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Attitudes toward the use of gender-inclusive language among residency trainees. The McMaster Residency Training Program Directors.

OBJECTIVE: To explore postgraduate medical trainees' attitudes toward the use of gender-inclusive language. DESIGN: Self-administered questionnaire. SETTING: Seven residency training programs at McMaster University, Hamilton, Ont., from July 1993 to June 1994. PARTICIPANTS: Of 225 residents in the programs, 186 responded to the survey, for a response rate of 82.7%. Men and women were equally represented among the respondents. OUTCOME MEASURES: Categorization of attitudes about the use of language as gender-inclusive or gender-exclusive; characteristics predicting a gender-inclusive attitude. RESULTS: Factor analysis and Cronbach's alpha (0.90) supported the existence of a construct related to attitudes about language use, the poles of which were categorized as gender-inclusive and gender-exclusive. The authors classified residents with respect to their attitudes to language use from their responses to the questionnaire. In univariate analyses, sex, residency program and country of graduation significantly predicted a gender-inclusive attitude (p < 0.01). Only the first 2 variables were significant in a multivariate model; residency program explained 18% of the variance and sex 3%. Residents in obstetrics and gynecology and psychiatry had the most gender-inclusive attitudes, whereas residents in surgery and anesthesia had the most gender-exclusive attitudes. CONCLUSIONS: Residents' values are reflected in the language they choose to use. Language use may provide an index of underlying attitudes that may create hostile environments for female trainees.

Adult↗

The situation of diagnostic radiology training programs and their graduates in 1998.

OBJECTIVE: In light of concerns about the job market, the American College of Radiology studied the employment situation of 1998 graduates from diagnostic radiology training programs and the status and plans of the programs. MATERIALS AND METHODS: In April and May 1998, the American College of Radiology surveyed a 50% random sample of diagnostic radiology residency directors about the employment situation of their 1998 residency and fellowship graduates and about their programs. Ninety-one percent of those surveyed responded. We compared findings from the 1998 survey with similar findings from the 1997 survey, with a p value less than or equal to .05 representing statistical significance. RESULTS: Similar to 1997, 96% of residency graduates and 89% of fellowship graduates had commitments for posttraining jobs or fellowships as of the survey date. Approximately 92% of graduates had positions that directors believed reasonably matched their training and personal employment goals. The percentage of fellows with positions was similar across subspecialty fields. Completed plus planned changes in program size for residents would gradually lead to a 21 % reduction in the annual number of graduates within the next 4 years. Much as in previous years, by late April to mid May 1998, 94% of beginning-year residency slots were filled. Residency program directors were more optimistic in 1998 about graduates' job prospects than in the previous 3 years. CONCLUSION: In past years, unemployment of graduates was less than 1% by 6 months after graduation, and that is the likely outcome for 1998 graduates. Employment prospects across all subspecialty areas are approximately equal.

Employment↗

Balancing teaching and research experiences in doctoral training programs: lessons for the future educator.

While a variety of alternative careers has emerged for Ph.D. life scientists in industry, business, law, and education in the past two decades, the structure of doctoral training programs in many cases does not provide the flexibility necessary to pursue career experiences not directly related to a research emphasis. Here I describe my efforts to supplement my traditional doctoral research training with independent teaching experiences that have allowed me to prepare myself for a career that combines both into a combined educational program. I describe the issues I have come across in finding and taking part in these endeavors, how these issues have affected my work in pursuing my Ph.D., and how my experiences translate into my hopes for a future education-based career in molecular and cell biology.

Anecdotes as Topic↗

Survey of neonatology training programs: 2002 to 2003.

The Committee on Research in Neonatology from the Section on Perinatal Pediatrics, American Academy of Pediatrics presents an overview of the update of the Neonatal-Perinatal Training Program Survey obtained in 2002 to 2003. Our goal was to update the last survey in 1996 and to begin to assess research resources and the potential for training life-career physician scientists (basic and clinical investigators).

Biomedical Research↗

Developing a postgraduate medical oncology training program in Taipei, Taiwan, Republic of China.

Because cancer is the number one cause of mortality in Taiwan, a governmental decision was made to develop an experiment in medical oncology education using a United States-style training program in medical oncology in three Taipei, Taiwan, university hospitals. In the past, trainees from developing countries came to the United States or other foreign countries to receive specialty training. In doing so, the training did not necessarily prepare the individuals with skills to treat the indigenous cancers, nor did they work with other related specialists or support staff such as nursing and pharmacy, so important to providing good cancer care. This program involved 13 fellows with significant laboratory experience working with American faculty on-site. The major benefits of this model for oncology training are that the trainees developed important interdisciplinary relationships with local staff at each of the hospitals; they were involved in the treatment of the major cancer diseases of Taiwan such as nasopharyngeal, hepatocellular, and cervical cancers as well as breast, lung, and colon cancers; and they completed a certification process involving written and oral tests by two senior American oncologist examiners. Oncology services have been established at each of the hospitals and most of the fellows have expressed an interest or made arrangements to come to the United States to get additional research experience.

Education, Medical, Graduate↗

A community outreach training program for pediatric residents and medical students.

In 1982 the Division of Community Pediatrics of the University of North Carolina at Chapel Hill began a new training program for all first-year pediatrics residents and fourth-year medical students taking an ambulatory pediatrics elective. The program was designed to introduce the trainees to community resources for children and increase their knowledge of the factors affecting children's development. During their regular hospital clinic rotations, the trainees spend approximately one-third of their time in program activities that involve 25 community agencies. Educational packets (consisting of books, journal articles, films, slides, videotapes, self-instruction materials, manuals for developmental tests, and/or agency materials) are provided for each program component. At the end of each one-month rotation of program activities, the trainees meet individually with the program director and coordinator to discuss the trainee's experiences and reactions and to identify strengths and weaknesses of the program components.

Child↗

Exercise training program for older adults. Incentives and disincentives for participation.

The purpose of this study was to describe the incentives and disincentives for participating in an exercise training program for community-dwelling individuals 78 and older. One hundred forty-seven women and 62 men participated in this descriptive study, and ages ranged from 78 to 95 years (mean 82.7 +/- 4.1). Individuals were interviewed by phone about their decision to participate in an exercise program. Qualitative responses were analyzed using content analysis. Three main incentive themes emerged: Health Benefits, Psychological Benefits, and Positive Program Features. Disincentive themes included Competing Commitments, Doubts about Exercise, and Negative Program Features. To better tailor an exercise program to the needs of this older age group, nurses working with older adults should keep in mind the lifestyle, age-specific obligations, and set of values affecting this cohort's participation.

Aged↗

[Experience with field epidemiology training programs in Africa: Cours IEIAA].

The International Course on Epidemiology and Applied Data Processing in Africa (Cours IEIAA) is a practical 4-week French-language training course for professional health care personnel working in Africa. The first course was organized in 1998 by the Association pour l'Aide à la Médecine Préventive (Association for the Promotion of Preventive Medicine). The course organizing committee includes a pedagogical director and a faculty of field epidemiology experts. Course activities are designed to give attendees competency in epidemiology, biostatistics, computer techniques and communication. Attendance is funded mainly through education grants from the French Foreign Affairs Ministry, WHO, UNICEF, Belgian Technical Cooperation, Swiss Technical Cooperation, and German GTZ. Based on 7 years of experience, consideration is now being given to transforming this course into a tutorial Field Epidemiology Training Program modeled after those now operating in Ghana and Uganda [TEPHINET members Programs located in Africa].

Africa↗

Training program on microbiological test collection material methods at a teaching hospital: investment and result assessment.

This study aimed at evaluating the results, direct costs and investment of a training program on microbiological test material collection at a teaching hospital. Test collections that did not follow the established criteria (failure) were considered as the result measure. Variable and absorption costing were used to calculate direct costs and investments, respectively. Of the 11,893 collected materials, failures were evidenced in 59 (0.5%). Direct cost corresponded to R$ 154.10 and R$ 2,431.29 was invested in training. These findings revealed that the evidenced number of anomalies (failures) represented a low percentage in relation to the total collected material for microbiological exams. Therefore, this should not be considered a critical point that justifies the continuity of the training and, consequently, the investment.

Bacteriological Techniques↗

Injuries and adherence to walk/jog and resistance training programs in the elderly.

To evaluate the effects of 26 wk of aerobic and resistance training on the incidence of injury and program adherence in 70- to 79-yr-old men and women, 57 healthy volunteers (25 males, 32 females) were randomly assigned to a walk/jog (W/J, N = 21), strength (STREN, N = 23), or control (CONT, N = 13) group. Walk/jog training was for 30-45 min, 3 d.wk-1 with intensity equal to 40-70% heart rate max reserve (HRmax reserve) during the first 13 wk, and 75-85% HRmax reserve for weeks 14-26. STREN training consisted of one set (10-12 repetitions) each of 10 variable resistance exercises performed to volitional fatigue. Forty-nine of the original participants completed the training program. Walk/jog training increased VO2max from 22.5 to 27.1 ml.kg-1.min-1 (P less than or equal to 0.05) while STREN and CONT showed no change. STREN improved significantly in chest press and leg extension strength (P less than or equal to 0.05) while W/J and CONT showed no change. Adherence to training was 20/23 (87%) and 17/21 (81%) in STREN and W/J, respectively. One repetition maximum (1-RM) strength testing resulted in 11 injuries in the 57 subjects (19.3%) while STREN training resulted in only two injuries in 23 subjects (8.7%). Walk training during weeks 1-13 resulted in one injury in 21 subjects (4.8%). Eight of 14 subjects (57%) who began jogging intervals at week 14 incurred an injury: two of eight (25%) of the men and all of the women (6 of 6). All W/J training injuries were to the lower extremity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Application of a social skills training program in the modification of interpersonal deficits among retarded adults: a clinical replication.

Six mentally retarded adults, equally divided into two treatment groups, were provided with individualized social skills training programs. Treatment, evaluated via a multiple-baseline design strategy, was sequentially and cumulatively applied across target behaviors over a four-week intervention period. Behavioral observation probes and social validation measures served as the primary dependent variables. Results indicated that (a) treatment was effective for virtually all behaviors across all subjects, (b) improvements occurred for both training and generalization scenes, and (c) behavioral performance was maintained one month following the termination of treatment.

Adult↗

Substance abuse education in residency training programs in emergency medicine. NIAAA Task Force of the American College of Emergency Physicians.

The emergency department is the focal point for many social ills, not the least of which is substance abuse. We conducted a study to determine to what degree substance abuse education is taught in emergency medicine residency training programs. A set of educational objectives was developed by a task force composed of representatives of the American College of Emergency Physicians, the Society of Teachers of Emergency Medicine, and the University Association for Emergency Medicine. A questionnaire then was sent to the directors of all emergency medicine residency programs accredited by the Accreditation Council for Graduate Medical Education to determine the degree to which those objectives are covered in residency training. A 62% response rate was achieved. The data revealed that such topics as narcotic prescription law, patterns of risk, and issues pertaining to substance abuse by physicians were covered by fewer than half of the programs responding. Respondents were generally satisfied with the adequacy of training of residents and faculty in the area of substance abuse; however, they were dissatisfied with the adequacy of available training materials. Recommendations for changes in graduate curriculum as well as avenues for further research are provided.

Attitude of Health Personnel↗

Does measurement dependence explain the effects of the Life Skills Training program on smoking outcomes?

BACKGROUND: The Life Skills Training (LST) program is the most prominent school-based smoking prevention program in terms of its consistency in being named on lists of best practices. This study assessed whether the results pertaining to cigarette smoking reported in evaluations of the LST program are measurement dependent. METHODS: Seventeen reports published between 1980 and 2003 that included at least one outcome measure pertaining to cigarette smoking were identified. Data pertaining to the cigarette smoking measures used in the analysis and whether the results showed a statistically significant difference between experimental and control groups at follow-up were extracted from the reports. RESULTS: Fourteen different outcome measures were used across 17 reports. Only three pairs of reports presented the same set of outcomes. Recent reports showed the most consistent set of findings in support of the LST program, but there was little consistency in the outcome measures used in these analyses. CONCLUSIONS: The use of so many smoking outcomes in the LST program evaluations raises concern as to whether the positive program effects reported are measurement dependent.

Follow-Up Studies↗

Measuring professionalism in a physiatry residency training program.

A 12-item questionnaire modeled after the one prepared by the American Board of Internal Medicine dealing with professionalism was distributed to 122 physiatry residents representing six training programs, of whom 59% (72) responded. The mean item score on the survey was 7.7 (SD = 1.0) on a scale from 1 to 10, where 10 represents the highest level of professionalism. The internal reliability of the questionnaire was found to be satisfactory (Cronbach's alpha = 0.75). A factor analysis of the questionnaire items resulted in three factors explaining 64% of the variance. These factors were: excellence, honor/integrity, and altruism/respect; Eigen values were 3.35, 2.37, and 1.31, respectively. These factors are similar to those obtained in the American Board of Internal Medicine survey. This similarity is a positive feature in ongoing efforts to develop a reliable tool for measuring professionalism in physiatry residency training.

Altruism↗

Development and evaluation of a training program in peer support for former consumers.

While mental health policy in Australia promotes the involvement of mental health consumers in service planning, implementation and evaluation, little has been reported on the training required for the new roles that consumers are being expected to undertake. In this study, 10 former consumers of mental health services participated in a 16-week training program in peer support. The impact of the program on the psychological well-being of the participants was assessed using a battery of self-evaluation questionnaires and focus group interviews. Findings suggest that exposure to people with acute mental health problems (i.e. inpatients), did not, in this instance, adversely impact on the psychological well-being of the participants. Barriers to consumer participation in the mental health field are discussed and recommendations for the content and structure of future consumer peer support training initiatives are proposed.

Acute Disease↗

Recommendations for the screening of military personnel over 35 years of age for physical training programs.

Persons over 35 years old have an increased prevalence of risk factors. Careful medical examinations, even in a fit military population, are needed before initiating intensive physical training regimens. Risk factor profiling, which synthesizes major risk factors into a composite score, is a beneficial procedure by which to evaluate individuals. Training programs should be based on several considerations: (1) the individual's age and physical condition; (2) his body composition; (3) his risk factor profile; (4) his preference and physical ability for activity; and (5) the available facilities and climatic conditions. Exercise should enhance work capacity and serve as a preventive measure for coronary heart disease. The most efficient types of exercise to meet these ends are activities that involve the large muscles in continuous activity for 20 to 30 min daily, including warm-up and cool-down periods.

Adult↗

Fellowship and practice trends in neuroradiology training programs in the United States.

BACKGROUND AND PURPOSE: Neuroradiology has become an increasingly diverse and subspecialized discipline. We evaluated the current status and trends affecting fellowship programs and the practice of clinical neuroradiology at academic medical centers, with emphasis on invasive procedures. METHODS: All 85 program directors at Accreditation Council for Graduate Medical Education-approved fellowships in neuroradiology were sent a detailed questionnaire pertaining to various demographic aspects of their program and the performance of certain radiologic examinations of the brain and spine. RESULTS: Sixty-seven programs (79%) responded. As many as 50% of programs are 1 year in length. Twenty-five percent of 2-year fellows leave their program after 1 year of training. During the past 5 years, 36% of programs have decreased in size and 73% reported a decline in the number of applicants. The majority (55%) of programs have had applicants renege on their commitment to begin a fellowship. Twenty percent of 2-year programs do not offer training in endovascular interventional procedures. Neurosurgeons perform endovascular interventional procedures at 18% of centers. There is an 18-fold variation in the volume of neuroangiographic procedures performed each year and a 150-fold variation in the volume of myelographic procedures performed. In 29% of programs, neuroradiologists are nonparticipants in nonvascular interventional spinal procedures; in 40%, they share these procedures with musculoskeletal radiologists/nonradiologists. CONCLUSION: Interest in fellowship programs in neuroradiology is declining. An applicant's commitment to either begin a fellowship or complete 2 years of training cannot be regarded with assurance, and there is a lack of uniformity in many areas of the training experience, particularly in invasive diagnostic and therapeutic procedures.

Central Nervous System Diseases↗

A genetic study of sex hormone--binding globulin measured before and after a 20-week endurance exercise training program: the HERITAGE Family Study.

Familial aggregation and a major gene effect were assessed for baseline serum sex hormone-binding globulin (SHBG) levels and the response (post-training minus baseline) to a 20-week endurance training program in a selected sample of 428 non-obese nonhypertensive individuals from 99 white families who were sedentary at baseline in the HERITAGE Family Study. Baseline SHBG levels were not normally distributed, and were therefore logarithmically transformed prior to genetic analyses. In a sample without postmenopausal mothers, maximal (genetic and familial environmental) heritabilities were 50% averaged across sexes, 73% in men, 50% in women, and 31% in men versus women for the age-body mass index (BMI)-adjusted baseline. The estimate reached 64% when the baseline was further adjusted for the effects of estradiol, fasting insulin, and testosterone levels. For the response to training, no sex difference was found and the heritability reached about 25% to 32%. Segregation analysis was separately performed in the whole sample and in the sample without postmenopausal mothers. In addition to a multifactorial effect for both the baseline and the response to training, a major effect for the baseline appeared to be familial environmental in origin, whereas a major effect for the response to training was Mendelian in nature. The major gene effect for the response to training in the whole sample was undetectable in the sample without postmenopausal mothers, and it is therefore possible that the postmenopausal mothers, characterized by decreased sex hormones with or without estrogen replacement therapy for menopause, produced some confounding effects. In addition, the reduced sample size might also be a plausible candidate explanation. The novel finding in this study is that baseline SHBG levels and the response to training were influenced by a multifactorial effect with sex difference for the baseline. The response to training appeared to be additionally influenced by a single recessive locus that is independent of baseline SHBG levels.

Adult↗