2-day Training Course Research Articles

A needs assessment for simulation-based training in emergency urological skills in Ethiopia.

Urologic emergencies are common and complications from their management are high. Simulation-based education (SBE) is a highly effective training method, allowing trainees to learn both technical and nontechnical skills in a safe environment. Training in the management of urological emergencies is limited in many healthcare settings, so we performed a needs assessment for a urological emergencies SBE course in Ethiopia. This study presents data from a descriptive cross-sectional, survey-based survey of consultants and residents in the Ethiopian surgical community. The survey was disseminated using online Google Forms, through social media (WhatsApp), and to colleagues in the College of Surgeons of East, Central and Southern Africa (COSECSA) via email and social media. One hundred-seven results were received; two were discarded due to incomplete data. Fifty three of the respondents were general surgeons and 38 of the respondents were urologists. Sixty nine respondents strongly agreed that simulation-based training was important for first-year surgical residents, whereas twenty-five respondents agreed and nine respondents strongly disagreed; one respondent disagreed and one was neutral. Eighty seven respondents suggested a 3-day training course, whereas 17 respondents suggested a two-day course. More than 80 of the respondents rated training in the management of acute urinary retention, acute scrotum, urethral, and suprapubic catheterization as extreme or very important and 79 respondents wanted education about urologic trauma and Fournier's gangrene. Surgical and urology residents in Ethiopia have expressed a need for, and a strong interest in, simulation-based urological emergency training.

Online SPE-LC-MS-MS method for eight hydroxylated metabolites of polycyclic aromatic hydrocarbons in urine and determination of optimal sampling time after firefighter training

Polycyclic aromatic compounds (PAHs) are formed during incomplete combustion and firefighters are inadvertently at risk of being exposed to these and other hazardous compounds. Exposure to PAHs is often estimated by measuring their hydroxylated metabolites (OH-PAH) in urine. Here, an online-SPE LC-MS-MS method was set up for eight OH-PAHs thus increasing sample throughput and minimizing manual handling. The method was validated over a 5-month period and showed good reproducibility with intra- and inter-day variation of 2.4–8.1 % and 1.6–6.5 %, respectively, of low-level samples and accuracy (91.6–104.8 %) for a standard reference material. The method was applied to urine samples from conscripts training to become firefighters to determine the optimal sampling time for this training activity before a large intervention study. In total, six conscripts sampled urine 6–8 times over a 40-hr period during a 3-day training course. All eight metabolites were detected in ≥ 97 % of the samples and showed peak excretion 4–6 hrs after the training corresponding to 8–10 hrs after first exposure. Samples taken the morning after the exercise contained low levels of most metabolites. Consequently, 4–6 hrs post exposure is recommended as the optimal sampling time for quantification of PAH exposure and monitoring of potential differences in exposure.

Changes in Physical Education Teachers’ Beliefs Regarding Motivational Strategies: A Quasi-Experimental Study

Physical education teachers use motivational strategies that can (positively or negatively) affect their students’ level of motivation and engagement. Indeed, according to their experiences and beliefs, some teachers may focus on strategies that thwart, rather than support, students’ psychological needs (autonomy, competence, and relatedness). Effective professional development represents an excellent opportunity to help teachers use research-supported motivational strategies. Therefore, this study aimed to discover if attendance at a 2-day training course could positively affect PE teachers’ beliefs regarding empowering motivational strategies. Specifically, 11 PE teachers (experimental group = 6 [attending the training]; control group = 5 [no training]) from primary school (n = 6) and secondary school (n = 5) expressed their beliefs (effectiveness, feasibility, and normality) regarding 31 empowering motivational strategies proposed during training at the beginning (October) and the end (April) of the school year. Results of the Wilcoxon signed-rank test for related samples indicated no significant differences for the belief regarding effectiveness in either group. However, some positive significant changes (p ≤ .05) occurred in the experimental group for two motivational strategies supporting students’ need for autonomy and one supporting their need for competence. Given the small sample, positive trends (p ≤ .10) are also considered results of interest. In conclusion, the training appears likely to impact teachers’ beliefs. However, future professional development should provide additional feedback and follow-up time with teachers during experimentation with students to allow teachers to refine their understanding and use of the motivational strategies proposed.

Hand Dominance Is Not of Significance in Performing Fundamental Arthroscopic Skills Simulation Training Tasks

To compare the performance of the dominant and nondominant hand during fundamental arthroscopic simulator training. Surgical trainees who participated in a 2-day simulator training course between 2021 and 2023 were classified, according to their arthroscopic experience in beginners and competents. Only right-handed individuals with complete data sets were included in the study. Ambidexterity was trained using a box trainer (Fundamentals of Arthroscopic Surgery Training, Virtamed AG, Schlieren, Switzerland).Two tasks, periscoping for learning camera guidance and triangulation for additional instrument handling, were performed 4 times with the camera in the dominant hand and then in the nondominant hand. For each task, exercise time, camera path length, and instrument path length were recorded and analyzed. Out of 94 participants 74 right-handed individuals (22 females, 52 males) were classified to novices (n= 43, less than 10 independently performed arthroscopies) and competents (n= 31, more than 10 independently performed arthroscopies). Competents performed significantly better than novices. No significant difference was found after changing the guiding hand for the camera from the dominant to the nondominant hand regarding the camera path length and the instrument path length. Notably, tasks were performed even faster when using the camera in the nondominant hand. Our data demonstrate that the learned manual skills during basic arthroscopic training are quickly transferred to the contralateral side. In consequence, additional fundamental skills training for camera guidance and instrument handling of the nondominant hand are not necessary. For skillful arthroscopy, camera guidance and instrument handing must be equally mastered with both hands. It is important to understand how hand dominance may affect learning during arthroscopic simulator training.

Impact of ERCP simulator training on early ERCP learning curves of novice trainees: a cohort study.

Background and study aim Simulator-based training has been extensively studied in training gastroduodenoscopy and colonoscopy and shown to significantly improve learning curves of novices. Data on simulator-based training in endoscopic retrograde cholangiopancreatography (ERCP) are scarce. We aimed to determine the impact of 2-day intensive hands-on simulator training on the course of the learning curve of novice trainees. Methods We conducted a prospective cohort study using a validated mechanical ERCP simulator (Boškoski-Costamagna ERCP Trainer). Six trainees were allocated to the simulation course program (SG). Each of these trainees were paired with an endoscopy trainee starting regular ERCP training at the same center who had no exposure to a simulation course program (control group; CG). The course included lectures, live ERCP demonstrations, and hands-on ERCP training to educate trainees in basic techniques related to cannulation, stent placement, stone extraction and stricture management. After the course, both the SG and CG started formal ERCP training in their respective centers. The Rotterdam Assessment Form for ERCP was used to register each performed ERCP. Simple moving average was applied to create learning curves based on successful common bile duct (CBD) cannulation. Outcomes were plotted against a historical cohort (HC). Results Thirteen trainees were included, six trainees in the SG and seven trainees in the CG, with a total of 717 ERCPs. Mean successful ERCP cannulation rate was higher for the simulator group at baseline compared to both CG and HC, 64% versus 43% and 42%, respectively. Differences became less explicit after 40 ERCPs, but persisted until a median of 75 ERCPs. Conclusions We demonstrate that 2-day hands-on simulator-based ERCP training course has a positive effect on the learning curves of ERCP trainees and should be considered an integral part of the training curricula for ERCP to develop skills prior to patient-based training.

Accessible mental well-being intervention for adolescents in school settings: a single-group intervention study using a pretest–post-test design

BackgroundA growing number of adolescents seek treatment for mental health problems, a circumstance that stresses the importance of implementing accessible treatment options. This study evaluates the impacts of brief, mental well-being intervention for adolescents in a school environment. As mental health interventions are often targeted at specific disorders, we sought a comprehensive approach to reach adolescents with a range of mental health symptoms.MethodsSingle-group intervention study with a pretest–posttest design was utilized and conducted in lower, upper secondary, and vocational schools on adolescents ages 12–18 who sought medical attention for mental health symptoms. The cut-off point for inclusion was ≥ 14, for the Young Persons Clinical Outcomes for routine Evaluation (YP-CORE) measurement. The intervention included six face-to-face visits implemented by psychiatric nurses who received a 3-day training course. The impacts were evaluated after 6 weeks (n = 87) and again at 6 months (n = 68) and assessed using the YP-CORE, Beck Depression Inventory (BDI-II) and Overall Anxiety Severity and Impairment Scale (OASIS).ResultsThe participants reported significant levels of mental distress at baseline with a YP-CORE mean score = 21.48, a BDI-II mean score = 23.60, OASIS mean score = 10.98. Post-intervention results at 6 weeks for the primary outcome YP-CORE showed a significant (p < .001) mean score decrease of − 3.82, a medium effect size d = .627. For participants attending upper secondary and vocational schools the YP-CORE scores changed significantly from baseline to 6-weeks (p = .005) and from baseline to 6-months (p < .001). Long-term outcomes at 6-months showed a − 1.14 decrease (p = non-significant), effect size d = .175. After the 6-week intervention, 12% of the participants were assessed as not requiring additional visits.ConclusionsThis easily accessible intervention in a school setting indicated improvement for those participants with mild to moderate mental disorder symptoms and attending upper secondary and vocational schools. After the 6-week intervention, significant positive effects were observed. Participants reported substantial levels of mental distress at the baseline, which could contribute to the decline of symptoms and need for extended care during the 6 months follow-up.Trial registration Retrospectively registered with Clinicaltrials.gov identifier NCT05356949

Quick coherence technique facilitating commercial pilots’ psychophysiological resilience to the impact of COVID-19

This study investigates the effect of quick coherence technique (QCT) on commercial pilots’ resilience to the unprecedented impact of a pandemic. Eighteen commercial pilots voluntarily participated in a 2-day training course on QCT followed by 2 months of self-regulated QCT practicing during controlled rest in the flight deck and day-to day life. There are subjective and objective assessments to evaluate the effects of QCT on commercial pilots’ psychophysiological resilience. Results demonstrated that QCT training can significantly increase pilots’ psychophysiological resilience thereby improving their mental/physical health, cognitive functions, emotional stability and wellness on both subjective (PSS & AWSA) and objective measures (coherence scores). Moreover, pilots who continued practicing self-regulated QCT gained the maximum benefits. Current research has identified great potential to enhance pilots’ mental/physical health via QCT training. Operators can develop peer support programs for pilots to increase resilience and maintain mental and physical health using the QCT technique. Practitioner summary: QCT breathing has been proven to increase commercial pilots’ resilience by moderating psychophysiological coherence, strengthening mental/physical capacity and sustaining positive emotions to deal with the challenges both on the flight deck and in everyday life. HIGHLIGHTS Pilots have suffered from the impact of the Covid-19 pandemic across many factors including social, economic, mental, physical, emotional, and operational issues Biofeedback training can increase commercial pilots’ resilience by moderating psychophysiological coherence, strengthening mental and physical capacity Self-regulated practicing QCT to form a habitual behaviour is required to sustain the maximum benefits either in the flight or day-to-day life QCT is an effective intervention for aviation authorities and airline operators to develop peer support programs to increase pilots’ fatigue resilience

The orthopedic surgery preparatory exam course: Measuring residents’ satisfaction and perceptions through video ethnomethodology and survey analysis

Objectives: Orthopedic training in Saudi Arabia has changed how residents are assessed for their board examination. The new format uses scenario cases instead of real patients during the assessment. However, these changes were not received well by the residents. The Orthopedic Surgery Preparatory Exam Course is a 3-day training course designed specifically to address these concerns. This study investigated the effectiveness, perceptions, and satisfaction levels of the residents who took this course, emphasizing the video recording approach. Methods: A quantitative survey was designed by the research team and validated by experts. Edits were made after their feedback. Purposive sampling was used, and all 12 attendees of the course participated. All participants were 5th-year residents enrolled in the orthopedics residency training program in Saudi Arabia. A qualitative ethnomethodology analysis of video recordings for pre- and post-mock exams was also conducted. Results: The analysis demonstrated that participants were less anxious in the post-mock exam and showed improvement in their confidence and communication skills based on analysis of the assessed criteria such as eye contact, vocal projection, gestures, posture, and movement. The participants generally perceived the course useful in preparing for their board exam. Conclusion: The participants generally perceived the course to be useful in helping them to prepare for their board exam by familiarizing them with the exam environment. The participants reported the strength of the course as being able to provide a realistic simulated experience. On the other hand, the participants viewed the weakness of the course in its duration and generally requested more days to be added to the course. They were generally satisfied with the course helping them prepare for the board exam. It is recommended to incorporate the course as part of the residency training program curriculum.

A unified approach to faculty development

Due to the effect of the global pandemic and rising student cohort numbers, simulated practice placements are being implemented into nursing curricula. To deliver simulation-based education (SBE) within the Higher Education Institutions (HEI) staff must be adequately prepared. For SBE to be effective, thoughtful consideration to appropriate staff training is important [1]. A structured unified approach is more beneficial as it sets the same aspirations and contributes to a shared philosophy [2]. This unified approach meant both Health Board and HEI staff were being trained to delivery simulation in the same way, which was new for this HEI. Creating a faculty for simulation emulates a community of practice and also comprises essential networking with other simulationists [2]. It helps support Benner’s novice to expert theory as staff start of as novices and subsequently develop emulating that robust educational training for SBE faculty development is essential [3]. Importantly, it addresses quality assurance and governance frameworks in meeting the requirement of the International Nursing Association for Clinical Simulation Learning (INACSL) [3], Association for Simulated Practice in Healthcare (ASPiH), and Nursing and Midwifery Council (NMC) standards. The overall aim of this innovation was to implement a unified approach to faculty development training for academic staff within an HEI. Three training sessions were delivered in January and February 2022. HEI staff attended a one-day session. Health Board Simulation Educators facilitated the sessions for the HEI Academic Staff. Using a unified approach to this faculty development had a positive outcome in supporting HEI staff to be upskilled in the delivery of SBE. It has also resulted in the subsequent development and implementation of a 2-day training course comprising the following sessions: Session 1 – Introduction to clinical skills and simulation and writing learning outcomes and scenarios; Session 2: Technology supporting simulation; Session 3: Preparation, briefing, and debriefing; Session 4: Running an immersive simulation session. This in-house training programme will continue to be delivered to HEI staff undertaking SBE and evaluated. Using a unified approach enhances the quality and parity of the delivery of SBE within the HEI. A unified approach to faculty development within the HEI will continue to be delivered to upskill staff in SBE. Collaboration with clinical partners in faculty development is crucial in the delivery of SBE to ensure a unified evidence-based approach. 1. Bryant K, Aebersold ML, Jeffries PR, Kardong-Edgren S. Innovations in simulation: Nursing leaders’ exchange of best practices. Clinical Simulation in Nursing. 2020;41:33–40. 2. Peterson DT, Watts PI, Epps CA, White ML. Simulation faculty development: a tiered approach. Simulation in Healthcare. 2017;12(4):254–259. 3. Hallmark BF. Faculty development in simulation education. Nursing Clinics. 2015;50(2):389–397.

Training on Reporting and Data System (RADS) for Somatostatin-Receptor Targeted Molecular Imaging Can Reduce the Test Anxiety of Inexperienced Readers

PurposeFor somatostatin receptor (SSTR)-positron emission tomography/computed tomography (PET/CT), a standardized framework termed SSTR-reporting and data system (RADS) has been proposed. We aimed to elucidate the impact of a RADS-focused training on reader’s anxiety to report on SSTR-PET/CT, the motivational beliefs in learning such a system, whether it increases reader’s confidence, and its implementation in clinical routine.ProceduresA 3-day training course focusing on SSTR-RADS was conducted. Self-report questionnaires were handed out prior to the course (Pre) and thereafter (Post). The impact of the training on the following categories was evaluated: (1) test anxiety to report on SSTR-PET/CT, (2) motivational beliefs, (3) increase in reader’s confidence, and (4) clinical implementation. To assess the effect size of the course, Cohen’s d was calculated (small, d = 0.20; large effect, d = 0.80).ResultsOf 22 participants, Pre and Post were returned by 21/22 (95.5%). In total, 14/21 (66.7%) were considered inexperienced (IR, < 1 year experience in reading SSTR-PET/CTs) and 7/21 (33.3%) as experienced readers (ER, > 1 year). Applying SSTR-RADS, a large decrease in anxiety to report on SSTR-PET/CT was noted for IR (d = − 0.74, P = 0.02), but not for ER (d = 0.11, P = 0.78). For the other three categories motivational beliefs, reader’s confidence, and clinical implementation, agreement rates were already high prior to the training and persisted throughout the course (P ≥ 0.21).ConclusionsA framework-focused reader training can reduce anxiety to report on SSTR-PET/CTs, in particular for inexperienced readers. This may allow for a more widespread adoption of this system, e.g., in multicenter trials for better intra- and interindividual comparison of scan results.

Assessing Skill Acquisition in Anesthesiology Interns Practicing Central Venous Catheter Placement Through Advancements in Motion Analysis

The study authors hypothesized that a combination of previously used (path length, translational motions, and time) and novel (rotational sum) motion metrics could be used to analyze learning curves of anesthesiology interns (postgraduate year 1) practicing central venous catheter placement in the simulation setting. They also explored the feasibility of using segmented motion recordings to inform deliberate practice. A prospective cohort study. A single academic medical center. Anesthesiology interns (postgraduate year 1). Anesthesiology interns underwent a 2-day training course in which they performed 9 central venous catheter placements, while attached to motion sensors on the dorsum of their dominant hand and ultrasound probe. Motion metrics were analyzed using generalized estimating equations for both the overall procedure and predefined segments. Five attending anesthesiologists performed 3 trials each for comparison. Overall, there was a negative trend in path length, translational motions, rotational sum, and time (p < 0.001), with the exception of translational motions of the ultrasound probe. Interns reached within 1 standard deviation of the attending anesthesiologists by trials 7-to-8 for most metrics. Segmentation identified specific components of the procedure that were either significantly improved upon or required deliberate practice. The novel metric of rotational sum exhibited a moderate-to-strong positive correlation with other metrics (p < 0.001). A comprehensive series of motion metrics was able to describe the learning curves of novices training to perform central venous catheter placement in the simulation setting. Furthermore, it was determined that segmentation may provide additional insight into skill acquisition and inform deliberate practice.

Mental health support and training to improve secondary school teachers’ well-being: the WISE cluster RCT

Background Health and Safety Executive data show that teachers are at heightened risk of mental health difficulties, yet few studies have attempted to address this. Poor teacher mental health may impact on the quality of support provided to young people, who also report increased mental health difficulties themselves. Objective To test the effectiveness of an intervention aiming to improve secondary school teachers’ well-being through mental health support and training. Design A cluster randomised controlled trial with embedded process and economic evaluations. Setting Twenty-five mainstream, non-fee-paying secondary schools in the south-west of England and South Wales, stratified by geographical area and free school meal entitlement, randomly allocated to intervention or control groups following collection of baseline measures (n = 12, intervention; n = 13, control) between May and July 2016. Participants All teachers in the study schools at any data collection. All students in year 8 (baseline) and year 10 (final follow-up). Intervention Each intervention school received three elements: (1) a 1-day mental health first aid for schools and colleges training session delivered to 8% of all teachers; (2) a 1-hour mental health session delivered to all teachers; and (3) 8% of staff trained in the 2-day standard mental health first aid training course set up a confidential peer support service for colleagues. Control schools continued with usual practice. Main outcome measures The primary outcome was teacher well-being (using the Warwick–Edinburgh Mental Wellbeing Scale). Secondary outcomes were teacher depression, absence and presenteeism, and student well-being, mental health difficulties, attendance and attainment. Follow-up was at 12 and 24 months. Data were analysed using intention-to-treat mixed-effects repeated-measures models. Economic evaluation A cost–consequence analysis to compare the incremental cost of the intervention against the outcomes measured in the main analysis. Process evaluation A mixed-methods study (i.e. qualitative focus groups and interviews, quantitative surveys, checklists and logs) to examine intervention implementation, activation of the mechanisms of change outlined in the logic model, intervention acceptability and the wider context. Results All 25 schools remained in the study. A total of 1722 teachers were included in the primary analysis. We found no difference in mean teacher well-being between study arms over the course of follow-up (adjusted mean difference –0.90, 95% confidence interval –2.07 to 0.27). There was also no difference in any of the secondary outcomes (p-values 0.203–0.964 in the fully adjusted models). The average cost of the intervention was £9103 (range £5378.97–12,026.73) per intervention school, with the average cost to Welsh schools being higher because of a different delivery model. The training components were delivered with high fidelity, although target dosage was sometimes missed. The peer support service was delivered with variable fidelity, and reported usage by teachers was low (5.9–6.1%). The intervention had high acceptability, but participants reported low support from senior leadership, and minimal impact on school culture. Limitations Participants and the study team were unblinded, self-report for the main outcome measures and inaccurate measurement of peer support service usage. Conclusions The Wellbeing in Secondary Education (WISE) intervention was not effective at improving teacher or student well-being, or reducing mental health difficulties, possibly because of contextual barriers preventing it becoming embedded in school life. Future work Identification of ways in which to achieve system-level change and sustained support from senior leaders is important for future school-based mental health interventions. Trial registration Current Controlled Trials ISRCTN95909211. Funding This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 12. See the NIHR Journals Library website for further project information. Intervention costs were met by Public Health Wales, Public Health England and Bristol City Council.

Effects of a training course on creation of an empowering motivational climate in physical education: a quasi-experimental study

ABSTRACT Background Physical education (PE) teachers report needing additional support in terms of classroom climate and students’ motivation (Verret et al. [2017]. Enquête provinciale sur les pratiques inclusives en enseignement de l’éducation physique et à la santé: Rapport provincial primaire et secondaire. Montréal, Québec: Université du Québec à Montréal. https://inclusion-eps.uqam.ca/diffusion/). Professional development represents an opportunity to exchange on their practices with colleagues, become familiar with the latest research on effective motivational strategies, develop new skills and support transfer into practice. Objective This study aims to determine if participation in a 2-day training course (spread over 3 days) on how to create an empowering motivational climate impacted students’ motivational variables (self-determined motivation, basic needs satisfaction, perception of motivational climate and PE effort as well as their intention to be physically active) and observed motivational climate. Research design Quasi-experimental study Method A total of 11 PE teachers (experimental group-EG = 6, control group-CG = 5) and their students (elementary = 107, secondary = 100) were recruited. Students completed questionnaires twice: once before the course and once after it was over. Teachers were filmed during two lessons: once before the start of training and once between the second and the last day of training, during a motivational strategy experiment planned by PE teachers on the second day of training. To analyze the data, we used non-parametric tests: the Wilcoxon–Mann–Whitney test and the Wilcoxon signed rank test for related samples. Two experts coded the videos (intrarater reliability = 90.6%; interrater reliability = 93.8%). Findings Results indicate that the teachers’ training had no significant positive effect on students’ motivation. In fact, it was surprising to observe a significant decline in students’ perception of an empowering motivational climate and effort in the experimental group. However, scores were already quite high at the start of the year, remained high in the middle of the year and were similar for the two groups. Between both measurement points, the control group's amotivation increased and autonomy satisfaction decreased. This was not the case for students in the experimental group, suggesting that the training course might be effective in avoiding the detriment of students’ motivation. PE teachers in the experimental group were more empowering during the integration phase of the lesson. Gaps and the overall rating of the lesson (motivational climate) were both more empowering in the experimental group, but did not reach statistical significance (p = .066), which is promising for future interventions.

Critical Care Education and Skills Validation Course for Internal Medicine Physicians in the Military.

Military internist and internal medicine (IM) subspecialist physicians must be prepared to function in both traditional inpatient and outpatient settings, as well as manage critically ill patients within a deployed austere environment. As many critical care procedures are not performed on a routine basis in general IM practice, many active duty IM physicians experience skills degradation and lack confidence in performing these procedures. In order to address this perceived deficiency, the U.S. Army and Air Force Internal Medicine Education and Skills Validation Course was developed to provide essential training in critical care procedures for active duty military IM physicians and subspecialists. Staff internist and subspecialist physicians at multiple military treatment facilities participated in a 2-day simulation-based training course in critical care procedures included in the Army Individual Critical Task Lists and the Air Force Comprehensive Medical Readiness Program. Educational content included high-yield didactic lectures, multi-disciplinary Advanced Cardiac Life Support/Advanced Trauma Life Support high-fidelity simulation scenarios, and competency training/validation in various bedside procedures, including central venous and arterial line placement, trauma-focused ultrasound exam, airway management and endotracheal intubation, chest tube thoracotomy, and mechanical ventilation, among others. A total of 87 staff IM physicians participated in the course with an average of 2-4 years of experience following completion of graduate medical education. Upon course completion, all participants successfully achieved rigorous, checklist-based, standardized validation in all the required procedures. Survey data indicated a significant improvement in overall skills confidence, with 100% of participants indicating improvement in their ability to function independently as deployed medical officers. Broad implementation of this program at military hospitals would improve pre-deployment critical care procedural readiness in military IM physicians.

P077 Upskilling rheumatology therapists in work rehabilitation: an evaluation of the Workwell training programme

Abstract Background/Aims Keeping people with arthritis working is an important goal of rehabilitation. Rheumatology therapists may provide work advice to employed patients but conducting a structured work assessment and providing vocational rehabilitation (VR) is unusual. As part of a VR trial, we developed a VR training course (Workwell). The course consisted of 3 elements: a pre-training self-study module (reading on ergonomics and activity analysis; activity analysis of at least 2 videos of people working; observing people working); a 2-day training course (how to conduct a structured work interview (the Work Environment Survey: WES); case studies; planning work interventions; practical workshops about VR strategies and solutions; addressing disclosure; writing reports); followed by a 1:1 one hour telephone call practising conducting the WES with a trainer, developing a treatment plan, and individual feedback. A “Workwell Solutions Manual” was also provided for use in practice, with information on legislation, patient booklets and work solutions linked to problems identified in the WES. Our aim was to evaluate therapists’ views about the course and its impact. Methods All therapists attending the Workwell course were asked to complete questionnaires pre- and post-training. These included: knowledge of and confidence in providing VR (measured on a 0-4 scale of very limited to excellent); the Evidence Based Practice Attitude Scale (EBPAS); and views about course content and duration. Results Three courses were delivered: 32/40 attendees completed pre-and-post training questionnaires. All were occupational therapists (OTs): 30 women and 2 men; 2 NHS Band 5, 15 Band 6, 11 Band 7 and 4 Band 8; with 11 (SD 7) years’ experience in Rheumatology. Median scores of Knowledge of: VR; the VR process; VR strategies; relevant legislation and policies; and Confidence in: conducting a work assessment; and identifying work solutions, significantly increased from 1 (limited: IQR 1-2) to 3 (good: IQR 2-3) (p &amp;lt; 0.001). Total EBPAS scores did not change. However, Openness sub-scale scores did (i.e. extent to which willing to use new research -based interventions): Pre 2 (moderate: IQR2-3) to Post 3 (great: IQR 3-3): p = 0.04. Most (i.e. 26-30) considered very/extremely relevant: the pre-training self-study; conducting the WES and case studies; practical workshops (workstation assessment; upper limb strategies; load handling; environment; disclosure); and the post-training 1:1 practice WES, treatment planning and feedback. The training about using the WES (roleplay by trainers; case studies and 1:1 telephone practice) was considered the most beneficial aspect. Of the 21 commenting on course length, 16 considered it about right and 5 wanted longer. Conclusion The 2-day VR course, plus 2 days self-study, led to significant improvements in knowledge and confidence in delivering VR amongst attending OTs. Work is a key component of OT. This training course could help expand work services in Rheumatology to keep patients working. Disclosure A. Hammond: None. S. Woodbridge: None. R. O'Brien: None. A. Ching: None. J. Parker: None.

Assessment of Healthcare Professionals' Self-Perceived Competence in Perinatal/Neonatal Palliative Care After a 3-Day Training Course.

Background: Perinatal/neonatal palliative care (PNPC) offers a plan of care for improving the quality of life of infants when the prolongation of life is no longer the goal of care. The number of PNPC programs has increased in recent years, but training for clinicians has not kept pace. Therefore, an interdisciplinary team developed a 3-day intensive PNPC training course for physicians, nurses, and other healthcare professionals at Columbia University Irving Medical Center (CUIMC).Objective: The aim of this study was to assess the efficacy of a PNPC training course in improving the self-reported competence of participants.Study Design: A cross-sectional survey design was used to obtain data from 88 healthcare professionals who attended the PNPC training course. Data was collected using a validated questionnaire. The questionnaire included 32 items that queried participants about their self-assessed competence using a forced 1–4 Likert scale. The 32 items, which served as the outcome variables, were clustered into the eight domains of palliative care. The survey was administered through a web-based tool at the beginning and the conclusion of the course.Results: Results from two-sample t-tests comparing pre-test and post-test self-assessed competence were statistically significant for each item across disciplines. Additional analysis revealed that after participation in the training course, the statistically significant differences between physicians' and nurses' pre-course self-reported competence disappeared.Conclusion: The development of an evidence-based curriculum improved the self-reported competence of participants across disciplines, filled a specific gap in nurses' self-reported competence and addressed a global training need.

The training and support needs of 22 programme directors of community-based childhood obesity interventions based on the EPODE approach: an online survey across programmes in 18 countries

BackgroundTackling childhood obesity is complex and requires a community-based approach implemented in multiple environments. It is known from literature that knowledgeable and skilled professionals are essential to implement such an approach successfully. The aim of the present study was to assess the need for training and support among a global network of programme directors implementing a Community-Based Childhood Obesity Intervention (CBCOI) based on the EPODE approach, in order to assist them in optimising the implementation process.MethodsAn online survey was sent to 40 programme directors representing programmes implementing a CBCOI based on the EPODE approach. The survey consisted of statements on a 5-point Likert scale and multiple-choice questions about attitude towards and usefulness of training and support, and preferences for some predefined training types and training topics. In total, 22 programme directors responded to the survey (55% response rate). Data were analysed using descriptive statistics to describe the need for support in order to improve successful implementation.ResultsRespondents strongly agreed that continually updating skills and learning how to make their programmes more effective and sustainable at the start and during the implementation was important. On-site training was preferred most at the commencement of a programme, while a 2-day training course was most valued during implementation. Monitoring, measuring and programme evaluation was identified as the most valuable training topic.ConclusionsThe results indicate a continuing and significant need for support and training among programme directors implementing a CBCOI. The findings give directions regarding topics and types of training and support in order to improve the implementation process.

Effectiveness of Flow Volume Measurement Training Using a Custom-Made Doppler Flow Simulator.

This study was conducted to analyze the effectiveness of a custom-made Doppler ultrasound (DUS) flow simulator, vascular phantom, and Doppler test fluid in the training of dialysis staff in flow volume (FV) measurements for arteriovenous (AV) access in hemodialysis (HD) patients. A DUS flow simulator was constructed using a continuous renal replacement therapy machine. Vascular phantoms were constructed using a rubber enema tube and keyboard cleaning gel. The Doppler test fluid consisted of freeze-dried instant coffee granules and 0.9% saline. This easy and affordable simulator was used to train 12 dialysis staff members, with no previous experience in DUS FV measurement. After a 3-day lecture course, the staff members performed DUS analyses on the AV access of HD patients. Thereafter, they underwent a 3-day training course using the simulator and then performed the DUS analyses of the AV access again. Each staff member assessed the FV 3 times, and the mean values of the measurements pretraining and posttraining were analyzed using paired t tests. The difference in the mean value of FV measurements and the reference value decreased from 131.6 mL/min to 62.5 mL/min (95% confidence interval = 30.0-108.0, P = 0.002), and the standard deviation of the FV measurements decreased from 96.9 mL/min to 47.0 mL/min (95% confidence interval = 7.9-91.8, P = 0.023) after DUS training with the simulator. The accuracy and reproducibility of FV measurements markedly improved after training with the simulator; it may be helpful for medical practitioners involved in AV access for HD treatment.

Standardizing training for Pressurized Intraperitoneal Aerosol Chemotherapy

BackgroundPIPAC is a novel mode of intraperitoneal drug delivery for patients with peritoneal cancer (PC). PIPAC is a safe treatment with promising oncological results. Therefore, a structured training program is needed to maintain high standards and to guarantee safe implementation. MethodsAn international panel of PIPAC experts created by means of a consensus meeting a structured 2-day training course including essential theoretical content and practical exercises. For every module, learning objectives were defined and structured presentations were elaborated. This structured PIPAC training program was then tested in five courses. ResultsThe panel consisted of 12 experts from 11 different centres totalling a cumulative experience of 23 PIPAC courses and 1880 PIPAC procedures. The final program was approved by all members of the panel and includes 12 theoretical units (45 min each) and 6 practical units including dry-lab and live surgeries. The panel finalized and approved 21 structured presentations including the latest evidence on PIPAC and covering all mandatory topics. These were organized in 8 modules with clear learning objectives to be tested by 12 multiple-choice questions. Lastly, a structured quantifiable (Likert scale 1–5) course evaluation was created.The new course was successfully tested in five courses with 85 participants. Mean overall satisfaction with the content was rated at 4.79 (±0.5) with at 4.71 (±0.5) and at 4.61 (±0.7), respectively for course length and the balance between theory and practice. ConclusionsThe proposed PIPAC training program contains essential theoretical background and practical training enabling the participants to safely implement PIPAC.

Evidence-Based Practice for Cardiac Intensive Care Unit Nurses: An Educational Intervention Study.

This study examined the effectiveness of two educational methods on nurses' skills and commitment to implementing evidence-based practice (EBP). Ninety nurses were randomly assigned to three groups. Participants in the workshop group took part in a 2-day training course, participants in the multimedia group received educational content through video, and participants in the control group did not receive any training content. The nurses' skills and commitment to implement EBP were assessed at baseline and 1 month after the teaching sessions. The EBP skills of nurses in the intervention groups were significantly enhanced compared with nurses in the control group (p < .05). Mean scores in the multimedia group were slightly better than in the workshop group; however, this difference was not statistically significant. Commitment to EBP implementation did not change significantly over time among the groups (p > .05). Different methods of training can be useful in improving nurses' EBP skills; however, the participants' commitment to implement EBP did not change considerably. Because of its cost effectiveness, the multimedia method should be considered for use in nurse training. [J Contin Educ Nurs. 2020;51(4):167-173.].