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NIH-FDA Analgesic Drug Development Workshop: translating scientific advances into improved pain relief.

Analgesic drug development as currently undertaken is limited by a number of factors that contribute to the paucity of new analgesics introduced into clinical practice despite marked advances in delineating of the molecular-genetic mechanisms contributing to acute and chronic pain. The participants in this workshop explored the unmet need in analgesia and recommended strategies for enhancing analgesic drug development in the future. The workshop concluded that translating scientific advances into improved pain relief will require new thinking and a cooperative effort among the pharmaceutical industry, regulatory agencies, funding agencies, the biomedical research community, professional societies and clinicians. The workshop also recommended that a better understanding of the epidemiology of pain could contribute to improvement in clinical trial methodology and outcome measures.

Analgesics↗

Evaluation of a hands-on workshop as a teaching tool for critical care medicine.

Many medical students have difficulty correlating the principles of cardiorespiratory physiology with the practice of critical care medicine. We developed a workshop to make this transition easier. After a computer-administered preworkshop test, groups of four students intubated a dog, and inserted arterial, peripheral, and pulmonary artery catheters. After baseline cardiorespiratory variables were measured, noncardiogenic pulmonary edema was created by administration of oleic acid via the right atrial port of the pulmonary artery catheter. Measurements were repeated after equilibration and again during the application of 5, 10, and 15 cm H2O of positive end-expiratory pressure. Monitoring techniques and calculation of physiologic variables and their significance were stressed; emphasis was also placed on the interrelationship between respiratory and cardiovascular manipulations. The educational validity of this workshop was confirmed by a significant improvement in the mean score of a post-workshop test over the mean preworkshop test score.

Anesthesiology↗

International collaborative workshops. A 6-year partnership between Canada and China.

Interprofessional exchanges such as workshops are common activities in international development programs. The authors describe processes used to select, implement, and evaluate six collaborative workshops held in Tianjin, China, between 1990 and 1995. These workshops targeted curricular change for a baccalaureate nursing program in Tianjin Medical University. Our experience highlights the importance of understanding the assumptive base for change, developing an institutional memory in both partner universities, introducing interactive teaching methods congruent with Chinese value systems, and using a formative evaluation strategy to foster cross-cultural dialogue and mutual understanding among project partners.

Canada↗

A charge nurse workshop based on research.

The authors describe a charge nurse workshop based on a qualitative research study of charge nurse competencies and a commitment to include all levels of staff in the planning process. The workshop met the needs of nursing staff to have an interactive, educational experience that addressed leadership, human relations, and team-building skills needed for the charge nurse role and was fun. Evaluation of the workshop with lessons learned also is presented.

Clinical Competence↗

Ninth Japanese-German Workshop on Molecular and Cellular Aspects of Carcinogenesis, Essen, Germany, 18-20 September, 2003.

The Japanese-German Workshops "Molecular and Cellular Aspects of Carcinogenesis," held biennially since 1987, have been organized traditionally at the University of Essen Medical School and West German Cancer Center Essen in Germany. This 9th Workshop was held on September 18-20, 2003. It was generously supported by the Cancer Research Program of the Ministry of Education, Culture, Sports, Science and Technology and the International Cooperation Program for the 2nd Term Comprehensive 10-Year Strategy for Cancer Control of the Ministry of Health, Labour and Welfare on the Japanese side, and by the Deutsche Forschungsgemeinschaft (DFG) on the German side. Additional support from many other sponsors in Germany and Japan is gratefully acknowledged. The Workshop participants are listed at the end of this Report.

Animals↗

Joint report of the First International Workshop on Lymphocyte Alloantigens of the Horse held 24-29 October 1981.

Six equine lymphocyte alloantigen (ELA) specificities were defined by an international antiserum comparison test and workshop held in 1981. Twelve laboratories from four countries submitted 195 antisera for analysis. The antisera were exchanged among the 12 laboratories and tested in a standard lymphocyte microcytoxicity assay against the isolated lymphocytes at 1009 horses of several breeds. The data was pooled and analysed by a single computer analysis. The calculated chi 2 values of all cells with all antisera provided comparisons between antisera. Fifteen antisera clusters were formed by this analysis, but only six of these clusters met the criteria established by the workshop for the identification of ELA antigens. No horses of the cell panel positively reacted with more than two of these six specificities. The consensus of the participants, although not substantiated in this workshop, was that these six clusters of antisera define alleles of a single genetic region, the ELA region, and it is likely that this genetic region is the major histocompatibility complex of the horse.

Animals↗

Joint Report of the Fourth International Bovine Lymphocyte Antigen (BoLA) Workshop, East Lansing, Michigan, USA, 25 August 1990.

Blood samples from 54 animals were exchanged between 15 laboratories in nine countries to improve and expand BoLA class I and class II typing. A total of 27 out of 33 (82%) of previously accepted BoLA-w specificities were represented within the cell panel. Seventeen new serum-defined BoLA specificities were accepted by the workshop participants, thus expanding the number of internationally recognized BoLA specificities to 50. The large number of new specificities detected resulted from the number of serological reagents used (n = 1139) and the genetic diversity of the cell panel. Confidence derived from the high percentage of agreement between the laboratories on antigen detection (97.3%; r = 0.84) permitted the removal of the workshop (w) notation from 23 BoLA-w specificities and their acceptance as full status BoLA-A antigens. Two new non-BoLA antigens were also detected, one completely included within the red blood cell factor S' (BoLy-S'), whereas a second (BoLy-w1) did not show any association with tested red blood cell factors. A comparison between serological, isoelectric focusing (IEF) and DNA typing for BoLA class II polymorphism was conducted with a subset of workshop cells. Correlation between the three methods was significant for three combinations of alleles. Three other serologically defined class II specificities were correlated with DR and/or DQ restriction fragment length polymorphism (RFLP) types, whereas six additional IEF types were correlated with DR and/or DQ RFLP types (r greater than or equal to 0.50). Several new IEF, DRB, DQA and DQB RFLP patterns were identified. In 46 animals that were typed for BoLA-DR and DQ genes by RFLP analysis, 46 different BoLA haplotypes were tentatively defined. These 46 haplotypes were distinguished by 31 serologically-defined BoLA-A alleles (and 2 'blanks'), 15 DRB RFLP types (plus up to 10 new DRB RFLP patterns) and 23 DQA-DQB haplotypes.

Animals↗

The planning of a clinical trials workshop.

The groundwork involved in the planning and running of a Clinical Trials Workshop using a computerized simulation exercise called 'Instant Experience' is described in detail. 2. Groups of six or seven students, each with an experienced tutor, are set the problem of designing a clinical trial protocol for a given drug. By using a computer programme, results can be generated for these designs according to pre-set rules laid down by the organizers. 3. The game itself acts as a vehicle for emphasizing the practical and theoretical problems associated with clinical trials. Further valuable information can be imparted during the group discussion periods when the trial design is being developed and during analysis of the results. 4. Limitations of this type of workshop include the need for students to have a working knowledge of clinical medicine and pharmacology, the competence of the tutors and organizers and the technical problems associated with computers and a comparatively rigid computer programme. 5. The value of this type of workshop lies in its ability to allow students to apply themselves to practical problems in clinical trials and to make mistakes with no harm to the patient.

Computer-Assisted Instruction↗

The Priory Parents Workshop.

The workshop was a successful attempt to to meet the needs of parents of handicapped children. Using a multidisciplinary team the 16-session workshop enabled both parents and professionals to discuss the problems associated with handicapped children and possible practical solutions. The unique approach of the Priory Workshop could be the prototype for future community services to help the mentally hanidcapped.

Adult↗

Description and evaluation of a brief workshop run by child psychiatrists for a group of speech therapists to help them in their work with disorganized families from a deprived city area.

Speech therapists working with children in a deprived inner city area expressed concern to the local child psychiatrists that they were used to 'fill gaps between families and other services in the absence of either the time or the appropriate training, and were unable to use their skills appropriately'. This paper describes three afternoon workshops run by child psychiatrists in which the speech therapists explored some of the issues involved in seeing disorganized families with disturbed children. The effectiveness of the workshop is evaluated and it is postulated that other primary care workers such as health visitors might benefit from similar workshops.

Child↗

An evaluation of a workshop for teachers of nursing by comparing the members' expectations with their opinions of the outcome.

Fifty-seven teachers of nursing, who comprised 42 women and 15 men and who also comprised 12 senior tutors, 16 nurse tutors and 29 clinical teachers, participated in a study to evaluate a workshop which they attended. The method of inquiry used was that of a survey by questionnaire. Two questionnaires were used, one being set at the beginning of the workshop and the other at the end of the proceedings. The learning objectives for the workshop were used as the questionnaire items and comprised 20 in all. When the before and after scores relating to the questionnaire items were compared through the use of t tests significant differences were found on 12 out of the 20 objectives. In the course of the paper the differences found are identified and discussed. Some of the limitations of the method of inquiry used are discussed and finally some conclusions are reached.

Education, Continuing↗

Workshops in personal relationships.

This paper describes the planning, implementation and evaluation of a series of workshops for practising health visitors, as one aspect of continuing professional education. The history demonstrates response to stated need. Planning was intensive and extensive, resulting in one broad educational objective and a flexible approach to teaching/learning, contributions of expertise from several disciplines proved valuable. Prior to full implementation, experimental workshops were organized and evaluated both objectively and subjectively. The variety of methods of evaluation permitted isolation of some factors which mitigate against success and their avoidance when possible. The objective evaluations used three criteria which appeared to demonstrate positive outcomes to a great extent. Evaluations of 17 workshops demonstrate the continuing value of this form of education, and the summarized response shows, inter alia, that impetus does not necessarily reduce with time. Of significance is the evidence that the results include improved professional practice and that there were increases in depth and breadth of knowledge. Additionally, there were developments of self-help and professional interest groups. Finally, the sequel should lead towards a model of training resource personnel within the NHS, the trial of the model being early in 1982.

Community Health Nursing↗

Practical audit workshops for nurses.

Six practical audit workshops were run for nurses working in the Greater Glasgow Health Board. Between 15 and 25 nurses came for a morning session and returned 6 weeks later for an afternoon session. The participants came from all grades, specialties and units across the health board. The morning session included a basic introduction to the principles and stages of the audit cycle and information on different audit methods. The majority of the time was devoted to small group discussions where individuals were able to develop their own ideas for audit projects relevant to their working situations. Together with one of the organizers, the members of the groups helped each other in the design of the different projects. Almost 65% of attenders (78 out of 122) returned 6 weeks later for the afternoon session and most had begun an audit project in the time interval. These projects were at various stages around the audit cycle. The afternoon sessions started with a talk by a nurse involved in an audit project, followed by the participants returning to their small groups to discuss the successes and problems involved in their own audits. The groups provided further support and advice based on a wide range of different experiences during the intervening time. The projects carried out were impressive both in the quality and the variety of topics covered. Ninety per cent of those attending felt that the knowledge gained from the exercise was of practical use in their own working environment. A measure of the success of the workshops was that several of the later afternoon talks were given by nurses who had attended the earlier workshops.

Education, Nursing, Continuing↗

Effects of a short educational planning workshop on attitudes of three groups of medical educators.

A series of short (3 days) educational planning workshops was held in three African faculties of medicine. The purpose of this study was to ascertain the effect of such a workshop on educational attitudes of teachers from three conservative traditional schools. An attitudes questionnaire given before and after the workshop allowed the participants to express opinions and feelings on a number of statements with a bipolar theme of teacher-orientation vs. student-orientation. The results showed that using experiential learning methods in small groups with little or no didactic presentation, it was possible in a short time to change long-held educational views of diverse groups of medical educator.

Attitude of Health Personnel↗

An evaluation of a rehabilitation workshop.

Staff awareness of the steps involved in rehabilitation was assessed before and after a multidisciplinary workshop concerned with the aims, methods and principles of rehabilitation in psychiatry. Results were compared with similar assessments derived from a matched control group which was not exposed to any educational programme. The data suggest severe limitations in staff performance on the rehabilitation problem solving task which was used. Performance was not improved by the workshop, and the limitations of staff opinion as measures of the educational value of the workshop were clearly demonstrated. These results are consistent with other findings, and demonstrate the need to evaluate educational programmes provided in the Health Services.

Evaluation Studies as Topic↗

Lectures and skills workshops as teaching formats in a history-taking skills course for medical students.

The consulting skills acquired by medical students during their training are an important determinant of their ability to conduct adequate and efficient clinical interviews. These skills comprise: the acquisition of medical knowledge and the ability to apply this; and communication skills required to obtain full, accurate clinical histories from patients and to be able to give to patients the information they need to comply with prescribed regimens. Until recently, consulting skills training has certainly not had a high profile in medical curricula, despite evidence that students do not gain sufficient expertise during their medical training. A history-taking skills course within the Austin Hospital Clinical School, utilizing mass lecture and small-group skills workshops is described. Independent evaluation of students' videotaped interviews with patients, completed before training, after mass lectures and following small-group workshops, showed that students trained in consulting skills demonstrated significant improvements in interview skills and techniques, compared with a similar group of students for whom training followed the more traditional model. Whilst there were some improvements after mass lectures, most significant gains in history-taking skills were obtained following skills workshops. Ongoing evaluation of these students will determine if these short-term improvements in consultation skills persist over their clinical training and internship.

Clinical Clerkship↗

Ninth International Histocompatibility pre-workshop testing of Dw6 HTCs. Two subtypes of Dw6.

In the scope of the cellular part of the 9th International Histocompatibility Workshop, the offered homozygous typing cells (HTCs) of several specificities have been screened in a pre-Workshop. In Leiden and Seattle all HTCs typing for "HLA-Dw6" have been tested. This implied that in both laboratories mixed lymphocyte culture (MLC) matrices were performed between the Dw6 HTCs and that all HTCs were tested as stimulator cells against a panel of heterozygous responder cells. The results clearly demonstrated that "HLA-Dw6" as defined by the different participating laboratories can be split into two major groups, Dw6.a and Dw6.b. This observation confirms and extends previous reports. None of the 9th Workshop B-cell sera could discriminate between the two presently described subgroups of HLA-Dw6.

HLA-DR Antigens↗

Measuring outcomes of a one-minute preceptor faculty development workshop.

BACKGROUND: Measuring outcomes of faculty development programs is difficult and infrequently attempted beyond measuring participant satisfaction with the program. Few studies have validated evaluation tools to assess the effectiveness of faculty development programs, and learners have rarely participated in assessing improvement of faculty who participate in such programs. OBJECTIVE: To develop a questionnaire to measure the effectiveness of an enhanced 1-minute preceptor (OMP) faculty development workshop via faculty self-assessment and resident assessment of faculty, and to use the questionnaire to assess an OMP faculty development workshop. DESIGN AND MEASUREMENTS: We developed and tested a questionnaire to assess the 5 "microskills" of a OMP faculty development program, and performed faculty self-assessment and resident assessment using the questionnaire 6 to 18 months before and 6 to 18 months after our experiential skills improvement workshop. PARTICIPANTS: Sixty-eight internal medicine continuity clinic preceptors (44 control and 24 intervention faculty) at a university, a veteran's affairs hospital, and 2 community internal medicine training sites. RESULTS: Twenty-two participants (92%) completed pre- and postintervention questionnaires. Residents completed 94 preintervention questionnaires and 58 postintervention questionnaires on participant faculty. Faculty reported improvement in behavior following the intervention. Residents reported no significant improvements in faculty teaching behaviors following the intervention. CONCLUSION: We attempted to rigorously evaluate a faculty development program based on the OMP. Although the intervention did not show statistically significant changes in teaching behavior, we believe that this study is an important step in extending assessment of faculty development to include resident evaluation of participating faculty.

Data Collection↗