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Integrating a bovine rectal palpation simulator into an undergraduate veterinary curriculum.

There are problems associated with teaching bovine rectal palpation to undergraduate veterinary students. The students need opportunities to examine enough cows to develop the required skills, but increasing student numbers and limitations on access to cows have made this more and more difficult to achieve. A virtual reality-based teaching tool, the Bovine Rectal Palpation Simulator, has been developed as a supplement to existing training methods. The student palpates computer generated virtual models of the bovine reproductive tract while interacting with a haptic (touch feedback) device. During training sessions, the instructor follows the student's actions inside the virtual cow on the computer screen and gives instruction. A trial integration of the simulator into the fourth-year bovine reproduction course was undertaken at the University of Glasgow Veterinary School during the 2003/2004 academic year. Students were offered two training sessions, and feedback was gathered using questionnaires. In the first session, all students were taught a range of basic skills using a standardized teaching protocol. The second training session was customized to each student's learning needs and included practice in dealing with a range of on-farm scenarios. Student feedback indicated that the training had been useful for learning various aspects of bovine rectal palpation and provided information that helped in the further development of the simulator as a teaching tool.

Animals↗

Perception of Canadian training programs by Saudi resident trainees.

BACKGROUND: The aim of the study was to determine how Saudi medical trainees in Canada perceive their training programs with regards to educational, ethnic and socio-cultural issues, and if different factors such as the chosen field of training, place or level of training make any difference to this perception. SUBJECTS AND METHODS: All Saudi residents in training programs in Canada in the 1996/1997 academic year were surveyed using a written anonymous self-administered questionnaire, evaluating educational, ethnic and socio-cultural aspects of various training programs. RESULTS: The response rate was 72.5% (185/255). Most of the respondents were in the fourth year of training. Overall, the level of stress was rated as tolerable in 154 (83%), and 179 respondents (96.8%) described the educational aspects of their program positively. Furthermore, 154 (83%) of the respondents agreed that they were treated fairly in the distribution of job functions with regards to Canadian residents, and 133 (72%) did not face any major difficulty in practicing their religion. The sites of training, type of specialty and the level of training made significant impact on the perceived educational, social, religious and administrative aspects of training. CONCLUSION: The majority of Saudi medical trainees in Canada perceived the educational aspects of their training as a positive experience. Major problems faced were mainly related to administrative matters and to some extent, social adjustment. Issues that affect the training process need to be tackled by the concerned authorities to ensure the success of the training programs.

Journal Article↗

Psychobiology and psychopharmacology: issues in clinical research training.

Although the scope of basic studies in psychopharmacology and psychobiology has been expanding steadily for about 30 years, relatively few clinical psychiatrists, psychologists, and psychopharmacologists now choose to become researchers or teachers in these disciplines. Such training is crucial to the future vitality of both academic and private-practice psychiatry, and in view of increasing constraints on training funds, student researchers may well be an endangered species. With these concerns in mind, at its 1984 meeting, the American College of Neuropsychopharmacology's Education and Training Committee organized a symposium of investigators, administrators, and former trainees to explore aspects of effective clinical research training in psychobiology and psychopharmacology. Aspects discussed included mentoring, settings and content of training, depth versus breadth of curriculum, and the effect of a critical mass of colleagues at various stages of professional development. Following a brief overview, selected panelists addressed the issues from their individual perspectives.

National Institute of Mental Health (U.S.)↗

Improving patient safety: just do it!

Clinicians must celebrate and study medical errors. The dark culture of blame must be replaced by a scholarly culture of safety. This commentary presents six cases that show what we can learn from errors. The first step to identifying and understanding patient safety problems is to develop a common language for discussing patient safety. Latent unsafe conditions are ongoing circumstances of daily practice that reduce the safety of patients. An error is the failure ofa planned action to be completed as intended (error of execution), or the use of a wrong plan to achieve an aim (error of planning). Errors can be intercepted by appropriate action that minimizes the threat to patient safety. An adverse event is any unintended result of medical treatment that results in prolonged hospital stay, morbidity or mortality. If an adverse event is caused by an error, or series of errors, then it is a preventable adverse event. The teaching hospital is the first place where students (physicians, nurses, pharmacists and all other disciplines) are exposed to the culture of healthcare. It is essential to expose students to a culture of safety early in their training. Clinicians can make safety an academically important activity. Clinicians will find it difficult to undertake major safety initiatives given the existing constraints on time and energy. Although clinicians can identify the safety problems,there must also be a commitment to understand safety problems and make improvements. It is strongly recommended that hospitals train, implement and support Patient Safety Consultation Teams.

Adult↗

Managed care and the role and training of psychiatrists.

While each sector of medical practice and academic medicine confronts the reality of a changing economic environment driven by managed care, psychiatry faces some of the most difficult challenges in defining the future roles and training of psychiatrists. In this paper we describe the challenges and opportunities for psychiatry in this new era, as well as some of the unique problems facing academic psychiatry departments as they seek to fund their academic mission.

Academic Medical Centers↗

Memory strategy training in children with cerebral infarcts related to sickle cell disease.

Cerebral infarcts occur in approximately 30% of children with sickle cell disease (SCD), but little information exists regarding remediation of associated cognitive deficits. The authors examined the benefits of training children with infarcts to use memory strategies. Six children with SCD-related infarcts received academic tutoring; three of these children received additional training in memory strategies (silent rehearsal to facilitate short-term memory and semantic organization to facilitate long-term memory). The performance of children receiving strategy training appeared to improve more than that of children receiving only tutoring. Memory in children with SCD-related infarcts may be enhanced through strategy training.

Adolescent↗

Life as an academic medical statistician and how to survive it.

This article aims to review the professional life of academic medical statisticians. Topics covered include training opportunities, the shortage of medical statisticians, the relevance of PhD degrees, the varied working life (teaching, research, computing, refereeing etc.), research priorities across consultancy, collaborations and methodology, professional recognition and the variety of working environments. In conclusion, some tentative suggestions are made on how to survive happily in the world of academic medical statistics.

Curriculum↗

Surgical oncology fellowship: viable pathway to academic surgery?

BACKGROUND: Data that document academic status after surgical oncology fellowship are sparse. This study was done to report the academic status and clinical practice of graduates of a major surgical oncology program. METHODS: During the 10 years that ended in 1994, 68 fellows graduated. Each was surveyed about current academic status, number of jobs, job satisfaction, hours worked per week, and clinical practice. During 1995 and 1996, 11 fellows graduated. From this group, data were available on clinical practice while in fellowship (n = 6) and from the most recent year (ending July 1997) in a new position (n = 8). RESULTS: Sixty-seven of the 68 (99%) who were fellows from 1985 to 1994 returned surveys. Most (69%) are in "academic full-time" positions. Of those who listed an academic rank, 51% and 27% are assistant or associate professors, respectively. Job satisfaction was reported at a mean of 4.2, median of 5, on a scale from 1 to 5, with 5 being the best. Seventy-one percent remain at their first job, whereas 26% have had one previous position. The median number of hours worked per week was 70 (range, 45-100). Time allocation was patient care--60%; research--20%; education--10%; and administration--10%. CONCLUSIONS: Surgical oncology fellowship results in the majority placed in academic surgery, satisfied with their positions. Graduates are prepared for current practice patterns, and surgical oncology fellowship training should be suggested to residents interested in academic medicine.

Academic Medical Centers↗

Plasma concentrations of beta-endorphin in trained eumenorrheic and amenorrheic women.

OBJECTIVE: To characterize the pattern of plasma beta-endorphin throughout the normal menstrual cycle and test the hypothesis that beta-endorphin concentrations are elevated in trained women with amenorrhea compared with trained and sedentary eumenorrheic women. DESIGN: Cohort analytic study. SETTING: Academic research environment. PARTICIPANTS: Healthy female volunteers: 10 eumenorrheic sedentary, 11 eumenorrheic trained, and 11 amenorrheic trained women. INTERVENTIONS: Blood samples were collected three times per week for either one complete menstrual cycle (eumenorrheic sedentary and trained subjects) or for a 4-week period (amenorrheic trained subjects). MAIN OUTCOME MEASURE: Plasma beta-endorphin concentrations. RESULTS: beta-Endorphin levels varied considerably across the sampling period and were not associated with menstrual status, gonadotropin, or gonadal steroid concentrations. Average beta-endorphin levels were not different between the follicular and luteal phases for menstruating subjects, but were greater in the eumenorrheic athletes. Compared with eumenorrheic sedentary subjects, plasma beta-endorphin levels were higher in the athletic groups, regardless of menstrual status. CONCLUSION: There were no cycle-related beta-endorphin changes. Eumenorrheic and amenorrheic athletes have higher beta-endorphin concentrations that may reflect adaptations to intense training and not exercise-associated amenorrhea.

Adult↗

X-train: teaching professionals remotely.

Increased popularity of the Internet, along with the development of new software applications have dramatically improved our ability to create and deliver online continuing education trainings to professionals in the areas of nutrition and food safety. In addition, these technological advances permit effective and affordable measurement of training outcomes, i.e., changes in knowledge, attitude, and behavior, that result from these educational efforts. Impact assessment of engagement programs is becoming increasing important for demonstrating the value of training activities to stakeholders. A novel software program, called X-Train, takes advantage of technological advances (databases, computer graphics, Web-based interfaces, and network speed) for delivering high-quality trainings to teachers and health care professionals. X-Train automatically collects outcome data, and generates and sends certificates of completion and communicates with participants through electronic messages. X-Train can be used as a collaborative tool whereby experts from various academic institutions are brought together to develop Web-based trainings. Finally, X-Train uses a unique approach that encourages cooperative extension specialists and educators to promote these educational opportunities within their state or county.

Dietary Supplements↗

Female urologists: a growing population.

PURPOSE: Although urology continues to be a male dominated field, the participation and influence of women within the specialty are growing. In the United States as of July 1995, 56 of 1,339 urology residents (4.2%) and 97 of 8,227 board certified urologists (1.2%) were women. The demographics of this group, including age, board certification, fellowship experience and practice patterns, are unknown. Mentorship and motivations leading to urology as a specialty choice for women are also unreported. MATERIALS AND METHODS: We surveyed 161 female urologists by mail. RESULTS: Of the women surveyed 80% responded. Female urologists tend to be young and board certified, 39% are fellowship trained and 22% hold full-time academic positions. Women were discouraged from selecting urology as a specialty because of gender. Many women had male (59%) or no (35%) mentors throughout the training years, 70% were married and 44% had children. Of the 25 respondents who had children during residency most (84%) felt supported by the program director and resident peers. Despite obstacles 94% of female urologists would encourage other women to enter urology. CONCLUSIONS: Female urologists are young, well educated and career oriented. Although most did not have mentors during training, there is a high level of job satisfaction and low attrition after training.

Female↗

Where have all the cardiothoracic surgery residents gone? Placement of graduating residents by United States thoracic surgery training programs, 1998 to 2002.

OBJECTIVE: We studied the evolving job placement trends of graduating cardiothoracic surgery residents over a 5-year period from the perspective of the program director. METHODS: Graduate placement questionnaires were sent to program directors of Accreditation Council for Graduate Medical Education-accredited United States thoracic surgery residency programs (n = 92). Program directors were asked to categorize the type of job that each resident chose upon graduation (1998-2002). RESULTS: Of the program directors surveyed, 71.7% (66/92) responded, representing 76.4% (545/714) of the total graduating resident population during the study period. Three-year training programs constituted 24.2% (16/66) of the respondents and accounted for 20.2% (110/545) of the graduates. Annually, graduates most commonly chose private practice jobs. Between 2001 and 2002, the percentage of graduates entering fellowships increased (11.8% [13/110] versus 19.1% [21/110], P = .008) as the percentage of graduates choosing private practice positions decreased (56.4% [62/110] versus 45.5% [50/110], P = .15). In total, 12.8% (70/545) of the graduates pursued fellowships, with associated specialty choices being: 38.6% (27/70) adult cardiac, 37.1% (26/70) congenital, 15.7% (11/70) transplantation, and 8.6% (6/70) thoracic. There were no significant differences between 2-year and 3-year training program graduates in choice of private practice versus academic jobs. CONCLUSIONS: In 2002, a greater percentage of graduates chose to pursue fellowship training at the expense of private practice employment. This difference may in part result from fewer employment opportunities rather than graduate choice. Ongoing studies are needed to follow this trend. Annual analysis of the placement of all graduating residents would help to identify changes in employment.

Career Choice↗

Effect of an occupational intervention on printing in children with economic disadvantages.

OBJECTIVE: The purpose of this study was to evaluate whether an occupational therapy intervention improved an academic outcome (D'Nealian printing) in a school setting. The study specifically examined improvement in printing skills in economically disadvantaged first graders who were at risk academically and socially. The intervention was based on an occupational framework including biomechanical, sensorimotor, and teaching-learning strategies. METHOD: The final sample consisted of 59 first-grade children from a low socioeconomic urban elementary school-based health center who were randomly assigned to an occupational therapy intervention or a control condition. In addition to regular academic instruction, the intervention group received 10 weeks of training twice a week for 30-minute sessions. The control group received only regular academic instruction. Subjects were pretested and posttested on the Minnesota Handwriting Test, which assesses legibility, space, line, size, and form (the main variables in this study) as well as speed. RESULTS: Multivariate analysis of variance confirmed that the gain scores in the occupational therapy intervention group were significantly greater than those in the control group. The Hotelling-Lawley Trace value was 0.606, with F(5, 53) = 6.43, p < .0001). The estimated effect size (eta2) was .378, with an observed power of .994. Largest gains for the intervention group were in the areas of space, line, and size. CONCLUSION: The intervention group demonstrated a significant increase in scores on the posttest of the Minnesota Handwriting Test when compared to the scores of the control group. Occupational intervention was effective in improving the academic outcome of printing in children who are economically disadvantaged.

Child↗

Development of clinical scientists.

The education and training of clinical scientists has served society in several ways. For academic pharmacy, the emergence of clinical science has provided research and scholarship opportunities for clinical faculty development. Clinical scientists have also begun to play important roles in industrial drug research and development. For all faculty and students, clinical science research reinforces a "research mindset" that will become increasingly important as our society moves from a production/extraction to an information-based economy. Pharmacy will best evolve by increasing its commitment to clinical science research. In the process, academic pharmacy must continue to improve and support excellent education and training programs for clinical scientists.

Education, Pharmacy, Graduate↗

Selecting radiology resident candidates.

Radiology resident candidate selection has become a burdensome, subjective, and somewhat arbitrary process. Because the luxury of many well-qualified candidates exists, there is an obligation to select them as honestly, equitably, and objectively as possible. Two years were spent in revising and modifying the resident selection process to make it more uniform and more efficacious. An application scoring form was devised to extract uniform pertinent information from the original application form. Candidates could then be ranked according to a numerical score derived from the form. This allowed easy selection of top candidates to be interviewed. A new interviewing scoring form was developed to include desirable characteristics of resident candidate performance. This form was also devised in such a way as to be easily scored and to allow selection of the top 20 to 25 candidates. These candidates were then ranked by participating faculty members while reviewing their application score forms and their interview forms. Positions for the residency training program were offered according to the ranking. The usefulness of both new forms was evaluated and confirmed by correlating form scores with faculty ranking of academic performance of current residents in the training program.

District of Columbia↗

The educational impact of team-skills training: preparing students to work in groups.

BACKGROUND: Despite a vast literature on collaborative learning (CL), there is little research on preparing students to work collaboratively. AIMS: This two-phase evaluation investigated whether team-skills training could enhance the performance of collaborative groups through the introduction of a team development programme to a group-based undergraduate key-skills unit. SAMPLE: Phase 1 compared two consecutive cohorts of second-year students, Cohort 1 (N = 94) who received no preparation, and Cohort 2 (N = 113) who received team-skills training. Phase 2 added Cohort 3 (N = 88), who also received team-skills training, to extend the analysis. METHOD: In Phase 1, students in both Cohorts 1 and 2 worked on a series of curriculum based key-skill tasks across two semesters. Students worked in one group in Semester 1 and were then formed into new groups for Semester 2. Effects of the training were measured by student group marks and key-skill ratings. RESULTS: Marks and key-skill ratings were significantly higher for the trained cohort in Semester 1 (p < .01). However, in Semester 2 performance reduced for the trained cohort in comparison to Semester 1. To explore this further, Phase 2 of the study evaluated Cohort 3, where after training, collaborative groups remained intact throughout the academic year. Results for Cohort 3 showed no attenuation of performance effects in Semester 2. CONCLUSIONS: Phase 1 results support the use of team-skills training to enhance CL group performance. The findings for Phase 2 suggest that these benefits may be lost if training groups are disrupted.

Adolescent↗

The effects of Arthritis Society fellowships on career choice.

OBJECTIVE: To find out if The Arthritis Society (TAS) fellowship grants influenced career choice or career development. METHODS: Two hundred former TAS training fellowship recipients (1975-1990 inclusive) were sent a questionnaire to evaluate the effects of TAS clinical or research fellowship support on their subsequent career development. RESULTS: One hundred and forty (70%) completed questionnaires were returned by 88 clinical and 37 research fellowship recipients--a further 17 had received both a clinical and a research fellowship. Fifty-one percent of the respondents are now academic rheumatologists, 40% in community practice and 9% still in training. Seventy-three percent of the research fellowship recipients currently receive research grant support, compared to 16% of the former clinical fellowship recipients. Seventy-one percent agreed that their TAS fellowship support had "directly or indirectly influenced or facilitated their chosen career path"--this included 100% of the research fellowship recipients, compared to 55% of the clinical fellowship recipients. The majority decided on an academic or a community based career path during their postgraduate training. Fourteen percent who trained for an academic career are now in community practice and 9% who planned on a community based career later became academic rheumatologists. Eighty-nine respondents (64%) enclosed a CV. This subset was further analyzed using career markers such as academic rank, number and size of research grants and number of publications. In this subset those who had received both a clinical and a research fellowship had the most advanced academic rank (22% full professor), largest number of publications (n = 39) and largest number of grants (5.3/year; average $40,446), compared to former research fellowship recipients: 4.0% full professor, 22 publications, 3.2 grants/year; average $25,164. Recipients of clinical fellowships in this subset had lower levels of all the academic career markers. CONCLUSION: Of 200 consecutive TAS fellowship recipients 71% of those responding (n = 140) to a career tracking study agreed that the fellowship support "directly or indirectly" influenced or facilitated their career choice. An apparent synergistic effect of providing both clinical and research fellowships on subsequent development of an academic career deserves further study.

Career Choice↗

National appraisal of dermatology residency training: a Canadian study.

OBJECTIVES: To provide the first comprehensive assessment of dermatology residency training in Canada based on the residents' perspective; to examine and elucidate trends in current residents' envisioned career paths and aspirations. DESIGN: A national survey conducted in June 2004. PARTICIPANTS: All Canadian dermatology residents. MAIN OUTCOME MEASURES: Cross-sectional analysis of (1) satisfaction with and importance placed by the trainees on the various curriculum components as measured by a 5-point Likert-type scale and (2) current residents' career and practice plans. RESULTS: One hundred percent of dermatology residents across the country (n = 48) responded to the survey. The greatest discrepancies between ranked importance and corresponding satisfaction were observed for the teaching from faculty (both didactic and clinic based) and for the practice management exposure and training. Residents were most satisfied with dermatopathology education (score, 4.4 of 5.0) and least satisfied with cosmetic dermatology (2.7 of 5.0) and dermoscopy training (2.8 of 5.0). Men indicated more interest than women in academics (71% [n = 12] vs 45% [n = 14]), research (41% [n = 7] vs 16% [n = 5]), and teaching (71% [n = 12] vs 42% [n = 13]), while female residents were more inclined toward pediatric dermatology (42% [n = 13] vs 29% [n = 5]) and cosmetic dermatology (48% [n = 15] vs 29% [n = 5]). An overall trend of decreased interest in academic and hospital-based practice was noted with progression through residency training. CONCLUSIONS: This study provides a current picture of dermatology postgraduate education in Canada from the residents' perspective. Above all, dermatology residents desire more teaching (clinic, didactic, and practice management) and mentorship from their faculty. Recruitment and retention of women in academic dermatology may benefit from early intervention during residency. The data are intended to assist dermatology programs with development, evaluation, and improvement of their curricula and can serve as a reference point to gauge future trends.

Attitude of Health Personnel↗