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PubMed1999

Recruitment of house staff into anesthesiology: factors responsible for house staff selecting anesthesiology as a career and individual training program.

STUDY OBJECTIVE: To identify factors responsible in the selection of anesthesiology as a career by Mayo Clinic house staff (i.e., residents and clinical fellows); to evaluate their level of satisfaction with their choice of career and training program, and their perceptions of the future for anesthesiology trainees. DESIGN: Cross-sectional analysis using a questionnaire survey of 67 house staff enrolled in the anesthesiology training program during the 1995-1996 academic year. SETTING: Mayo Clinic, Rochester, MN. MEASUREMENTS AND MAIN RESULTS: Forty-eight (72%) of those surveyed responded to the questionnaire. Data were analyzed using the Chi-square and Mann-Whitney rank sum tests. A p-value less than or equal to 0.05 was considered statistically significant. The most frequently cited reasons for selecting anesthesiology as a career included the following: it is a "hands-on" specialty, it involves clinical application of physiology and pharmacology, and it provides immediate gratification in one's work. The most frequently cited reasons for selecting our training program were the diversity of training experience, prestige associated with Mayo Clinic, and employment opportunities following training. Forty-four (92%) felt downsizing of anesthesiology training programs was a national trend, 26 (54%) anticipated difficulty obtaining a job following training, and 16 (33%) felt they had future job security. Overall, 47 (98%) were happy with their career choice, and 40 (83%) would choose anesthesiology as a career if they were now graduating from medical school. All 1996 graduates found suitable employment without difficulty. CONCLUSIONS: Our data indicate that selection of a career in anesthesiology and training program are strongly associated with concerns regarding educational experiences and postgraduate employment opportunities.

Adult↗

PubMedDate not supplied

A modular laparoscopic training program for pediatric surgeons.

OBJECTIVES: A structured endoscopic training program for pediatric surgeons has not yet been established. This study was conducted to develop a modular training program (MTP) for pediatric surgeons and to evaluate its effectiveness for surgeons with and without previous experience in laparoscopic surgery. METHODS: Nine pediatric surgeons participated in the study. They were divided into 2 groups: group A (n=4), surgeons who had experienced more than 10 cases of laparoscopic surgery prior to MTP; group B (n=5), those who had experienced fewer than 10 cases. They participated in a standardized MTP workshop, which consisted of 2 "see-through" and 3 "laparoscopic" tasks. Each participant's psychomotor skills were evaluated objectively before and after MTP with a computer-generated virtual simulator and were evaluated for precision, efficiency, and speed. RESULTS: In participants, speed was significantly enhanced after MTP. In group A, no differences were observed after MTP, whereas significant improvements were noted in efficiency and speed after MTP in group B. Before MTP, efficiency was significantly higher in group A than in group B; however, no difference remained between the 2 groups after MTP. CONCLUSIONS: MTP is effective for nonlaparoscopic pediatric surgeons to become familiar with basic endoscopic skills.

Adult↗

PubMedDate not supplied

Death anxiety and death competency: the impact of a palliative care volunteer training program.

Before and immediately after the 2 most recent offerings of a local palliative care volunteer training program, 17 participants completed the Collett-Lester Fear of Death Scale and Bugen's Coping with Death Scale. The training program consisted of approximately 27 hours of training presented in 3-hour blocks during a 9-week period. Topics included the philosophy and goals of palliative care, spiritual issues from a multi-cultural and multifaith perspective, communication, the dying process, grief and bereavement, and the role of the volunteer. The results showed no differences in participants' pretraining and posttraining scores on the 4 subscales of the Fear of Death Scale. However, participants felt significantly more able to cope with death and dying after the training program than before. With proper training, volunteers will feel more prepared to handle situations involving terminal illness and death. In short, they will be more effective in their work with dying patients and their families.

Adaptation, Psychological↗

PubMed1995

Neuropsychiatric training in American psychiatric residency training programs.

Psychiatric residency training directors are faced with the daunting challenge of incorporating an avalanche of neuroscientific advance into their programs. This survey of U.S. psychiatric residency training directors reveals that 1) the majority of residency directors consider that neuropsychiatry should fall under the purview of psychiatry and 2) many programs fail to provide adequate training in the evaluation and treatment of patients with neuropsychiatric disorders associated with problems such as developmental disabilities, movement disorders, and head injuries. Residency directors cite lack of faculty with subspecialty training in neuropsychiatry as the major hurdle to improving resident training in this area.

Attitude of Health Personnel↗

PubMed1980

Providing preventive dental care in the community using the team approach: a comparison of five training programs.

Five dental schools developed training programs for dental and dental auxiliary students in planning and delivering preventive dental services in a community setting. The schools (1) designed a curriculum that would train dental students to plan, organize, and manage the delivery of community preventive services using a team approach; (2) developed a related curriculum for dental auxiliary students; (3) implemented the program intramurally and extramurally in selected community settings; and (4) planned and conducted an evaluation of the program. Each school individualized the program to the interests of its students, the constraints of its curriculum, and the needs of community groups. A total of 228 dental and 576 dental auxiliary students were trained. A full range of community sites and target populations were provided with preventive dentistry services.

Clinical Competence↗

PubMed1983

The effects of a teacher training program in family life and human sexuality on the knowledge and attitudes of public school teachers.

This study evaluated the effects of a teacher training program in family life and human sexuality. An attempt was made to determine the extent to which age, sex, race, marital status and years of teaching experience can be used to predict sex-related attitudes of teachers. Teachers who volunteered for a Title IV-C Teacher Training Program in Family Living and Human Sexuality were tested before and after the training program using a knowledge test and an attitude inventory. The pretest and posttest scores of the experimental teachers were compared with a control group to assess the degree of change. Results indicated the teachers who participated in the teacher training program made significant gains in sex-related knowledge. While no changes were evident in overall attitudes, the experimental teachers became more accepting of the practice of masturbation. A major finding in the study was the relationship between age and permissiveness of attitudes toward controversial issues.

Adult↗

PubMed1980

The pharmacist practitioner training program.

Since 1973, the Indian Health Service has been training pharmacists to provide primary care to patients in an expanded role, including the compilation of complete medical histories, physical examination, diagnosis, and treatment of outpatients with selected acute and chronic illnesses. This article discusses the evolution of the Pharmacist Practitioner Training Program, the training and experience received through this program, and the utilization of graduates in the clinical setting.

Curriculum↗

PubMed2004

Subspeciality training in hematology and oncology, 2003: results of a survey of training program directors conducted by the American Society of Hematology.

A survey of directors of adult and pediatric hematology/oncology subspecialty training programs in the United States and Canada was conducted to assess the environment in which recruitment and training is conducted in these medical disciplines. A total of 107 program directors responded to the survey, representing 66% of internal medicine and 47% of pediatric subspecialty programs in hematology or hematology/oncology. Specific areas covered in the web-based questionnaire included the type and demographics of the training program, profile of the training program director, characteristics of the applicant pool and existing trainee recruits, characteristics of the training program environment and curricula, research productivity of trainees, and the career pathways taken by recent training program graduates (including dominant areas of clinical interest). The results of this survey show considerable heterogeneity in the recruiting practices and the environment in which subspecialty training occurs, leading the authors to recommend improvements in or a heightened attention to issues, including recruitment of minority trainees, flexibility to recruit international medical school graduates, timing of trainee acceptance, maintaining the financial support of Medicare graduation medical education (GME), training of physician scientists, organization of the continuity clinic experience, visibility of nonmalignant hematology as a career path, and level of training program director support.

Career Choice↗

PubMed1997

An analysis of the operative experience of North American pediatric surgical training programs and residents.

There has been a rapid increase in the number of pediatric surgical training programs. To meet the goals of quality patient care and surgical education, training and practice activities must be objectively monitored. The aim of this study was to collect and analyze the experience of American and Canadian Pediatric Surgical training centers and residents. The authors collected the 1-year operative experience of 31 American and six Canadian training programs and the 2-year operative experience of the 25 most recently graduated residents. Categories analyzed included total cases, defined categories (neonatal, important, and tumor cases), routine cases, thoracic, cardiac, urologic reconstructive, head and neck, endoscopy, vascular, plastics and burn procedures. From these data six assumptions about the training in pediatric surgery were addressed. (1) The operative activity of the United States and Canadian training programs and residents are comparable. The results show that there are few major differences in operative experience. (2) There should be variability in operative experience between programs but little variability between residents. The North American operative experience for both residents and institutions are marked by high variability and leftward shift in the frequency distributions. (3) A resident's training should consist of a significant portion of "index cases" and fewer routine cases. The residents perform 28% of their total cases in the three defined categories (index cases) and 26% as routine cases. (4) Pediatric surgeons are the true general surgeons, performing operations in areas such as cardiac, reconstructive genitourinary, plastic, and burn surgery. Examination of the data shows that most programs and residents perform few cases in these four areas. (5) Certain procedures such as thoracic, genitourinary, vascular, head and neck, and endoscopy remain within the domain of pediatric surgery. The results show that this assumption is true for thoracic, vascular, head and neck, and endoscopy but not for genitourinary, and there is wide variability between institutions and between residents. (6) "Core" pediatric surgical conditions such as esophageal atresia, biliary atresia, and intersex are still available in significant numbers to train residents. The data show that a surprising number of programs and residents perform few or none of the core operations. This analysis is the first step toward monitoring of pediatric surgical resident education. A future study is underway to evaluate the current experience of practicing pediatric surgeons who have taken the recertification examination.

Canada↗

PubMedDate not supplied

The MAPP training program evaluation.

This article reports on an evaluation of regional training programs designed to increase the knowledge and use of Mobilizing for Action through Planning and Partnerships (MAPP). The objectives for the MAPP training program included teaching participants about MAPP resources on the Web, providing participants with instruction about what MAPP is, and why it is important for community health improvement. Participants were also instructed on how to implement MAPP through a series of concrete steps such as mobilizing community partnerships, creating an action plan, conducting a series of assessments, and identifying strategic issues. An on-site survey with pretraining and posttraining questions and a follow-up survey were developed and administered to participants to assess their readiness levels to access MAPP resources and actively use and promote MAPP in their communities. The findings indicate that participants' knowledge of MAPP and confidence to use it improved as a result of training. Six months after training, participants' readiness levels increased from pretraining levels in the areas of incorporating MAPP into their roles, presenting MAPP to community partners, and using MAPP for community health improvement projects. Making changes in their organizations and communities to implement MAPP did not change significantly from pretraining levels. Just under half of training participants were implementing MAPP 6 months posttraining.

Community Health Planning↗

PubMed2002

Interactions of staff and residents with pharmaceutical industry: a survey of psychiatric training program policies.

OBJECTIVES: In response to perceived controversies regarding interactions between physicians and the pharmaceutical industry, we undertook a study to look at the relationship between Canadian psychiatry training programs and the pharmaceutical industry. METHODS: The authors distributed a survey to the residency program directors and chief residents of the 16 psychiatry training programs in Canada. RESULTS: Of respondents, 75 per cent were either unaware of or noted an absence of policies or guidelines regarding interactions with the pharmaceutical industry in their training programs; 70 per cent viewed staff psychiatrists and residents to be at least 50 per cent familiar with the Canadian Medical Association's policy summary; and 74 per cent were unaware of any structural teaching regarding potential conflicts of interest between psychiatry and the pharmaceutical industry. A significant number of respondents perceived occasional excessive influence by the pharmaceutical industry on residents' training. CONCLUSIONS: Despite concerns about potential conflicts of interest, there are a few guidelines in most psychiatry training programs in Canada regarding the relationship between physicians and the pharmaceutical industry.

Canada↗

PubMed2002

Benchmarks of support in internal medicine residency training programs.

PURPOSE: To identify benchmarks of financial and staff support in internal medicine residency training programs and their correlation with indicators of quality. METHOD: A survey instrument to determine characteristics of support of residency training programs was mailed to each member program of the Association of Program Directors of Internal Medicine. Results were correlated with the three-year running average of the pass rates on the American Board of Internal Medicine certifying examination using bivariate and multivariate analyses. RESULTS: Of 394 surveys, 287 (73%) were completed: 74% of respondents were program directors and 20% were both chair and program director. The mean duration as program director was 7.5 years (median = 5), but it was significantly lower for women than for men (4.9 versus 8.1; p =.001). Respondents spent 62% of their time in educational and administrative duties, 30% in clinical activities, 5% in research, and 2% in other activities. Most chief residents were PGY4s, with 72% receiving compensation additional to base salary. On average, there was one associate program director for every 33 residents, one chief resident for every 27 residents, and one staff person for every 21 residents. Most programs provided trainees with incremental educational stipends, meals while oncall, travel and meeting expenses, and parking. Support from pharmaceutical companies was used for meals, books, and meeting expenses. Almost all programs provided meals for applicants, with 15% providing travel allowances and 37% providing lodging. The programs' board pass rates significantly correlated with the numbers of faculty fulltime equivalents (FTEs), the numbers of resident FTEs per office staff FTEs, and the numbers of categorical and preliminary applications received and ranked by the programs in 1998 and 1999. Regression analyses demonstrated three independent predictors of the programs' board pass rates: number of faculty (a positive predictor), percentage of clinical work performed by the program director (a negative predictor), and financial support from pharmaceutical companies (also a negative predictor). CONCLUSIONS: These results identify benchmarks of financial and staff support provided to internal medicine residency programs. Some of these benchmarks are correlated with board pass rate, an accepted indicator of quality in residency training. Program directors and chairs can use this information to identify areas that may benefit from enhanced financial and administrative support.

Benchmarking↗

PubMed2006

Using eye movements to evaluate a PC-based risk awareness and perception training program on a driving simulator.

OBJECTIVE: Evaluation of the effects of a PC-based training program on risk perception in a driving simulator. BACKGROUND: Novice drivers have a fatality rate some eight times higher than that of the most experienced group of drivers, primarily because of the novice driver's inability to predict ahead of time the risks that will appear in the roadway. Current driver education programs, at least those in the United States, do not emphasize the teaching of risk awareness skills to novice drivers. METHOD: A PC-based risk awareness and perception training program was developed and evaluated. The training involved using plan (top-down) views of 10 risky scenarios that helped novice drivers identify where potential risks were located and what information should be attended. Both the 24 trained novice drivers and 24 untrained novice drivers were evaluated on an advanced driving simulator. The eye movements of both groups of drivers were measured. The evaluation on the driving simulator included both scenarios used in the training and others not used in training. RESULTS: The set of trained novice drivers were almost twice as likely as untrained drivers to fixate appropriately either on the regions where potential risks might appear or on signs that warned of potentially risky situations ahead, both for the scenarios they had encountered in training and for novel scenarios. APPLICATION: The PC training program developed, which is portable and can be widely used, has great promise in improving risk perception for novice drivers on the road.

Adolescent↗

PubMed1998

The effects of a stress-management training program in individuals at risk in the community at large.

In this study we examine the effects of a stress-management training program on individuals without serious (mental) health complaints but with an increased chance of developing them as a consequence of stress. Potential subjects were randomly selected from the community at large and, then screened for participation in the training program if some of several (mental) health risk factors could be attributed to them: past life-events, neuroticism, inassertiveness, avoidant coping style and lack of social support. The control group, which did not take part in the training program, consisted of individuals with a similar risk profile as those in the training group. The training program consisted of several stress-management techniques: changing unhealthy life-style, relaxation training, problem-solving training and social skills-training. Multivariate analyses of variance showed that the training group, as compared to the control group, reported significantly less distress, less trait anxiety, less daily hassles, more assertiveness and more satisfaction with social support at follow-up. There were, however, no significant changes found in the coping skills of either group.

Adaptation, Psychological↗

PubMed1997

Effects of a 6-week strength and proprioception training program on measures of dynamic balance: a single-case design.

OBJECTIVE: To examine the effects of a 6-week strength and proprioception training program on clinical measures of balance, and to introduce characteristics of a single-case research design that may be beneficial to the athletic training profession as both a research and a clinical tool. DESIGN AND SETTING: A multiple baseline design across subjects was used to assess the effects of the intervention. The training program was performed three times a week and consisted of manual muscle strengthening and proprioception training for the plantar flexor, dorsiflexor, inversion, and eversion muscle groups. SUBJECTS: Three subjects (age = 17.6 +/- 1.24 yr, wt = 78.6 +/- 1.07 kg, ht = 186.2 +/- 4.3 cm) who had previously sustained first-degree lateral ankle sprains. MEASUREMENTS: Dynamic balance was tested three times a week using a single-plane balance board (SPBB). Each subject was tested for two double-leg conditions (forward/backward, right/left) and one single-leg condition (forward/backward) for each extremity. The dependent variable was the number of times that the balance board made contact with the floor. Visual inspection was used to evaluate whether the treatment resulted in a change of performance. RESULTS: Although the intervention did not produce obvious improvements in balance for all evaluation criteria for all testing conditions, it is apparent that the strength and proprioception training program positively influenced all three subjects' ability to balance dynamically on an SPBB. A change in mean scores from baseline to intervention phase was evident for all testing conditions. However, a change in slope and level was not as apparent for all testing conditions, especially the single-leg conditions. CONCLUSION: The results revealed that the strength and proprioception training program produced improvements in the ability to balance as assessed dynamically on an SPBB.

Journal Article↗

PubMed2004

A meta-analysis of periodized versus nonperiodized strength and power training programs.

The purpose of this study was to quantitatively combine and examine the results of studies examining the effectiveness of periodized (PER) compared to nonperiodized (Non-PER) training programs for strength and/or power development. Two analyses were conducted to (a) examine the magnitude of treatment effect elicited by PER strength training programs compared to Non-PER programs and (b) compare these effects after controlling for training volume, frequency, and intensity. Studies meeting the inclusion criteria were coded based on characteristics that might moderate the overall effects (i.e., participant characteristics and characteristics related to the training program). Effect sizes (ESs) were calculated for each study, and an overall ES of 0.84 (+/- 1.41) favoring PER training was found. Further analyses identified the treatment effect specific to training variation to be ES = 0.25. Significant moderating variables included age, training status, and length of training program. As a result of this statistical review of the literature, it is concluded that PER training is more effective than Non-PER training for men and women, individuals of varying training backgrounds, and for all age groups. In line with the overload principle, additions to volume, intensity, and frequency result in additional training adaptations.

Exercise↗

PubMed1989

Evaluation of training program for volunteer family planning communicators.

The objectives of the VFPCs training program are to develop the strategy for promotion of sterilization by contraceptive comsumers in the provinces. The program promoted coordination among government and the private sector. The project was planned to cover 12 provinces in Northeastern Thailand. The results indicated that the project had achieved readiness to some degree. Consequently, the significant differences between pre and post tests (p less than 0.01) indicated that the VFPCs had benefited by the training program. For the most part, the objectives of training were achieved.

Communication↗

PubMed1997

A process of developing terminal competencies for an interdisciplinary training program.

This article describes the process used in developing terminal trainee competencies for an interdisciplinary training program for professional students representing 13 disciplines. The major steps of the process are delineated and described. Although the process is explained in terms of its use in this specialized training program, it can be applied to other training programs that are interdisciplinary in their focus.

Clinical Competence↗