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Inservice Training↗
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The effect of a feeding skills training program for nursing assistants who feed dementia patients in Taiwanese nursing homes.
A quasi-experimental 2-group repeated-measures design was used to test the impact of a feeding skills training program on 67 nursing assistants (treatment group n = 31; control group n = 36) regarding their knowledge, attitudes, perceived behavior control, intentions, and behaviors in feeding dementia patients. The treatment group received a feeding skills training program. Nursing assistants' knowledge, attitudes, perceived behavior control, and intentions were measured before (Pretest) and after the program (Posttest 1), and again 4 weeks later (Posttest 2). Nursing assistants (treatment group n = 20; control group n = 16) and the same number of dementia patients were measured on feeding behaviors during mealtimes before and after the training. The treatment group had significantly more knowledge (P < .001), greater intention to feed (P = .05), and better behaviors toward feeding dementia patients (P = .009) than the control group. There were no significant differences between the groups in attitude (P = .85), intention beliefs (P = .11) or perceived behavior control (P = .99). Thus, the intervention was effective at changing knowledge, intention, and behaviors among nursing assistants.
Adult↗
Attributes of curriculum athletic training programs related to the passing rate of first-time certification examinees.
The purpose of this study was twofold: (1) to identify attributes of athletic training programs that have been accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) as they relate to outcomes of their students on the National Athletic Training Association Board of Certification (NATABOC) examination and (2) to determine the most effective curriculum in preparing candidates for the examination. For all subjects, the following survey information was assessed: the seven domains (competencies), number of clinical rotation sites, grade point average requirement, faculty responsibilities, faculty terminal degrees, faculty K-12 experience, association with allied health schools, capstone course availability, and course examination similarities. Fifty-four subjects, representing 60% of all of the program directors of CAAHEP accredited athletic training programs, responded in this study. Data were analyzed using a general linear model procedure and regression analyses. Even domains of athletic training, variety of rotation sites, clinical responsibility of faculty, faculty terminal degrees, and faculty K-12 school experience significantly affected the passing rate of first time certification examinees. Grade point average requirement, allied health school association, course examination format, and capstone course were not related significantly to the passing rate of first-time certification examinees. The most effective curricular model included the seven domains of athletic training, faculty clinical responsibilities, and faculty K-12 work experience as related to the passing rate. Emphasizing the domains of athletic training (competencies), having a variety of rotation sites, separating clinical and academic responsibilities for faculty, and having faculty with terminal degrees and less public school experience increase the passing rate of first-time NATABOC examinees. The most effective curricular model in affecting passing rate, according to this study, includes emphasizing the seven domains of athletic training (competencies), separating clinical and academic responsibilities of faculty, and not focusing on hiring faculty with K-12 work experience. Although this article focuses primarily on athletic training education, we believe that this study can be used as a model to evaluate educational programs in other allied health, competency-based educational programs.
Allied Health Personnel↗
Where have all the cardiothoracic surgery residents gone? Placement of graduating residents by United States thoracic surgery training programs, 1998 to 2002.
OBJECTIVE: We studied the evolving job placement trends of graduating cardiothoracic surgery residents over a 5-year period from the perspective of the program director. METHODS: Graduate placement questionnaires were sent to program directors of Accreditation Council for Graduate Medical Education-accredited United States thoracic surgery residency programs (n = 92). Program directors were asked to categorize the type of job that each resident chose upon graduation (1998-2002). RESULTS: Of the program directors surveyed, 71.7% (66/92) responded, representing 76.4% (545/714) of the total graduating resident population during the study period. Three-year training programs constituted 24.2% (16/66) of the respondents and accounted for 20.2% (110/545) of the graduates. Annually, graduates most commonly chose private practice jobs. Between 2001 and 2002, the percentage of graduates entering fellowships increased (11.8% [13/110] versus 19.1% [21/110], P = .008) as the percentage of graduates choosing private practice positions decreased (56.4% [62/110] versus 45.5% [50/110], P = .15). In total, 12.8% (70/545) of the graduates pursued fellowships, with associated specialty choices being: 38.6% (27/70) adult cardiac, 37.1% (26/70) congenital, 15.7% (11/70) transplantation, and 8.6% (6/70) thoracic. There were no significant differences between 2-year and 3-year training program graduates in choice of private practice versus academic jobs. CONCLUSIONS: In 2002, a greater percentage of graduates chose to pursue fellowship training at the expense of private practice employment. This difference may in part result from fewer employment opportunities rather than graduate choice. Ongoing studies are needed to follow this trend. Annual analysis of the placement of all graduating residents would help to identify changes in employment.
Career Choice↗
Efficacy of a home-based training program for older adults using elastic tubing.
The purpose of this study was to investigate the efficacy of, and the adherence to, a 12-week home-based progressive resistance training program for older adults utilizing elastic tubing. Sixty-two adults (mean age, 71.2 years) qualified to participate in the study. Subjects were randomly assigned to either the exercise (E) (n = 31) or non-exercise (NE) group (n = 31). Pre- and post-testing included isokinetic (1.05 rad.s-1) concentric/eccentric knee extension/flexion strength testing and flexibility measures of the hip, knee, and ankle. The E group trained three times per week, performing one to three sets of 10-12 repetitions for each of 12 resistance exercises. The exercises involved muscles of both the lower and upper body. Within the E group, 25 of the 31 subjects (80.6%) completed the study. Of the E subjects completing the study adherence to the three training sessions per week was 90% (range 72%-100%). Training resistances used during workouts increased significantly with the average estimated increase being 82% (P < 0.001). The E group also demonstrated significant (P < 0.05) increases in isokinetic eccentric knee extension (12%) and flexion (10%) strength. No other significant changes were observed between E and NE groups. These results suggest that home-based resistance training programs utilizing elastic tubing can serve as a practical and effective means of eliciting strength gains in adults over the age of 65.
Aged↗
Evaluating the Accreditation Council on Graduate Medical Education core clinical competencies: techniques and feasibility in a urology training program.
PURPOSE: We describe several traditional and novel techniques for teaching and evaluating the Accreditation Council on Graduate Medical Education (ACGME) core clinical competencies in a urology residency training program. MATERIALS AND METHODS: The evolution and underpinnings of the ACGME Outcome Project were reviewed. Several publications related to the evaluation of clinical competencies as well as current assessment techniques at our institution were also analyzed. RESULTS: Several tools for the assessment of clinical competencies have been developed and refined in response to the ACGME Outcome project. Standardized patient encounters and expanded patient satisfaction surveys may prove useful with regard to assessing resident professionalism, patient care and communication skills. A feasible and possibly undervalued technique for evaluating a number of core competencies is the implementation of formal written appraisals of the nature and quality of resident performance at departmental conferences. The assessment of competency in practice based learning and systems based practice may be achieved through innovative exercises, such as practice guideline development, that assess the evidence for various urologic interventions as well as the financial and administrative aspects of such care. CONCLUSIONS: We describe several contemporary methods for teaching and evaluating the core clinical competencies in a urology training program. While the techniques described are neither comprehensive nor feasible for every program, they nevertheless provide an important starting point for a meaningful exchange of ideas in the urological graduate medical education community.
Accreditation↗
Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up.
BACKGROUND: Among female athletes it has not been established whether a neuromuscular and proprioceptive sports-specific training program will consistently reduce the incidence of anterior cruciate ligament injuries. PURPOSE: To determine whether a neuromuscular and proprioceptive performance program was effective in decreasing the incidence of anterior cruciate ligament injury within a select population of competitive female youth soccer players. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: In 2000, 1041 female subjects from 52 teams received a sports-specific training intervention in a prospective non-randomized trial. The control group consisted of the remaining 1905 female soccer players from 95 teams participating in the same league who were age and skill matched. In the 2001 season, 844 female athletes from 45 teams were enrolled in the study, with 1913 female athletes (from 112 teams) serving as the age- and skill-matched controls. All subjects were female soccer players between the ages of 14 and 18 and participated in either their traditional warm-up or a sports-specific training intervention before athletic activity over a 2-year period. The intervention consisted of education, stretching, strengthening, plyometrics, and sports-specific agility drills designed to replace the traditional warm-up. RESULTS: During the 2000 season, there was an 88% decrease in anterior cruciate ligament injury in the enrolled subjects compared to the control group. In year 2, during the 2001 season, there was a 74% reduction in anterior cruciate ligament tears in the intervention group compared to the age- and skill-matched controls. CONCLUSION: Using a neuromuscular training program may have a direct benefit in decreasing the number of anterior cruciate ligament injuries in female soccer players.
Adolescent↗
Establishment of an operating room committee and a training program to improve aseptic techniques for rodent and large animal surgery.
Investigators of our research facility generally accept the concept of asepsis as an important component of adequate surgical care for animals. However, they experience difficulties putting it into practice, especially in the case of rodents. The reasons for this are inconvenience, cost, and lack of training. To better assist investigators in the implementation of aseptic surgical techniques in their laboratories, we have created an Operating Room (OR) Committee modeled after OR committees found in human hospitals. A reconstructive surgeon, a veterinarian, a research scientist, a nurse involved in the training of OR personnel, interns, graduate students, and an animal health technician were chosen as committee members in light of their OR and animal care expertise. The first task of the OR Committee was to establish institutional guidelines for aseptic surgery, taking into account the costs imposed on research budgets by these procedures. The OR Committee also supports a complete training program in aseptic surgery techniques, which consists of lectures, a training manual, videos, and a practical course. Furthermore, when experimental procedures require specialized equipment, the OR Committee collaborates with researchers to develop strategies to achieve asepsis. This OR Committee and the training program proved to be important tools to promote and improve the quality of animal care during surgery.
Animal Care Committees↗
An interdisciplinary health team training program for school staff in Minnesota.
This paper describes an interdisciplinary health team training program for school-based clinic staff in Minnesota. The project sought to improve team functioning, level of practice, and health care services at the school sites. Participants were interdisciplinary staff members from clinics in senior high, middle, and elementary schools. The program consisted of further development in team training knowledge and skills and educational sessions on issues identified by participants. Evaluations indicated participants reported greater knowledge and improved team functioning experiences from the team training. Gains also were shown in knowledge and skills in specific school topic areas such as violence, resiliency, working with resistant families, and self-care. The program could serve as a model for other interdisciplinary school health team training.
Curriculum↗
Metabolic responses to interval training programs of high and low power output.
The metabolic responses of 30 college-aged males were compared following high power (30-sec runs with 19 repetitions-Group HP) and low power (120-sec runs with 7 repetitions-Group LP) interval training programs (8-wk, 3 days/wk). Measurements included: maximal aerobic power (Vo2max, open circuit spirometry); maximal lactacid capacity (net-LAmax, blood LA accumulation following exhaustive exercise); net energy production (net Vo2 and netLA) following a 2-min run that was exhaustive before but not following training; and maximal muscular power (stair-climbing procedure). The results indicated: 1) significant but equal increases in Vo2 max in both groups; 2) no change in either group in netLAmax; 3) net Vo2 during the 2-min run was unchanged, however, netLA was significantly greater in Group LP; 4) no changes in either group in muscular power. It was concluded that low power and high power output interval training programs elicit similar changes in maximal aerobic and anaerobic metabolism, and that the physiological and or biochemical changes responsible for lowered lactic acid production during heavy, but submaximal exercise following training are produced to a greater extent by the low power program.
Adolescent↗
Education in adult basic life support training programs.
The Panel on Educational Issues in Adult Basic Life Support Training Programs reviewed the characteristics of adult learners, aspects of educational theory, issues concerning barriers to learning and performing CPR, and issues concerning testing and evaluation. The panel made the following recommendations: a comprehensive evaluation of the basic life support program with the goal of improving the program design and educational tools must be initiated; adult programs must be designed to motivate laypersons to become trained in CPR, as well as to target relatives and friends of high-risk individuals; and emotional and attitudinal issues, including the student's reluctance to act in an emergency, must be addressed. Programs must incorporate information on the willingness of an individual to perform CPR; CPR programs must be simplified and focus on critical success factors; flexible educational approaches in programs are encouraged; flexible programming that addresses the needs of the allied health professional is encouraged; formal testing should be eliminated for layperson programs; and formal testing for health care providers and instructors should be continued.
Adult↗
Self-evaluation by house officers in a primary care training program.
Expertise in ambulatory care requires a broad range of knowledge and skills. A modified Delphi survey technique was used to delineate diagnoses, management techniques, and procedural skills in seven subspecialty areas necessary for house officers in a primary care internal medicine training program. Self-evaluation instruments were developed, and residents were asked to rate their abilities in the seven areas. At entry, the house officers generally had more confidence in their diagnostic abilities than in their management techniques and procedural skills. Progression through the training program was accompanied by increases in confidence in all areas except the behavioral sciences. The self-evaluation approach provided a longitudinal assessment of changes in the confidence of house officers throughout their training and an indication of the effectiveness of the educational program.
Ambulatory Care↗
Increasing ethnic diversity in cancer control research: description and impact of a model training program.
BACKGROUND: There is little ethnic diversity at the doctoral level among researchers in cancer control. The Minority Training Program in Cancer Control Research is designed to encourage underrepresented master's level health science students to pursue doctoral training and careers in research. METHODS: Program components include an annual 5-day summer institute, internships, and doctoral incentive awards. Intention to pursue doctoral training is measured before and after participation. Doctoral applications and enrollment are tracked through annual surveys. RESULTS: Seventy students participated during the first three years, 1999-2001. Intention to apply increased significantly for each class (year one, p %lt; 0.001; year two, p = 0.042; year three, p = 0.006). Thirty-one percent of participants have either enrolled in doctoral programs (n= 10) or report plans to apply in the next one to two years (n = 9). Over half of these students indicated that the MTPCCR had a positive influence on their plans. CONCLUSIONS: A targeted training program encourages under-represented students to pursue doctoral degrees and thus has the potential to increase ethnic diversity in public health research.
Biomedical Research↗
Residents' perceptions of communication skills in postgraduate medical training programs of Pakistan.
BACKGROUND: The importance of communication skills in postgraduate medical training is likely to be highlighted given the convergence of research and educational forces. Assessment of these skills in residency training is vital since it can provide basis for policy undertaking among Pakistani medical academia for improving postgraduate training programs. AIM: To assess the perceived status of communication skills of residents in different specialties. MATERIALS AND METHODS: A cross sectional survey was conducted in four teaching hospitals of Karachi between July 1999 and January 2001. A total of 455 residents in different residency programs were contacted. Residents registered both with College of Physicians and Surgeons of Pakistan and Postgraduate Medical Education office of selected hospitals were included in this study. Responses of residents were obtained on 5-point Likert scale. Indices were formed for three components of communication skills: informative, affective and professional communication. STATISTICAL ANALYSIS: Differences between residents' groups were assessed through analysis of variance. RESULTS: Total informative communication index was lowest for multi-disciplinary (12.05, SD = 4.87) and highest for surgical (15.27, SD = 2.51) residents. Total affective index was lowest for multi-disciplinary (12.58, SD = 5.68) and highest for medical (15.74, SD = 3.59) residents. The group differences for four groups of residency programs were not statistically significant for either professional attributes separately or for the total professional index. CONCLUSIONS: The residency programs must establish goals, process and outcomes to incorporate communication skills in postgraduate medical training since this can enhance residents' performance as effective health care providers. Accomplishment of better communication skills can be achieved if the importance of its teaching and training is valued by residency program coordinators.
Adult↗
A national survey of performance objectives of physician's assistant training programs.
A nationwide survey of physician's assistant (PA) training programs was carried out to determine the performance expected of students upon graduation. A list of tasks reflecting primary medical care problems was sent to PA program directors asking whether they expected their graduates to be able to perform the task, only to know about the task, or neither to be able to perform nor to have knowledge of the task. The results indicated that all students were expected to perform a history and physical examination. Almost all of the program directors expected students to establish a working diagnosis for the most common problems and to formulate a management plan for many of them. Extensive skills in patient education and counseling were expected. There was considerable congruence among the directors in performance expectations of students. The expected performance of the PA student by graduation emerged as comprehensive and not merely technical.
Clinical Competence↗
Use of problem-oriented medical record in psychiatry: a survey of university-based residency training programs.
A survey of university-based psychiatric residency training programs revealed that nearly one-half of them use the problem-oriented medical record (POMR) and that conversion to this system appears to be growing rapidly. Experiences with the method have in general been positive. The author identifies factors associated with successful operation of the POMR and suggests that an integrated, hospital-wide adoption of the system may be crucial.
Hospitals, University↗
The total assessment of rheumatoid polyarthritis--evaluation of a training program for physiotherapists and occupational therapists.
We evaluated a training program for physiotherapists and occupational therapists in the total assessment of patients with rheumatoid polyarthritis. Close agreement was seen between the active joint counts of the rheumatologists and 36 therapists (p2 = 0.23). In the 7 quality variables for bedside case workups, a statistically significant learning effect was seen over the 6 week period (p2 = less than 0.005). In the 10 quality variables for the case presentations at Week 6, judged at the graduate medical trainee level, mean global scores achieved were 72.5%. Therapists reported a high level of satisfaction with all components of the program.
Arthritis, Rheumatoid↗
Building a solid GLP foundation: implementing shared training programs between the QAU and study personnel.
Quality assurance representatives and study personnel are equally responsible for conducting preclinical studies in compliance with good laboratory practices (GLPs). To provide all employees with a solid understanding of GLP requirements we have implemented a system of shared training programs for the quality assurance unit (QAU) and study personnel. Biologists and chemists complete a three-phase training module that encompasses GLP history, roles and responsibilities of the QAU, and QAU procedures specific to Wildlife International, Ltd. Study directors work with experienced QA trainers and are provided mock auditing assignments, including data, reports, and in-process and facility inspections. QA personnel are in turn trained by qualified study personnel in principal scientific concepts, testing guidelines, and study procedures that will be observed when performing in-process inspections and data audits. Also, as permanent positions become available, selected individuals from the QAU may assume responsibilities in various departments as study directors or laboratory supervisors, and study directors may assume responsibilities as quality assurance representatives. At Wildlife International, Ltd., these shared training programs provide a mutual understanding and knowledge of GLP requirements and their application while promoting respect and harmony between the QAU and study personnel.
Facility Regulation and Control↗