A training program for housekeepers. 6. Trainees put their training into practice.
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Hospital Administration↗
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Attitudes of program directors toward women in pediatric dentistry training programs.
The number of women entering pediatric dentistry graduate programs is increasing. A formal survey was conducted in the fall of 1990 to determine what impact, if any, this increase is having on the programs. The survey sample consisted of the 57 pediatric dentistry graduate program directors from the United States and Canada. The survey form included program data about gender distribution in the current and previous classes, and female faculty distribution within the programs. The survey requested information about the attitudes of various groups of individuals who interacted with the residents relative to the gender of the resident and again, relative to whether the resident was pregnant. Inquiry was made concerning maternity leave policies and selected treatment scenarios involving pregnant residents. Finally, questions were asked about motivational factors, personal priorities, and policy change for female vs. male residents. Fifty forms were returned for a return rate of 88%. The 48 forms analyzed revealed that 52% of current classes are female and 51% of applicants for 1991 were female. Women comprise 23% of full-time and 26% of part-time faculty. There was no single issue perceived by program directors as a group to be a significant concern or problem relating to gender. Program directors would consider removing pregnant females from contact with combative patients (83%) and environmental hazards (85%), but fewer would consider removing them from contact with for HIV+ or Hb+ patients.
Administrative Personnel↗
National Study of Internal Medicine Manpower: XIX. Trends in internal medicine residency training programs.
The National Study of Internal Medicine Manpower (NaSIMM) reports on the results of its 1989-1990 census of residency programs. The results are integrated into an organizational model identifying inputs, process, outputs, and environment of medical training programs. The number of residents entering internal medicine continues to grow at a relatively rapid pace. This growth is largely accounted for by foreign citizens who are graduates of foreign medical schools (AFMGs). Residents are spending an increasing proportion of their time in ambulatory care settings, but, thus far, this ambulatory care training has occurred primarily in hospital clinics and emergency rooms. The proportion of a program's residents entering general internal medicine was found in a multiple regression analysis to be negatively associated with the number of subspecialty programs located in the training hospital, the percent of AFMG residents in the program, and the presence of a preliminary track in the program.
Career Choice↗
The Heilbronn laparoscopic training program for laparoscopic suturing: concept and validation.
BACKGROUND AND PURPOSE: More than a decade after the first description of laparoscopic nephrectomy, an increasing number of laparoscopic procedures are being performed worldwide. Nevertheless, there still exists a significant lack of standardized training programs to teach ablative and, most important, reconstructive laparoscopic operations (i.e., pyeloplasty, radical prostatectomy). We evaluated and validated a new standardized step-by-step program to improve laparoscopic skills and enable trainees not experienced in laparoscopy to perform a urethrovesical anastomosis. MATERIALS AND METHODS: In an inanimate model (pelvic trainer) with defined trocar positions, the 10 participants were exposed to six reconstructive exercises. The steps consist of improvement of hand-eye coordination (two-row metal-pin model; step I), linear and curved suturing with changing angles of the needle (chicken leg and catheter model; steps II-V), and performance of an anastomosis in a porcine bladder (step VI). Times of 3, 15, 15, 10, 20, and 30 minutes for steps I, II, III, IV,V, and VI, respectively, were defined as the goal before proceeding to the next stage. The time required to succeed in each step and the increase in the speed of suturing and knotting activities were analyzed with the Wilcoxon signed-rank test. RESULTS: After a mean of 40 hours of training, all participants were able to perform all steps within the specified times and complete an accurate urethrovesical anastomosis in 30 minutes. The time required to succeed before and after training showed a significant decrease (P < 0.05). Continual training in reconstructive procedures decreased the time needed for suturing activities by between 66.3% and 72.2%. The time needed for the knotting activities decreased by between 34.3% and 38.3%. CONCLUSIONS: Our program enabled participants not experienced in laparoscopy to increase reproducible performance in reconstructive laparoscopy. These results indicate that the challenging parts of reconstructive laparoscopy such as intracorporeal suturing can be taught using a standardized concept. This experience could be incorporated easily by every department developing a laparoscopic training program.
Anastomosis, Surgical↗
Working with the elderly: a one-year internship training program combining practice and theory.
The Golden Age Association, a 6,000-member senior center, provides educational, recreational, social, cultural, and physical activities to well, aged people. In 1983, a training program was developed to enable the center to offer new services and programs to a growing senior population during a time of budgetary restrictions. The importance of maintaining and increasing the quality of life of seniors was paramount. A program was designed to recruit and train intern/staff assistants for a practical and theoretical one-year course. They received hands-on experience in the center and participated in an ongoing gerontology course. The center's goals were to provide high-caliber workers and generate a group of skilled people to work with seniors in the center and elsewhere in the community. This article focuses on recruitment, training, job assignment, and the evaluation process. The plausibility of this type of program is explored using a nontraditional adult education model and the "teachable moment" as well as staff-intern-volunteer relationships. This program is an example of what can be done to provide service and simultaneously train future gerontology workers.
Aged↗
The effects of a hockey-specific training program on performance of Bantam players.
Few studies have attempted to identify the effects of training on performance measures related to ice hockey. The present study was designed to examine the effects of a 7-week hockey-specific training program on the on- and off-ice test performance scores of 14- and 15-year-old (Bantam) hockey players. Pre- and post-training tests of percent fat (ultrasound), center of gravity location, 40-yard dash, vertical jump, and on-ice tests of top speed, acceleration, and concerning ability were completed on 28 male subjects (16 in a training group, 12 in a control group of summer league participants). The training group showed significant improvements (p less than .01) in percent fat, top speed, acceleration, and cornering test performance whereas only percent fat was significantly improved for the control group. The results suggest that performance on tests related to ice hockey can be improved by training specifically for hockey but that performance is not affected by summer league play alone.
Adolescent↗
Do training programs work? An assessment of pharmacists activities in the field of chemical dependency.
OBJECTIVES: The primary objective of this study was to determine if a selected sample of pharmacists who had attended a chemical dependency training program were performing more chemical dependency related activities than a group of American Pharmaceutical Association (APhA) members who had not had this training. Additionally, an assessment of the perceived barriers to performing chemical dependencyrelated activities was performed. DESIGN: A confidential mail questionnaire was sent to 305 Utah School participants and 305 APhA members who had not participated in the program (See Appendix). RESULTS: Respondents who had received educational training in chemical dependency were more likely to perform the following activities: lecture to community groups and health care professionals about chemical dependency, participate in a pharmacists' recovery program, provide patients with information about treatment centers, and counsel patients about the alcohol in over-the-counter products. Respondents who had not received chemical dependency training indicated that the following barriers prevented them from taking a more active role in the chemical dependency field: lack of knowledge of chemical dependency resources in the community, unaware of how to get involved with the state recovery program, belief that involvement in the state recovery program would hurt their professional reputation, belief that chemically dependent individuals cannot be rehabilitated, and uncomfortable working with chemically dependent patients. CONCLUSIONS: Pharmacists who have attended substance abuse training programs are performing more chemical dependency activities than pharmacists who have not received training in chemical dependency. In addition, different barriers to performing chemical dependency related activities exist between pharmacists with and without training in this field.
Education, Pharmacy, Continuing↗
The implementation of postgraduate training programs through state and local resources.
A profile of implementation strategies for funding postgraduate training programs using local or state resources is described. The need for those implementation strategies as well as basic principles for successful implementation is documented. Two programs are briefly described--a University Affiliated Program (UAP) in western New York and a UAP in Missouri--as the basis for generating implementation strategies. Finally a discussion is provided reviewing the strengths and weaknesses of these strategies.
Developmental Disabilities↗
Design and dissemination of a multiregional long-term care infection control training program.
Long-term care facilities have only recently begun to receive attention in the area of infection control. A training program was developed in Nebraska to help supply practitioners with knowledge and techniques designed specifically for the long-term care environment. This program's success led to its implementation in other regions. The regional extensions of the program were designed to operate with independent faculty but standardized course materials.
Cross Infection↗
A model for improving physician performance in developing countries: a three-year postgraduate training program in Laos.
The Faculty of Medical Sciences of the National University of Laos, in partnership with Health Frontiers, an American nonprofit organization, Case Western Reserve University of Cleveland, Ohio, and Khon Kaen University of Khon Kaen, Thailand, administer a postgraduate internal medicine training program for Lao physicians. Begun in 2001, the program admits six participants per year; participants complete clinical rotations in three hospitals in Vientiane, Laos, as well as one other clinical site. The goal of the program is to prepare a core group of local physicians to deliver healthcare, and train others according to an international standard of care. The program has two exceptional features. First, the vast majority of the training takes place in Laos. This avoids the "brain drain" that can occur when nationals of developing countries train abroad. In addition, because the training uses personnel, facilities, and technology available locally, graduates are better prepared to serve the needs of the Lao people. Second, the partnership is an all-volunteer model, committed to a long-term undertaking. American-trained specialists who live in Laos are available to work with the participants on a daily basis. Participants have a long period of time to acquire, reinforce, and be tested in new knowledge and benefit from learning from American colleagues who model an evidence-based approach to medical care, while still working in local conditions. As more Lao physicians receive this level of training, the program will become locally sustainable and help break a cycle of dependency on foreign expertise within the Lao health care sector. Preliminary results suggest that the program is succeeding, and could be replicated elsewhere.
Developing Countries↗
Kabisa: an interactive computer-assisted training program for tropical diseases.
In Europe, tropical pathology is usually taught in special short courses, intended for those planning to practise in developing countries. The theoretical knowledge to be assimilated during this short period is considerable, and turning such newly acquired knowledge into competence is difficult. Kabisa is a computer-based training program for tropical diseases. Instead of concentrating on strictly tropical diseases, students are trained in recognizing diseases in patients presenting randomly in an imaginary reference hospital in a developing country. Databases are compiled by experts from experiences in various parts of Africa, Asia and tropical America. Seven languages and three levels of competence can be chosen by the student. Updating of all databases is possible by teachers who want to describe a particular setting. A 'consistency checker' verifies the internal consistency of a new configuration. The logical engine is based upon both a 'cluster' and a Bayesian logic, with built-in corrections for related disease characteristics. This correction allows calculated probabilities to stay closer to real probabilities, and avoids the 'probability overshoot' that is inherent to 'idiot Bayes' calculations. The program provides training in diagnostic skills in an imaginary second-line setting in a tropical country. It puts tropical and cosmopolitan diseases in perspective and combines applied clinical epidemiology and pattern recognition within varying sets of presenting symptoms. Students are guided in searching for the most relevant disease characteristics, in ranking disease probability, and in deciding when to stop investigating.
Belgium↗
Chinese Dementia Specialist Education Program: training Chinese American health care professionals as dementia experts.
A Chinese Dementia Specialist Education Program (CDSEP) was launched in the Greater Boston Area to educate Chinese American health care providers who lacked adequate dementia education and services. This program trained bilingual health care providers to identify, assess and serve people with dementia and their families, and raised dementia awareness in Chinese American communities. The ten-month follow-up survey documented that the sixteen graduates helped over 70 families and held 76 workshops and formal and informal discussions, reaching over 400 people. The CDSEP demonstrates that a "Train the Trainer" model is an effective approach for building dementia care capacity in community-based agencies, increasing outreach to people with dementia and their families, and for raising dementia awareness in bilingual and minority communities.
Adult↗
[Effects of a sexual assertiveness training program in high school girls].
PURPOSE: This study was done to develop an applicable training program for high school girls on sexual assertiveness. METHOD: The design combined methodological study and non-synchronized quasi experimental study designs. The participants were 174 high school girls from two schools. Two questionnaires were used, one consisted of 23 questions on self efficacy and the other, of 22 items on sexual assertiveness. The SPSS 10.0 program was used for data analysis. Experimental group 1(3 hour program) and experimental group 2(6 hour program) were received on sexual assertiveness. The sexual assertiveness program was carried out by members of the research team. There were no differences in demographic characteristics between control group, experimental group 1, and experimental group 2. RESULT: There was no significant increase in self efficacy scores in experimental group 1 over the control group, but there was a significant increase in sexual assertiveness scores in the experimental group 1 over the control group. There was an increase in self efficacy scores in experimental group 2 over the control group, but it was not significant. There was a significant increase in sexual assertiveness scores in experimental group 2 over the control group. There was no significant increase in self efficacy scores in the experimental group 2 over the experimental group 1, and there was no significant increase in sexual assertiveness scores in experimental group 2 over the experimental group 1. CONCLUSION: The results show that a 3 hour program was as effective as a 6 hour program for sexual assertiveness. Therefore, it is advisable to use a 3 hour program for clinical convenience. But further study is needed to determine the lasting effect on sexual assertiveness.
English Abstract↗
Is there gender bias toward male residents in an obstetrics and gynecology training program?
OBJECTIVE: To assess whether male obstetric and gynecologic residents experience gender bias in training for vaginal deliveries. STUDY DESIGN: We compared male and female resident training experiences in vaginal deliveries in a community hospital. Three analyses were performed: (1) total number of deliveries performed by male and female residents, (2) percentage of deliveries that male and female residents performed with female attendings, and (3) percentage of attending deliveries performed by male residents. The main outcome measure was whether male residents had limited training opportunities with female attendings as compared to female residents. RESULTS: There was no difference between male and female residents with regard to total deliveries performed per rotation. Male residents were as likely as female residents to participate in vaginal deliveries by a female attending. Conversely, female attendings were as likely as male attendings to have a male resident attend their patients' deliveries. CONCLUSION: There was no evidence of gender bias regarding male resident training opportunities in vaginal deliveries in an obstetric and gynecologic training program.
Delivery, Obstetric↗
Evaluation of clinical competence in hematology training programs.
The American Board of Internal Medicine (ABIM) has called on directors of hematology training programs to establish systems to evaluate, document, and substantiate those components of overall clinical competence considered essential for certification in the subspecialty. Many of these can be assessed only by repeated direct observations. In particular, proficiency is now required in the preparation of blood smears, bone marrow aspiration and biopsy, administration of chemotherapy, management of indwelling vascular access, lumbar puncture with chemotherapy, bleeding time, phlebotomy, and exchange transfusion. The goal of this expanded evaluation program is to ensure that the public and the profession can identify, through certification, physicians with demonstrated excellence in hematology.
Certification↗
Gender-related attrition in a general surgery training program.
BACKGROUND: Attracting and retaining highly qualified applicants to careers in surgery is a goal of residency training programs. Few studies of attrition in residency exist. This study examines the hypothesis that reasons for attrition during general surgery training are different for male and female trainees. MATERIALS AND METHODS: NRMP matching information was used to evaluate attrition rates in a categorical general surgery (CGS) residency program from 1984 through 1996. The records of all matched residents were examined to determine the association between gender and attrition outcomes. Outcome variables included: voluntary vs involuntary withdrawal and the reasons for withdrawal. RESULTS: During the study period 132 candidates matched (103 men and 29 women) into CGS positions. Of that group, 18 residents, 11 (10.7%) from the male and 7 (24.1%) from the female cohorts withdrew. Only three involuntary withdrawals occurred. Women were 2.26 times more likely to withdraw than men, a finding that is not statistically significant (P = 0. 073). Women rarely left for preference of other specialty (relative risk 0.25), whereas men were 4 times more likely to leave for this reason. CONCLUSION: These numbers suggest that women are at higher risk of leaving general surgery training than men. When women do leave, it is more likely for family reasons such as lifestyle considerations or to join a spouse in another geographic location. Such findings support the conclusion that fundamental differences exist in decisions regarding attrition between genders. National studies of attrition and the reasons for leaving are needed to develop specific strategies promoting retention for both genders.
Career Choice↗
Coping modeling problem solving versus mastery modeling: effects on adherence, in-session process, and skill acquisition in a residential parent-training program.
This trial compared two approaches used to introduce parenting skills in a residential staff training program. Fifty staff were randomly assigned to: mastery modelling in which videotaped models demonstrated new skills, coping modelling problem solving (CMPS) in which participants formulated their own solutions to the errors depicted by videotaped models, or a waiting-list control group. In both, leaders used modelling, role playing, and homework projects to promote mastery and transfer of new skills. The skills of all groups improved, but CMPS participants attended more sessions, were late to fewer sessions, completed more homework, engaged in more cooperative in-session interaction, rated the program more positively, and reported higher job accomplishment scores. These data suggest that CMPS allowing participants to formulate their own solutions may enhance adherence and reduce the resistance observed in more didactic programs.
Adaptation, Psychological↗
Physical training program in arterial hypertension. A long-term prospective follow-up.
A long-term training program was performed on 30 chronic hypertensive female patients, stages I-II, WHO criteria. The effect on blood pressure (BP) and other physiological parameters, as exercise BP, heart rate, physical working capacity, VO2max, double product, were studied. Four phases were outlined throughout the trial: (1) 3 months training at 70% of the maximal heart rate; (2) 3 months without training; (3) 1 year training at the same level as phase I, and (4) 12 or more months with increasing intensity training over 70% of the maximal heart rate. Serial ergometric work tests were performed every 3 months. We observed a close relationship between physical working capacity and VO2max increases with training intensity. Resting BP fell significantly with training (182/114-161/97 mm Hg; p less than 0.001) but increased again when training was discontinued (161/97-179/115 mm Hg; p less than 0.001). BP persisted low throughout the trial, but there was a tendency to a further but not significant decrease when training intensity was raised over 70% of the maximal heart rate. Both the submaximal and maximal exercise BP showed similar changes to those found in the resting BP throughout the trial. The submaximal heart rate and the double product (BP X heart rate) also fell significantly with training but with maximal values not changing significantly throughout the whole follow-up period.
Adult↗