaluate two samples of German psychotherapy trainees in psychoanalytic (PA, psychodynamic (PD and cognitive behavioural therapy (CBT training. Trainees from sample 1 (N = 184 were asked to describe their interpersonal behaviour in relation to their patients when filling out the Intrex, whereas trainees from sample 2 (N = 135 were asked to describe the private relationship with a significant other. Results: Interpersonal affiliation in professional relationships significantly predicted the level of Healing Involvement (HI, while Stress Involvement (SI was predicted by interpersonal affiliation and interdependence in trainees' relationships with their patients. Social behaviour within professional relationships provided higher correlations with WI than private interpersonal behaviour. Significant differences were found between private and professional relation settings in trainees’ interpersonal behaviour with higher levels of affiliation and interdependence with significant others. Differences between therapeutic orientation and social behaviour could only be found when comparing trainees' level of interdependence with the particular relationship setting. Conclusion: Trainees' interpersonal level of affiliation in professional relationships is a predictor for a successful psychotherapeutic development. Vice versa, controlling behaviour in professional settings can be understood as a risk factor against psychotherapeutic growth. Both results strengthen an evidence-based approach for competence development during psychotherapy training.
Foreman, L.R.; Stark, J.C.
This tenth meeting of specialists in target fabrication for inertial confinement is unique in that it is the first meeting that was completely unclassified. As a result of the new classification, we were able to invite more foreign participation. In addition to participants from the US, UK, and Canada, representatives from France, Japan, and two Russian laboratories attended, about 115 in all. This booklet presents full papers and poster sessions. Indirect and direct drive laser implosions are considered. Typical topics include: polymer or aluminium or resorcinol/formaldehyde shells, laser technology, photon tunneling microscopy as a characterization tool, foams, coatings, hohlraums, and beryllium capsules. Hydrogen, deuterium, tritium, and beryllium are all considered as fuels
Lebedev, Vladimir; Puhova, Olga
The article reviews the knowledge assessment software module of electronic teaching and testing in mining specialist training. To develop the software module integrated programming environment state-of-the-art is used. Its advantage consists in small computer resource consumption, simple editing, and protection against the users' trying to find out the correct answers to test tasks. The software makes it possible to learn the ongoing learning information systematically and consistently as well as to assess the current knowledge in mining. The developed module meets the following requirements: a software module user-friendly interface, the storage of passed test results to be used for subsequent viewing, analyses, and evaluation, fast troubleshooting in case of any troubles with a stable module operation, and further software function extension and upgrading.