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PubMed2005

Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta.

BACKGROUND: Despite the critical importance of well-being during residency training, only a few Canadian studies have examined stress in residency and none have examined well-being resources. No recent studies have reported any significant concerns with respect to perceived stress levels in residency. We investigated the level of perceived stress, mental health and understanding and need for well-being resources among resident physicians in training programs in Alberta, Canada. METHODS: A mail questionnaire was distributed to the entire resident membership of PARA during 2003 academic year. PARA represents each of the two medical schools in the province of Alberta. RESULTS: In total 415 (51 %) residents participated in the study. Thirty-four percent of residents who responded to the survey reported their life as being stressful. Females reported stress more frequently than males (40% vs. 27%, p < 0.02). Time pressure was reported as the number one factor contributing to stress (44% of males and 57% of females). A considerable proportion of residents would change their specialty program (14%) and even more would not pursue medicine (22%) if given the opportunity to relive their career. Up to 55% of residents reported experiencing intimidation and harassment. Intimidation and harassment was strongly related to gender (12% of males and 38% of females). Many residents (17%) rated their mental health as fair or poor. This was more than double the amount reported in the Canadian Community Health Survey from the province (8%) or the country (7%). Residents highly valued their colleagues (67%), program directors (60%) and external psychiatrist/psychologist (49%) as well-being resources. Over one third of residents wished to have a career counselor (39%) and financial counselor (38%). CONCLUSION: Many Albertan residents experience significant stressors and emotional and mental health problems. Some of which differ among genders. This study can serve as a basis for future resource application, research and advocacy for overall improvements to well-being during residency training.

Adult↗
PubMed2002

Training practitioners in preparing systematic reviews: a cross-sectional survey of participants in the Australasian Cochrane Centre training program.

BACKGROUND: Although systematic reviews of health care interventions are an invaluable tool for health care providers and researchers, many potential authors never publish reviews. This study attempts to determine why some people with interest in performing systematic reviews do not subsequently publish a review; and what steps could possibly increase review completion. METHODS: Cross-sectional survey by email and facsimile of the 179 participants in Australasian Cochrane Centre training events between 1998 and 2000. RESULTS: Ninety-two participants responded to the survey (51 percent). Response rate of deliverable surveys was 82 percent (92/112). The remainder of the participants had invalid or no contact information on file. More than 75 percent of respondents felt that the current workshops met their needs for training. The most critical barriers to completion of a Cochrane review were: lack of time (80 percent), lack of financial support (36 percent), methodological problems (23 percent) and problems with group dynamics (10 percent). CONCLUSIONS: Strategies to protect reviewer time and increase the efficiency of the review process may increase the numbers of trained reviewers completing a systematic review.

Attitude of Health Personnel↗
PubMed2006

Reminiscences of a training director and the future of training programs.

Psychiatric education in the United States has undergone vast changes during the past 40 years, from a classical psychoanalytic model to an evidence-based neurobiological paradigm. Training standards, set by the Accreditation Council for Graduate Medial Education, have brought more scientific rigor to the training of young psychiatrists, but the danger of losing the psychotherapeutic skills provided in the past by long-term psychodynamic supervision is of concern to many psychiatric educators. A model for evaluating competence in psychodynamic psychiatry is discussed and postgraduate psychoanalytic training is encouraged.

Adolescent↗
PubMed1989

Co-worker implemented job training: the use of coincidental training and quality-control checking on the food preparation skills of trainees with mental retardation.

In two studies, co-workers of persons with disabilities were taught to use coincidental training procedures while completing their own jobs. In Study 1, the effects of coincidental training on the salad-making skills of 3 trainees with mild and moderate mental retardation were evaluated. Coincidental training by co-workers resulted in improved accuracy of the salad-making skills of the trainees. In Study 2, trainees were also coincidentally taught to make quality-control checks of their salads. An alternating treatments and multiple baseline design indicated that the trainees more readily acquired the skills when taught to check the correctness of their work.

Adult↗
PubMed2006

A unique, environmentally sustainable and cost-effective programme to re-vegetate military training lands utilising composted wastewater biosolids at a large Canadian military training centre.

The Greater Moncton Sewerage Commission has developed, in concert with National Defence Canada, an environmentally sustainable and cost effective biosolids management and land reclamation programme at the Canadian Forces Base (CFB) Gagetown, New Brunswick, Canada (the second largest land based Military Training Facility in the British Commonwealth). The use of composted biosolids to revegetate military training lands is thought to be a unique application for the beneficial use of biosolids. Results and practical experience gained from this approach to successfully re-vegetate initial sections of extremely large and vast tracts of these lands are described. The paper also overviews the Commission's modern 115000 m3 x d(-1) advanced, chemically assisted primary wastewater treatment facility and associated alkaline (lime) sludge stabilisation process. Planning strategies, security aspects, special and unique challenges in operating adjacent to an active military training facility, costs, spreading techniques, monitoring, next steps and conclusions are also presented.

Canada↗
PubMed1999

Training family practice residents in psychiatry: an ambulatory care training model.

OBJECTIVE: To demonstrate the importance of providing psychiatric training to primary care practitioners in ambulatory care settings. Additionally, to describe the model used for this purpose in the Department of Psychiatry and Behavioral Sciences of the University of Texas Medical School at Houston in order to further stimulate educational opportunities on this topic. METHOD: A review of the psychiatric curriculum offered to family practice residents during their PGY-2 year one-month rotation in psychiatry at the University of Texas Mental Sciences Institute is provided. Emphasis is given to key areas of the curriculum such as: knowledge, skills, and attitude development. Special focus on the clinical and educational experiences is also offered for the purpose of providing unique perspectives about the curriculum methodology. RESULTS: The careful assessment of the feedback obtained from the family practice residents who were exposed to this ambulatory training model demonstrates that this type of setting was satisfactory for the teaching of psychiatry to primary care residents. CONCLUSIONS: Primary care residents have always treated a large number of psychiatric patients. Given the current status of our health care system, primary care practitioners should have even a greater role in the future delivery of psychiatric services. In this article, we offer a model of training for primary care residents in psychiatry, which emphasize cost-effectiveness, high quality of care, and ambulatory care settings.

Academic Medical Centers↗
PubMed2000

The effect of contralesional limb activation training and sustained attention training for self-care programmes in unilateral spatial neglect.

PURPOSE: To evaluate the effectiveness of two rehabilitation techniques for unilateral spatial neglect, contra-lesional limb activation and sustained attention training, on impaired activities of daily living. METHODS: Two single case, time-series designs incorporating baseline, intervention and post-intervention phases. RESULTS: Significant improvements were observed in both neuropsychological measures and in the independent performance of everyday activities coincident with the start of training. The benefits were well maintained during the post-training period. CONCLUSIONS: The results support the use of the two techniques in achieving functional goals for unilateral neglect patients.

Journal Article↗
PubMed2003

[Sarcopenia and strength training. Age-related changes: effect of strength training].

Sarcopenia signifies the age-related loss of muscle mass and consequently muscle strength. Sarcopenia appears to be caused by both muscular and neural factors. Concurrently with the muscle atrophy, a non-linear loss of muscle strength is observed. The decline accelerates after the age of 60. The ability to produce muscular power is reduced even more than the muscle strength. Strength training increases muscle strength and muscular power in the elderly thus counteracting part of the age-related reduction. Improvements, however, depend on the initial strength in the elderly person. The benefit of strength training is greatest in frail elderly and the oldest old, although elderly in general could benefit from strength training. Considering the growing section of elderly in the population, the focus on sarcopenia and measures to counteract this seems more relevant than ever.

Aged↗
PubMed2003

[Effect of physical training on growth and total cardiovascular and respiratory capacity in pupils from schools with different physical training programs].

AIM: Influence of physical exercise on psychomotor growth of children is well known. In present study we tried to evaluate influence of two different physical training programs carried out in schools, on parameters of cardiovascular and respiratory system. In addition we tried to evaluate the possible influence of diet on children growth. MATERIAL AND METHODS: Children from two schools were studied. Group I: 56 children (aged 10-12) from swimmers classes of the School of Sport Championship, who participated in 8 hours/week of physical exercises in addition to 10 hours/week of swimming exercises. Group II: 28 children (aged 10-12) from standard school, who participated in 3 hours/week of physical exercises. In both groups medical examination, spirometry, blood pressure and heart rate measurement, and diet analysis were performed at baseline and after maximal physical extortion. RESULTS AND CONCLUSIONS: 1. Spirometry analysis showed statistical differences between the groups, which were impaired in children from school with standard physical training program. 2. We observed worse adaptation to physical exercise of cardiovascular and respiratory system in from school with standard physical training program, as compared to children from group I. 3. No statistical differences in nutrition were shown between the groups. 4. Vitamins, iron and magnesium seem to have good influence on respiratory system adaptation to physical exercise. 5. In general, we observed better total capacity of cardiovascular and respiratory system in connected with better interest in correct nutrition in group I as compared to group II.

Blood Pressure↗
PubMed1987

Survey of ultrasound training in obstetrics and gynecology residency training programs in the United States.

A survey was mailed to all 292 nonmilitary obstetrics and gynecology residency programs in the United States. The extent and type of ultrasound training and degree of compliance with recommended guidelines was evaluated from the 230 (78.8%) responses. Criteria for evaluation were based on guidelines from the American Institute of Ultrasound in Medicine Joint Task Group on Training for Diagnosis in Obstetrical and Gynecological Ultrasound, and on recommendations from The American College of Obstetricians and Gynecologists. Although almost 98% of respondents claimed to have ultrasound "training" in their programs, more than 55% indicated no resident experience with either reading or writing ultrasound reports, and only 39% of program chiefs claimed greater experience than 200 ultrasound scans per resident over four years. Overall, it appears that current suggested guidelines are not being met.

Data Collection↗
PubMed1980

[Sports in the centres of vocational training and re-training (author's transl)].

The majority of disabilities are coupled with impairments of the motor system. In its action programme on rehabilitation, the Federal Government therefore recognises that sports should invariably be included in present-day rehabilitation as provided in the centres for vocational rehabilitation. This thesis was investigated on the basis of a study of 14 vocational re-training centres (= 93 percent) and 13 vocational training centres (= 81 percent) in operation in 1978/1979. It was found that there still is marked understaffing in this sector, especially as regards specifically trained personnel. The majority of sports facilities moreover are still in need of equipment capable of stimulating motaivation. The organisational patterns found in the field of sport for the disabled widely lack uniformity, with solutions being rather unsatisfactory.

Persons with Disabilities↗
PubMed1984

Medical teacher and his pedagogical training (experience with Bratislavian system of training the assistants for pedagogical activity in postgraduate education of physicians and pharmacists).

System of training the medical teachers for pedagogical activity, used in the Institute for Postgraduate Education of Physicians and Pharmacists (IPEPP) in Bratislava, have not had long tradition as yet. We do not want this training to be understood as universal instruction to prepare the assistants for pedagogical activity, which is in a final consequence always dependent on the concrete conditions and social needs. It should serve as information on one of the possibilities to secure the systematic training of medical teachers for pedagogical activity in postgraduate education of physicians and pharmacists.

Czechoslovakia↗
PubMed1994

[Possibilities of driver fitness diagnosis and training using a stationary training car].

The study presented had dealt with the potential of a stationary training car in assessing and improving the driving skills of patients having neurological disorders, with reaction testing and reaction training carried out by means of the training car. The aim had been to verify whether, and to what extent, such a device might contribute to driving fitness diagnosis and improvement. The sample was comprised of patients who, mostly following brain injury, participated in an in-patient rehabilitation programme. It was found that an individual's driving fitness cannot be diagnosed on the basis of laboratory testing alone. The deficits elicited by the tests have to be verified concerning their impact in real road traffic in every individual case, taking adaptive potential into account. In view of improved driving skills, the findings show performance improvements in various reaction tests as well as better driving sample ratings.

Adult↗
PubMed1998

Adapting residency training. Training adaptable residents.

Graduate medical education has been criticized for failing to adequately prepare young physicians to enter the workforce upon completion of their training. In addressing this criticism, the author makes arguments both for and against this assertion. Broad qualitative changes (graduate medical education training position allocation, subspecialists' role in health care delivery, educational quality, faculty development, and faculty promotion) that graduate medical education has undergone and is undergoing are discussed. Population health management, clinical resource management, teamwork, continuous quality improvement, ethics, and evidence-based medicine are addressed as important curricular elements for residency training. Innovations in graduate medical education that are being introduced as well as those that should be tried are discussed. Finally, the author asserts that although residency education should not be vocationally driven by the needs of managed care organizations, a powerful opportunity exists for collaborative educational research between academic medicine and managed care organizations. In a health care environment undergoing rapid changes, the primary goals of graduate medical education have not significantly changed: to produce compassionate physicians with a passion for lifelong learning who have leadership skills, are critical thinkers, skilled at self-assessment, and able to adapt to the needs of the health care marketplace.

Curriculum↗
PubMed1998

[Can injuries cause by train crash be prevented? Experiences from the train crash in Jelling in 1995].

Among 69 persons involved in a train crash, 53 were injured. Twenty-two persons were admitted to hospital. No-one was killed. There was a significantly increased risk of getting hurt when facing forward in the moving train. The mechanism of injury for the majority was being thrown forward and thereby hitting parts of the seats in front. The iron frames of the seats became exposed as some parts of the seats were only loosely attached. Arrangements to reduce injuries in train crashes could be an improved maintenance of the seats and their frames and the use of safety belts.

Accidents, Traffic↗
PubMed2003

Development and evaluation of an advanced training technology course within a union-based industrial emergency response training program.

BACKGROUND: The Health and Safety Department of the United Automobile Workers recently introduced the use of Advanced Training Technologies (ATTs) into a previously successful Industrial Emergency Response (IER) program. The new curriculum attempted to incorporate web-based technology, while preserving the historical emphasis on the use of peer trainers and the Small Group Activity Method (SGAM) to promote team problem solving and worker empowerment. METHODS: The University of Michigan evaluated the program by administering a survey combining open- and closed-ended questions to trainees. RESULTS: Of the 46 respondents, most rated the program very highly, found that the use of internet technology allowed faster access to current information, reported peer trainers as one of program aspects they liked best, and did not find working in groups of three per computer difficult. CONCLUSIONS: It is possible to enhance a workplace health and safety training program through the introduction of ATT without compromising participant-centered, group learning program philosophies.

Curriculum↗
PubMed1992

The effect of maximal exercise on the activity of neutrophil granulocytes in highly trained athletes in a moderate training period.

Leucocyte cell counts and the phagocytic and chemotactic activities of neutrophil granulocytes were investigated in highly endurance-trained long-distance runners (n = 10) and triathletes (n = 10) during a moderate training period and compared with untrained subjects (n = 10) before and up to 24 h after a graded exercise to exhaustion on a treadmill. After exercise a leucocytosis was noted with a significant increase in lymphocyte (P < or = 0.01) and neutrophil (P < or = 0.01) counts in all groups. In neutrophils the number of ingested inert latex beads was significantly increased (P < or = 0.01) from 0.21 (SD 0.09) to 0.45 (SD 0.22) in controls, from 0.20 (SD 0.12) to 0.56 (SD 0.16) in long-distance runners and from 0.25 (SD 0.08) to 1.03 (SD 0.42) particles per cell in triathletes 24 h after exercise, compared with resting values. The capability of neutrophils to produce microbicidal reactive oxygen species fell (P < or = 0.05) immediately after exercise in all subjects and then increased by 36 (SD 8)%, 31 (SD 6)% and 19 (SD 9)% in controls, runners and triathletes respectively up to 24 h after exercise (P < or = 0.05) compared with pre-start values. With respect to the absolute number of neutrophils, ingestion capacity, production of superoxide anions and chemotactic activity, no significant differences were found between athletes and control subjects at rest and after exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗