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PubMed2003

Effectiveness of a training program for ECT nurses.

Electroconvulsive therapy (ECT) is a highly technical procedure requiring a team that consists of an anesthetist, a psychiatrist, a clinical nurse specialist, and recovery nurses. Traditionally, nursing education and training in the context of providing a safe and high standard of care has not been addressed. Ninety-two nurses from 42 different health agencies participated in a training program focusing on defibrillation, electrocardiogram (ECG) and electroencephalogram (EEG) monitoring, intubation, stimulus dosing, setting up the ECT equipment, and caring for the patient. A non-experimental, one-group, pretest-posttest research design was used in this study to evaluate the effectiveness of the training program for nurses working with ECT. Effective training for nurses was hypothesized to make a difference in the standards of practice and clinical effectiveness for patients undergoing ECT. Findings from this study indicated a major knowledge deficit in key components of ECT among nurses who have responsibilities in this area of nursing care. With effective training, nurses' confidence levels increased related to setting up the equipment, administering a double dose, helping with intubation, and using a defibrillator. If nurses are to effectively function as team members in the ECT procedure, they must receive the training necessary to prepare them for this important role. The results of this study support the recommendation of the Royal Australian and New Zealand College of Psychiatrists that ECT nurses should be appropriately trained in anaesthetic and resuscitation techniques and modern ECT practice.

Education↗
PubMed2004

Enhancing medication adherence: clinician outcomes from the Medication Alliance training program.

OBJECTIVE: Patient nonadherence to psychiatric medication is a key cause of relapse but clinicians do not appear to possess specific adherence skills. We sought to demonstrate that a brief training program on medication adherence strategies could improve the adherence skills, attitudes and knowledge of mental health clinicians. METHODS: Twenty-three Tasmanian mental health workers were provided a 3 day training workshop on strategies to enhance patient adherence to medications (Medication Alliance). Pre- and post-training measures were taken of clinician knowledge about adherence strategies, ability to identify predictors of nonadherence, attitudes toward working with nonadherent patients, and optimism about treatment outcomes for patients. Videotapes of clinicians demonstrating key adherence therapy skills were also collected before and after training and blind-rated by two experienced therapists. RESULTS: A series of paired samples t-tests indicated significant improvements in skills, knowledge and attitudes. CONCLUSIONS: Compared with similar studies in the UK, Medication Alliance was found to be an effective and efficient training program. However, there is a need for further research to assess maintenance of training effects over time and patient outcomes.

Adult↗
PubMed2006

[Benefits of a multimodular outpatient training program for patients with COPD].

BACKGROUND: The partition and chronological sequence of the different training items and modalities necessary for an effective training of patients with chronic obstructive pulmonary disease (COPD) remains a subject of debate. We investigated the combination of effective components of pulmonary rehabilitation in the settings outpatient lung sports group, home-based training and training in a gym. METHODS: Subjects were randomized to a 12-month training program and a no training group. PATIENTS AND MAIN RESULTS: The training group (n = 10, mean age: 62.5 years, FEV1 53.4% predicted) reached an average increase in peakVO2 of 10% (p = 0.01) from 1.30 +/- 0.41 L/minute to 1.44 +/- 0.38 L/minute, in peak work rate of 14% (p = 0.007) from 82 +/- 39 W to 93 +/- 43 W and in the six-minute walking distance of 79 meters (p = 0.003), whereas in the control group (n = 9, mean age: 63.2 years, FEV1 53.7% predicted) no significant changes were observed. The quality of life obtained by use of the SF36-questionnaire and SGRQ also significantly improved in the training group, but not in the control group. CONCLUSION: This outpatient rehabilitation program is effective and appropriate for long-term rehabilitation of patients with COPD.

Aged↗
PubMed2003

The effectiveness of community-based occupational therapy education and functional training programs for older adults: a critical literature review.

BACKGROUND: This paper examines the results of a critical literature review describing the provision of education and functional training programs by occupational therapists with older adults to maximize their occupational performance. PURPOSE: The critical review addressed the following question: What is the effectiveness of education and functional training programs in improving occupational performance and quality of life for older adults? Review methods are described and the outcomes of the critical review discussed. RESULTS: The results indicate that there is evidence that programs are effective in three areas: prevention of functional decline and falls, stroke and rheumatoid arthritis. Methodological limitations exist in some studies. There are several randomized controlled studies in this area, though the description of specific occupational therapy interventions is often vague and the programs could not be easily duplicated by occupational therapists. PRACTICE IMPLICATIONS: Occupational therapists are provided with information through this critical review to facilitate evidence-based practice when working with older adults.

Accidental Falls↗
PubMed1989

A nutrition/health training program for Peace Corps volunteers.

Nutrition and health education is a crucial component of the overall mission of the Peace Corps program. Individuals selected to work as Peace Corps volunteers need to be well prepared to perform this complex and challenging job in recipient countries. This article presents a model for a training program for Peace Corps trainees that was conducted over a 5-week period. The program was planned in accordance with some specific training guidelines that were provided by the Peace Corps. The trainees included nine women ranging in age from 22 to 61 years with diverse backgrounds; however, all had a BA/BS in a health-related discipline. Training curriculum included fundamental nutrition and health-related areas: basic nutrition, foods, clinical nutrition, maternal and child health, communicable diseases and sanitation, health strategies, and community development. Fifty percent of the curriculum was devoted to "hands-on" practical and clinical activities. Maternal and child health was emphasized in the training curriculum as this is an area of concern in all developing countries. The trainees were evaluated by weekly quizzes as well as completion of a special project involving applications of all their newly acquired skills. Implications of the training program are discussed.

Adult↗
PubMed2002

Changes of immune system in military recruits after the training program.

The aim of the exercise was to improve body health including the immune system function. However, several studies have observed the suppression of immune response in athletes who were trained with strenuous exercise. Recruits who have been in the recruitment-training program for 8 weeks might also have immune suppression. Twenty males, aged from 21 to 23 years in Chulachomklao Royal Military Academy infantry battalion volunteered to participate in this study. They were asked to wear a Polar Accurex Plus Telemetric heart rate monitor during the training period. Tuberculin skin test which is the screening method for cellular immune responses was significantly decreased at post-training compared to the pre-training (p<0.02). The levels of serum IgG and IgM at pre-training, 4th week, 8th week and one week post-training were significantly decreased at the initiation period, which were compared with pre-training and 4th week of training (p<0.01), and returned to normal at the 8th week of training and one week post-training. The level of circulating immune cells and number of CD markers (CD3, CD4, CD8, and CD56) were not significantly changed throughout the training period. This study demonstrated that subjects who underwent the recruit-training program were able to improve their health after the period of training i.e., in the adaptation period. The decrease in the initiation period could be compensated with proper diet and enough rest.

Adult↗
PubMed2005

Summary report on current clinical trauma care fellowship training programs.

BACKGROUND: Almost 10 years ago, the Careers in Trauma Committee of the Eastern Association for the Surgery of Trauma (EAST) identified four main problems with trauma fellowships: (1) lack of specified educational objectives, (2) undefined curricula, (3) inconsistent emphasis on research, and (4) inconsistent surgical exposure. These perceived problems still exist and may threaten the future of trauma surgery as a career. The objective of this study was to examine these issues in a profile of the current active clinical trauma care fellowship training programs. METHODS: The database foundation was the Trauma Fellowships Listing at the EAST Web site (http://www.east.org). All active clinical trauma training programs on this list were identified, and descriptive information was updated and abstracted. A supplemental survey was sent to each program contact person with specific questions regarding program organization, educational material, fellow responsibilities, and scholarly opportunities. In 2003, the entire database was updated, and the survey process was repeated. RESULTS: The number of active trauma care fellowship programs was 39 (1996), 43 (1999), and 50 (2003). From 1996 to 2003, 15 new programs came into existence, and 4 programs became inactive. Current programs are located in 23 states, Washington DC, Canada, and Australia. California has seven; Pennsylvania has four; and three states have three programs each. The annual trauma admissions for most programs (42 of 50, 84%) vary between 750 and 4,000, with six programs admitting more than 4,000. The most common program format (20 of 50, 40%) offers combined trauma and critical care training, whereas only three programs (6%) offer a choice of trauma only, critical care only, or combined trauma and critical care. A Residency Review Committee (RRC)-approved surgical critical care program was an integral component in 54% (1996), 76% (1999), and 78% (2003). The majority of programs (39 of 50, 78%) are of 1-year duration, with some (22 of 50, 44%) having an optional second year. Most programs (40 of 50, 80%) have one or two positions per year, with the largest program having eight fellows per year. The total number of positions available per year was 66 (1996), 89 (1999), and 95 (2003). Most fellows lead and direct a team of residents and medical students. More programs reported that fellows direct the initial resuscitation of all trauma patients admitted, and more programs are requiring in-house call requirements for fellows. CONCLUSIONS: There is steady growth in trauma fellowship training, with an emphasis on direct clinical management. An RRC-approved surgical critical care program is an important link, but one not essential to the trauma fellowship. Expected radical changes in surgical and trauma training are on the horizon. It is imperative that leaders in trauma surgery continue to monitor these trends for successful integration of trauma care training into surgical residency redesign efforts, and for facilitation of programmatic improvement in trauma care as a career.

Accreditation↗
PubMed1991

Specialized physical training programs: effects on serum lipoprotein cholesterol, apoproteins A-I and B and lipolytic enzyme activities.

To determine the effects of different types of physical training on lipid metabolism, serum lipids, lipoprotein cholesterol, apoproteins A-I and B, hepatic (HTGL), extrahepatic (LPL) and total (PHLA) post-heparin lipoprotein lipase activities were studied in elite athletes engaged in aerobic ("B", no. 13), anaerobic ("C", no. 17) and mixed ("D", no. 9) training programs and in a group of sedentary controls ("A", no. 15). In the aerobic and mixed groups serum triglycerides were significantly lower compared to sedentary controls while total serum cholesterol and LDL cholesterol, as well as serum apoprotein B levels were only slightly lower. HDL cholesterol and HDL2 cholesterol were slightly higher while serum cholesterol/HDL cholesterol (2.89 +/- 0.37 vs 3.6 +/- 0.47, p less than 0.01) and LDL cholesterol/HDL cholesterol (1.69 +/- 0.38 vs 2.23 +/- 0.43, p less than 0.05) ratios were significantly lower only in aerobic athletes compared to the control group. PHLA and LPL activities were slightly higher in the aerobic group than in controls, while PHLA and HTGL were significantly lower in aerobic and mixed athletes. No significant correlations were found between HDL cholesterol and energy expenditure during training, indexes of adipose mass or lipolytic enzyme activities. The results of this cross-sectional study seem to indicate that specialized training programs have a different effect on lipoprotein pattern and lipolytic enzyme activities, and only aerobic exercise has a potentially antiatherogenic effect.

Adult↗
PubMed1997

Evaluation of a worksite injury and illness prevention program: do the effects of the REACH OUT training program reach the employees?

In this article the authors report the findings of a 2-year study evaluating the effectiveness of REACH OUT, a train-the-trainer program developed to assist small businesses comply with California legislation, Senate Bill 198 (1989), requiring employees to implement a worksite Injury and Illness Prevention Program. Data from a case study sample of 8 companies, drawn from 151 Southern California small businesses participating in the larger study, are reported. Diagnostic walk-throughs were performed, and employee surveys collected at the case study companies approximately 2 months before the treatment group received the intervention and again 1 year later. Results indicate that greater corporate compliance led to employees' perceptions of increased health and safety meetings and training sessions, which led to greater employee health and safety knowledge and improved employee health outcomes.

Accidents, Occupational↗
PubMed2000

Utility of a brief self-efficacy scale in clinical training program evaluation.

Self-efficacy is often studied as a predictor of professional practice behaviors or as an outcome of clinical training, using brief scales with little validation. This study examines the utility of a brief self-efficacy scale in the evaluation of a clinical training program. Subjects were 119 registered dietitians who participated in diabetes training. Hypothesized relationships between self-efficacy ratings and indices of skill mastery, participation in training, and subsequent practice change were examined. Self-efficacy ratings after training correlated significantly with relevant prior experience (r = .4 and .29, p < .01) but not total experience and with knowledge post-test score (r = .21, p < .02). Self-efficacy for all 12 program objectives increased significantly after training. Post-training self-efficacy for two program objectives correlated significantly with self-reported successful practice changes related to those objectives (r = .4, p < .04 and r = .51, p < .01). The data suggest that brief self-efficacy assessments can contribute meaningfully to clinical training program evaluation.

Analysis of Variance↗
PubMed1993

Choices of training programs and career paths by women in internal medicine.

PURPOSE: To examine the choices of career paths of women in internal medicine, specifically to determine (1) whether women continue to prefer primary care practice more often than men do and (2) whether differences in career paths between men and women result from differences in the natures of the training programs they complete. METHOD: A database containing demographic, training, and clinical-practice information on 19,151 physicians (3,569 women and 15,582 men) who had been trained in internal medicine was constructed by merging data from the National Resident Matching Program matches in internal medicine for 1977-1982 with data from the 1985 American Medical Association Physician Masterfile, which contains physician practice profiles. RESULTS: Similar percentages of the men and the women chose primary care residencies (8% versus 9%, ns) and trained in the 100 major medical centers (49% versus 50%, ns). The women more frequently trained in programs affiliated with medical schools in the top prestige quartile (38% versus 33%, p < .05). The attrition rates of residents who left their training for careers in other medical fields were the same for the men and the women (14%). Fewer women obtained board certification (74% versus 80%, p < .01). The women chose to practice general internal medicine more frequently than did the men (52% versus 45%, p < .0001), regardless of the training program completed (primary care or traditional). CONCLUSION: The women pursued primary-care-oriented internal medicine to a significantly greater degree than did the men, regardless of the type of training program completed (primary care or traditional).

Career Choice↗
PubMed2006

Does establishing a bariatric surgery fellowship training program influence operative outcomes?

BACKGROUND: Roux-en-Y gastric bypass (RYGB) has a long learning curve that may be reflected in operative outcomes. This study sought to assess whether training a fellow has an impact on the operative outcomes of the training program. METHODS: Prospectively collected data on 150 consecutive patients were compared before (group 1) and after (group 2) establishment of a fellowship-training program. RESULTS: A greater number of patients underwent laparoscopic RYGB (LRYGB) in group 2 than in group 1 (63% vs 46%; p = 0.01). The group 2 patients were similar to the group 1 patients in terms of age, gender, length of stay, and complication rate. However, they had a higher body mass index (BMI) (median 50 kg/m2; range, 39-64 kg/m2 vs median, 46 kg/m2; range, 38-56 kg/m2; p = 0.01) and a higher incidence of prior abdominal procedures (21% vs 7%; p = 0.006). In addition, operative time was significantly shorter for the patients who underwent open RYGB (ORYGB) (median, 150 min; range, 65-280 min vs median, 110 min; range, 50-210 min; p < 0.001) and LRYGB (median, 202 min; range, 105-450 min vs median, 134 min; range, 50-191 min; p < 0.001) in group 2 than for the patients in group 1. The patients who underwent ORYGB in groups 1 and 2 had similar characteristics and outcomes. Increasing experience with both ORYGB and LRYGB correlated with a decrease in operative times for group 2 (p < 0.001), but not for group 1. CONCLUSION: Establishment of a fellowship program shortens the operative times for both open and laparoscopic RYGB and expands the scope of bariatric practice by compounding the experience of the operating team without increasing complications.

Adult↗
PubMed2004

Evaluation of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction.

This study's objective was to evaluate the effect of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction. Using a longitudinal research design, 69 participants whose scores on the Assertive Scale were < or = 50% (i.e., low assertiveness) and who were willing to participate were included and assigned to an experimental group (33 subjects) or comparison group (36 participants; participants were matched with the experimental group by grade and sex). Participants in the experimental group received eight 2-h sessions of assertiveness training once a week. Data were collected before and after training and again one month after the end of the training using the Rotter's Internal versus External Control of Reinforcement Scale, Sex Role Inventory, Assertive Scale, Esteem Scale, and Interpersonal Communication Satisfaction Inventory. The generalized estimated equation (GEE) method was used for statistical analysis. The assertiveness and self-esteem of the experimental group were significantly improved in nursing and medical students after assertiveness training, although interpersonal communication satisfaction of the experimental group was not significantly improved after the training program.

Assertiveness↗
PubMed1992

The effect of participation in an exercise training program on cardiovascular reactivity in sedentary middle-aged males.

Exaggerated cardiovascular reactivity to mental stressors may be a risk factor for cardiovascular disease. To determine if participation in a moderate intensity aerobic exercise training program reduces cardiovascular reactivity to laboratory stressors, 40 sedentary middle-aged males were randomly assigned: training group (n = 25) and control group (n = 15). Cardiovascular reactivity during and after three mental stressors (passive responding, push-button Stroop and verbal Stroop) and mild exercise (bicycle ergometer) was assessed before and after an 8-week intervention. VO2(peak) was determined using the Balke protocol. Among 19 subjects who completed the training, VO2(peak) increased 13.7%. Also, trained compared to untrained subjects showed significant reductions in baseline and absolute heart rate responses to all stressors. Baseline adjusted heart rates were significantly lower during push-button Stroop recovery and during verbal Stroop. Blood pressure, T-wave amplitude, finger pulse amplitude and pulse transit time responses were unaffected by exercise training. It was concluded that participation in a short-term, moderate intensity aerobic exercise training program may have a cardioprotective effect by significantly reducing absolute and baseline-adjusted heart rate responses to stressors.

Adult↗
PubMed2006

Prevalence trends in chlamydial infections among young women entering the national job training program, 1998-2004.

OBJECTIVES: To assess the trends and risk factors of chlamydial infections in disadvantaged women aged 16 to 24 years entering a national job training program. GOAL: To assess the impact of chlamydia screening program on chlamydia trend. STUDY DESIGN: The authors calculated the prevalence of chlamydia by demographic and geographic characteristics from 106,377 women who were screened from 1998 through 2004. RESULTS: Chlamydia prevalence was inversely associated with age, decreasing from 12.7% in women aged 16 to 17 years to 6.6% in women aged 22 to 24 years. Blacks had the highest prevalence (13.1%). Chlamydia prevalence significantly decreased from 11.7% in 1998 to 10.0% in 2003 and then slightly increased to 10.3% in 2004. After direct standardization and adjustment for the laboratory test type, a similar trend was observed by age and race/ethnicities. CONCLUSIONS: Among disadvantaged women aged 16 to 24 years entering a national job training program, the chlamydia prevalence and racial disparities in prevalence were consistently high from 1998 to 2004, especially among younger black women.

Adolescent↗
PubMed1993

Occupational medicine training program surveys.

Although the quantity of Occupational Medicine (OM) residents in training programs has risen in the past 15 years, there remains a significant shortage of OM physicians in the United States. A survey of OM residency program directors and residents and fellows (trainees) was accomplished to answer questions relevant to recruiting and supplying OM trained physicians. Twenty-six of 29 program directors (89.7%) replied. One hundred forty-three of 174 (82.2%) trainees responded. Fifty percent of responding program directors were satisfied with the current quantity of program applicants. Medical students were provided a median of 3 hours (range, 0 to 20 hours; mean, 5.35 hours) of formal OM teaching by the responding programs. Almost half of trainees, 68 (48.6%), did not receive formal OM instruction in medical school. An average of 5.4 +/- 13.3 hours of OM was taught to OM trainees in medical school. Disproportionate numbers of trainees were taught OM as fourth-year medical students and in other residencies. Reasons for pursuing OM training were diverse and often related to postgraduate clinical experience with OM. Only a total of 84 primary care residents (0.32%) rotate through the OM residency programs in an average year. We conclude that an insufficient quantity of qualified applicants, combined with limited exposure to OM in medical schools and low levels of contact with residents in primary care programs, will continue to hinder efforts to reduce the shortage of OM residents and physicians. Further training specifically targeting the fourth year of medical school and the primary care residencies may have the most impact on recruitment.

Certification↗
PubMed1992

[A multi-stage cognitive training program for improving cognitive functions of chronic alcoholic patients].

In accordance with neuropsychological findings, that chronic alcohol abuse can lead to cognitive impairment, a multi-phased cognitive training program (MKT) developed by Sagstetter was conducted with a group of chronic alcoholic patients. In this article this program is introduced and evaluated with regard to chronic alcoholic patients and their improvement in certain cognitive functions. The study group consisted of 11 chronic alcoholics, who regularly took part in the program. The control group consisted of 11 patients who took part on a behavior therapy program offered by the clinic and had similar social and pathological histories to those of the study group. The two groups were compared with each other with the help of a follow-up study design after approximately seven weeks. The results reveal that this present cognitive training program promotes, above all, cognitive functions such as visual short-time memory, concentration, form perception as well as combination and organisation ability.

Adult↗