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PubMed1995

How uniform are post-graduate training programs in medical oncology in the European Union?

BACKGROUND: Medical oncology is a relatively new discipline whose rapid evolution is not paralleled by advances in the academic curricula. The present study was designed to provide a description of the status of post-graduate training programs in medical oncology in the European Union. RESULTS: Our survey shows that 'some form' of training in medical oncology is available in 10 countries of the European Union, but that there are officially recognized Schools of Specialization in this discipline in only four (Great Britain, Portugal, Republic of Ireland and Spain). Italy and France offer training programs in medical oncology as specific tracks of the School of Specialization in Oncology. A 'special competence' in medical oncology, within the specialty of internal medicine, is issued in 3 additional countries (Denmark, Belgium and the Netherlands). Finally, training in medical oncology is linked to that in haematology in Germany. A wide variation was found among the different European countries regarding the requirements for admission to these training programs. Similarly, the duration of the programs in the various schools ranges between 2 and 6 years and the total number of years from graduation to achievement of the title of specialist ranges from 4 to 9 years. CONCLUSIONS: Our survey discloses a broad heterogeneity of academic attitude regarding medical oncology in the European Union and points to the need for recognition of this discipline as a specific and essential specialization.

Education, Medical, Graduate↗
PubMed1975

Frequency and duration of interval training programs and changes in aerobic power.

This study was designed to ascertain whether 7- and 13-wk interval training programs with training frequencies of 2 days/wk would produce improvement in maximal aerobic power (VO2max) comparable to that obtained from 7- and 13-wk programs of the same intensity consisting of 4 training days/wk. Sixty-nine young healthy college males were used as subjects. After training, there was a significant increase in VO2max (bicycle ergometer, open-circuit spirometry) that was independent of both training frequency and duration. However, there was a trend for greater gains after 13 wk. Maximal heart rate (direct lead ECG) was significantly decreased following training, being independent of both training frequency and duration. Submaximal VO2 did not change with training but submaximal heart rate decreased significantly with greater decreases the more frequent and longer the training. Within the limitations of this study, these results indicate that: 1) maximal stroke volume and/or maximal avO2 difference, principle determinants of VO2max, are not dependent on training frequency nor training duration, and 2) one benefit of more frequent and longer duration interval training is less circulatory stress as evidenced by decreased heart rate, during submaximal exercise.

Adult↗
PubMed1986

The use of goal attainment scaling to evaluate a cancer research training program for high school and college students.

Goal attainment scaling has been used frequently in the evaluation of mental health services. The purpose of this study was to assess the usefulness of the goal attainment scaling methodology in the evaluation of a cancer research training program. Subjects were 62 high school and college students participating in a summer research program. Prior to the program, all students were asked to predict the specific outcomes they expected to attain in relation to eight independent dimensions of the research training program. At the close of the program students were asked to indicate the outcome they attained for each dimension. Students also ranked the importance of each dimension. The analyses indicated that participants entered the program with accurate expectations of their ultimate achievement and satisfaction with the program. Significant differences were found for expected outcomes on a number of program dimensions for the high school and college students at the preprogram assessment. Significant differences were also found for the high school and college students' importance rankings at both the pre-program and post-program period. Goal attainment scaling proved to be a valuable and flexible technique for the evaluation of a cancer research training program.

Adolescent↗
PubMed1975

A report of a 1972 survey of physician's assistant training programs.

This article presents select results of a 1972 survey of all physician's assistant training programs in the United States and its territories. The survey gathered a broad range of information useful to federal health manpower policymakers, physician assistant training program administrators, guidance counselors, and prospective students. Responses were received from 75 operational programs and 13 programs still in planning for an estimated response rate of 81 per cent from the estimated 108 programs in existence.

Accreditation↗
PubMed1993

Pediatric and MCH training in Japan: JICA training program in the National Children's Hospital.

The experience of the training program for overseas doctors in the National Children's Hospital during 8 years is described. The program was supported by the Japan International Cooperation Agency (JICA) and the objectives of the training course are to provide doctors from developing countries with a better understanding of diagnosis and treatment as specialized pediatricians and pediatric surgeons and to introduce recent medical techniques and equipment for child care. From 1984 to 1993, 37 doctors from 22 developing countries of Asia, Middle and South America and Africa have attended this program. There were 22 pediatricians, 14 pediatric surgeons and one dentist. The outline of this group training program and problems with the course are discussed.

Child↗
PubMedDate not supplied

Trust in training: the Oil, Chemical, and Atomic Workers International Union Worker-to-Worker Training Program.

The OCAW's Worker-to-Worker Training Program was established with one of the first grants awarded under the Superfund Amendments and Reauthorization Act of 1986. The union intended the program to serve as a model to industry and to raise the standard of safety and health training throughout the industry. The program, which requires trainees to actively participate in learning activities, has garnered praise from its participants.

Chemical Industry↗
PubMedDate not supplied

Evaluation of two training programs for laparoscopic cholecystectomy: incidence of major complications.

To determine the need for a training program for laparoscopic cholecystectomy, we evaluated two programs by surveying perioperative complications. The two programs were completed by eight surgeons in each. Program A consisted of 10 supervised operations and program B of only 2. A total of 1054 operations were performed, and 12 major complications required conversion to open surgery owing to transection of the bile duct in 5 cases, laceration of the common bile duct in 1 case, delayed perforation of the common hepatic duct in 1 case, bile leakage in 2 cases, duodenal injury in 1 case, and bleeding from the cystic artery in 2 cases. The incidence of a major complication was significantly higher in group B than in group A, and six of the nine major complications in group B occurred during the initial seven independent operations. Overall, the most common major complication was an injury during the operation to the common bile duct or to the hepatic duct. Four of the five transections of the bile duct required Roux-en-Y hepaticojejunostomy, and the other required end-to-end anastomosis with T-tube drainage; one laceration required simple suture closure; and the one delayed perforation required T-tube drainage. The mean duration of hospitalization for 7 patients with an injury to the bile duct was 74.4 days (range 16-151 days). We recommend that a training program for laparoscopic cholecystectomy should include at least 10 operations to prevent a major complication during the initial 10 operations.

Adolescent↗
PubMed1981

Accuracy of DSM-III diagnoses following a training program.

The authors describe a 2 1/2-day training program designed to teach mental health professionals how to use a new DSM-III classification scheme. The 251 participants had previous clinical training but no prior exposure to DSM-III. They were asked to diagnose three cases from a series of five videotapes case vignettes; the authors then compared the participants' diagnoses with the expert opinion of clinical faculty. The degree of agreement among the participants with the expert opinion varied across the five cases, but the overall level of agreement was high (74.2%). These results indicate that with adequate training the new DSM-III classification scheme can be accurately applied to diagnostic situations.

Clinical Competence↗
PubMed1983

The outcomes of mental health training programs: a review of the literature.

In these times of fiscal austerity, educators are asked increasingly to justify their programs. This review of literature indicates there are few controlled studies focusing on outcomes of mental health training programs, largely because the goals of training programs have been poorly identified and/or infrequently used as a basis for evaluation. In addition, these studies lack adequate criteria of success and standardized measures of success. Educators are, therefore, unable to critically evaluate the impact of the trained worker on patient care.

Community Mental Health Services↗
PubMed1980

Evaluation of a training program for certified alcoholism counselors.

Evaluation of a training program for alcoholism counselors indicated that such training resulted in significant gains in knowledge, changes in attitude, greater ego strength and capacity for self-disclosure, as well as higher ratings of trainees on scales of effectiveness of counseling.

Adult↗
PubMed1988

Audiology training in Nigeria--II: A cost-effective approach to training programs.

The purpose of this article is to provide some ways and means so that an audiology training program can be implemented in a developing country (Nigeria). Specific problems facing students, faculty and the training process itself are examined. Suggestions are provided to reduce these problems. In addition to mobilization of local resources, it is suggested that international cooperation be sought in the development, establishment and implementation of audiology training programs in developing countries. While the present approach may not be unique, it may provide some cost-effective means for meeting the shortage of hearing health care professionals in many developing countries.

Audiology↗
PubMed1996

Voucher-based reinforcement of attendance by unemployed methadone patients in a job skills training program.

This study evaluated the use of voucher reinforcement for maintaining attendance of unemployed methadone patients in a job skills training program. Participants received vouchers for attending daily 2-h computer data entry training sessions. The vouchers had monetary values and were exchangeable for goods and services. During the first 6-week condition, daily vouchers were initially worth $8, increased by $0.90 for every consecutive day of attendance to a maximum of $34.10, and reset to $8 following any day of missed attendance. During the second 6-week condition, voucher values decreased each day by 20% of that individuals' earnings on the previous day. During a final 4-week condition, the highest pay level previously achieved by each individual was reinstated and stayed at that level for the remainder of the condition, except that voucher values reset back to $8 following any missed session. Five of 7 participants completed the study. For those 5 participants, 94% and 98% attendance rates were sustained during first and second high pay conditions, respectively. Four of 5 subjects stopped attending when pay fell to $6-$9 (median = $7) per session in the descending pay amount condition (the fifth subject continued to attend throughout). Mean percent of work days attended was significantly higher during the two high pay conditions than during the decreasing pay condition (P < 0.001). All participants acquired data entry skills. Participants reliably rated the work experience as 'interesting', 'enjoyable', 'challenging', and 'helpful'. Mean ratings for these adjectives obtained on all days attended were significantly higher than ratings of the experience as 'frustrating', 'boring', or a 'waste of time' (P < 0.001). These data show that voucher-based reinforcement can promote sustained attendance of chronically unemployed substance abusers in intensive employment training programs and support the continued evaluation of these incentive procedures under a wider range of worksite training conditions.

Adult↗
PubMed1995

Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy. Part VI. Evaluation of psychomotor training programs in schizophrenic patients.

Parts I-III of this series established signs of disturbed motor performance--the "psychotic motor syndrome" (PMS)--in schizophrenic and endogenous depressed patients, which was not found in neurotic/reactive depressed nor healthy persons. Part IV yielded EEG signs of concomitant brain dysfunction in these patients, which were demonstrated by other (SPECT/PET) neuroimaging methods also. In part V we engaged in the development of motor-training programs applied both actively and mentally, using the PMS as target syndrome in depressed patients. We hypothesized that motor training would not only improve disturbed motor behaviour, but ameliorate other symptoms of psychopathology additionally, which was supported for these patients. Part VI is the final paper of this series demonstrating favourable results of our motor-training programs in 96 schizophrenic inpatients in two separate investigations. A general discussion to the whole series attempts to link motor symptoms to neuroimaging findings of brain dysfunction during motor challenge and to modern three- and four-factor models of schizophrenic symptomatology. A final version of our complete training programs will be published as an appendix to this paper along with information regarding the abbreviated test battery.

Adolescent↗
PubMed1994

The reading habits of RACGP Training Program doctors.

AIM: To describe the reading habits of a cohort of Western Australian RACGP Training Program doctors undertaking general practice terms in 1992. METHOD: A questionnaire that included a list of journals and books relevant to general practice was distributed to trainees. Information obtained included demographic data, the frequency of journal reading and the number of books read. RESULTS: There were 68 respondents from a total of 100. Time spent in medical reading ranged from one to 12 hours per week, with a mean of 3.3. The number of journal titles read in the past six months ranged from three to 16. The number of books actually read (from the 39 titles presented) ranged from zero to 17. The most frequently read were the reference type books. Very few of the 'core' books about the nature, scope and philosophy of general practice had been read. CONCLUSIONS: RACGPTP doctors read mainly for information. To produce educated doctors knowledgeable about their chosen discipline, the Training Program will need to place greater emphasis on introducing their vocational trainees to the writings of the thinkers and philosophers of general practice and family medicine.

Adult↗
PubMed1978

Ambulatory neurology in residency training programs: a perspective.

Inpatient care and teaching have been the central theme in academic medicine, including neurology, for the last several decades. However, pressures from within and outside of medicine are building to create a renewed commitment to ambulatory care and education. Most neurology training programs have not yet made that commitment. They should do so for the benefit of both the patients and residents served by the programs. Effective outpatient clinic training programs should include full-time staff devoted to ambulatory care, teaching, and research. The practicing clinical neurology staff could be used more effectively. Regular chart review, case management conferences, and other teaching strategies, and the reorganization of the clinic to include private patients, as well as group practice and interdisciplinary team concepts, could improve both the patient care and resident training in the neurology clinic.

Ambulatory Care↗
PubMed1992

What is the legal 'standard of medical care' when there is no standard medical care? A survey of the use of home apnea monitoring by neonatology fellowship training programs in the United States.

In treating a patient, a doctor is obliged to use the skill and care that is ordinarily used by reasonably well-qualified doctors in similar cases. In addition, the only way in which a juror may decide whether the defendant used the skill and care which the law required of him or her is from evidence presented by doctors called as expert witnesses (cf Illinois Pattern Jury Instructions). However, what should be done if expert opinions differ concerning the care that is "ordinarily used"? Home apnea monitoring (HAM) is prescribed at times for graduates of neonatal intensive care units despite the fact that indications for its use are not well established and efficacy is completely unknown. The authors attempted to determine standards for HAM as it is currently practiced in neonatology training programs. The primary teaching hospital for each of the 99 neonatology training programs in the United States was identified. Both the medical director (MD) and a neonatal intensive care unit nurse manager (RN) were asked about the use of HAM in their own nursery for four clinical vignettes. Each vignette depicted a 1000-g birth weight infant, currently 7 weeks old and ready for discharge. In three vignettes, the infant had demonstrated no apnea, mild apnea (resolved by 2 weeks of age), or moderate apnea (requiring theophylline therapy at discharge) during the hospital course. In the fourth vignette, the infant had no apnea but was to be discharged home with supplemental oxygen. For 67 of 99 training programs, paired responses of RN managers and MD directors were obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Aftercare↗
PubMed1977

Governmental peer review of training programs in child psychiatry.

The authors present the results of a review of grant applications from 84 child psychiatry training programs that was conducted by the Psychiatry Education Branch of NIMH during fiscal year 1975. They found that training programs whose applications were approved were (among other things) university based and successful in filling training positions; they provided experiences in two or more treatment modalities in varied settings and with diverse types of patients, had active liaison with community organizations and with departments of pediatrics, and provided research opportunities for trainees.

Child Psychiatry↗