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PubMed1985

Goals, objectives, and competencies for reference service: a training program at the UCLA Biomedical Library.

The UCLA Biomedical Library, in cooperation with the UCLA Graduate School of Library and Information Science, offers a medical library internship program for second-year library school students. Goals, objectives, competencies, and training guidelines have been developed for the reference services section of the internship, including reference desk experience, online searching, group discussions, assigned readings, and training new staff members, allows flexibility in meeting the differing interests, needs, and abilities of trainees.

Competency-Based Education↗
PubMed2004

Coronary risk factor management in the framework of a community hospital-based ambulatory exercise training program.

Ischemic heart disease is a chronic illness that causes major mortality and morbidity. Angiographic studies have shown the effectiveness of exercise programs, in combination with aggressive lipid management, in reversing or slowing the progression of atherosclerotic coronary disease. Despite these studies, participation in supervised programs that combine exercise and risk-factor management is limited. The authors measured the ability of a community hospital-based ambulatory cardiac rehabilitation program to recruit patients and to facilitate reduction of risk factors that have been demonstrated to influence progression of disease. Patients were recruited from a single community hospital for an ambulatory exercise training and cardiac risk-factor management program, and clinical and laboratory data was collected periodically. Recruited patients participated in a minimum 3-month period of training and counseling by a multidisciplinary team with follow-up measurements of weight, lipid profile, blood pressure, and exercise capacity. Thirty-two percent of the eligible hospitalized patients were successfully recruited into the program. Dropout rates over the initial 3 months were low (25%). Improvement in low-density lipoprotein cholesterol level (-4.5%), high-density lipoprotein cholesterol level (+7%), body mass index (-2%), systolic blood pressure (-3%), and maximum metabolic equivalents (+25%) were comparable to levels achieved in studies showing angiographic stabilization and/or regression of disease. Implementation of a community hospital-based risk management exercise program is an effective method for improving the long-term management of patients with chronic ischemic heart disease.

Blood Pressure↗
PubMed1978

Future impact of manpower needs on ophthalmology training programs.

Current projections for ophthalmology manpower needs in the year 2000 suggest that the number of new ophthalmologists trained should be frozen at 500 a year. Factors that would cause a need to train more ophthalmologists would be a shorter workweek or workyear, an increased length of time for each patient visit, universal comprehensive health insurance, an earlier age of retirement, and an increased incidence of eye disease. The factor that would most likely reduce the need for new ophthalmologists would be the transfer of primary eye care delivery to nonophthalmologists. Modulation of resident numbers should be based on peer-judged program quality, not on geography or government edict.

Forecasting↗
PubMedDate not supplied

Successful development and implementation of' a tactical emergency medical technician training program for United States federal agents.

INTRODUCTION: The emerging need for tactical operations in law enforcement often places personnel involved at risk. Tactical operations often are carried out in environments in which access to emergency care is limited. With the war against terrorism expanding, special operations involving United States federal agents are occurring worldwide. Currently, there are very few tactical medicine curricula training traditional emergency medical services (EMS) providers to operate in these high-risk missions. Trainees in existing programs must have previous EMS experience, and are selected from a wide range of backgrounds. The goal of this study is to examine a Special Agent Emergency Medical Technician (SAEMT) training curriculum developed specifically for federal special agents with prior experience in tactical operations, but without previous medical training. METHODS: An analysis of the SAEMT Program given to federal agents of the Drug Enforcement Administration (DEA) in Quantico, Virginia between July 2000 and April 2002 was performed. The SAEMT curriculum provided enrolled agents 181.5 hours of training in tactical emergency topics, including medical mission planning, logistics, operations, evacuation, and weapons training. In addition, SAEMT concurrently provides emergency medical technician (EMT) training. All of the participants were DEA agents with no previous medical training. Upon completion of the course, all participants took the National Registry of EMT-Basic examination. Measured endpoints included course completion rate and performance on certifying examinations. RESULTS: Ninety-five agents were enrolled and successfully completed the SAEMT course between July 2000 and April 2002. Of the agents enrolled, 84 (88%) passed the National Registry of EMTs-Basic examination within two attempts. CONCLUSION: The SAEMT Program provides basic emergency medical training to federal special agents with no previous medical experience. The design of this program provides a useful template to meet the expanding demand for tactical emergency medical personnel.

Certification↗
PubMed1995

Variability in the clinical skills of residents entering training programs in surgery.

BACKGROUND: Residents may have significant differences in clinical skills at the start of their surgical training. The purpose of this study was to investigate the variability in these skills by using an objective structured clinical examination. METHODS: A needs assessment was performed, and an objective structured clinical examination composed of 10, two-part stations was developed. Standardized patients (SPs) were trained, validated, and used as both simulated patients and evaluators to assess history taking, physical examination, and interpersonal skills of 10 first-year surgical residents. Structured patient notes (PNs) written by residents after the SP encounters were used to assess history and physical examination documentation skills. Data from one station were not used because more than 25% of the SP ratings were missing. RESULTS: The alpha-reliability was 0.78 for SP ratings, 0.91 for PN scores, and 0.91 for the combined scores. ANOVA revealed significant variation in individual residents' clinical skills as assessed by SPs (F = 4.56, p < 0.01), PNs (F = 11.09, p < 0.001), or both (F = 10.9, p < 0.001). Paired t tests showed that residents scored significantly higher on history taking than on physical examination and attained significantly lower scores on documentation as compared with performance of both history and physical examination (p < 0.001 for each comparison). CONCLUSIONS: The results showed significant variability in clinical skills of the group of residents and yielded detailed information on the performance of each resident. The data were shared with individual residents and are being used to make changes in the educational activities of the program.

Clinical Competence↗
PubMed1996

Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events.

To evaluate the effect of cardiac rehabilitation and exercise training on depression after major cardiac events, we studied 338 consecutive patients in whom a major cardiac event had occurred 4 to 6 weeks previously and who were participating in phase II cardiac rehabilitation consisting of 36 sessions over a 3-month period. Depressive symptoms and other behavioral characteristics and quality-of-life parameters were analyzed by validated questionnaire. Depression was prevalent in patients with coronary heart disease, occurring in 20% of the patients evaluated. At baseline, depressed patients had lower exercise capacity, reduced high-density lipoprotein cholesterol level, and higher triglyceride levels; had lower scores for mental health, energy or fatigue, general health, pain, overall function, well-being, and total quality of life; and had greater scores for somatization, anxiety, and hostility than those of nondepressed patients. After cardiac rehabilitation, depressed patients had marked improvements in depression scores and other behavioral parameters (anxiety, somatization, and hostility) and quality of life. Depressed patients also showed improved exercise capacity, percentage of body fat, and levels of triglycerides and high-density lipoprotein cholesterol. Depressed patients exhibited statistically greater improvements in certain behavioral and quality-of-life parameters than did nondepressed patients. Two thirds of the patients who were initially depressed resolved their symptoms by study completion. In conclusion, depression is reduced in patients with symptomatic coronary heart disease patients enrolled in cardiac rehabilitation. Greater emphasis is needed to ensure that depressed patients are referred to and attend formal cardiac rehabilitation programs after major cardiac events.

Angioplasty, Balloon, Coronary↗
PubMed2001

A relaxation training program to increase self-efficacy for anxiety control in Alzheimer family caregivers.

This study investigated whether relaxation training would increase caregivers' self-efficacy for controlling anxiety associated with difficult behaviors by care recipients. Thirty-six individuals caring for relatives with Alzheimer's disease were taught four types of relaxation techniques. Caregivers' self-efficacy increased following the intervention. Length of time spent in the caregiving role and duration of time since care recipients' diagnosis were significantly related to caregiver self-efficacy before the intervention, but became non-significant following the intervention. An insignificant decrease in incidence of reported behavioral problems occurred following the intervention.

Adaptation, Psychological↗
PubMed2001

International education: 20 years after implementation of a training program.

Medical care in developing countries may be improved by various means. Advances in the medical education and training of specialists play an important role in improving health care systems. The results of the efforts of a neurosurgeon from North America who helped establish neurosurgical training in Taiwan are reported after a follow-up period of 20 years.

Canada↗
PubMed2001

Learning manual skills in spinal anesthesia and orotracheal intubation: is there any recommended number of cases for anesthesia residency training program?

Wide variability exists in the number of anesthetic procedures to which anesthesia residents are exposed during their training. The number of attempts at various procedures before a trainee becomes proficient at performing each anesthetic procedure is not known. To determine the learning process of 150 attempts of spinal anesthesia and 100 attempts of orotracheal intubation, the two most frequent anesthetic procedures, we evaluated 9 first-year anesthesia residents according to their rate of success or failure. The learning curves of both procedures revealed an initial rapid improvement of success during the first 20 attempts. Spinal anesthesia was more difficult to learn (p=0.0002) but the learning curves of spinal anesthesia and orotracheal intubation reached a nondifferent high success rate of 82 per cent and 88.9 per cent respectively (p=0.13). According to this study the institutional recommended number of cases for spinal anesthesia and orotracheal intubation were 112 and 27 cases respectively.

Adult↗