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PubMed1998

A comprehensive resident training program in operative endoscopy.

We describe a structured and uniform resident experience in operative endoscopy and analyze the costs of implementing such a program at an urban academic medical center. The residency curriculum at Northwestern Memorial Hospital incorporates a five-part approach to endoscopy training: weekly endoscopy rounds, an annual animal laboratory for residents, an individual animal laboratory, supervision by skilled endoscopic surgeons, and a laparoscopic training facility. Thirty-two residents have completed the training over 4 years. The annual cost of the entire program is $34,500, which can be offset partially by vendor support. A comprehensive and continuous endoscopic training program is an important and affordable part of resident education.

Animals↗
PubMed1998

Education and training in residential dementia care in Australia: needs, provision and directions.

This paper summarises existing education and training in dementia for aged care workers in Australia. The majority of aged care workers have no formal qualifications, while those with formal qualifications are mostly from a nursing background. Only half of nursing staff have attended any dementia care training. Existing training is either service based and provided in-house or by private consultants, or tertiary institution based and provided by academics and professional educators. There is considerable in-service and one-off service-based training being provided around Australia, but few of these training exercises are linked to competency standards or staff appraisal. While there are some formal courses addressing training in dementia care available in every state of Australia, the emphasis on dementia care within generalist tertiary institution courses for aged care workers varies considerably.

Australia↗
PubMed1989

Teaching MEDLINE to non-urban end users.

The University of Oklahoma Health Sciences Center (OUHSC) Library conducted a two-year program, funded by the National Library of Medicine (NLM), to teach Oklahoma's nonurban health professionals to perform searches of NLM's MEDLINE files using microcomputers. The training program included lectures, online demonstrations, and hands-on practice time. The initial target audience of non-urban physicians was later broadended to include other health professionals. Data collected on the 334 seminar participants included professions and specialties, previous microcomputer usage, and the size of their hospitals. On-site evaluation indicated a high degree of satisfaction with the trainers' communication skills, preparation, information imparted, and the visual aids used. The results of a follow-up survey to determine how many trainees subsequently obtained NLM codes, the amount of searching done, and the problems experienced await analysis.

Academic Medical Centers↗
PubMedDate not supplied

[Current status of cardiopulmonary resuscitation in Monterrey, Nuevo León, Mexico].

Upon a questionnaire based on the international standards of the American Heart Association on Basic Cardiac Life Support (CPR) a survey was conducted to determine the knowledge and capabilities of doctors and nurses of different hospitals of the Mexican Institute of Social Security in Monterrey, NL. The findings reported upon three groups were: the first (A) with informal training, the second group (B) without it, and the 3rd one (C) with formal training in cardiopulmonary resuscitation. Within these first levels and depending on the academic one, seven subgroups were formed. The four basic areas in the questionnaire were evaluated with percentage of correct answers from both, general and individual answers and the results were analyzed through statistical references. Outstanding was the very low number of people with formal training and of those with informal training, only 30% had executed practices with manikins. Both groups A and B had a 64% of correct answers, when compared to the 88% obtained by group C, give us a statistical value of P less than 0.001. Underlining the very low results and outcomes in the four areas analyzed. The conclusion reached is the need of formal training of both medical and nurse staff in the various techniques of cardiopulmonary resuscitation in our community.

Health Surveys↗
PubMed1999

Patients' understanding of the roles of interns, residents, and attending physicians in the emergency department.

OBJECTIVE: To assess patients' knowledge of the responsibilities and roles of physician training in the ED. METHODS: This was a prospective survey of a convenience sample of 345 adult patients and family members in an academic county ED. Thirty questions addressed the different roles, responsibilities, and hierarchies of physician levels of training. Four opinion-based questions assessed patients' willingness to have physicians-in-training care for them. RESULTS: 96.5% of the surveys were returned. Of the participants responding, 68% were Hispanic, 23% were non-Hispanic white, and 55% were women. Forty percent of the participants indicated that they had education greater than a high school diploma. Most participants answered fewer than 50% of the questions correctly, indicating that they did not understand the levels of physician training. Participants with higher education were more likely to know the correct answer. Seventy-nine percent of the participants believed that it is very important to know the level of training of their physicians. However, only 34% of the participants actually thought they knew the training level of their physicians when they were being treated. Twenty-nine percent of the participants did not want learning to take place on themselves by physicians-in-training. CONCLUSION: Participants believe that it is important to know their physicians' level of training, but they do not understand the roles and responsibilities of physicians-intraining in the medical training system in which they receive care. In particular, patients who have less than a high school education seem to know least about this system.

Adult↗
PubMed2003

Brief intervention by surgeons can influence students toward a career in surgery.

BACKGROUND: General surgery training programs are experiencing an alarming decrease in applicants. The purpose of the current study was to determine whether exposing students to surgery through a brief intervention early in their medical education could influence perceptions toward surgery as a career choice. METHODS: First-year medical students were asked to rank 19 items coded on a Likert-type scale from 1 (not important) to 8 (very important) regarding their beliefs about surgery as a career both before and after a brief 1-h intervention with a panel of surgeons. Each panelist spoke about his or her professional and personal lives, followed by a question and answer period. Survey data were analyzed by Wilcoxon sign-rank and Spearman rank correlation. RESULTS: Of 210 first year students, 121 (58%) students voluntarily attended and completed the presurvey and 94 (45%) the post, of which 82 were matched responses. Preintervention responses revealed that career opportunities, intellectual challenge, and the ability to obtain a residency position were positively correlated with surgery (P < 0.007) whereas length of training, lifestyle during residency, lifestyle after training, and work hours during residency were negatively correlated (P < 0.01). The following factors were significantly influenced by the intervention: academic opportunities, patient relationships, prestige, and gender distribution became more important whereas concern about debt and length of training became less important. CONCLUSIONS: Positive encounters with surgeons can favorably influence the perceptions of first-year medical students toward a career in surgery. In addition to addressing lifestyle issues, surgeons can and must make a concerted effort to interact with medical students early in their education and foster their interest throughout their career.

Attitude↗
PubMed2006

So you want to be a dermasurgeon: how to get training or choose a fellowship.

BACKGROUND There are many routes to obtaining training in dermasurgery. OBJECTIVE The objective is to discuss some considerations that may guide selection of dermasurgery training. METHODS Current training options are reviewed. RESULTS Some considerations that may guide selection of type of dermasurgery training include: (1) individual temperament; (2) the subtype of dermasurgery in which training is desired (Mohs, cosmetic surgery, laser); (3) family and geographic factors; (4) preference for private practice versus academic career; and (5) proportion of future practice to be devoted to dermasurgery. CONCLUSIONS There are a growing number of training choices for budding dermasurgeons, with multiple options available for each set of particular circumstances.

Career Choice↗
PubMed1985

From DNA to NDA--the impact of recombinant DNA technology on new drug development.

Man's long-standing efforts to alter living things through genetic manipulation have become reality. Recent advances in recombinant DNA technology have the potential to alter the drug-development process profoundly. The pharmaceutical industry has had to adjust its research efforts and develop new state-of-the-art laboratories. In addition to the standard biological and in vivo assays, many new tests are required, e.g., amino acid sequencing, high-pressure liquid chromatography, and radioimmunoassays. Academic researchers have played a vital role in developing the new biotechnology, supplying most of the basic scientific knowledge and the initial supply of the scientific work force. The recent shifting of support for scientific training from the government to the pharmaceutical industry has resulted in unprecedented academe-industry relationships. Universities now stand to profit significantly from patent rights resulting from biotechnology research efforts. While the advances in biotechnology have had considerable impact on the pharmaceutical industry and academia, they have thus far had only a minor impact on the regulatory process. To date, the preferred regulatory path appears to be modification of existing procedures through the issuance of guidelines, which can be updated as knowledge increases.

Academies and Institutes↗
PubMedDate not supplied

Designing and implementing a primary care intervention trial to improve the quality and outcome of care for major depression.

Complex interventions, which have been shown to improve primary care depression outcomes, are difficult to disseminate to routine practice settings. To address this problem, we developed a brief intervention to train primary care physicians and nurses employed by the practice to improve the detection and management of major depression. Before recruitment began, the research team conducted academic detailing conference calls with primary care physicians and nurses, and provided in-person training with nurses and administrative staff. Administrative staff screened over 11,000 patients before their visits to identify those with probable major depression. Primary care physicians delegated increased responsibility to office nurses, who educated over 90% of patients about effective depression treatment and systematically monitored their progress over time. Early results demonstrate that community primary care practices can rebundle traditional team roles over the short-term to provide more systematic mental health treatment without adding additional personnel. A rigorous evaluation of this effort will reduce time-consuming, expensive, and often unsuccessful efforts to "translate" research intervention findings into everyday practice.

Major Depressive Disorder↗
PubMed2003

Implementing PDA technology in a medical library: experiences in a hospital library and an academic medical center library.

Personal digital assistants (PDAs) have grown from being a novelty in the late 1990s to an essential tool for healthcare professionals in the 2000s. This paper describes the experiences of a librarian who implemented PDA technology first in a hospital library, and then at an academic medical center library. It focuses on the role of the library in supporting PDA technology and resources. Included are programmatic issues such as training for library staff and clinicians, and technical issues such as Palm and Windows operating systems. This model could be used in either a hospital or academic health sciences library.

Academic Medical Centers↗
PubMedDate not supplied

Evaluation of the Centers for Disease Control and Prevention's chronic disease state-based epidemiology for public health program support (STEPPS) program.

To identify effective strategies for improving epidemiology capacity in state chronic disease programs, staff epidemiologists and program directors from 25 states were interviewed using a structured questionnaire by phone or in person. Respondents reported three chief barriers to chronic disease epidemiology capacity: lack of institutional commitment and support for chronic disease epidemiology; lack of professional opportunities to engage with peers, colleagues, and scientists; and lack of trained epidemiology staff and resources to support chronic disease functions and activities. Epidemiology capacity in states would be improved by expanding the role and scope of staff placement programs; assisting states in establishing formal collaborations with academic institutions; and providing technical assistance to staff currently employed in states through training, consultation, and networking.

Centers for Disease Control and Prevention, U.S.↗
PubMed1978

Perspectives on the training experiences and the training needs of community psychologists.

The present study examined the attitudes and perspectives of Division 27 (Community Psychology) members toward training roles and issues. Surveys sent to Division members focused upon: (a) background and demographic data; (b) past and present academic and employment characteristics; (c) relevance of community psychology to present employment; (d) community psychology relevance as an area of training; and (e) roles and functions which are perceived as essential to community psychology. Results indicate that the membership perceives human service topics (social planning and community change) as more important than traditional direct service aspects. The significance of the emphasis on broader social system activities is discussed in relationship to the predominantly clinical academic background of Division members.

Attitude of Health Personnel↗
PubMed1996

Surgery in South Africa.

The practice of surgery in South Africa ranges from full-time service in state-funded and academic hospitals serving a largely indigent population to a private sector for medically insured patients. Surgical training occurs at eight medical schools, and specialist registration is obtained after 4 to 5 years with either a university-conferred degree or a fellowship from the College of Surgeons of South Africa. The wide spectrum of First- to Third-World diseases and the high incidence of trauma provide comprehensive experience for practical training. Surgical standards are uniformly high, matching and sometimes pioneering the very best of Western medicine. The health care system is undergoing radical change to correct the imbalances of the apartheid era. Academic institutions are under pressure, and with incipient major financial cutbacks, there is concern that the proud record of service, teaching, and research excellence may be compromised. To facilitate the mission of broadening health care services, diploma training in surgery for rural practitioners is being developed. Outreach programs and closer liaisons with surgical societies in sub-Saharan African countries have also been initiated.

Academic Medical Centers↗
PubMed1983

[A new concept for the training of odontological human resources].

This article describes different aspects, and particularly those of the academic-administrative structure of the Dentistry Program in the Health Sciences Faculty of Universidad Católica "Madre y Maestra," in the Dominican Republic. It presents a general account of the University's approach to the problems of health, and of the events leading up to the establishing of the Program, the basis on which this was done, the theoretical framework in which the curriculum is embedded, and the methodological principles applied. It also gives a detailed description of the curriculum, including the general and specific objectives, the structure and organization, and the modules comprised in each academic year. Finally, the teaching-learning, service, and research activities, and an account of the resources available for the conduct of the Program are reviewed in brief.

Curriculum↗
PubMed1998

Model of computerized academic medical clinic.

In the traditional medical graduation course, the student receives a great amount of information while training at the Outpatient Care; the student assumes the physician's role, collecting all the information regarding the patient's clinical history and learns to get along with patients as well. During the attendance process, several factors interfere in the academic teaching, such as limitations of room numbers, amount of patients, difficulties in obtaining medical records, paper illegibility, among other problems. Due to those difficulties, the Model of Computerized Academic Health Clinic, implies in a new learning paradigm in the medical practice, rethinking the traditional process of learning-attendance, where the old model, in which attendance is restricted to a place, is extended in an open atmosphere of shared knowledge, rich of computer resources. The pilot project was implanted in the Pediatrics General Health Clinic of UNIFESP/EPM. It allows that the fifth-year medical students, residents, trainees and tutors use computerized clinics, connected with the academic net of UNIFESP and to the Internet. All the computing and information resources settled at the Outpatient Care improved the organization of its services, increased the medical students' curiosity, improved their participation in learning through interactive programs and clinical attendance.

Academic Medical Centers↗
PubMed1985

Relationship between music therapy students' contact with and attitude toward disabled persons.

The purpose of this study was to determine the extent to which the amount and type of contact with disabled persons affects student attitudes toward these individuals. University music therapy students (N = 67) were divided into four groups: Group 1 acted as a no-contact control. Group 2 viewed videotapes of disabled persons and received information about clients viewed. Group 3 observed music therapy sessions and participated in post-session feedback, and Group 4 planned, conducted, and evaluated actual music therapy clinic sessions. After pretesting with Nelson's Musical Interaction Scale, students participated in assigned therapy training sessions 3 hours per week for 12 weeks, followed by posttesting with the same measurement scale. Multivariate analysis of covariance using pretest scores as covariates revealed no significant group differences on the Musical Interaction Scale subscales due to degree and type of client contact or to students' academic class. The article discusses the impact of these results on clinical training.

Analysis of Variance↗
PubMed2003

Gender differences among physician-scientists in self-assessed abilities to perform clinical research.

PURPOSE: To examine gender differences in physicians' self-assessed abilities to apply knowledge and skills in six core competencies for success as a clinical investigator. METHOD: A written questionnaire containing 35 learning objectives was administered to physicians involved in a clinical-research training program at the University of Wisconsin-Madison. Between 2000 and 2002, 57 postgraduate trainees (49% women) completed the questionnaire; 40 of the 57 completed the questionnaire a second time after a four-day intensive workshop in clinical research. The main outcome measure was gender differences in ratings for each question answered. RESULTS: Before the workshop, women physicians rated their abilities lower than men rated their own abilities on 22 of 35 learning objectives and women were significantly lower in rating their ability to spend sufficient time developing and advancing their own area of scientific knowledge and research. After the workshop, women rated themselves lower than men rated themselves on 33 of 35 objectives, with significant differences in seven. Women did not rate themselves significantly higher than men rated themselves on any of the 35 objectives assessed. CONCLUSION: Women physicians consistently rated their abilities to perform or apply knowledge and skills related to clinical research lower than men rated themselves, and a traditional training venue exacerbated these gender differences. This previously unexplored gender difference in self-perceived competency may indicate an additional barrier women face in academic career development and suggests that educational programs incorporate learning activities that address gender differences when training physicians for careers in clinical research.

Biomedical Research↗