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PubMed2002

An evaluation plan to assess the process and outcomes of a learner-centered training program for clinical research.

In 1994, the National Center for Research Resources' Committee on Addressing Career Paths for Clinical Research reported that insufficient training in research methods, inadequate mentoring, and inappropriate timing of training presented major barriers to the development of clinical researchers. The National Institutes of Health responded to the need for additional training programs by supporting 57 institutions through the Clinical Research Curriculum Award (K30) Program. The ability to assess the success of these programs depends on the nature and extent of their evaluation plans. Evaluation plans for clinical research training programs should include means of assessing both process and outcomes of a program's implementation in its formative and summative stages. This article describes the University of Wisconsin-Madison's Clinical Investigator Preparatory Program and an evaluation plan that incorporates process and outcome assessments based on a theoretical framework of adult and professional education.

Adult↗

PubMed2006

Sources of information on postgraduate medical training programs and medical specialty career resources-2006 update.

This is the final biennial update listing directories, journal articles, Web sites, and general books that aid the librarian, house officer, or medical student in finding information on medical residency and fellowship programs. The World Wide Web provides the most complete and up-to-date source of information about postgraduate training programs and specialties. This update continues to go beyond postgraduate training resources to include selected Web sites and books on curriculum vitae writing, practice management, personal finances, the "Match," certification and licensure examination preparation, lifestyle issues, job hunting, and the DEA license application process. Print resources are included if they provide information not on the Internet, have features that are particularly useful, or cover too many relevant topics in depth to be covered in a journal article or on a Web site. The Internet is a major marketing tool for hospitals seeking to recruit the best and brightest physicians for their training programs. Even the smallest community hospital has a Web site.

Education, Medical↗

PubMed2005

STAR: a dementia-specific training program for staff in assisted living residences.

PURPOSE: This article describes, and provides data on, an innovative, comprehensive, dementia-specific training program designed to teach direct care staff in assisted living residences to improve care and reduce problems in residents with dementia. DESIGN AND METHODS: STAR-which stands for Staff Training in Assisted living Residences-provides two 4-hr workshops augmented by four individualized on-site consultations and three leadership sessions. Developed by means of an iterative process of implementation and revision, it was then evaluated in a small randomized controlled trial. A total of 114 staff and 120 residents in 15 residences participated. RESULTS: STAR was exceptionally well received. Training details are provided with a discussion of unique challenges inherent in implementation. Following training, STAR residents evidenced significantly reduced levels of affective and behavioral distress compared with control residents. Furthermore, STAR residents improved whereas control residents worsened (p < .05). Staff with STAR staff training reported less adverse impact and reaction to residents' problems (p < .05) and more job satisfaction (p < .10) compared with control staff. IMPLICATIONS: STAR is an effective training program for direct care staff working with dementia residents in assisted living. The importance of continued development and investigation of STAR efficacy and effectiveness is underscored by the growing numbers of residents with dementia who are receiving care in these settings.

Assisted Living Facilities↗

PubMed1984

The California Statewide Family Health Education and Training Program 1981-1982.

Through support from the California State Department of Health Services, San Diego State University continued a statewide program in family life education, which consisted of: 1) establishment of a statewide advisory committee representative of many diverse points of view; 2) performance of a study of the teaching of family life education in the ninth and 10th grades of public schools in the state, as well as an examination of the present status of training of teachers; 3) provision of consultation and training programs for local school districts, including community support and implementation training, program development consultation teacher training and a limited number of small block grants to improve local family life education program efforts; and 4) preservice education classes to be conducted at teacher preparation campuses in the California State University system. The paper describes some of the findings of the study of the ninth and 10th grades, as well as the details of methodology of all four components of the statewide program.

California↗

PubMed1992

The effects of a six-week, low-intensity Nautilus circuit training program on resting blood pressure in females.

Twenty-six healthy, untrained females were studied to determine the effects of a low-intensity Nautilus circuit training program on resting systolic and diastolic blood pressure. Thirteen subjects who were in good health with no personal history or family history of cardiovascular disease participated in a six-week training program on the Nautilus circuit (14 exercises) and trained at 30% of maximum. Measurements in blood pressure were made before, during (three times per week) and after the study. Another group of 13 females served as controls. An attempt was made to determine if strength increase (due to circuit training) would have an affect on reducing resting systolic and diastolic blood pressure. The following changes occurred in the treatment group: (1) resting systolic blood pressure dropped significantly (from 113 to 99 mmHg) after training and (2) diastolic blood pressure dropped significantly from (70.9 to 62.0 mmHg) after training. However, there were no differences in these decreases between the exercise and control groups. The investigators concluded that low-intensity, resistive training should not increase blood pressure in white, healthy females, ages 18 to 28 years.

Adolescent↗

PubMed1980

The evaluation of a training program for improving residents' teaching skills.

As a response to the growing recognition of the need for improvement in medical instructional practices, a training program on teaching skills for resident physicians in the East Tennessee State University College of Medicine was implemented. The program consisted of 13 weekly, one-hour, small-group sessions attended by 20 residents. The microteaching method was utilized for practicing instructional techniques. Significant gains in teaching performance and in attitude toward participating in a teaching skills program were demonstrated, on the basis of videotaped teaching performances and a written questionnaire, indicating that short training programs can assist physicians in the process of instructional improvement.

Attitude of Health Personnel↗

PubMed2001

The effects of a 20-week exercise training program on resting metabolic rate in previously sedentary, moderately obese women.

The present study was designed to investigate the effects of exercise training on resting metabolic rate (RMR) in moderately obese women. It was hypothesized that exercise training would increase resting metabolic rate. Nineteen previously sedentary, moderately obese women (age = 38.0 +/- 0.9 years, percent body fat = 37.5 +/- 0.8) trained for 20 weeks using either resistance training (RT) or a combination of resistance training and walking (RT/W). The high intensity resistance-training program was designed to increase strength and fat-free mass and the walking program to increase aerobic capacity. There was also a non-exercising control group (C) of 9 subjects in this study. Fat-free mass was significantly increased in both the RT (+1.90 kg) and RT/W (+1.90 kg) groups as a result of the training program. No group showed significant changes in fat mass or relative body fat from pre- to post-training. Aerobic capacity was slightly, though significantly, increased in the RT/W group only. The RT group showed a significant increase (+44 kcal x day(-1)), while the RT/W group showed a significant decrease (-53 kcal x day(-1)) in resting metabolic rate post-training. RT can potentiate an increase in RMR through an increase in fat-free mass, and the decrease in RMR in the RT/W group may have been a result of heat acclimation from the walk training.

Adipose Tissue↗

PubMed2000

Adaptation to a standardized training program and changes in fitness in a large, heterogeneous population: the HERITAGE Family Study.

PURPOSE: This paper describes the variations in response to a standardized, computer-controlled training program. METHODS: Steady-state heart rate (HR) and oxygen intake (VO2) of 614 healthy, sedentary men and women aged 16-65 yr were measured during three cycle ergometer exercise tests. The HR associated with 55, 65, 70, and 75% of each subject's pretraining VO2max was used to prescribe exercise intensity. Subjects exercised three times a week, beginning at a HR associated with 55% VO2max for 30 min. Duration and intensity was gradually increased over 20 wk of training. The duration and HR of each training session were controlled by a computer. RESULTS: Using the linear relationship between HR, VO2 and power output (PO), PO were predicted for each of 60 training sessions at the respective programmed HR. The average ratio of the actual training HR to programmed HR was 0.99. It was hypothesized that participants whose actual training PO exceeded their predicted PO would improve VO2max more than those whose actual PO was less than their predicted PO. Using the ratio of actual/predicted PO determined after the training was over, participants were arbitrarily assigned to three groups: 128 participants had low (LO) ratios (0.65-0.84), 408 had average (AV) ratios (0.85-1.14), and 78 had high (HI) ratios (1.15-1.34). Secondary analysis showed that the training program significantly increased mean VO2max of all three groups. Those who had a smaller increase in training PO (LO) had significantly less increase in VO2max than those with larger increases in PO (HI). CONCLUSION: People who exercise at a HR associated with the same %VO2max can vary substantially in their training PO, in their rate of increase in PO over a 20-wk training program, and in improvement of their VO2max.

Adaptation, Physiological↗

PubMed2001

Health and safety organizing: OCAW'S worker-to-worker health and safety training program.

In 1987, the Oil, Chemical, and Atomic Workers International Union (OCAW) was funded as one of the original eleven awardees of the Superfund Worker Training Program of the National Institute of Environmental Health Sciences. The OCAW, with the Labor Institute, developed a hazardous waste worker and hazardous materials emergency responder health and safety training program that was specific to its members in the represented industries. A social history is developed to explore a union-led, worker health education intervention. The program sought to develop worker-trainers who would conduct the training, using the Small-Group Activity Method, participate in curriculum development, and ultimately use health and safety training as a vehicle for identifying, developing, and mobilizing health and safety activists among the membership. Although the direction for this effort came from progressive leadership, it arose from the political economy of labor/management relations within specific industrial sectors.

Journal Article↗

PubMed2000

A preliminary evaluation of emergency ultrasound in the setting of an emergency medicine training program.

In this article we seek to evaluate the diagnostic accuracy of emergency physicians performing emergency ultrasonography in the setting of an emergency medicine training program. A prospective observational study was performed at an inner city Level I trauma center with an emergency medicine residency training program. From July 1994 to December 1996 a convenience sample of ultrasound exams was recorded. The diagnostic quality ("acceptable or technically limited") was determined by a board-certified cardiologist or radiologist with fellowship training in ultrasonography. The emergency department interpretations were then compared to those of the blinded cardiologist or radiologist. Four hundred and fifty-six ultrasound examinations were videotaped and entered into the study; 408 (89%) of the studies performed were determined to be "acceptable." The diagnostic accuracy (sensitivity, specificity, positive and negative predictive values) of these studies were as follows: cardiac, to rule out effusion (n = 67; 0.83, 0.98, 0.88, 0.98); transabdominal, to rule out abdominal aortic aneurysms (AAA), cholelithiasis, or free peritoneal fluid (n = 263; 0.91, 0.89, 0.88, 0.92); renal, to rule out hydronephrosis (n = 45; 0.94, 0.96, 0.94, 0.96); pelvic, to rule in intrauterine pregnancy (n = 33; 1.0, 0.90, 0.96, 1.0). The 48 "technically limited studies" included: 39 transabdominal (33 gallbladder, 1 abdominal aortic aneurysm, 5 free peritoneal fluid), 6 cardiac, 2 renal, and 1 pelvic ultrasound. This study suggests that emergency physicians with a minimal amount of training display acceptable technical skill and interpretive acumen in their approach to emergency ultrasonography.

Clinical Competence↗

PubMed1996

Action on worksite health and safety problems: a follow-up survey of workers participating in a hazardous waste worker training program.

In it's worker health and safety training program, the California-Arizona Consortium aims to promote worker action to improve health and safety conditions. To assess action on worker-identified health and safety problems, 278 trainees were interviewed 3-8 months after training. Associations with three outcomes were analyzed: (1) attempted action, (2) problem correction, and (3) trainee participation. Perceived management support was associated with all three outcomes, pointing to its key role in maximizing the impact of training. Odds of attempted action were 2-5 times greater with support than without. Trainees for whom English was not the primary language (mostly Spanish speakers) attempted action as often as English speakers. However, the odds of their correcting problems were half that of the English-speaking workers. It is suggested this was due to a perceived lack of control over organizational resources for change, not simply due to communication barriers.

Arizona↗

PubMed1983

Cardiac dimensions in athletes in relation to variations in their training program.

The cardiac dimensions of male long-distance runners (LDR) and cycle racers (CR) were determined echocardiographically during four different training seasons, i.e., a preparation, a competitive, a slowing-down and a resting season, and were compared with those of control subjects (CS). Left ventricular hypertrophy (LVH) was also assessed from the electrocardiogram. The maximal aerobic performance was determined on a bicycle ergometer. In the athletes, left ventricular mass was significantly greater in all seasons than the values in the CS. This difference resulted from a thicker interventricular septum and left ventricular posterior wall as well as a larger left ventricular internal diameter. The existence of LVH was confirmed by the electrocardiographic findings. No differences were observed between the four different training seasons, despite considerable changes in the training program for weeks to months. The maximal aerobic performance test in LDR showed a significantly higher workload during the competitive than during the preparation season. The CR reached significantly lower values during the resting season than during the other seasons. The results indicate that the possible adaptation of the cardiac dimensions to variations in the heaviness of the training program is relatively slow.

Adolescent↗

PubMed2003

Comparison between linear and nonlinear in-season training programs in freshman football players.

The purpose of this study was to compare linear (LT) with nonlinear (NL) in-season training programs in freshman football players during the course of 2 separate seasons. During the first year (n = 14, mean +/- SD = 177.3 +/- 4.8 cm, 88.0 +/- 9.7 kg), the LT program was employed 2 days per week. In the second year (n = 14, 175.0 +/- 7.1 cm, 94.2 +/- 20.5 kg), a 2 days per week LT was used. Subjects were tested for maximal strength in the squat (1 repetition maximum [1RM]) and bench press (1RM) exercises. A significant improvement in 1RM squat was seen in LT, but not in NL. No significant improvement in 1RM bench press was seen in either group. A significant difference between LT and NL was observed in Delta1RM squat (13.8 +/- 7.4 kg compared with 1.6 +/- 2.6 kg, respectively). Results of this study suggest that LT may be more effective in eliciting strength gains than NL in freshman football players during an in-season training program.

Adolescent↗

PubMedDate not supplied

Opinions of practitioners and program directors concerning accreditation standards for postdoctoral pediatric dentistry training programs.

PURPOSE: This study was performed to assess opinions of program directors and practitioners about the importance and necessary numbers of experiences required by current accreditation standards for training of pediatric dentists. METHODS: A 32-item questionnaire was sent to all program directors of ADA-accredited postdoctoral pediatric dentistry training programs and to a random sample of 10% of the fellow/active membership of the American Academy of Pediatric Dentistry. RESULTS: An overall response rate of 56% was obtained from the single mailing. Practitioners and program directors differed significantly (P < or = 0.05) only in their opinions about the number of submucosal and intravenous sedation cases required for proficiency of eight experiences surveyed. The two groups differed significantly in 3 of 12 areas in terms of importance attributed for practice of contemporary pediatric dentistry: initiating and completing a research paper, biostatistics/epidemiology, and practice management. Program directors had little difficulty obtaining required experiences, and program dependence on Medicaid did not negatively affect quality of education. CONCLUSION: Practitioners and program directors agreed on the importance of most experiences and activities required by current accreditation standards.

Accreditation↗

PubMed1976

Designed experience: a multiple, goal-directed training program in family therapy.

A family-therapy training program, one of three main branches of the "Boston model," is described in detail. Salient features of the program include planned integration of a multiplicity of experiential and cognitive learning modes; grounding in a unified, theoretical framework that is neither eclectic nor limited to a single school of thought; focus on nonpathological process in families; and systematic structuring in terms of specific, articulated, training objectives. The goal-directed design process by which training units are developed is explained.

Affect↗

PubMed2005

Teaching behavioral pain management to healthcare professionals: a systematic review of research in training programs.

UNLABELLED: Pain is a common and potentially debilitating condition. Whereas there is vast literature on developmentally appropriate behavioral techniques for pain management, results of curriculum evaluations and knowledge surveys reveal a dearth of awareness of these strategies in healthcare professionals. As a result, the development and evaluation of pain management training programs are important endeavors. Results of studies evaluating such programs are promising and suggest that training might be an effective means of impacting healthcare professionals' knowledge, attitudes, and even patient care. These results must be interpreted with caution, however, because the literature contains several conceptual and methodologic limitations. These limitations, in combination with the wide diversity in program components, format of delivery, and research methods, preclude definitive conclusions on the most practical and effective means to provide training. To address this question, further systematic work on the development and evaluation of pain management training programs is warranted. PERSPECTIVE: To address the problems of dissemination of behavioral pain management techniques, the development and evaluation of pain management training programs are important endeavors. The current article presents a systematic review of studies evaluating such programs and provides recommendations for future systematic work in this area.

Behavioral Medicine↗

PubMed1992

Physically aggressive elderly: a social skills training program.

The present investigation utilized a social skills training program to eliminate physically aggressive behavior in a group of six institutionalized elderly patients. The treatment package consisted of instructions, modeling, role playing and feedback. Dependent measures included confirmed incidents of physically aggressive behavior monitored across an ABAB design with a 5-month follow-up period. Results indicated that physically aggressive behavior can be significantly decreased in a group training setting and subsequently generalized to ward and other socialized behavior. Ancillary aspects of the study include the differential properties associated with physical and verbal aggression, the role of vicarious reinforcement on behavior, and generalization effects.

Aged↗

PubMedDate not supplied

Development of a standardized training program for the Hamilton Depression Scale using internet-based technologies: results from a pilot study.

Poor inter-rater reliability is a major concern, contributing to error variance, which decreases power and increases the risk for failed trials. This is particularly problematic with the Hamilton Depression Scale (HAMD), due to lack of standardized questions or explicit scoring procedures. Establishing standardized procedures for administering and scoring the HAMD is typically done at study initiation meetings. However, the format and time allotted is usually insufficient, and evaluation of the trainee's ability to actually conduct a clinical interview is limited. To address this problem, we developed a web-based, interactive rater education program for standardized training to diverse sites in multi-center trials. The program includes both didactic training on scoring conventions and live, remote observation of trainees applied skills. The program was pilot tested with nine raters from a single site. Results found a significant increase in didactic knowledge pre-to-post testing, with the mean number of incorrect answers decreasing from 6.5 (S.D.=1.64) to 1.3 (S.D.=1.03), t(5)=7.35, P=0.001 (20 item exam). Seventy-five percent of the trainees' interviews were within two points of the trainer's score. Inter-rater reliability (intraclass correlation) (based on trainees actual interviews) was 0.97, P<0.0001. Results support the feasibility of this methodology for improving rater training. An NIMH funded study is currently underway examining this methodology in a multi-site trial.

Depression↗