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Encouraging cycling through a pilot cycling proficiency training program among adults in central Sydney.

In the face of declining population levels of physical activity, programs that encourage cycling represent an under-developed strategy in Australia. In 2003, we implemented a pilot cycling proficiency training (CPT) program for adults in central Sydney, New South Wales. To evaluate the program, participants completed pre- and post-course self-administered questionnaires and participated in a follow-up telephone interview 2 months after their course. Between April and December 2003, 20 CPT courses were conducted. Of 113 people who started a course, 81 (72%) completed at least one course (beginner or intermediate) and 105 (93%) took part in the pre and follow-up interview. Participant satisfaction with all aspects of the course was high. At 2-month follow-up, the course had significantly increased participants' self-reported skills and confidence for cycling. More than half of the participants (56%) said they cycled more 2 months after the course. There was a 40% increase in participants having cycled in the previous week at follow-up among baseline non-cyclists, although this was not statistically significant. There was also a significant increase in weekly participation in other forms of moderate intensity physical activity. Overall, the program was reasonably successful, particularly among those people not cycling at baseline. Cycling proficiency training for adults is one strategy that can supplement other active transport policies to encourage physical activity, although bicycle friendly urban planning and policies are still required to create more supportive environments for cyclists.

Adult↗

Wheelchair skills training program for clinicians: a randomized controlled trial with occupational therapy students.

OBJECTIVE: To test the hypothesis that a brief formalized period of wheelchair skills training, added to the standard curriculum, results in significantly greater overall improvements in wheelchair skills than a standard undergraduate occupational therapy (OT) curriculum alone. SETTING: Rehabilitation center. DESIGN: Randomized controlled trial. PARTICIPANTS: Eighty-two students in a university undergraduate OT program. INTERVENTIONS: All students received the standard university curriculum. The 22 second-year students, randomly allocated to the Wheelchair Skills Training Program (WSTP) group, were also trained (on a single occasion each, in groups of 1-3 at a time) on the 50 skills that make up the WSTP. The mean +/- standard deviation (SD) training time was 121.2+/-33.5 minutes per group. MAIN OUTCOME MEASURE: Total percentage score on the Wheelchair Skills Test (WST), Version 2.4. RESULTS: From before to after intervention, second-year students in the WSTP group increased their mean percentage WST scores +/- SD from 64.8%+/-9.0% to 81.0%+/-5.2%, a 25% improvement (P<.001). Over a comparable period, the 18 students in the second-year control group increased from 66.0%+/-8.0% to 72.4%+/-7.1%, a 9.7% improvement (P=.015). The WSTP group improved to a significantly greater extent (P=.005). For a subset of 8 students in the WSTP group who were retested 9 to 12 months later, the mean WST score was 79.7%+/-4.1%, not significantly less than their WST 2 scores (P=.29). The mean WST score for the 42 students in the fourth-year control group was 73.9%+/-4.1%, significantly lower than the mean postintervention WST score of the second-year students in the WSTP group (P< .0001) and not different from the second-year control group (P=.58). CONCLUSIONS: The WSTP is an effective way to improve the wheelchair-skills performance of OT students. This has implications for the education of all rehabilitation clinicians.

Adult↗

Wheelchair skills training program: A randomized clinical trial of wheelchair users undergoing initial rehabilitation.

OBJECTIVE: To test the hypothesis that a brief, formalized period of additional wheelchair skills training is safe and results in significantly greater improvements in wheelchair skills performance than a standard rehabilitation program. DESIGN: Randomized controlled trial. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-five wheelchair users (20 with musculoskeletal disorders, 15 with neurologic disorders) admitted for initial rehabilitation. Subjects' mean age +/- standard deviation (SD) was 59+/-18.3 years. INTERVENTION: Subjects randomly allocated to the treatment group participated in the Wheelchair Skills Training Program (WSTP), averaging 4.5+/-1.5 training sessions, each 30 minutes long. Subjects in the control group did not receive any wheelchair skills training beyond that given in a typical rehabilitation stay. MAIN OUTCOME MEASURES: Wheelchair Skills Test (WST), version 2.4, before and after training. Changes in total percentage WST score and individual skill scores were examined. RESULTS: There were no adverse incidents. The control group's mean percentage score +/- SD increased from 60.1%+/-14.4% to 64.9%+/-13.3%, an 8% improvement of the posttest relative to the pretest (P=.01). The WSTP group's mean score increased from 64.9%+/-9.4% to 80.9%+/-5.6%, a 25% improvement of the posttest relative to the pretest (P<.000). The WSTP group showed significantly greater improvements than the control group (P<.000). Among the specific skills, significantly greater improvements were seen in the WSTP group for the gravel and high-curb descent skills (P<.001). CONCLUSIONS: The WSTP is safe and practical and has a clinically significant effect on the independent wheeled mobility of new wheelchair users. These findings have implications for the standards of care in rehabilitation programs.

Adult↗

Training programs.

Explore the source record for details and available documents.

Inservice Training↗

Reciprocal peer management: Improving staff instruction in a vocational training program.

To test the feasibility and utility of involving peers as sources of feedback, 6 subjects, instructors in a vocational program for adults with mental retardation, participated in a staff training and management program. Subjects' teaching interactions were assessed during baseline, in-service training (on effective teaching), return-to-baseline, peer management, and follow-up phases. Peer management was introduced in multiple baseline fashion across pairs of subjects. Members of each pair were trained to monitor peer teaching, to record and graph data, to provide feedback, and to set goals with the peer. Each pair then performed these procedures on the job for several weeks, during which time 4 of the 6 subjects increased their use of effective teaching methods (over baseline). However, inconsistencies in the magnitude and durability of these increases require that the study be viewed as inconclusive, although it has heuristic value as a promising model for involving co-workers in staff management programs.

Journal Article↗

Gynecological laparoscopy in residency training program: Dutch perspectives.

BACKGROUND: Implementation of laparoscopy into residency training is difficult. This study was conducted to assess the current state of implementation of laparoscopic surgery into gynecological residency program, to identify factors influencing laparoscopic skills training, and to find solutions toward better training and implementation. METHODS: In 2003 a questionnaire was sent to all 68 postgraduate year 5 and year 6 residents in obstetrics and gynecology in The Netherlands. The questionnaire addressed demographics, performance of laparoscopy, self-perceived competence, simulator training, and factors influencing laparoscopic training in residency. RESULTS: Of the 68 residents, 60 (88%) responded; 46 (37%) were men and 78 (63%) women. Men showed significant higher mean self-perceived competence in some laparoscopic procedures than women. Of the respondents, 20% had no advanced laparoscopic gynecologist present in their teaching hospital. Residents felt that simulator training is important in relation to their performance in the operating room. Of all gynecological teaching hospitals in the Netherlands, 55% did not have the opportunity of simulator training. Of the respondents who had the possibility of simulator training, 33% did not use the simulator voluntarily. Residents who trained on a simulator felt training was significantly more important (p = 0.02) than residents who never practiced on a simulator. Respondents' laparoscopic skills were subjectively evaluated in the operating room (92%) or were evaluated based on the number of laparoscopic procedures performed as primary surgeon (49%). Of the respondents, 47% were satisfied with their current laparoscopic skills and 27% also felt prepared for the more advanced procedures. Not having been primary surgeon in nonacademic teaching hospitals and even more so in academic teaching hospitals (p < 0.05) was a limiting factor in acquiring laparoscopic skills. CONCLUSIONS: Incorporation of basic laparoscopic procedures into residency training has been successful; however, advanced procedures are not. Simulator training is still in its infancy in The Netherlands, is not frequently used voluntarily, and should be mandatory during residency. Acquired laparoscopic skills on a simulator and in the operating room should be objectively assessed, and above all, training of trainers is imperative.

Female↗

The Cultural Genogram: experiences from within a marriage and family therapy training program.

The purpose of this article is to illustrate and demonstrate the use of the Cultural Genogram (CG) in a graduate-level course in gender and culture for family therapists-in-training at a large Midwestern university's accredited program in family therapy. Although the importance of the CG as a training tool is delineated by Hardy and Laszloffy, very little information exists about the actual implementation and usefulness of this tool within a training program for family therapists. In this article, we present a qualitative research study of the lived experiences of a class of women from diverse cultures as they constructed and presented their CGs. We discuss the basic curriculum and structure of the course in which the CG was used, the process the class members developed to create and present their CGs, the effects of presenting the CGs, and a set of recommendations and ideas for further exploration.

Adult↗

Lessons learned in developing family medicine residency training programs in Japan.

BACKGROUND: While family medicine is not well established as a discipline in Japan, a growing number of Japanese medical schools and training hospitals have recently started sougoushinryoubu (general medicine departments). Some of these departments are incorporating a family medicine approach to residency training. We sought to learn from family medicine pioneers of these programs lessons for developing residency training. METHODS: This qualitative project utilized a long interview research design. Questions focused on four topics: 1) circumstances when becoming chair/faculty member; 2) approach to starting the program; 3) how Western ideas of family medicine were incorporated; and 4) future directions. We analyzed the data using immersion/crystallization to identify recurring themes. From the transcribed data, we selected representative quotations to illustrate them. We verified the findings by emailing the participants and obtaining feedback. RESULTS: Participants included: five chairpersons, two program directors, and three faculty members. We identified five lessons: 1) few people understand the basic concepts of family medicine; 2) developing a core curriculum is difficult; 3) start with undergraduates; 4) emphasize clinical skills; and 5) train in the community. CONCLUSION: While organizational change is difficult, the identified lessons suggest issues that merit consideration when developing a family medicine training program. Lessons from complexity science could inform application of these insights in other countries and settings newly developing residency training.

Academic Medical Centers↗

[Discussing the assessment of a nursing training program].

This article discusses the property of training activities developed in health sector, based on the author's experiences. It tries to evidence the most important aspects to introduce health workers training getting ahead mere especifical work dimention. It also intends to discuss the importance of this training as a part of the process for people improvement as well as for the knowledge transference process.

Clinical Competence↗

Developing an Internet-based communication system for residency training programs.

Administrative communication is increasingly challenging for residency programs as the number of training sites expands. The Internet provides a cost-effective opportunity to address these needs. Using the World Wide Web, we developed a single, reliable, accurate, and accessible source of administrative information for residents, faculty, and staff in a multisite internal medicine residency at reduced costs. Evaluation of the effectiveness of the website was determined by tracking website use, materials and personnel costs, and resident, staff, and faculty satisfaction. Office supply and personnel costs were reduced by 89% and personnel effort by 85%. All users were highly satisfied with the web communication tool and all reported increased knowledge of program information and a greater sense of "connectedness." We conclude that an internet-based communication system that provides a single, reliable, accurate, and accessible source of information for residents, faculty, and staff can be developed with minimum resources and reduced costs.

Adult↗

Do smoking prevention programs really work? Attrition and the internal and external validity of an evaluation of a refusal skills training program.

This study investigated the effects of a smoking prevention program that emphasized refusal skills training on 1730 adolescents in three high schools and six middle schools. Classes within these schools were randomly assigned to treatment or no-treatment conditions to avoid confounding schools with treatment condition. The effects of attrition on the internal and external validity of the study were examined. Although the results indicated an apparent effect of the program at the 1-year follow-up in deterring continued smoking among those who were smoking at pretest, this result may have been due to a higher rate of attrition among high-rate smokers in the treatment condition than in the control condition. Attrition also affected external validity. Across both conditions, subjects who were smoking at pretest and who were at risk to smoke were more likely to be missing at follow-up. The program did have an effect on the refusal skills of participants and the validity of this effect was not jeopardized by differential attrition.

Adolescent↗

Evaluation of postdoctoral physician-scientist training programs in obstetrics and gynecology.

Individuals previously awarded American Association of Obstetricians and Gynecologists Foundation/American Gynecological and Obstetrical Society or Reproductive Scientist Development Program postdoctoral physician-scientist training fellowship in Obstetrics and Gynecology were evaluated for their current status and research support. Forty-two (91%) of the first 44 fellows currently have medical school appointments, 15 at associate or full professor rank, and 75% have received extramural funding. These initial results are encouraging.

Education, Medical, Graduate↗

Cincinnati Restoration, Inc.'s housing support and training program.

A Cincinnati mental health agency has developed a unique program using in-home training and support to help people with mental illness help themselves. Cincinnati Restoration, Inc.'s Housing Support and Training Services was designed to help these adults attain independence.

Activities of Daily Living↗

A strength training program for postmenopausal women: a pilot study.

This pilot study examined a specific exercise program designed for skeletal muscle strengthening in postmenopausal women. The program consisted of patterns of movement using diagonal and spiral patterns, superimposed on a progressive weight-bearing sequence from prone lying to standing. Progressive resistance was provided with the use of progressively thicker elastic straps. Eighteen of an initial 22 healthy volunteer women aged 50 to 64 years completed 8 weekly hour-long group exercise sessions supplemented with twice weekly sessions at home to pilot test the program's safety, acceptability, and effectiveness in changing muscle strength. A physical therapist conducted baseline and final quadriceps, hamstrings, and grip strength assessments using a portable isokinetic dynamometer. Participants achieved a 21% increase in quadriceps (p < or = .001), 9% increase in hamstrings (p < or = .07), and a 14% increase in grip strength (p < or = .002). A positive dose-response relationship was observed between strength gains and compliance with the program. This approach to strength training in postmenopausal women is feasible and effective in increasing muscle strength. It has considerable promise and deserves further testing and evaluation.

Biomechanical Phenomena↗