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PubMedDate not supplied

Qualitative assessment of training programs for alcohol servers and establishment managers.

OBJECTIVE: In an attempt to reduce the societal burden associated with alcohol-related problems such as underage drinking and drunk driving, some local communities and state governments mandate training programs for employees of establishments that serve or sell alcoholic beverages. This study was designed to assess the available training programs for employees and managers and to identify states that either mandate training programs or encourage them by reducing establishments' legal liability. METHODS: Training programs were identified through the Internet, key informants, and the research literature. Three researchers independently rated each of 22 local and national programs across 10 categories. In addition, the authors surveyed alcoholic beverage control agencies and legislative research bureaus in the 50 U.S. states. RESULTS: The results show that training programs are not standardized and vary widely in content, use of behavior change methods, and production quality. Most programs targeted waitstaff and bartenders. Only one program exclusively targeted owners and managers. CONCLUSIONS: National standards must be developed for training programs for servers, managers, and owners.

Adolescent↗

PubMed2004

Improving resident research in physical medicine and rehabilitation: impact of a structured training program.

OBJECTIVE: This study describes a research training program that implemented several processes and structures with the aim of increasing the quality and quantity of resident research in physical medicine and rehabilitation. Another aim of the program was to address the Accreditation Council for Graduate Medical Education (ACGME) Practice-Based Learning and Improvement competency. DESIGN: Educational program. RESULTS: Data on resident research activity for 11 years before the implementation of the research program were compared with 4 years of data after implementation. There were statistically significant increases in both the total number of publications (P = 0.03) and the number of empirical, data-based publications after implementation of the program (P = 0.03). CONCLUSIONS: The findings from this study suggest that a structured research training program may have a salutary effect on increasing the quality and quantity of resident research.

Curriculum↗

PubMed2006

Effects of a postoperative strength-training program on the walking ability of children with cerebral palsy: a randomized controlled trial.

OBJECTIVE: To investigate the effect of a postoperative strength-training program on the walking of children with cerebral palsy (CP). DESIGN: Randomized controlled trial. SETTING: Hospital rehabilitation department. PARTICIPANTS: Thirty-nine children with CP (age range, 6-16 y). After orthopedic surgery, the control group (n=20) followed a conventional physiotherapy (PT) program, and the strength-training group (n=19) followed a strength-training program in addition to the conventional PT. Twenty-nine age-matched healthy children were used as references. INTERVENTION: A 9-month strength-training program. MAIN OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic parameters during gait analysis were analyzed before (E0) and 1 year after (E1) the surgery. For 22 children, a 2-year postoperative gait analysis (E2) took place as well. RESULTS: At E1, several kinematic and kinetic parameters improved, although there was no significant difference between the groups. Spatiotemporal parameters showed a worsening at E1 and a recovery to preoperative values at E2. CONCLUSIONS: The examined parameters may be more substantially influenced by factors such as the surgery outcome and the variability of pathologic characteristics than by the strength-training program per se. However, a more significant effect of the strength-training may appear if more intense and short-term training protocols are used, considering factors such as patients' motivations, ages, and postoperative statuses.

Adolescent↗

PubMed2006

Neurology training programs worldwide: a world federation of neurology survey.

This World Federation of Neurology (WFN) project was aimed at collecting data about the number and nature of neurology residency programs in different countries. A survey was sent to delegates from the neurology societies belonging to the World Federation of Neurology. Over 6200 physicians graduating from neurology training programs each year were identified. Many regions of the world, including those with the highest prevalence of disorders of the nervous system, have few or no post-graduate neurology training programs. Adequate teaching in psychiatry, neuroradiology, and neuropathology is lacking in many programs. Training in a large number of countries is hampered by inadequate access to books, journals, and the internet. The global distribution of postgraduate neurology training programs is unrelated equally to the burden of neurological diseases or to the need for their treatment and prevention.

Data Collection↗

PubMed1998

[The effect of muscle training program for home care employees].

To assess the results of general muscle training for home helpers and home nurses we followed 40 women who completed a six month strength training program. All participants were employees at the home care district Skovgården Hjørring. The training program consisted of exercises for all parts of the body. It was a general rehabilitation program and consisted of a teeterboard, a rubberband and a weight bag adjustable from one to six kg. The duration of the program was one hour. All participants were instructed in the training program by author Ulla Willadsen. The period of training lasted six months and was performed twice a week.

Adult↗

PubMed2005

Effects of a 6-mo endurance-training program on venous compliance and maximal lower body negative pressure in older men and women.

Aging and chronic exercise training influence leg venous compliance. Venous compliance affects responses to an orthostatic stress. The extent to which exercise training in a previously sedentary older population will affect venous compliance and tolerance to the simulated orthostatic stress of maximal lower body negative pressure (LBNP) is unknown. The purpose of this investigation is to determine the influence of a 6-mo endurance-training program on calf venous compliance and responses and tolerance to maximal LBNP in older men and women. Twenty participants (exercise group: n = 10, 5 men, 5 women; control group: n = 10, 6 men, 4 women; all >60 yr) underwent graded LBNP to presyncope or 4 min at -100 mmHg before and after a 6-mo endurance-training program. Utilizing venous occlusion plethysmography, calf venous compliance was determined in both groups using the first derivative of the pressure-volume relation during cuff pressure reduction before training, at 3 mo, and at the end of the training program. The exercise group improved their fitness with the 6-mo endurance-training program, whereas the control group did not change (14 +/- 3 vs. <1 +/- 2%; P < 0.05). LBNP tolerance did not differ between groups or across trials (P = 0.47). Venous compliance was not different between groups or trials, either initially or after 3 mo of endurance training, but tended to be greater in the exercise group after 6 mo of training (P = 0.08). These data suggest that a 6-mo endurance-training program may improve venous compliance without affecting tolerance to maximal LBNP in older participants.

Adaptation, Physiological↗

PubMed2006

Soccer players' muscular imbalances: restoration with an isokinetic strength training program.

The aim of the study was to investigate the effect of a muscular training program on soccer players' performance which initially appeared imbalanced or bilaterally asymmetrical. During the preparation period, 35 soccer players performed an isokinetic measurement of knee flexors and extensors (60 degrees(-1) and 180 degrees sec.(-1)). 15 of these had muscular imbalances or deficits and followed a specific isokinetic training program for 2 mo., 3 times per week. After the completion of the isokinetic training program, the 35 players underwent the same isokinetic test. Significant differences were noted between the pre- and posttraining measures at both angular velocities in peak torque values, in differences from one limb to the other, and in peak torque ratios for flexors and extensors. Consequently, the application of this specific isokinetic training program can restore imbalances in knee muscle strength efficiently.

Adult↗

PubMed2007

The current role of medical simulation in american urological residency training programs: an assessment by program directors.

PURPOSE: Although medical simulation opportunities are increasingly available, resident training to date has involved primarily hands-on, subjective assessments. The role of simulation and computer based training for urology residents remains unknown. We evaluated the current status of medical simulation among urological training programs in the United States. MATERIALS AND METHODS: An anonymous questionnaire was developed and mailed to the program director at the 119 Accreditation Council for Graduate Medical Education accredited United States urology training programs, and consisted of 17 questions documenting the prior experience of the responder to medical simulation as well as the current status of simulation at their institution. An additional 14 questions sought the responders' opinion of medical simulation in urology training programs. RESULTS: The questionnaire was returned by 41 program directors (35%). Among respondents, access to a laparoscopy simulator was 76%. In comparison, reported access to cystoscopy, ureteroscopy, transurethral resection and percutaneous access simulators was 16%, 21%, 8% and 12%, respectively. Respondents indicated that these simulators were good educational tools, realistic and easy to use. Unanimous agreement was reported for simulation training in residency and that simulators allow practice in a controlled environment. Disagreement was reported about the cost effectiveness, validity and ability of simulators to replace hands-on instruction in the operating room. CONCLUSIONS: Among responders a high level of access to laparoscopic simulators for urology residents is coupled with low levels of access to other endoscopic trainers. Urology residency program directors unanimously recognize a role for simulation training in residency, although the extent to which they may be incorporated remains to be resolved.

Computer Simulation↗

PubMed1997

Identifying the need for curriculum change. When a rural training program needs reform.

OBJECTIVE: To identify what changes should be made in the University of British Columbia's rural family practice training program curriculum to help graduates be better prepared to practice. DESIGN: Two cross-sectional surveys via mailed questionnaires: one designed to measure physicians' self-reported preparedness for practice and the other to measure the importance of various rural family medicine components. SETTING: Rural training program graduates and preceptors representing rural communities in British Columbia. PARTICIPANTS: Thirty-nine graduates of the rural training program between 1982 and 1991 and 14 community-based rural training program preceptors representing eight communities throughout the province participated in this study. MAIN OUTCOME MEASURES: Percentage of graduates of the rural program who reported themselves to be underprepared on each family practice item and preceptors' mean scores for the attributed importance to rural practice of each item on this questionnaire. RESULTS: A list of curriculum areas most in need of reform was created. This list included trauma, counseling skills, radiology, vacuum extraction, fracture care, exercising community leadership, cost-effective use of diagnostic tests, using community health resources, obtaining hospital privileges, ophthalmology, dermatology, otolaryngology, personal and professional growth, relationships with other physicians, and personnel issues. CONCLUSIONS: Using both the level of graduates' self-reported underpreparedness and the attributed importance of elements of rural practice, as indicated by the preceptor survey, we developed a list of the areas of the rural training program curriculum most in need of reform.

Adult↗

PubMed2004

Participatory approaches to improving safety and health under trade union initiative--experiences of POSITIVE training program in Asia.

The participatory, action-oriented training program in occupational safety and health named POSITIVE (Participation-Oriented Safety Improvements by Trade Union InitiatiVE) was established in Pakistan and extended to other countries in Asia. The steps taken in the development of the POSITIVE program included collecting local good examples in safety and health, developing an action-checklist, testing a participatory training program, and conducting follow-up activities to examine local achievements. Training manuals were compiled to provide workers with the practical, easy-to-understand information on safety and health improvements and on the positive roles of trade unions. Trade union trainers trained in the methodology conducted serial POSITIVE training workshops in Pakistan and then in Bangladesh, Mongolia, Nepal, the Philippines and Thailand and recently in China. These workshops resulted in many low-cost improvements at the workplace level. These improvements were carried out in the technical areas of materials handling, workstations, machine safety, physical environment, and welfare facilities. The trade union networks have been vital in reaching an increasing number of grass-root workplaces and in expanding the program to other countries. This included the visits to Mongolia and Thailand of Pakistani trade union trainers to demonstrate the POSITIVE training. The participatory training tools used in the POSITIVE program such as the action checklist and group discussion methods were commonly applied in different local situations. Participatory approaches adopted in the POSITIVE program have proven useful for providing practical problem-solving measures based on the local trade union initiative.

Asia↗

PubMedDate not supplied

A supervised training program in flexible sigmoidoscopy: evaluating skills from residency training to clinical practice.

To assess the effectiveness of a training program in flexible sigmoidoscopy for family practice residents, we prospectively studied the performance of four residents during their training and after graduation. One hundred and four training exams performed with the assistance of an experienced gastroenterologist were compared with 118 unassisted post-training, post-residency exams. The mean depth of insertion for the post-training period was 51.1 +/- 1.2 cm, which was significantly greater (P less than .05, Student's t test) than the mean training period depth of 47.6 +/- 1.2 cm. There was no significant difference in the identification of polyps or cancer between the training and post-training periods. The mean duration of an exam was 17.3 +/- 0.6 minutes in the post-training period. No significant complications were encountered in either period. The residency trained family physicians obtained results similar to those reported by trained endoscopists in depth of examination and pathology detected, although their examinations required more time. We conclude that this model of training was effective in the development of flexible sigmoidoscopy procedural skill for family practice residents.

Clinical Competence↗

PubMed2004

Effect of a training program for maternity ward professionals on duration of breastfeeding.

BACKGROUND: Training programs are commonly viewed as an effective way to improve breastfeeding-related practices of health professionals. The objective of this study was to determine whether a 3-day training program for maternity ward professionals was followed by an increase in duration of any breastfeeding. METHODS: A before-and-after study was conducted involving two retrospective random samples of 308 mothers who had delivered a healthy singleton infant of 37 weeks' or more gestation and 2,500 g or more birthweight in a level 3 maternity ward in a university hospital in France. Data were gathered from medical records and postal questionnaire. RESULTS: Study participants included 169 mothers (54.9%) in the pre-intervention sample and 178 (57.8%) in the post-intervention sample. The prevalence of any breastfeeding at birth was 77.5 percent (70.5%-83.6%) in the pre-intervention sample and 82.6 percent (76.2%-87.8%) in the post-intervention sample(p=0.24); the median duration of any breastfeeding was 13 weeks and 16 weeks, respectively(chi2 log-rank test=5.8, p=0.02). The decreased risk of weaning in the post-intervention sample persisted after adjustment for baseline characteristics (adjusted hazard ratio=0.70 [0.54-0.91]). It was paralleled by significant improvement in maternity ward practices that are known to affect the duration of breastfeeding. CONCLUSION: An intensive 3-day training program for maternity ward professionals can be followed by a significant but moderate increase in the duration of any breastfeeding. Multifaceted interventions involving prenatal components and community support should be planned in Western countries with low to intermediate prevalence of breastfeeding.

Adult↗

PubMedDate not supplied

Effectiveness of a clinical interviewing training program for family practice residents: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: This study evaluated the effectiveness of a clinical interviewing training program for third-year family practice trainees and determined which other factors influence residents' training in clinical communication. METHODS: This was a randomized, multicenter, educational trial involving 193 third-year family practice residents from eight centers in Spain. Centers were randomly assigned to two groups, one of which would undertake a communication skills training program and one of which would not. The program was resident centered, based on residents' practice experience, and provided structured feedback. The main outcome measures were residents' consultation behavior with six standardized patient encounters (three before and three after the training) as measured with the GATHA-RES rating scale by an observer blinded to group assignment of the residents. RESULTS: The intervention group trainees displayed marginally better communication skills at the start of the study than those in the control group. At the end of the study, trainees who had received the training program did not show better communication skills than those who had not received the training program. Factors related to the training center environment, having a teacher trained in clinical interviewing, younger age, and a longer interview duration correlated with better communication skills. CONCLUSIONS: The trial program did not appear to improve the global communication skills of trainees. This study highlights the importance of the trainee's teachers, the residency program environment, and earlier exposure to training in planning future programs to improve residents' communication skills.

Family Practice↗

PubMedDate not supplied

Effect of an oral health training program on knowledge and behavior of state agency long-term-care surveyors.

This study examines the effect of a training program on long-term-care (LTC) surveyors' knowledge of factors affecting oral health and their behavior in citing oral health deficiencies of LTC residents. Twenty surveyors were recruited for the experimental group, along with a non-equivalent comparison group of 31 surveyors. The experimental group participated in a three-hour interactive, case-based training program. The experimental group had a significant increase in total knowledge (p < 0.002) post-test scores with a moderate effect size, eta 2 = 0.115. The training program resulted in a statistically significant increase (p < 0.0001) in oral health citation behavior for the experimental group for six months following training. This study provides evidence that an interactive case-based training program can affect participants' knowledge regarding oral health of LTC residents and participants' oral health citation behavior. As the elderly population experiences an increased life expectancy with increased need for assistance with Activities of Daily Living (ADL), similar training programs will become an important factor in assessing the quality of care provided to LTC residents.

Activities of Daily Living↗

PubMed2004

Impact of the training program on lipid profile and cardiac health.

The aim of this study was to investigate the effects of training programs on serum lipid profile and myocardial oxidative stress. Male Wistar rats (2 mo-old) were divided into three groups (n = 8): sedentary (S), loadless trained (T) and trained-overload 2% body weight (TL). T and TL were trained through swimming for 9 weeks. T and TL rats had increased myocardial lipoperoxide (TBA) and lipid hydroperoxide (HP), whereas HP was higher in TL than in T animals. Superoxide dismutase (SOD) activities were lowest in TL. Myocardial glutathione peroxidase (GSH-Px) was lower in TL than in T and S rats. TL decreased HDL-cholesterol and increased LDL-cholesterol. The serum lactate dehydrogenase and TBA were increased, while SOD and GSH-Px activities were decreased in TL rats. Loadless training was able to improve HDL-cholesterol and to reduce LDL-cholesterol. In conclusion, the loadless training program induced beneficial effects on lipid profile, while overload training induced dyslipidemic profile that was associated with serum oxidative stress. The overload training program was deleterious relative to loadless training program, increasing myocardial oxidative stress.

Animals↗

PubMed2002

Randomized controlled study of in-hospital exercise training programs in children with cystic fibrosis.

The aim of this study was to compare aerobic and resistance training in children with cystic fibrosis (CF) admitted to hospital with an intercurrent pulmonary infection with a control group. The subjects were randomized into three groups on the first day of admission. The fat-free mass (FFM) was calculated, using the skin fold thickness from four sites (biceps, triceps, subscapular, and iliac crest). Pulmonary function tests were performed within 36 hr of admission and repeated on discharge from the hospital, and again at 1 month after discharge. All subjects performed an incremental treadmill exercise test, using a modified Bruce protocol. Lower limb strength was measured using a Cybex dynamometer. An assessment of quality of life was made using the Quality of Well Being Scale, as previously reported. Activity levels were measured using a 7-day activity diary, and subjects also wore an accelerometer on their hips. There were no significant differences between the three groups in terms of disease severity, and length of stay in hospital. Subjects in all three groups received intravenous antibiotics and nutritional supplementation as determined by the physician. Children randomized to the aerobic training group participated in aerobic activities for five sessions, each of 30-min duration, a week. The children randomized to the resistance training group exercised both upper and lower limbs against a graded resistance machine. Subjects in the control group received standard chest physiotherapy. Our study demonstrated that children who received aerobic training had significantly better peak aerobic capacity, activity levels, and quality of life than children who received the resistance training program. Children who received resistance training had better weight gain (total mass, as well as fat-free mass), lung function, and leg strength than children who received aerobic training. A combination of aerobic and resistance training may be the best training program, and future studies to assess optimal training programs for CF patients are indicated.

Adolescent↗

PubMed1984

Six-month hospital-pharmacy-based technician training program.

A six-month training program for hospital pharmacy technicians is described. The development of this program was stimulated by the need to use departmental resources more efficiently and the desire of local hospital pharmacy directors to have trained technicians. Financial support was sought and received from the local Private Industry Council. The department selects 10 students and two alternates for each class on the basis of test performance and an interview. The program consists of 1014 scheduled hours of instruction. The first week is spent orienting the students to the program and general hospital pharmacy concepts. The next six weeks are spent in a laboratory where the students acquire their basic skills. The rest of the program, approximately 4.5 months, is spent in on-the-job training, additional didactic lectures, and field trips. The students are evaluated routinely throughout the program. At the end of the program, each participant is granted a certificate. Attrition has been low; three classes have completed the program, and 28 technicians have graduated. Twenty-five of these technicians are now employed full-time. Positive feedback has been received from the technicians' employers. This program meets the need of area hospital pharmacies to recruit trained technicians.

Curriculum↗

PubMed2006

[Effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients].

PURPOSE: The purpose of this study was to identify effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. METHOD: The subjects were 60 stroke patients hospitalized in an oriental medical hospital; 31 in the experimental group and 29 in the control group. A nonequivalent control group pretest-posttest design was used. The tilting training program consisted of 3 sessions and was implemented for 30 minutes daily during 3 weeks. Data was collected from Feb to July 2003, and analyzed by percentage, Fisher's exact probability, chi2-test, and t-test using the SPSS/Win 10.0 computerized program. RESULT: After treatment with the tilting training program, the experimental group was significantly increased in the mean score for function of lower extremities (t=2.72, p=.009) compared to the control group, especially for keeping standing balance (t=2.78, p=.007) and standing by oneself (t=3.32, p=.002). However, in the mean scores of depression and self-efficacy, there were no significant differences between the two groups. CONCLUSION: The tilting training program was effective for increasing the function of lower extremities and to improve walking ability earlier among stroke inpatients. Therefore, the tilting training program is applicable to increase the balance level in standing and walking ability at the early rehabilitation stage for stroke patients.

Adult↗