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PubMed1999

The effect of exercise training programs on bone mass: a meta-analysis of published controlled trials in pre- and postmenopausal women.

With the aging of the population, the medical and social costs of skeletal fragility leading to fractures will cause an immense burden on society unless effective prophylactic and therapeutic regimens can be developed. Exercise is suggested as a possible regimen against involutional bone loss. The purpose of the present meta-analysis is to address a quantitative review of the randomized controlled trials (RCTs) and nonrandomized controlled trials (CTs) on the effects of exercise training programs on bone mass, measured as bone mineral density (BMD) or bone mineral content (BMC), of the lumbar spine (LS) and the femoral neck (FN) in pre- and postmenopausal women. The literature from 1966 through December 1996 was searched for published RCTs and CTs. Study treatment effect is defined as the difference between percentage change in bone mass per year in the training group and the control group. Overall treatment effects (OTs) with the 95% confidence intervals of these study treatment effects were calculated using inverse-variance weighting. Of the 62 articles identified, 25 met the inclusion criteria and were maintained for further analyses. The weighted OTs for the RCTs showed very consistently that the exercise training programs prevented or reversed almost 1% of bone loss per year in both LS and FN for both pre- and postmenopausal women. The two OTs that could be calculated for strength training programs did not reach significance. The OTs for the CTs were almost twice as high as those for the RCTs, which gives an indication of the confounding introduced by the nonrandom allocation of the subjects to groups.

Adult↗
PubMed1990

Effect of neurolinguistic programming training on self-actualization as measured by the Personal Orientation Inventory.

Neurolinguistic programming training is based on principles that should enable the trainee to be more "present"-oriented, inner-directed, flexible, self-aware, and responsive to others, that is, more self-actualized. This study reports within-person changes on self-actualization measures of the Personal Orientation Inventory following a 24-day residential training in neurolinguistic programming. Significant positive mean changes were found for 18 master practitioners on nine of the 12 scales and for 36 practitioners on 10 of the 12 scales. Findings are consistent with the hypothesis that training increases individual self-actualization scores.

Adult↗
PubMed2004

Reducing medication errors in a surgical residency training program.

Medication errors contribute to in-hospital morbidity and mortality. Teaching hospitals and the surgical residency training programs they support should take proactive steps to reduce error frequency. In order to accomplish meaningful error reduction, we must first define the scope and nature of the problem. Pharmacists at the Monmouth Medical Center prospectively recorded medication prescribing errors made by surgical residents during 2 years. These data were reviewed to determine the types of medication errors made most frequently by surgical house officers. Seventy-five medication-prescribing errors were made by surgical house staff in the years 2001 and 2002. Thirty-three of these errors involved orders for antibiotic therapy. Errors that could not be directly attributed to knowledge deficits were responsible for 36 of the 75 errors (48%), whereas specific knowledge deficits were responsible for 39 of the 75 errors (52%). Twentyeight of the 36 errors not directly attributable to knowledge deficits (78%) were made at the postgraduate year one level, whereas only 15 of the 39 knowledge deficit errors (38%) were made at the postgraduate year one level. Though targeted education to address specific knowledge deficits may substantially reduce the occurrence of "knowledge deficit" medication errors within surgical residency training programs, more costly measures such as the implementation of physician computerized order entry will likely be needed to reduce maximally the frequency of medication ordering errors. Many prescribing errors cannot be attributed to specific knowledge deficits.

Clinical Competence↗
PubMed2006

Teaching teachers about childhood cancer: the effects of a web-based training program.

The purpose of this study was to examine the utility and acceptability of a modular computer-based training program on childhood cancer (eg, acute and late effects of treatment, intervention strategies) for teachers. A within-subjects design was implemented with 41 teachers and teachers in training. Participants completed tests of childhood cancer knowledge and application skills both before and after completing the web-based training. An acceptability questionnaire was completed after the training. Results indicated significant gains in knowledge and in case application, as well as high levels of acceptability of the training. It seems that a web-based training program can be accessed by teachers and in 2 to 4 hours can significantly increase cancer knowledge in an acceptable manner.

Child↗
PubMedDate not supplied

Feasibility of laparoscopic extraperitoneal surgical staging for locally advanced cervical carcinoma in a gynecologic oncology fellowship training program.

STUDY OBJECTIVE: Feasibility of laparoscopic extraperitoneal surgical staging for locally advanced cervical carcinoma in a gynecologic oncology fellowship training program. DESIGN: Retrospective analysis (II-2) of all patients who underwent laparoscopic extraperitoneal surgical staging at Women and Children's Hospital for locally advanced cervical cancer between June 2002 and June 2005. SETTING: Gynecologic oncology fellowship training program at a University-County Hospital PATIENTS: Thirty-two patients with clinical stage IIB-IVA cervical carcinoma were identified. INTERVENTIONS: Laparoscopic extraperitoneal surgical staging for clinical stage IIB-IVA cervical cancer. MEASUREMENTS AND MAIN RESULTS: A total of 32 cases of laparoscopic extraperitoneal surgical staging for locally advanced cervical cancer performed by fellows-in-training were identified. Fellows were first assistant surgeon in 10 cases, and operating surgeon in 22 cases. Each fellow was mentored an average of 5 cases as first assistant surgeon. As operating surgeon, all 22 fellow cases (100%) were successfully performed without conversion to laparotomy. Fellow mean operative time was 163 minutes. Fellow mean aortic nodal count was 14. Fellow mean blood loss was 42 mL. The mean hospital stay was 1.6 days. Overall, 2 patients (6.2%) experienced a complication from the procedure. Over one half (53%) of the patients reported a prior abdominal surgery. No lymphedema has been reported in patients who underwent laparoscopic extraperitoneal surgical staging with a median follow-up of 10 months. Surgical comorbidities such as hypertension, diabetes, and obesity were common in the study group. A steep surgical learning curve for the fellows was demonstrated by comparing mean operative times to academic year. Aortic nodal metastasis was detected in 25% of cases, and 14% were occult. CONCLUSIONS: It is feasible to teach laparoscopic extraperitoneal surgical staging to fellows-in-training. Our data suggest that by the end of training, fellows can become proficient with the procedure and are capable of surgical outcomes and complication rates comparable to reported literature.

Adolescent↗
PubMedDate not supplied

Structured research training in residency training programs. The impact on the level of resident research activity.

A survey was conducted to construct a profile of structured resident research training and experience in physiatric residency training programs. Resident research activity was quantified, and factors that may influence the level of resident research activity were examined. Questionnaires were sent to all 72 residency training program directors, of which 87% responded. To construct the profile of structured training and experience in research that currently exists, descriptive analyses were applied to the survey responses. Resident research activity was quantified according to projects per resident per year over the last 3 yr. Resident research activity was assigned to level I activity (> or = 0.25 projects/resident/year) or level II activity (< 0.25 projects/resident/year). This point of discrimination was chosen because it represents one project per resident per 4-yr graduate medical education cycle. Nonparametric, univariate analyses were used to evaluate the impact of each characteristic in the research training profile on resident research activity. The following characteristics were found to be statistically significant (P < 0.05): (1) the use of mentors outside of the physical medicine and rehabilitation department; (2) the provision of guidelines to residents for choosing a mentor; (3) the provision of responsibility guidelines to mentors; (4) the presence of a classroom curriculum. Mentorship outside of the department, however, had a negative impact on resident research activity, although the other three characteristics had positive impacts. A multivariate analysis using stepwise logistic regression was applied to further determine the capacity of each characteristic to predict independently the level of resident research activity. Only one characteristic simultaneously and independently remained significant (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1991

Characteristics of pediatric intermediate care units in pediatric training programs.

BACKGROUND/OBJECTIVE: To assess effective alternate care sites for the technology-dependent, but less acute critically ill child, we surveyed pediatric training programs to determine the availability and characteristics of non-neonatal pediatric intermediate care units. METHODS: A questionnaire was mailed to the program directors of all 226 United States pediatric residency programs in October 1988. Institutions were queried about pediatric residency program and hospital demographics, along with specific day-to-day management issues in an intermediate care unit. RESULTS: The intermediate care unit offers highly skilled nursing care with greater than 90% of the units primarily covered by RNs in a 1:2 or 1:3 RN/patient ratio. The technologies used in these units were similar to those technologies used in an ICU, and the average daily bed charge was 40% less than the average daily bed charge in an ICU. However, an intermediate care unit was present in only 33% of pediatric training programs and pediatric residents were not specifically trained to care for patients in these units; 37% of these units did not have daily attending physician/nurse/resident rounds, despite the complexity and degree of illness in the patients located in these units. In addition, greater than 20% of intermediate care units were predominantly staffed by RNs with degrees less than BSN. Thirteen percent of these units had a predominance of RNs with only routine experience. CONCLUSIONS: Standard levels of care and academic and financial guidelines should be established to optimize the value of pediatric intermediate care units.

Child↗
PubMed1978

National study of internal medicine manpower: II. A typology of residency training programs in internal medicine.

This second paper of the National Study of Internal Medicine Manpower describes the differing environments of residency training programs. Using previous studies as prototypes, the authors apply factor analysis to data from questionnaires returned by residency training directors and residents to illustrate the myriad interrelations within training programs. The most important result of this study is the demonstration that the largest residency programs have the most subspecialty programs, and their residents are more likely to pursue subspecialty fellowships after completing their third residency year. However, preliminary findings show no associations between the typology (typologic categories of residencies and their trainees) used and desired practice locations in states having few physicians relative to the population or in states with fewer urban inhabitants. The typology also does not predict the future practice aspirations of residents who are more likely to care for the poor or minority populations. A separate set of factors, possibly unrelated to training environments, will help to predict such career outcomes. Further specification of these factors will be the subject of a later paper in this series.

Environment↗
PubMed2001

General practice residency training program in Thailand: past, present, and future.

The General Practice was approved by the Thai Medical Council as a specialty in 1969. The residency training programs were revised in 1992. The first three - year rotating postgraduate residency training program was started in 1973 with a total of 9 programs by the late 1980s. Seven were in Bangkok, and the other 2 were in the North. The programs contained curricula objectives, clinical rotation in various disciplines including a general practice block in provincial or community hospitals. The weakness of the programs was the lack of a general practice department, a general practice trainer or preceptor and a general practice course organizer. Finally, the General Practitioners Association played a little role in the postgraduate general practice residency. After the revision, the general practice residency was changed to family medicine residency training in 1999. The College of Family Physicians of Thailand was established to take a central role in postgraduate education.

Certification↗
PubMed2001

Effectiveness of the "teaching the teachers" diagnostic US training program.

RATIONALE AND OBJECTIVES: The "Teaching the Teachers" training program was meant to establish standardized ultrasound education programs worldwide, reaching the largest possible number of physicians. The authors performed this study to evaluate the results of this training. MATERIALS AND METHODS: An open-ended test question format (ie, uncued testing) that would evoke responses from physicians in a manner ensuring the highest fidelity with a real clinical setting was selected. An examination was administered at the beginning and the end of the program and then again 6 months later to assess baseline knowledge, changes in knowledge, and knowledge retention, respectively. RESULTS: Scores on entry and end-of-program examinations were available for 112 participants. The mean entry test score was 35%, and the mean end-of-program examination score was 73%. All changes in scores were statistically significant (P < .001) as determined with paired t tests. Follow-up examinations were available for 27 of the 112 participants at the time of the analysis. On these examinations, mean total test scores increased by nearly 4 percentage points. Although follow-up test scores were available for only 27 participants, these mean test scores were comparable to those reported for the entire group on the end-of-program examination. CONCLUSION: The examinations administered at the end of the 3-month program showed marked improvement compared with the baseline assessment. That this improvement remained stable over 6 months indicates the success of the educational process.

Curriculum↗
PubMed2006

www.tnt-radiology.de: Teach and be taught radiology: implementation of a web-based training program based on user preferences as determined by survery.

RATIONALE AND OBJECTIVES: To create a Web-based training program addressing the needs of a large, heterogeneous audience of users. MATERIALS AND METHODS: We defined our target group as consisting of medical professionals who teach radiology, or who, by their own perception, would benefit from improving their radiologic image interpretation skills. We interviewed 483 members of this group, eliciting their preferences with regard to layout, interactivity, contents, and other categories (11 in total). Considering majority preferences as recommendations and using the help of a special interest group of medical students, we assembled 500 teaching cases over a 1-year period into an interactive training program and made it available on the World Wide Web. RESULTS: Important preferences expressed by majorities of interviewees were: high levels of interactivity, clear layout, intuitive usability, short page load times, permissibility of saving content locally, cost-free access, consideration of user input in the site development. To our knowledge, our web program TNT-Radiology, accessible at , is the first to implement all of these recommendations simultaneously. CONCLUSIONS: We have created a Web-based program usable for teaching and learning radiologic image interpretation that meets the needs of a heterogeneous target audience to an unprecedented extent.

Computer-Assisted Instruction↗
PubMed1994

A competency-based training program in early intervention.

This paper describes a federally funded training program developed to prepare entry-level occupational therapists to deliver early intervention services. The program had two phases. Phase I was designed to provide occupational therapy supervisors with advanced skills for supervising and teaching the students about the provision of early intervention services. These skills were specific supervisory strategies and learning techniques designed to facilitate optimal communication between the student, the supervisor, and the academic faculty members, as well as to facilitate consistency of information between workshops and practices in the clinic. Phase II involved a 12-week clinical fieldwork experience for the students in an early intervention program combined with didactic programs at the university. Both supervisors and students provided feed-back on the program. Supervisors reported that the training strengthened their supervisory skills and techniques. Students reported that the training helped them to clarify the role of occupational therapy in early intervention and that they had developed skills critical to providing family-centered early intervention. These skills included both providing direct treatment to children and working in partnership with families and caregivers.

Adolescent↗
PubMed1983

A survey of cleft lip and palate surgery taught in Plastic Surgery Training Programs.

A mail survey was used to document the surgical methods for repair of cleft lip and palate being taught in Plastic Surgery Training Programs. The survey was completed by Senior Residents representing over 80% of the training programs in the United States. The results demonstrate that variation exists regarding methods and techniques for cleft lip and palate surgery.

Age Factors↗
PubMed1991

Effects of a resistive training program on lipoprotein--lipid levels in obese women.

The purpose of this study was to determine the effects of a resistive training program on the time course of changes in strength, body mass index, lipids, lipoproteins, and apolipoproteins in sedentary obese women. Sixteen sedentary obese women strength trained 3 times . wk-1 for 12 wk performing three sets of six to eight repetitions per set with sets 1 and 2 at 60-70% of one-repetition maximum. During set 3, the subjects used the greatest weight possible so that failure occurred between six to eight repetitions. Six sedentary obese women served as controls. Blood samples for serum total cholesterol (TC), high-density lipoproteins (HDL-C), low-density lipoproteins (LDL-C), triglycerides (TG), TC/HDL-C ratio, apolipoprotein A-I (apo A-I), and apolipoprotein B-100 (apo B-100) were obtained pre, and after 4, 8, and 12 wk of training and approximately 3-4 d following the last training session. A 3-d dietary record was obtained on all subjects pre and post, and subjects were instructed not to alter their diet. The 12 wk of resistive training did not result in a significant change in body weight, BMI, or total kilocalories consumed per day but did show a mean improvement of 58% in muscular strength (P less than 0.05). The training program did not significantly alter the TC, HDL-C, LDL-C, TG, TC/HDL-C ratio, apo A-I, or apo B-100 levels, which suggests that this increase in strength owing to resistive training in the absence of body weight loss did not alter the lipid profiles in these sedentary obese women.

Adult↗
PubMed1977

Cross-sectional and longitudinal evaluations of an endurance training program.

A comparison of the cardiorespiratory responses obtained using both a longitudinal and cross-sectional evaluation of an endurance training program was made in two groups of 60 young male military personnel. Both groups were initially tested (T1) and then retested 6 months later (T2). At T1, Group I was a sample of personnel not participating in a training program while Group II had undergone a 5-month endurance program (2-4 mile run/day). At T2, Groups I and II had been participating in the program for 6 and 11 months, respectively. Testing consisted of sub-maximal and maximal determinations of VO2, VE and heart rate (HR) using an interrupted treadmill test. VO2 max was 11% greater in Group II compared to Group I at T1 and increased 10% in Group I at T2. Similar results were also seen for HR submax, HR max and VE max. These results show that similar values indicative of an improved level of cardiorespiratory fitness can be obtained using either a cross-sectional or longitudinal design when relatively homogeneous groups are studied.

Adolescent↗
PubMedDate not supplied

A patient care training program for volunteers.

Properly trained and interested volunteers can perform basic nursing skills in a clinical setting. Staff development educators should 1) assess the needs of the area; 2) assess the skills of the volunteers available to them; 3) construct goals and objectives for a thorough orientation program geared to people with nonmedical backgrounds; 4) select appropriate course content and methods of presentation based on the framework provided by the goals and objectives and on the regulations governing the institution in which the volunteer will work; 5) implement the course; and 6) evaluate the adequacy and thoroughness of the program and the competency of the volunteers trained. The potential service that qualified and adequately trained volunteers could offer in patient care areas that are understaffed in nursing personnel is great. Similar programs can be used to supply needed assistance in facilities with limited nursing personnel.

Ambulatory Care↗
PubMed2003

[Postgraduate training program in laboratory medicine at a clinical teaching hospital].

The Tenri Hospital resident system was introduced in 1976 and the training program for laboratory medicine began in 1982. Thus, the author proposes goals for the the future on the basis of experience. It is appropriate that trainees study emergency tests, blood transfusion and microbiology(particularly Gram's stain and sputum culture) as practical matters, and in addition to these, learn how to reply to consultations from physicians, learn the laboratory flow(so-called laboratory system), and announce interpretations of laboratory data at reversed clinical pathological conference(R-CPC). The objectives of these training programs are to gain skills for appropriate laboratory utilization and interpretation, and develop communications and consultations with clinical pathologists and medical technologists. The key points of success in the training are close cooperation of the laboratory and teaching divisions. Particularly, cooperation with medical technologists is necessary, and it is essential medical practice for trainees because they will have to work with them in future. Finally it should be emphasized that there training has a limited effect because of the short duration. It is thus important to communicate and discuss clinical matters regularly in medicine.

Education, Medical, Graduate↗
PubMed1982

Diagnostic laparoscopy for infertile patients as a training program.

During a 3-year period, 2650 cases of diagnostic laparoscopy were performed on selected infertility patients in a training program on gynecologic laparoscopy at hospitals in Egypt, the Sudan and Saudi Arabia. All cases were attended by the senior author. Most of the procedures were performed by physicians who either had never performed the procedure or had not had significant experience with it. This report presents the laparoscopic findings, complications and problems encountered. It shows that with emphasis on equipment care and handling, careful patient selection and observation of simple precautions during and after the operation, the procedure can be safely included in the training program of residents in obstetrics and gynecology.

Female↗