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PubMed1987

Early diagnosis of acute myocardial infarction with a rapid latex agglutination test for semi-quantitative estimation of serum myoglobin.

A rapid latex agglutination test for the detection of elevated levels of myoglobin in serum was evaluated in a prospective study of 236 patients consecutively admitted to a Coronary Care Unit on suspicion of acute myocardial infarction (AMI). The final diagnosis was made according to the WHO criteria. The prevalence of AMI was 0.45 with a male to female ratio of 2:1. In all patients at least two blood samples were collected with 4 hours interval 4-12 hours after the onset of symptoms. All sera were analysed for myoglobin by a latex agglutination test and by a radioimmunoassay (RIA). The latex test was performed twice, first as an emergency test by the technical assistant on duty and later by another well-trained technical assistant as her daily routine work. If the latex test was carried out each day by the same well-trained technical assistant, the test results agreed well with the RIA test results, and the false-negative fraction for patients with AMI constituted 0.06 and the false-positive fraction for patients without AMI 0.46. However, when the latex test was performed by the occasional technical assistant on duty, a relatively high degree of discrepancy was observed between the latex test results and the RIA test results, thus giving a false-negative fraction of 0.11 and a false-positive one of 0.36. In conclusion, performed under optimal laboratory conditions, the latex test can be used as a reliable method to estimate elevated levels of serum myoglobin. However, used as a bedside emergency examination, the test results correlated rather poorly to the RIA test results, and consequently the latex myoglobin test seems to be of minor clinical importance in the early evaluation of patients with suspected AMI.

Female↗
PubMed2000

The impact of external feedback on computer-assisted learning for surgical technical skill training.

BACKGROUND: Computer-assisted learning (CAL) offers a number of potential advantages for surgical technical skills teaching. The purpose of this study was to evaluate the impact of individualized external feedback on surgical skill acquisition when a CAL package is used for instruction. METHODS: Freshman and sophomore students participated in a 1-hour CAL session designed to teach them how to tie a two-handed square knot. One group received individualized external feedback during the session and the other group did not. Subjects were videotaped performing the skill before and after the session. The tapes were independently analyzed, in blinded fashion, by three surgeons. Three measures were obtained: the total time for the task, whether or not the knot was square, and the general quality of the performance using a rating scale. RESULTS: Data from 105 subjects were available for final analysis. For both groups there were significant increases in the proportion of knots that were square when the posttest performance was compared with the pretest performance but there was no difference between groups on this measure. Comparison of the performance scores demonstrated that both groups had a significant improvement after the session but the performance scores were significantly better in the group that had received feedback. CONCLUSIONS: Novices in both groups using CAL showed improvement in two of the outcomes measured, suggesting that subjects in both groups attained some degree of competence with this skill. The higher posttest performance score for the group receiving feedback demonstrates that external feedback results in a higher level of mastery when CAL is used to teach surgical technical skills.

Analysis of Variance↗
PubMedDate not supplied

Improving the quality of service delivery in Nigeria.

This study evaluates the effect of a nurse training program in family planning counseling skills on the quality of service delivery at the clinic level, as well as its impact on client compliance with prearranged appointments. The study used a quasi-experimental design to compare certified nurses who received six weeks of family planning technical training with certified nurses who, in addition to the technical training course, received a three-day course in counseling skills. Data were collected through client exit interviews, expert observation, and inspection of medical record abstracts. Trained nurses performed better than their untrained counterparts in the quality-of-care areas investigated--interpersonal relations, information giving, counseling, and mechanisms for encouraging continuity. The likelihood that clients will attend follow-up visits was also found to improve when they were attended by trained professionals. Short-term counseling training can significantly improve the quality of care provided by family planning workers, as well as client compliance with follow-up appointments.

Adolescent↗
PubMed1991

Vocational-technical programs: follow-up of students with learning disabilities.

Recent research has examined the role of vocational-technical training in facilitating the transition from school to work of adolescents with learning disabilities. The present study provided 6-, 12-, and 24-month follow-up data on such students who had attended vocational-technical programs. Matched groups of students without disabilities from vocational-technical programs, as well as randomly selected students without disabilities from regular high schools, were also included for comparisons. Results of the study raised several questions about the value and purpose of vocational-technical training for adolescents with learning disabilities.

Adolescent↗
PubMed2006

Enhancing cancer control programmatic and research opportunities for African-Americans through technical assistance training.

African-Americans remain severely underrepresented in cancer control program delivery and research. Community-based organizational leaders and minority junior investigators have received little attention as representatives of target populations, or as agents to deliver and evaluate efforts to eliminate cancer health disparities. This paper describes activities of the National Black Leadership Initiative on Cancer II: Network Project, which has sought to address these issues. Community leaders and junior investigators received technical assistance (TA) and mentoring to develop applications for cancer education and community-based participatory research (CBPR) projects. TA was provided to 35 community leaders and 32 junior investigators. Twenty-nine community leaders won funding through the Community Partners for Cancer Education Program. Three pilot research applications were funded. Technical assistance may improve minority recruitment/retention in CBPR cancer control research and enhance understanding and elimination of cancer health disparities among African-Americans. Cancer 2006. (c) American Cancer Society.

Black or African American↗
PubMed1989

The circulatory assist device program at University Medical Center. Clinical training and technical support.

A great deal of preparation and coordination is necessary for participation in the investigational use of temporary circulatory assist devices. The use of engineers for technical support as well as for programs coordination has been very useful in the ongoing evaluation of our device performance. It is hoped that the early studies conducted today will lead to improvements in the devices and the eventual production of permanent, totally implantable circulatory assist devices. As these devices continue to develop, it is expected that the biomedical engineer will be able to continue to participate significantly in the development process.

Academic Medical Centers↗
PubMed2002

Teaching technical skills: training on a simple, inexpensive, and portable model.

The purpose of this study was to determine whether surgical residents could significantly improve their performance on a specific surgical procedure after a brief practice session with feedback. Attending plastic surgeons, using valid and reliable checklists and global rating scales, objectively assessed 37 junior surgical residents while performing two-flap Z-plasties on pig thighs (one before and one after a one-on-one, 5-minute practice session with feedback). The total cost per resident was $1.00 (Canadian currency). After the practice session, total checklist scores improved from 7.3 (range, 1 to 9) to 7.9 (range, 5 to 9), and the total global rating scores improved from 29.1 (range, 13 to 41) to 31.9 (range, 19 to 43). Paired Student's t tests revealed significant improvement in both the mean total checklist scores (p < 0.05) and mean total global rating scores (p < 0.01). Also, the global rating score for appearance and quality of the final surgical product significantly improved from 2.7 to 3.3 after the practice session (p < 0.01). There were no significant differences in performance scores between men and women, between first-year and second-year residents, with residents' previous experience with the Z-plasty procedure, or with resident's base surgical specialties. The results of this prospective study indicate that training on a simple and portable model with very brief individualized practice and feedback is an effective and inexpensive way of improving resident performance. A 5-minute practice session with a surgical trainee before performing a procedure on a living patient may significantly improve the patient's surgical performance and produce a superior result.

Adult↗