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PubMedDate not supplied

A survey of Cleveland Clinic training-program alumni. Implications for evaluation of graduate medical education.

The graduate of a medical training program is in a unique position to evaluate that program in comparison with the realities of medical practice. A survey of alumni of the Cleveland Clinic's graduate training programs was conducted in September 1986. The alumni's perceptions of the quality of their programs and the educational services provided by the Division of Education are discussed in relation to the educational administrative structure and evaluation process at The Cleveland Clinic Foundation. The need for such evaluation methods, as well as additional techniques to provide a comprehensive evaluation system in graduate medical education, is emphasized.

Attitude of Health Personnel↗
PubMed1990

A model curriculum for substance abuse education in child and adolescent psychiatry training programs.

Child psychiatry training recognizes substance abuse as a problem requiring an educational effort to provide fellows with adequate clinical skills to manage these patients. The components of a substance abuse educational module which may be integrated into existing child psychiatry fellowships are presented, with a discussion of practical problems raised by the expansion of child psychiatry into this neglected area.

Adolescent↗
PubMed1987

Treadmill training program for a bilateral below-knee amputee patient with cardiopulmonary disease.

This study was undertaken to determine the degree of progress an elderly bilateral below-knee amputee with cardiopulmonary disease could achieve by endurance training on a treadmill. Aspects of medications, orthotic/prosthetic evaluation, and energy expenditure are discussed. The subject was a 63-year-old Class IV cardiac patient with combined restrictive-obstructive pulmonary disease of moderate severity. He had undergone a coronary artery bypass graft (two-vessel) followed by a bilateral below-knee amputation for an ascending dry gangrene. The initial ambulatory aerobic evaluation showed the patient achieving only 50% of predicted maximal heart rate and 20% of maximal oxygen consumption. An individualized daily training program started the patient walking at .5 mph, 0% elevation, for five repetitions at two minutes each. By the end of the six-month training program the workload reached 1.4 mph at 2.5% elevation, for 30 minutes of total external work. The final exercise test evaluation showed an overall increase in age-predicted maximal heart rate (90%) and oxygen consumption (55%). The patient improved from cardiac Class IV to Class II, and therapeutically from Class E (bed rest) to Class C (moderate exercise restriction). These findings suggest a need for endurance training programs for patients with cardiopulmonary disease hindered by additional physical disabilities. The program enabled the participant to engage in significantly higher levels of activity for daily living within the community.

Activities of Daily Living↗
PubMedDate not supplied

The effect of a training program on the reliability of examiners evaluating amalgam restorations.

There have been long-term problems in establishing agreement among clinical and preclinical examiners in dentistry. The purpose of this study was to develop a training program and study its effect on examiner agreement when judging the clinical service ability of amalgam restorations. Ten examiners with varying backgrounds, levels of experience, and no previous training with methods to standardize clinical evaluation evaluated 44 amalgam restorations in 17 patients before and after a brief training session. The restorations were judged as either acceptable (leave alone), or unacceptable (replacement or alteration required). The training program was brief and consisted of the introduction of a rating scale with descriptive criteria, followed by a clinical session where the examiners practiced using the rating scale and criteria to arrive at operational decisions. Intraexaminer and intraexaminer agreement were calculated for both evaluation sessions. The training program improved the reliability of the examiners evaluating the clinical service ability of the amalgam restorations. Although the gain was not to the level commonly accepted in the literature, it clearly demonstrates a step in the right direction.

Adolescent↗
PubMed1983

Response of age forty and over military personnel to an unsupervised, self-administered aerobic training program.

The Army recently extended mandatory physical training and testing to include personnel 40 yrs of age and older. The purpose of this study was to describe the profile of aerobic fitness in a representative group from this age population and to evaluate the response of such a group to a self-administered, unsupervised training program. Maximal oxygen uptake (Vo2 max) and percent body fat (%BF) were assessed in 260 military personnel (40-53 yrs of age) before and after 6 mo of physical training consisting of a progressive walk/run mode of exercise. Before training the mean +/- S.D. for Vo2 max and %BF for all subjects was 38.1 +/- 6.2 ml/kg . min and 26.1 +/- 4.7%, respectively. Subjects were divided into three groups based upon their initial level of physical activity determined by interview as follows: inactive, moderately active and active. Upon retesting after 6 mo, 40% of the inactive group had not participated to any appreciable degree in the program and subjects of this group who did participate showed only a slight and insignificant increase (4.4%) in Vo2 max. The pretraining level of Vo2 max for the total population studied was similar to that reported in other studies on comparably aged subjects. However, changes with training were well below those seen with supervised group programs of 6 mo duration.

Adult↗
PubMed1995

How uniform are post-graduate training programs in medical oncology in the European Union?

BACKGROUND: Medical oncology is a relatively new discipline whose rapid evolution is not paralleled by advances in the academic curricula. The present study was designed to provide a description of the status of post-graduate training programs in medical oncology in the European Union. RESULTS: Our survey shows that 'some form' of training in medical oncology is available in 10 countries of the European Union, but that there are officially recognized Schools of Specialization in this discipline in only four (Great Britain, Portugal, Republic of Ireland and Spain). Italy and France offer training programs in medical oncology as specific tracks of the School of Specialization in Oncology. A 'special competence' in medical oncology, within the specialty of internal medicine, is issued in 3 additional countries (Denmark, Belgium and the Netherlands). Finally, training in medical oncology is linked to that in haematology in Germany. A wide variation was found among the different European countries regarding the requirements for admission to these training programs. Similarly, the duration of the programs in the various schools ranges between 2 and 6 years and the total number of years from graduation to achievement of the title of specialist ranges from 4 to 9 years. CONCLUSIONS: Our survey discloses a broad heterogeneity of academic attitude regarding medical oncology in the European Union and points to the need for recognition of this discipline as a specific and essential specialization.

Education, Medical, Graduate↗
PubMed1975

Frequency and duration of interval training programs and changes in aerobic power.

This study was designed to ascertain whether 7- and 13-wk interval training programs with training frequencies of 2 days/wk would produce improvement in maximal aerobic power (VO2max) comparable to that obtained from 7- and 13-wk programs of the same intensity consisting of 4 training days/wk. Sixty-nine young healthy college males were used as subjects. After training, there was a significant increase in VO2max (bicycle ergometer, open-circuit spirometry) that was independent of both training frequency and duration. However, there was a trend for greater gains after 13 wk. Maximal heart rate (direct lead ECG) was significantly decreased following training, being independent of both training frequency and duration. Submaximal VO2 did not change with training but submaximal heart rate decreased significantly with greater decreases the more frequent and longer the training. Within the limitations of this study, these results indicate that: 1) maximal stroke volume and/or maximal avO2 difference, principle determinants of VO2max, are not dependent on training frequency nor training duration, and 2) one benefit of more frequent and longer duration interval training is less circulatory stress as evidenced by decreased heart rate, during submaximal exercise.

Adult↗
PubMed1986

The use of goal attainment scaling to evaluate a cancer research training program for high school and college students.

Goal attainment scaling has been used frequently in the evaluation of mental health services. The purpose of this study was to assess the usefulness of the goal attainment scaling methodology in the evaluation of a cancer research training program. Subjects were 62 high school and college students participating in a summer research program. Prior to the program, all students were asked to predict the specific outcomes they expected to attain in relation to eight independent dimensions of the research training program. At the close of the program students were asked to indicate the outcome they attained for each dimension. Students also ranked the importance of each dimension. The analyses indicated that participants entered the program with accurate expectations of their ultimate achievement and satisfaction with the program. Significant differences were found for expected outcomes on a number of program dimensions for the high school and college students at the preprogram assessment. Significant differences were also found for the high school and college students' importance rankings at both the pre-program and post-program period. Goal attainment scaling proved to be a valuable and flexible technique for the evaluation of a cancer research training program.

Adolescent↗
PubMed1975

A report of a 1972 survey of physician's assistant training programs.

This article presents select results of a 1972 survey of all physician's assistant training programs in the United States and its territories. The survey gathered a broad range of information useful to federal health manpower policymakers, physician assistant training program administrators, guidance counselors, and prospective students. Responses were received from 75 operational programs and 13 programs still in planning for an estimated response rate of 81 per cent from the estimated 108 programs in existence.

Accreditation↗
PubMed1993

Pediatric and MCH training in Japan: JICA training program in the National Children's Hospital.

The experience of the training program for overseas doctors in the National Children's Hospital during 8 years is described. The program was supported by the Japan International Cooperation Agency (JICA) and the objectives of the training course are to provide doctors from developing countries with a better understanding of diagnosis and treatment as specialized pediatricians and pediatric surgeons and to introduce recent medical techniques and equipment for child care. From 1984 to 1993, 37 doctors from 22 developing countries of Asia, Middle and South America and Africa have attended this program. There were 22 pediatricians, 14 pediatric surgeons and one dentist. The outline of this group training program and problems with the course are discussed.

Child↗
PubMedDate not supplied

Trust in training: the Oil, Chemical, and Atomic Workers International Union Worker-to-Worker Training Program.

The OCAW's Worker-to-Worker Training Program was established with one of the first grants awarded under the Superfund Amendments and Reauthorization Act of 1986. The union intended the program to serve as a model to industry and to raise the standard of safety and health training throughout the industry. The program, which requires trainees to actively participate in learning activities, has garnered praise from its participants.

Chemical Industry↗
PubMed1999

The Costa Rican emergency medicine residency: design and implementation of a new specialty training program in Central America.

A program of physician training in the specialty of emergency medicine was developed in Costa Rica, Central America, during the years 1993 and 1994. The program involved 2 phases: a faculty preparation course, and the residency itself. The preparation of faculty members for the residency was undertaken in Costa Rica, with a US emergency faculty physician residing in the host country to assist in the development of the program. Twenty-one faculty members were prepared to teach the residency curriculum. A core group of Costa Rican physician educators with assistance from the US emergency medicine specialist developed a curriculum suitable for the needs of the region. A selection process for prospective applicants to the residency program is described. The first residents began training in February 1994, just before completion of the faculty program. The first emergency medicine specialists graduated from the 3-year training program in 1997. The residency program continues to function at the time of this publication. This description is offered as one model for the initiation of emergency medicine specialty training in a developing country.

Costa Rica↗
PubMed1997

Do victims of an out-of-hospital cardiac arrest benefit from a training program for emergency medical dispatchers?

In this paper, we assessed the effects of a training course for emergency medical dispatchers on the handling of out-of-hospital cardiac arrest cases in the dispatch center of a two-tiered emergency medical services system. A total of 112 cardiac arrest cases were studied; 64 before and 48 after the training course. Before the course, all relevant information was obtained in 36% of cases, only partial information in 56% and no useful medical information in 8%. The corresponding figures after the training program were 62, 38 and 0%, respectively (2 x 3 chi2 test, P = 0.01). Trends towards an increase in the percentage of cases in which a second-tier team was sent immediately after the initial call (58 vs 75%; chi2 test, P = 0.06) and towards shorter overall intervals between receipt of the call and dispatch of the second-tier team (logrank test, P = 0.10) were noticed. Similarly, the survival rate increased from 2% before, to 8% after the training course (chi2 test with Yates' correction, P = 0.24). We conclude that our training program for emergency medical dispatchers produced some beneficial effects.

Apnea↗
PubMedDate not supplied

Evaluation of two training programs for laparoscopic cholecystectomy: incidence of major complications.

To determine the need for a training program for laparoscopic cholecystectomy, we evaluated two programs by surveying perioperative complications. The two programs were completed by eight surgeons in each. Program A consisted of 10 supervised operations and program B of only 2. A total of 1054 operations were performed, and 12 major complications required conversion to open surgery owing to transection of the bile duct in 5 cases, laceration of the common bile duct in 1 case, delayed perforation of the common hepatic duct in 1 case, bile leakage in 2 cases, duodenal injury in 1 case, and bleeding from the cystic artery in 2 cases. The incidence of a major complication was significantly higher in group B than in group A, and six of the nine major complications in group B occurred during the initial seven independent operations. Overall, the most common major complication was an injury during the operation to the common bile duct or to the hepatic duct. Four of the five transections of the bile duct required Roux-en-Y hepaticojejunostomy, and the other required end-to-end anastomosis with T-tube drainage; one laceration required simple suture closure; and the one delayed perforation required T-tube drainage. The mean duration of hospitalization for 7 patients with an injury to the bile duct was 74.4 days (range 16-151 days). We recommend that a training program for laparoscopic cholecystectomy should include at least 10 operations to prevent a major complication during the initial 10 operations.

Adolescent↗
PubMed1997

An assessment of the efficacy of sports vision training programs.

BACKGROUND: The claim that sports vision training programs can enhance visual skills and the level of sporting performance was investigated. METHODS: Thirty young subjects were assigned equally to visual training, reading (placebo), and control groups. Visual and motor tests were administered before and after 4 weeks of training or control activity to determine whether any improvements in performance had occurred. RESULTS: Significant improvements on some aspects of vision were apparent for the visual training group, but their improvements in both vision and motor performance were no greater than for either of the other groups. DISCUSSION: There was no evidence for visual training improving either visual or motor performance beyond levels due simply to test familiarity. The benefits of the visual training exercises commonly used by optometrists to enhance sports performance are therefore open to question.

Accommodation, Ocular↗
PubMed1981

Accuracy of DSM-III diagnoses following a training program.

The authors describe a 2 1/2-day training program designed to teach mental health professionals how to use a new DSM-III classification scheme. The 251 participants had previous clinical training but no prior exposure to DSM-III. They were asked to diagnose three cases from a series of five videotapes case vignettes; the authors then compared the participants' diagnoses with the expert opinion of clinical faculty. The degree of agreement among the participants with the expert opinion varied across the five cases, but the overall level of agreement was high (74.2%). These results indicate that with adequate training the new DSM-III classification scheme can be accurately applied to diagnostic situations.

Clinical Competence↗
PubMed1983

The outcomes of mental health training programs: a review of the literature.

In these times of fiscal austerity, educators are asked increasingly to justify their programs. This review of literature indicates there are few controlled studies focusing on outcomes of mental health training programs, largely because the goals of training programs have been poorly identified and/or infrequently used as a basis for evaluation. In addition, these studies lack adequate criteria of success and standardized measures of success. Educators are, therefore, unable to critically evaluate the impact of the trained worker on patient care.

Community Mental Health Services↗