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The development of an operant conditioning training program for new world primates at the Bronx Zoo.

This article describes the development of an operant conditioning training program for 17 species of New World primates at the Bronx Zoo. To apply less invasive techniques to husbandry protocols, the study introduced behaviors-hand feeding, syringe feeding, targeting, scale and crate training, and transponder reading-for formal training to 86 callitrichids and small-bodied cebids housed in 26 social groups. Individual responses to training varied greatly, but general patterns were noted among species. With the exception of lion tamarins, tamarins responded more rapidly than marmosets, Bolivian gray titi monkeys, and pale-headed saki monkeys in approaching trainers and learning behaviors. Marmosets, in comparison to most tamarins, had longer attention spans. This meant that fewer, lengthier sessions were productive whereas shorter, more frequent sessions were most successful for tamarins. Among the cebids, pale-headed saki monkeys needed relatively few sessions to perform basic and advanced behaviors whereas Bolivian gray titi monkeys were less responsive and progressed at a deliberate pace. Marked changes in the animals' behavior during daily husbandry procedures, their voluntary participation in training activities, and the disappearance of aggressive threats toward care staff indicated that training reduced stress and improved the welfare of the animals. During daily training displays, zoo visitors experienced interactive animals while learning the importance of low-stress animal husbandry.

Animal Husbandry↗

A video based training program improves defibrillator inspection compliance.

Improperly maintained defibrillators are an important cause of defibrillation delay or failure during in-hospital cardiac arrest. This study investigated whether a brief training video of how to properly inspect crash carts and defibrillators would improve the quality and frequency of these inspections. The study was a before-after cohort design. Crash cart inspection logs were explicitly examined, and the electronic archive records of the defibrillators were interrogated. The compliance and quality of inspections were compared before and after the implementation of the training video program. The missed-inspection rate for defibrillators significantly improved from 8.9% to 6.9% (p= 0.037) after video training program implementation. The missed-inspection rate for crash carts, however, actually worsened from 2.7% before to 8.0% (p = 0.0001). The introduction of a new crash cart inspection training video program improved the frequency and quality of defibrillator inspections but not crash cart inspections. The inspection of crash carts and defibrillators is a vital hospital task. Because available training time for clinical personnel is limited, our 15-minute video can be viewed on a ward computer workstation at the most convenient time.

Cardiopulmonary Resuscitation↗

A descriptive analysis of National Library of Medicine-funded medical informatics training programs and the career choices of their graduates.

The initial 13 National Library of Medicine-supported medical informatics training programs and their graduates were studied to determine the program objectives, trainee selection factors, and curriculum components of the programs and the backgrounds and career choices of the trainees. All 13 programs and over 60% of the available population of trainees were studied. The analysis indicated that 1) the major objective was to train individuals in the applications of computer and information science to medicine: 2) the most frequent selection factor was the MD degree; 3) course work in computer science and a research project were the most common curriculum components; 4) 52% of the graduates selected academic careers; and 5) personal reasons most frequently influenced career choices. There is now a baseline of data that can be used in future studies.

Career Choice↗

University-based postresidency training programs in surgical oncology.

The issue of postresidency training in surgical oncology engenders much debate, particularly as it impacts on general surgery training. With the goal of enhancing instruction in surgical oncology in the future, a survey was conducted to assess the role of surgical oncology programs and educational activities within university-based surgery training programs. The results of the study demonstrate an increased emphasis on surgical oncology training over the past five years. The findings also indicate that education activity in surgical oncology in all departments of surgery has increased greatly, as demonstrated by an increased number of specific teaching rounds and conferences. The impact of this increased awareness on the future of surgical oncology training is discussed.

Curriculum↗

The effect of a 1-hour training program on the incidence of bacteremia in pediatric patients receiving parenteral nutrition.

The effect of a 1-hour nurse training program on the frequency of bacteremia in patients receiving parenteral nutrition was evaluated in a pediatric tertiary center. All of the nurses had previous instruction on aseptic techniques in nursing school. The current program focused on aseptic management of intravenous catheters and implanted subcutaneous ports in patients receiving parenteral nutrition (PN). One hundred eighty-four nurses had a 1-hour training session in groups of three to five. The frequency of bacteremia in children receiving PN was not reduced (9.2% versus 8.9%), and there was no significant difference in time from the start of PN to the diagnosis of bacteremia (P = 0.31). The authors conclude that a 1-hour training session for the nursing staff was not sufficient. It is suggested that staff training for prevention of bloodstream infections associated with intravascular devices should cover a wider range of topics and take place over a longer period of time.

Bacteremia↗

Influence of modelling and feedback provided by the supervisors in a microskills training program for beginning counsellors.

Investigated the influence of modelling and feedback on the effectiveness of a microskills training program for beginning counsellors. The microskills taught were: attending behavior, minimal encourages to talk, open questions, and reflection of feeling and content. Twenty-four trainee counsellors were allocated to three treatment groups: (1) no modelling, no feedback (NMF); (2) modelling and feedback from the supervisor (MF); and (3) feedback from the supervisor (F). Analysis of variance showed that MF was superior to NMF and F in increasing use of the skill reflection of feeling. These results lead to the conclusion that the microskills taught differ in level of difficulty, and, hence, in the amount of information, through instructions, practice, modelling or feedback, that will bring these skills to ceiling level. Supervisor modelling and feedback appear to improve learning of the comparatively difficult skill, reflection of feeling.

Affect↗

Developing communication competency in the context of cancer: a critical interpretive analysis of provider training programs.

We conducted a critical interpretive analysis of 47 studies from the Cochrane Review of the communications training literature to capture the empirical indicators used to judge provider communication competency and to describe how the indicators were characterized in the context of a cancer care system. Of the 47 studies reviewed, few showed any resemblance to recommendations from two international consensus conferences of experts in the communication research field. Some of the challenges in moving forward with cancer-related communication skills involve deciding what we want people to learn, providing learning across various experiences, identifying learning models, and finding alternate ways of motivating people to learn. Once core competencies are clearly articulated, we can determine the best approaches for developing cancer-specific training programs.

Communication↗

An alcoholism training program: its effect on trainees and faculty.

Evaluation of the effect of a three-year specialized training program in alcoholism on opinions and attitudes of trainees and faculty members at the University of Washington School of Nursing showed that the program influenced both trainees and faculty in a positive direction. Trainees were found to be more accepting of alcoholism as a disease and an increasing number of faculty believed alcoholism-related courses should be a part of the curriculum.

Alcoholism↗

How do medical students gather information about residency training programs?

UNLABELLED: New electronic sources of information are available for medical students in their search for residency training programs. METHODS: Senior students at the University of Missouri were surveyed regarding types and methods of information sought, and residency choice. RESULTS: Response rate was 96 percent. Ninety-one point five percent used the Internet to access information. Eighty-six percent used a computer at medical school; seventy-eight percent used one at home. Sixty-five point one percent used the university's web site for information. CONCLUSION: Students use the world wide web and the Internet for accessing residency programs information.

Female↗

Longterm physical training in rheumatoid arthritis. A randomized trial with different training programs and blinded observers.

The objective was to study the long-term effect (2 years) of different training programs in patients with rheumatoid arthritis. The method was a randomized trial with 75 patients participating. The measured variables included morning stiffness, a pain score, number of swollen joints, a health assessment score, a functional score, ESR, Hb, the cost of medicine, and progression using X-rays of hands and feet. The results showed no effect of training on the disease activity or on the progression of the disease. The conclusion is that although most patients are in favour of training, the present study does not support that training lessons per se affect the disease activity or the progression of the disease.

Adult↗

[Results of a training program to improve the speed of visual perception and concentration in brain-damaged patients].

A program for the training of perceptual speed and attention with a duration of four weeks was developed and given to thirty brain damaged patients. In order to evaluate a possible generalization effect of the training all subjects were tested three times, i.e. at the beginning of the training, after four and after eight weeks with a series of 16 standardized psychometric tests. These comprised tasks which closely resembled the training procedures as well as tasks testing psychomotor functions in a broader sense and even tasks of reasoning and other intellectual functions. To test the different effects of training, spontaneous recovery and test repetition an experimental design with two groups of patients and two control groups was necessary. Only the groups of patients showed a significant and marked improvement in all tests which could neither be explained by spontaneous recovery nor by test repetition. The training effect proved to be stable after four weeks. The most marked improvement, however, was seen with those tasks most closely resembling the training procedures; in no case the performance level of the control groups was reached.

Adolescent↗

Evaluation of organ procurement in an area under the influence of a training program.

INTRODUCTION: The procurement of organs was evaluated in an area of 1,450,000 inhabitants. This area provides two international programs and two training courses for transplant coordinators. One of them deals with the entire process of donation and transplantation, and the other is a monographic course about family consent and donation request. One transplantation coordinator manages the area. METHODS: The results of the last 6 years have been analyzed concerning the procurement of organ donors (related to brain death [BD] donors, exitus at the hospital, and the intensive care unit [ICU]); loss in the process, such as medically unsuitable; problem detection; and family refusals. RESULTS: During the past 6 years the donor potential increased from 1.67% to 4.06%. The BD by exitus in the ICU increased from 7% to 14.01% (the average in Spain 12.2%); the cases of BD in ICU beds increased from 0.5% to 1.31% (average in Spain 0.8%). The loss for medical exclusion criteria decreased from 27% to 20% and in family refusals from 19.7% to 13.6%. The efficiency of the process in percentage of actual donations by BD increased from 52.4% to 65.3% (average in Spain 49%). The actual donors per million population (PMP) increased from 37 PMP to 59 PMP. The average number of organs obtained from donors increased from 3.1 to 3.6, and the transplants increased from 2.7 to 3.04 per donor. The average waiting period for a renal transplant was reduced from 365 days to 199 days. CONCLUSION: The training of coordinators and the net system of regional coordinator, area coordinator, and hospital coordinator improved our donation rate.

Attitude to Death↗

A practical approach to housestaff teaching conferences in a multi-site training program.

The challenges of providing useful didactic teaching conferences for house officers and students on ward rotations in a program with several training sites are reviewed. An approach used by the Division of General Internal Medicine at the University of Washington minimizes these difficulties and may be of interest to others responsible for the teaching of house officers.

Congresses as Topic↗

Clinical pathologist in Korea--training program and its roles in laboratories.

A rapid development of practice of laboratory medicine in Korea owes its success to the clinical pathologists (CP), who have played a role of a pathfinder for laboratories. The Korean CP postgraduate education (residency) program is unique in that it is exclusively for laboratory medicine. The training program for clinical pathologists includes diagnostic hematology, diagnostic immunology, clinical microbiology, clinical chemistry, blood bank, diagnostic genetics, informatics and laboratory management. The program has produced a strong group of about 600 laboratory physicians, officially clinical pathologists since 1963. Most of Korean clinical pathologists work as laboratory directors, directors of university hospital laboratories or teaching faculty members in medical schools. The roles of clinical pathologists are laboratory management, interpretation of laboratory test results, clinical consulting services to clinicians and patients, ordering secondary tests after reviews of requested test results and utilization management. The clinical pathologists have developed clinical laboratories to be a main contributor for improved medical practice. During the last 40 years under the turbulent healthcare system, clinical pathologists have significantly contributed to safeguard the laboratory interests. The education program and the role of clinical pathologists are described.

Curriculum↗

The teaching of human sexuality in a family medicine training program.

Sexual health is an important component of the individual's total health picture. The primary physician, however, is often ill-prepared to deal with issues around sexuality and sexual dysfunction, and family medicine units need to structure programs for teaching in this area. This article describes a teaching program on human sexuality in a family medicine setting. Its major goals were the transmission of information, the teaching of skills, and the desensitization of the health care professional in this area. The program consisted of a series of four seminars and ongoing teaching. The seminars focused on the human sexual response, sexual myths, sexual history taking, and sexual dysfunction and treatment. Ongoing teaching included case discussion, consultation, and joint interviews. It is hoped that the description of this program will serve as a model and/or impetus to other family medicine training programs.

Family Practice↗

Cancer research training: the Southwest Oncology Group young investigator training program (YITP).

BACKGROUND: Recognizing the growing need for an infusion of new investigators into the cancer researchers, and realizing that well-trained cancer researchers are a dying breed, the Southwest Oncology Group (SWOG) initiated the Young Investigator Training Program (YITP) in 1999, supported by the Hope Foundation. The first author was one of four applicants accepted in 2004 and is reporting on this experience. METHODS: After a rigorous and competitive application process, four physicians beginning their career in Hematology-Oncology are chosen each year. Each investigator would have submitted an original research concept. Each class receives intensive training in statistical principles, data collection and analysis, critical decision making, and protocol development guidelines. Each investigator spends 4 days at the SWOG operations office in San Antonio, Texas, and 4 days at the statistical center in Seattle, Washington. RESULTS: As part of the training course, each investigator will design a clinical protocol that will be reviewed by the appropriate disease committees within SWOG. Once approved, it will be submitted to the National Cancer Institute for further review. The four investigators will receive a certificate at the successful completion of the training course and will be recognized at the group meeting. With the class of 2004, 31 investigators will have joined the ranks of seasoned researchers. Fifteen protocols have been introduced and activated at institutions across the United States. Four other protocols are in various stages of the development and approval process. CONCLUSION: The Hope Foundation sponsored SWOG YITP is a unique opportunity. It allows participants to acquire a thorough understanding of the conduct of cancer clinical trials through SWOG. Large institutions are urged to continue sponsoring similar programs. This will build an infrastructure of well-trained cancer researchers to foster and continue the progress achieved in cancer research.

Clinical Trials as Topic↗

Effects of a 10-month endurance-training program on performance of speeded perceptual-motor tasks.

This study investigated the effects of a 10-mo. endurance-training program (running) on speeded psychometric skills. On a weekly basis the experimental group of 36 subjects participated in one supervised and three unsupervised training sessions. The control group of 22 subjects engaged in no structural training activities during this period. Subjects' performance on a simple reaction-time task, a choice reaction-time task, and a letter-recognition task was assessed before and after the training intervention. Analysis indicated that a 20% improvement in aerobic fitness in the trained group was not accompanied by a significant improvement in psychometric performance. This result is discussed in terms of the relationship between aerobic fitness and cognitive performance. It is concluded that improved physical fitness is not necessarily accompanied by improved perceptual-motor skills.

Adult↗