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PubMed2006

Canadian psychiatry residency training programs: A glance at the management structure.

OBJECTIVES: To describe the administrative functioning of all current Canadian psychiatry residency training programs (RTPs) and to suggest available improvements to existing systems. METHOD: We obtained data about the 2004 RTPs by distributing 2 questionnaires to all Canadian psychiatry RTPs. RESULTS: Residency program committees (RPCs) are mainly consultative and carry only a small amount of the workload of managing a residency program. Program directors (PDs) manage more than 80% of the work and report that the time allowance to perform their duties is suboptimal. PDs remain in office for about 5 years, departing during or at the end of a predetermined second term. CONCLUSION: RPCs bear only a small amount of the workload generated by the RTP. We piloted administrative changes that led to more equitable work distribution.

Canada↗
PubMed1994

EPSDT model training program.

The National Association of School Nurses plans to present an Early Periodic Screening, Diagnosis and Treatment (EPSDT) model training program for school nurses at the NASN Annual Conference in Orlando, Florida on June 29, 1994. This program is designed to provide school nurses with essential information concerning the development and implementation of the EPSDT program for Medicaid-eligible students in their schools. It capitalizes on the central role of school nurses as the primary health professionals, health care initiators and health care coordinators of EPSDT program implementation.

Adolescent↗
PubMed2004

International training programs in reproductive sciences for conservation of Latin American felids.

Survival of the ten non-domestic felid species endemic to Latin America is imperiled by habitat loss, poaching and poor captive management. Over the past 10 years, conservation of these felids has been the primary focus of a reproductive research and training program conducted in Brazil, Mexico, and the USA. The objectives of this program were to: (1) provide intensive training in reproductive sciences to Latin American scientists, (2) conduct collaborative studies investigating basic and applied reproduction in endangered felids, and (3) establish a highly-trained scientific cohort to conduct independent conservation-based research. Four formal training courses, consisting of didactic lectures and hands-on instruction in research techniques, including semen collection, sperm cryopreservation and laparoscopic artificial insemination (AI), were taught in Brazil and Mexico between 1995 and 1998. Several of these scientists received further training in conducting fecal hormone analysis in the USA, and a number of research studies, many in collaboration with American scientists, were initiated in Latin American felids. Research findings have characterized basal reproductive traits in several felid species, including ocelots, margay, tigrinas and jaguars, and established that Latin American felids exhibit only minimal seasonal variation in most reproductive traits. Other studies have explored the impact of acute and chronic stressors on adrenocortical activity and demonstrated the importance of environmental enrichment in captivity, especially in small felids. Additional research has examined ovarian and immunological responsiveness of Latin American felids to exogenous gonadotropins and assessed the impact of nutrition on sperm production and oocyte quality. Applied reproductive studies have investigated sperm cryopreservation in both captive and wild felid populations and demonstrated the production of viable offspring in ocelots and tigrinas following laparoscopic AI. Ongoing studies are investigating the potential of in vitro fertilization (IVF), embryo cryopreservation and embryo transfer for genetic management of ocelots and tigrinas. To date, over 75 Brazilian ocelot and 50 tigrina IVF embryos have been cryopreserved and two pregnancies have been established in ocelots following transfer of frozen-thawed embryos. Findings from these studies are helping to improve husbandry, population management, and breeding of Latin American felids in captivity. Continued advances in assisted reproduction eventually may provide an alternative route for exchanging genetic material among Latin American felid populations. Most importantly, this collaborative program has been essential for building scientific capacity, within Brazil and Mexico, in establishing a core group of highly-trained reproductive biologists that will continue applying their new knowledge and skills to the conservation of Latin American felids.

Animals↗
PubMed2000

Training of pediatricians in care of physical disabilities in children with special health needs: results of a two-state survey of practicing pediatricians and national resident training programs.

OBJECTIVE: One goal of the American Academy of Pediatrics' Future of Pediatric Education II Project is to establish guidelines in training physicians to care for children with special health care needs (CWSN). Assessment of current practices in prescribing therapies and devices is necessary to meet this goal. Although much has been written about CWSN, there is a paucity of literature describing pediatricians' preparedness in prescribing such therapies and devices to children with physical disabilities. In an effort to assess physician preparedness, we surveyed pediatric residents nationwide and practicing pediatricians from 2 states, 1 urban and 1 rural. METHODS. A questionnaire aimed at identifying areas of concern regarding preparedness of physicians in practice and in training was prepared and mailed to prospective participants in Ohio and Mississippi. After follow-up mailings to nonresponders, approximately 59% responded. Summary statistics were reported as proportions with 95% confidence intervals. RESULTS: Among those polled, >70% reported no training in prescribing certain durable medical equipment and over 50% reported no training in prescribing certain therapies. In addition, at least 20% reported no training in treating some of the more common childhood physical disabilities. Nearly three fourths of the respondents indicated that they did not believe that they were adequately prepared to take an active role in prescribing therapies and durable medical equipment. Fewer respondents believed that they should be the sole providers of these therapies and durable medical equipment. CONCLUSIONS: The results of the survey indicate a lack of specific training and physician confidence in prescribing therapies and devices to CWSN, establishing the necessity of expanding training programs to better ensure quality health care for special needs children. Although additional ongoing research is necessary to fully evaluate the preparedness of physicians in caring for CWSN, this survey does help to identify areas of physician training that require improvement to provide quality health care for CWSN.

Child↗
PubMed2001

CD-ROM transnational training program in cervical cytology (CYTOTRAIN).

The Transnational Training Programme in Cervical Cytology (CYTOTRAIN) is a 3-yr project funded by the European Commission to harmonize training and quality standards in cervical screening across the European Union. The aim of the program is to develop new approaches in initial and continuing vocational training, particularly in the area of life-long learning with the aim of meeting national, regional, and local needs. We present a new approach to training in cervical cytology, using an interactive program of cytological images. The method used to prepare the program and the problems encountered are described. The authors have the feeling that giving details of the organizational and management structure adopted for the project implementation might help other pathologists realize more or less similar CD-ROM training programs in their own field of activity.

CD-I↗
PubMed2005

[A review of undergraduate ENT training programs in the light of the Core Education Program].

OBJECTIVES: The aim of this report was to evaluate the Core Education Program (CEP) and to contribute to the establishment of some national standards for undergraduate ENT training programs in medical schools. STUDY DESIGN: The documents of the national CEP for medical schools were reviewed. The lists under the titles of "Diseases-Condition-Symptoms," "Skills," and "Attitude and Behavior" were evaluated from the standpoint of ENT training. RESULTS: Of 396 items listed under the domain of "Disease-Condition-Symptoms," 25 items were found to be related to ENT training. The essential skills to be achieved concerning ENT were ear, nose, throat, and neck examinations, ear lavage, nasal packing, and the Heimlich maneuver. Skills such as tuning fork tests, paracentesis, and measurement of noise were regarded as optional. CONCLUSION: The aim of the CEP is to determine the necessary level of knowledge and skills for a general practitioner. It should be adopted by all disciplines of medical schools and incorporated into education programs. The ENT society, Association, and study groups of education should collect feedback from ENT departments and convey all this to the CEP Study Group, which convenes every four years to re-evaluate the CEP in the light of the feedback received and recent developments in medical sciences.

Curriculum↗
PubMed1990

A cognitive/affective empathy training program as a function of ego development in aggressive adolescent females.

This study investigated the effects of an affective/cognitive empathy training program on level of empathy in 24 aggressive adolescent females in a residential treatment center. In addition, the relationship between empathy and level of ego development was explored. Empathy was defined as a psychological construct regulated by both cognitive and affective components, interacting in a systemic manner to produce emotional understanding. Subjects were pretested on measures of affective empathy, cognitive empathy, and Loevinger's scale of ego development. High and low scores on the measures of ego development were defined by a median split. Following random assignment to groups, experimental subjects were exposed to four 1.5-hour training sessions directed at increasing levels of affective and cognitive empathy. Posttests revealed significant positive relationships between ego development and both measures of empathy. Training significantly increased levels of affective empathy, while increases in cognitive empathy were unremarkable. There was no difference between high and low ego development scorers in their ability to profit from training. The hypothesized systemic relationship between affective and cognitive empathy was also supported by the findings.

Adolescent↗
PubMed2004

The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial.

BACKGROUND: Ankle sprains are the most common injuries in a variety of sports. HYPOTHESIS: A proprioceptive balance board program is effective for prevention of ankle sprains in volleyball players. STUDY DESIGN: Prospective controlled study. METHODS: There were 116 male and female volleyball teams followed prospectively during the 2001-2002 season. Teams were randomized by 4 geographical regions to an intervention group (66 teams, 641 players) and control group (50 teams, 486 players). Intervention teams followed a prescribed balance board training program; control teams followed their normal training routine. The coaches recorded exposure on a weekly basis for each player. Injuries were registered by the players within 1 week after onset. RESULTS: Significantly fewer ankle sprains in the intervention group were found compared to the control group (risk difference = 0.4/1000 playing hours; 95% confidence interval, 0.1-0.7). A significant reduction in ankle sprain risk was found only for players with a history of ankle sprains. The incidence of overuse knee injuries for players with history of knee injury was increased in the intervention group. History of knee injury may be a contraindication for proprioceptive balance board training. CONCLUSIONS: Use of proprioceptive balance board program is effective for prevention of ankle sprain recurrences.

Adult↗
PubMed2000

The effects of a balance and strength training program on equilibrium in Parkinsonism: A preliminary study.

The purpose of this study was to determine if a balance and strength training program could improve equilibrium and strength in persons with stage I-III Parkinsonism. Subjects were pre-tested on strength and balance (EquiTest) and randomized into either a treatment or a control group. The treatment subjects participated in 10 weeks of lower limb strength training and balance exercises designed to challenge a stable posture and increase limits of stability. Both groups were then posttested on balance, knee flexion, knee extension, and ankle inversion strength. Subjects who received strength and balance training demonstrated significantly improved equilibrium and modest gains in knee flexion and extension strength, while the control group showed no improvement in conditions of destabilizing balance environments and significant declines in strength. Results indicate that 10 weeks of balance and strength training lead to improved equilibrium by producing positive changes in two different control mechanisms. One, training altered the ability to control the motor system when vestibular cues had to be the primary source of reliable feedback; and two, training helped subjects to override faulty proprioceptive feedback and utilize reliable visual or vestibular cues.

Journal Article↗
PubMed2006

Effectiveness of a collaborative recovery training program in Australia in promoting positive views about recovery.

OBJECTIVE: This study examined the impact of a two-day, recovery-based training program for mental health workers on knowledge, attitudes, and hopefulness related to the recovery prospects of people with enduring mental illness. METHODS: A self-report pre-post training repeated-measures design was used with 248 mental health workers from the community-based government health sector (N=147) and nongovernment organizations (N= 101) in eastern Australia. RESULTS: Staff attitudes and hopefulness improved after training. Trainees significantly increased their knowledge regarding principles of recovery and belief in the effectiveness of collaboration and consumer autonomy support, motivation enhancement, needs assessment, goal striving, and homework use. CONCLUSIONS: This preliminary evidence indicates that staff recovery orientation can improve with minimal training.

Adult↗
PubMedDate not supplied

Building a virtual network in a community health research training program.

OBJECTIVE: To describe the experiences, lessons, and implications of building a virtual network as part of a two-year community health research training program in a Canadian province. DESIGN: An action research field study in which 25 health professionals from 17 health regions participated in a seven-week training course on health policy, management, economics, research methods, data analysis, and computer technology. The participants then returned to their regions to apply the knowledge in different community health research projects. Ongoing faculty consultations and support were provided as needed. Each participant was given a notebook computer with the necessary software, Internet access, and technical support for two years, to access information resources, engage in group problem solving, share ideas and knowledge, and collaborate on projects. MEASUREMENTS: Data collected over two years consisted of program documents, records of interviews with participants and staff, meeting notes, computer usage statistics, automated online surveys, computer conference postings, program Web site, and course feedback. The analysis consisted of detailed review and comparison of the data from different sources. NUD*IST was then used to validate earlier study findings. RESULTS: The ten key lessons are that role clarity, technology vision, implementation staging, protected time, just-in-time training, ongoing facilitation, work integration, participatory design, relationship building, and the demonstration of results are essential ingredients for building a successful network. CONCLUSION: This study provides a descriptive model of the processes involved in developing, in the community health setting, virtual networks that can be used as the basis for future research and as a practical guide for managers.

Canada↗
PubMed2004

Effects of a short-term interval training program on physical fitness in prepubertal children.

The aim of this study was to analyze the effects of a 7-week interval-training program on different aspects of physical fitness in children who were 8-11 years old. Forty-six boys and 54 girls (9.7 +/- 0.8 years) were divided into an experimental group and a control group. The 2 groups performed selected tests from the European physical fitness test battery before and after training. Training consisted of 2 specific 30-minute sessions per week of short high-intensity, intermittent-running aerobic exercises at velocities ranging from 100-130% of maximal aerobic speed. After training, the experimental group demonstrated a significant improvement in the standing broad jump (9.6%, p < 0.001, F = 12.9) and 20-meter shuttle run (5.4%, p < 0.001, F = 14.4), whereas for the control group, no significant changes were observed. It was concluded that a high-intensity, intermittent-running program improved children's aerobic performance and explosive strength.

Analysis of Variance↗
PubMed1998

Unemployment and underemployment in 1996 graduates of New York City gastroenterology training programs.

OBJECTIVE: Based on anecdotal reports of young gastroenterologists facing extreme difficulty in finding a job, we sought to gain information about the success of newly trained gastroenterologists in finding employment in their subspecialty, and to find any possible predictors of unemployment. METHODS: We surveyed all fellows finishing basic or advanced gastroenterology fellowship training in New York City in June 1996. Data were collected on unemployment, underemployment (practicing less than half-time gastroenterology), and also type of job, employment terms, training program, medical school, gender, and satisfaction with job plans. RESULTS: Of the 59 study subjects who sought gastroenterology employment in the United States, data were collected on all of them (100%). Fifteen subjects (25%) were unemployed. An additional 10 subjects (17%) were underemployed. Of the 24 subjects expecting to be associates in a group practice, eight (33%) had either no signed contract, were underemployed, or both. Programs that did not participate in the National Residency Matching Program were more likely to have both unemployed and underemployed graduates. CONCLUSION: Unemployment among newly trained gastroenterologists in New York City is very high. Also, there is substantial underemployment, and this phenomenon needs to be taken into account when studying the workforce.

Data Collection↗
PubMed1999

Time perspective of female prisoners related to success in a training program.

This study compared scores on future time perspective of 50 female prison inmates who were participating in a vocational training program within the Julia Tutwiler Prison. There was no control group. Zimbardo's measure of future time perspective, administered a year earlier, was associated with success or failure in the program. Associations of future time perspectives with education, age, and ethnicity were investigated. An analysis of covariance between the 21 graduates and 16 dropouts while controlling for education was significant. Despite the incomplete design, some implications are of interest.

Adult↗
PubMed2001

Temporal relationships of self-efficacy and social support as predictors of adherence in a 6-month strength-training program for older women.

The present study investigated how self-efficacy and social support predicted adherence to a strength training program for elderly women over two time periods in the initial 6 mo. of the program. Participants were 30 elderly women volunteers aged 75 to 80 who completed measures of barrier self-efficacy and general social support at baseline and 3 mo. later. Social support from the program was also measured at 3 mo. Adherence to the program was measured by attendance. Hierarchical regression equations were utilized to identify the contributions of self-efficacy and social support for adherence at 0 to 3 mo. and 4 to 6 mo. For prediction of the first 3 mo. of adherence, both self-efficacy and social support contributed significant unique variance towards the total explained variance of 36%. For the 4- to 6-mo. period, self-efficacy explained significant (12%) variance in adherence even when controlling for the previous 3-mo. adherence. Inclusion of general social support and social support from the program, however, did not account for significant variance. Researchers must continue to examine self-efficacy and social support in exercise adherence within various time periods among older adults to develop effective intervention strategies.

Aged↗
PubMed2003

[An expert system for controlling the physical training program of crews on long-term space missions].

The concept of in-flight expert system for controlling (ESC) the physical training program during extended, including Martian, space missions has been developed based on the literature dedicated to the microgravity countermeasures and a retrospective analysis of effectiveness of the known ESC methods. This concept and the principle of crew autonomy were used as prime assumptions for defining the structure of ESC-based training in long-duration and planetary missions.

Astronauts↗
PubMed2003

In vitro training program to improve ambidextrous skill and reduce physical fatigue during laparoscopic surgery: preliminary experience.

PURPOSE: We illustrate the preliminary experience with our planned intensive in vitro training program focused on the nondominant hand and reducing physical fatigue. Apart from this, we tried to calculate how much training is required for a novice urologist to master laparoscopic freehand suturing with the dominant and nondominant hands. MATERIALS AND METHODS: Between December 2001 and May 2002, one trainee worked on a Pelvi-trainer, first with the dominant (right) hand and then with the left hand, practicing intracorporeal suturing and cutting and improving physical endurance by gradually increasing the duration of each training session. Along with the Pelvi-trainer, he worked on left-handed writing to improve wrist movements. Before starting this training, he did not have any laparoscopic experience as assistant or primary surgeon. The progress was stored in the computer prospectively to compare the results with those obtained at the end of the training. RESULTS: For the dominant hand, 30 hours over 2 months was required to master laparoscopic suturing skills. After training of the right hand, the nondominant hand required 40 hours of Pelvi-trainer work and 20 hours of handwriting during 2 months. Physical endurance for suturing in the Pelvi-trainer increased from 15 minutes to 150 minutes over 3 months. The main improvement was in the degree of pain over the right shoulder (because of the abducted position) and backache. CONCLUSION: Incorporation of sufficient in vitro training to improve nondominant hand functioning and reduce physical fatigue can make adaptation to laparoscopic surgery easier.

Clinical Competence↗
PubMed1995

Indicators of the educational effectiveness of subspecialty training programs in internal medicine.

PURPOSE: To identify markers within the subspecialty educational process in internal medicine that are associated with greater improvements in knowledge and skill. METHOD: Candidates for the 1991 cardiovascular disease examination of the American Board of Internal Medicine (ABIM) were matched to the fellowship programs they attended, and their performances on the internal medicine examination of the ABIM, demographic data, and performances on the cardiovascular disease examination were averaged within each program. Information on the programs themselves was also available. The variables were divided according to whether they controlled for input to the training programs, were indicators of educational process, or served as the outcome measure. Analyses were restricted to the 140 programs for which complete information was available and that had four or more candidates who took the cardiovascular examination (97 programs were excluded). RESULTS: The multiple correlation between all measures and scores on the cardiovascular disease examination was .80. Forty-five percent of the explained variance is attributable to previous performance on the internal medicine examination alone. The remaining 55% is shared by the educational indicators and the input measure or explained by the indicators alone. Among the indicators, location of medical school, length of fellowship training, ratings of overall clinical competence, fellow-to-faculty ratio, and number of subspecialties in the same institution made small contributions on their own. Program size, university affiliation, and period of approval by the residency review committee contributed little. CONCLUSION: The data are clear that indicators of educational process such as fellow-to-faculty ratio, longer periods of training, and performance during fellowship can generate greater gains in knowledge and judgment than would be expected if fellows merely built on their abilities at the time of entry to training. Such indicators may be useful if changes in health care delivery require reducing the numbers of specialty and subspecialty training positions.

Cardiology↗