Post Training Research Articles

The effect of inspiratory muscle training and detraining on the respiratory metaboreflex.

What is the central question of this study? Is the attenuation of the respiratory muscle metaboreflex preserved after detraining? What is the main finding and its importance? Inspiratory muscle training increased respiratory muscle strength and attenuated the respiratory muscle metaboreflex as evident by lower heart rate and blood pressure. After 5weeks of no inspiratory muscle training (detraining), respiratory muscle strength was still elevated and the metaboreflex was still attenuated. The benefits of inspiratory muscle training persist after cessation of training, and attenuation of the respiratory metaboreflex follows changes in respiratory muscle strength. Respiratory muscle training (RMT) improves respiratory muscle (RM) strength and attenuates the RM metaboreflex. However, the time course of muscle function loss after the absence of training or 'detraining' is less known and some evidence suggest the respiratory muscles atrophy faster than other muscles. We sought to determine the RM metaboreflex in response to 5weeks of RMT and 5weeks of detraining. An experimental group (2F, 6M; 26±4years) completed 5weeks of RMT and tibialis anterior (TA) training (each 5days/week at 50% of maximal inspiratory pressure (MIP) and 50% maximal isometric force, respectively) followed by 5weeks of no training (detraining) while a control group (1F, 7M; 24±1years) underwent no intervention. Prior to training (PRE), post-training (POST) and post-detraining (DETR), all participants underwent a loaded breathing task (LBT) to failure (60% MIP) while heart rate and mean arterial blood pressure (MAP) were measured. Five weeks of training increased RM (18±9%, P<0.001) and TA (+34±19%, P<0.001) strength and both remained elevated after 5weeks of detraining (MIP-POST vs. MIP-DETR: 154±31 vs. 153±28cmH2O, respectively, P=0.853; TA-POST vs. TA-DETR: 86±19 vs. 85±16N, respectively, P=0.982). However, the rise in MAP during LBT was attenuated POST (-11±17%, P=0.003) and DETR (-9±9%, P=0.007) during the iso-time LBT. The control group had no change in MIP (P=0.33), TA strength (P=0.385), or iso-time MAP (P=0.867) during LBT across all time points. In conclusion, RM and TA have similar temporal strength gains and the attenuation of the respiratory muscle metaboreflex remains after 5weeks of detraining.

Measuring nurses' attitudes to family care: a longitudinal mixed method study

In a scenario of demographic changes with an ageing population and an increase in people with chronic illnesses, the family assumes a central role in the care of their family member. Providing nurses with knowledge and strategies of family-centred care may change current standards of practice to a more family-focused approach. To explore nurses' perceptions on the importance of involving families in the project of care and their attitudes before, during and after an implementation of family-centred care. A longitudinal mixed method study was conducted during the implementation of family-centred care in a health district. A training package for the district nurses and individual coaching by an experienced nurse were offered. The Families' Importance in Nursing Care-Nurses Attitudes (FINC-NA) questionnaire was administered pre- and post training and one year later and two focus groups were conducted. All the 19 health district nurses participated in the study; average age 49.3 years, working experience 26.8 years. Statistically significant changes were observed in all four dimensions of the FINC-NA: family as a personal and professional resource, as a partner and a burden. The same results were confirmed by the focus groups. An educational intervention for home care nurses proved to be useful during the implementation of family-centred care. A key aspect was the support offered to nurses in transferring their knowledge and skills to their practice.

청소년 태권도 수련생이 지각한 부모의 긍정적⋅부정적 양육태도와 동기 분위기, 라이프스킬, 전이의 관계

The purpose of this study was to identify the relationship of perceived positive and negative parenting attitude, motivational climate, life skills, and transfer of adolescent Taekwondo trainees. Participants of this study were 294 (average age=15.45) Taekwondo trainees in Pusan including 226 middle school students and 68 high school students. The PSCQ-KA, Korean version of CCS and PMCSQ, KLSSS, and KLSTS were used to measure. After data collection, descriptive statistics, correlation, and structural equation model (SEM) were conducted for data analysis. In the SEM, we tested two models; (a) positive parenting attitude model and (b) negative parenting attitude model. First, positive parenting attitude had a positive effect on motivational climate and life skills. In addition, the path of motivational climate to life skills and life skills to transfer were statistically significant in positive. Second, negative parenting attitude had a negative effect on motivational climate. Furthermore, the path of motivational climate to life skills and life skills to transfer were statistically significant. In conclusion, parents’ positive attitude such as warmth, structure, and autonomy support, is a key component to increasing a positive climate and fostering life skills. In addition, motivational climate improves life skills development.

Measuring palliative care self-efficacy of intellectual and developmental disability staff using Rasch models.

The objectives of this study were to evaluate the psychometric properties of a palliative care self-efficacy instrument developed for intellectual and developmental disability (IDD) staff using Rasch analysis and assess the change in palliative care self-efficacy between 2 time points using Rasch analysis of stacked data. Staff from 4 nonprofit IDD services organizations in a US Midwestern state (n=98) answered 11 questions with Likert-style responses at baseline and 1-month follow-up post training. Rasch analysis was performed to examine rating scale structure, unidimensionality, local independence, overall model fit, person and item reliability and separation, targeting, individual item and personal fit, differential item functioning (DIF), and change in palliative care self-efficacy between 2 time points. The rating scale structure improved when 5 response categories were collapsed to 3. With the revised 3 response categories, the instrument demonstrated good psychometric properties. Principal components analysis of Rasch residuals supported the assumption of unidimensionality. Model fit statistics indicated an excellent fit of the data to the Rasch model. The instrument demonstrated good person and item reliability and separation. Gender-related DIF was found in 1 item, and work tenure-related DIF in 3 items. Overall palliative care self-efficacy improved between 2 time points. Rasch analysis allowed for a more thorough examination of this palliative care self-efficacy instrument than classical test theory and provided information on rating scale structure, targeting, DIF, and individual persons and items. These recommendations can improve this instrument for research and practical contexts.

Artificial intelligence in radiology: trainees want more

To understand the attitudes of UK radiology trainees towards artificial intelligence (AI) in Radiology, in particular, assessing the demand for AI education. A survey, which ran over a period of 2 months, was created using the Google Forms platform and distributed via email to all UK training programmes. The survey was completed by 149 trainee radiologists with at least one response from all UK training programmes. Of the responses, 83.7% were interested in AI use in radiology but 71.4% had no experience of working with AI and 79.9% would like to be involved in AI-based projects. Almost all (98.7%) felt that AI should be taught during their training, yet only one respondent stated that their training programme had implemented AI teaching. Respondents indicated that basic understanding, implementation, and critical appraisal of AI software should be prioritized in teaching. Of the trainees, 74.2% agreed that AI would enhance the job of diagnostic radiologists over the next 20 years. The main concerns raised were information technology/implementation and ethical/regulatory issues. Despite the current limited availability of AI-based activities and teaching within UK training programmes, UK trainees' attitudes towards AI are mostly positive with many showing interest in being involved with AI-based projects, activities, and teaching.

UK national trainee survey of hepatology training, research and the future workforce

ObjectiveThe increasing prevalence of liver disease in the UK means there is a pressing need to expand the hepatology workforce. This survey aims to evaluate current hepatology training provision, and...

Changes in Gatekeeper Beliefs Following ASIST and Relation to Subsequent Gatekeeper Suicide Prevention Behaviors.

This study examines relations between suicide prevention gatekeeper beliefs and actual helping behaviors following participation in Applied Suicide Intervention Skills Training (ASIST). Participants (n = 434) completed measures examining suicide-related beliefs and behaviors using a naturalistic pre-post design. All beliefs demonstrated significant change from pre- to posttest. Regression analyses indicate that beliefs about perceived barriers to action and the controllability of suicide predicted identification of high-risk youth; perceived barriers to action were also negatively related to helping responses and referrals 6-9months post training. Self-efficacy was not related to suicide prevention behaviors at follow-up. The importance of anchoring training curriculums and measurement to health behavior change theories is discussed.

A randomized study on the value of self-directed versus traditional mentor-led microsurgical training.

Analyze efficacy of self-directed resident microvascular training versus a mentor-led course. Randomized, single-blinded cohort study. Academic tertiary care center. Sixteen resident and fellow participants were randomized into two groups stratified by training year. Group A completed a self-directed microvascular course with instructional videos and self-directed lab sessions. Group B completed a traditional mentor-led microvascular course. Both groups spent equal time in the lab. Video recorded pre and post-course microsurgical skill assessments were performed to assess the efficacy of the training. Two microsurgeons, blinded to participant identity, evaluated the recordings and inspected each microvascular anastomosis (MVA). Videos were scored using an objective-structured assessment of technical skills (OSATS), a global rating scale (GRS), and quality of anastomosis scoring (QoA). The pre-course assessment identified that the groups were well matched with only "Economy of Motion" on the GRS favoring the mentor led group (p=.02). This difference remained significant on the post assessment (p=.02) Both groups significantly improved in OSATS and GRS scoring (p < .05). There was no significant difference in OSATS improvement between the two groups (p=.36) or improvement in MVA quality between groups (p > .99). Time to completion of MVA significantly improved overall by a mean of 8min and 9s (p=.005) with no significant difference between post training times to complete (p=.63). Different microsurgical training models have previously been validated as effective methods for improved MVA performance. Our findings indicate that a self-directed microsurgical training model is an effective alternative to a traditional mentor driven models. Level 2.

Effects of simulation training on student confidence in de-escalation skills

Background: There is increasing demand for access to mental health support services both for ongoing care and at time of crisis. Preparation of undergraduate students for encounters with those with ongoing mental health care and/or at a time of psychological distress/crisis remains sporadic and difficult to encompass. Simulation gives students opportunities to develop technical and non-technical skills through the recreation of an experience that is as close to reality as possible. Method: An exploratory evaluation of teaching practice of student self-perceptions of self-awareness and self-regulation in encountering clinical situations with persons in high states of arousal and potential conflict was conducted. To evaluate the exercise and its value, students were asked to self-evaluate their confidence and knowledge both prior to and subsequent to the teaching exercise. Results: There was a positive shift in self-awareness and self-regulation post training. Confidence in being able to de-escalate a situation was reported as the key outcome to take from the session, along with techniques on how to de-escalate a scenario. Conclusion: While it is not possible at this stage to definitively measure the impact of the teaching on practice or draw firm conclusions for education providers, the evaluation exercise does evidence individual impact and enjoyment. The teaching approach may prepare the future workforce with the skills and knowledge needed to provide high-quality care.

A study to assess the knowledge and attitude among teacher trainees about epilepsy in school children at selected teacher training institutes, at Bangalore, with a view to develop informational guide sheet

Background of the study: Epilepsy is a chronic condition characterized by uncertainty. It affects more than 50 million people worldwide and is an important public health problem (WHO, 2004). Some studies in developing countries suggest the prevalence of epilepsy to be more than 10 per 100 (WHO 2003) [2]. In India, there are 30 million people affected by epilepsy in 2004. According to Meadow and Smithells (2005) about 1 in 200 school children are affected with epilepsy about 1 person in 20 has a seizure of some type during life, and in the population at large about 1 in 200 has epilepsy. There are approximately 5 million people with epilepsy in India, and economic burden due to epilepsy to the nation is Rs. 13.500 million. According to this report there are only 400 Neurologists in India i.e., 1 Neurologist for 13.500 persons with epilepsy [8].Approach: The research approach adopted for this study was non-experimental descriptive survey approach.Design: The research design selected for this present study was descriptive research.Setting: The study was conducted at teacher training institutes at Bangalore, Karnataka.Participants: 60 teacher’s trainees were selected by purposive sampling technique, as non-probability sampling method.Methods: The data was generated by using the structured questionnaire. Purposive non-probability sampling techniques were adopted to select 60 subjects. The data was obtained from the study subjects were analyzed and interpreted in terms of the objectives and hypothesis of the study. Descriptive and inferential statistics were used for the data analysis and the level set at 0.05.Results: Data collected were analysed by using descriptive statistics. Results of the study revealed that, majority of the teacher trainees i.e. 76.67% had inadequate knowledge and 23.33% of teacher trainees had moderate knowledge. None of them had adequate knowledge. The Range knowledge of teacher trainees was 4-21. The Mean and Mean percentage of knowledge of teacher trainees was 14.44 and 48.13% respectively, with standard deviation 3.16. In the same way, majority of the teacher trainees i.e. 80% had unfavorable attitude. And 20% of teacher trainees had moderate attitude. None of them had Favorable attitude. The Range Attitude of teacher trainee’s was 40-92. The Mean and Mean percentage of attitude of teacher trainees was 77.5 and 51.67% respectively, with standard deviation 4.5. The correlation co-efficient value of knowledge and attitude of teacher trainees was + 0.19 that shows that there was positive correlation exists between knowledge and attitude of teacher trainees about epilepsy in school children. It indicates that this means more the knowledge better the attitude.Interpretation & Conclusion: On the basis of the study we can draw the following conclusions. The majority of the teacher trainees had inadequate knowledge and unfavorable attitude. The correlation co-efficient value of knowledge and attitude of teacher trainees was + 0.19 that shows that there was positive correlation exists between knowledge and attitude of teacher trainees about epilepsy in school children. It indicates that this means more the knowledge better the attitude.

A Study to Find Out the Effect of Plyometric Training on Power and Agility Performance in High School Basketball Players: An Interventional Study

Introduction: Plyometric training is a training strategy designed to improve the performance by incorporatingthe basic needs of agility and power, allows muscle to reach exponential increase in the maximum strength andspeed of movement in the shortest duration. Basketball requires players to move forward, backward, laterally,diagonally and need to change Directions in a split second.Methodology: This study was an interventional study, where 30 high school basketball players with age group14-20 years were selected by inclusion and exclusion criteria. Players who were willing to participate in the studywere requested to fill the consent form. 30 high school basketball players received plyometric training. Outcomemeasurements vertical jump height and T-agility measured before 5 weeks and after of the training. RESULT &amp;Conclusion: Data were analyzed by Statistical package of social science (SPSS) 20.0 software applying paired t testfor pre treatment and post treatment comparison of vertical jump height and wilcoxon sign ranked test used forT-agility. The results revealed that vertical jump height showed significant improvement after training (t=-10.679,p&lt;0.05), and T-agility test also showed significant improvement after training (t=-5.295, p&lt;0.05) in high schoolbasketball players. The result showed significant difference of pre and post training. So, it can be concluded thatplyometric training effective on power and agility in high school basketball players.

Attitudes of Family Medicine Trainees Towards Patient-Centeredness Practice.

The interaction between physicians and patients is essential in clinical practice. Patient-centered care (PCC) is becoming popular in healthcare and provides an approach to deliver high-quality healthcare to yield positive clinical outcomes. This study explores family medicine residents' attitudes toward the physician-patient relationship and patient-centered care and the possible influence of demographic characteristics, level of training, school of graduation, and previous training. A cross-sectional study was conducted among family medicine residents in Riyadh. They were invited to enroll in a web-based survey that includes demographic data, training details, and the "Patient Practitioner Orientation Scale (PPOS).". A total of 114 family medicine residents completed the survey. There were 68 (59.6%) males and 46 (40.4%) female residents. The overall PPOS was 4.23 ± 0.53. The mean score for sharing domain was 3.97 ± 0.66. The caring domain scored 4.49 ± 0.57. No correlations were found between the residents' demographic data and other included variables, and the means of sharing domain, caring domain, and overall score. Family medicine residents were found to have positive attitudes toward patient-centeredness. Integrating patient-centered training early in the curriculum can improve healthcare students' and trainees' attitudes toward patient-centered care. Future research can explore the possible interventions in systematic assessment and training programs that can improve PCP.

Research on the Routine Mode of Educational Practice for Normal University Students

Educational practice is an important part of teacher education, and it is also an essential content of practical teaching reform for teachers’ majors in colleges and universities. In this paper, the normal practice mode of normal students is studied to provide reference for exploring more effective practice mode. First, the centralized fixed-point model. Under the unified management and arrangement of colleges and universities, normal students go to the contacted primary and secondary schools to carry out educational practice.Second, the mixed formation mode, in which normal students from different majors are organized into a team, and one or several teachers lead them to practice in primary and secondary schools.Third, the supporting education mode. The school organizes normal students to go to rural schools or weak schools to carry out educational and teaching practice activities for one semester. Fourth, the post educational practice mode. After completing professional courses and teacher education courses, normal students go to primary and secondary schools to carry out a full semester of teacher post practice training.

Increasing the Screening Rate of Retinopathy of Prematurity in At-Risk Newborns-An Improvement Project in Special Newborn Care Unit of a Tertiary Care Maternity Hospital in Telangana

Introduction: Retinopathy of Prematurity (ROP) is a vasoproliferative disorder of the retinal vessels in premature neonates and is one of the leading causes of preventable blindness. The incidence of ROP across India ranges from 38% to 47%. This wide range is due to a lack of awareness among parents and a lack of high-quality care in the Special New-born Care Unit (SNCU). Paediatricians, neonatologists, and ophthalmologists play a vital role in improving the screening rate. Aim: To improve the screening rate of ROP at four weeks of age in at-risk new-borns by sensitizing paediatricians and educating neonatal nurses and parents regarding ROP from the current 38.3% to 90% within three months. Materials and Methods: The Plan Do Study Act (PDSA) quality improvement method was used for this project. It is a quality improvement (QI) study done in the SNCU of a tertiary care maternity hospital in Hyderabad. The study was done over a period of 13 months from January 2020 to February 2021. Baseline assessment was done by reviewing records and phone calls to know the baseline ROP screening rate. To improve the screening rate, we conducted periodic training of nurses, and awareness was increased among parents through audio-visual counselling, ROP posters, and timely reminders. Results: In 368 preterm babies, the ROP screening rate increased from 38.3% to 89.95% in phase 3. The knowledge in nurses’ and parent’s also increased significantly post training (p&lt;0.05). The incidence of ROP was found to be 6.04% (20) in our study. conclusions: The Point of Care Quality Improvement (POCQI) method helped us improve the ROP screening rate tremendously without many resources. It also significantly improved the knowledge of nurses and awareness among parents. The nurses had a sense of empowerment and satisfaction and could effectively communicate with parents.

Effects of Neurofeedback Training on Frontal Midline Theta Power, Shooting Performance, and Attentional Focus With Experienced Biathletes

Frontal midline theta power (FMT) has been associated with superior rifle shooting performance. Our experiment examined whether electroencephalographic-based training could increase FMT, shooting performance, and attentional focus in highly trained/elite biathletes. Participants (n = 28; age, M = 21.7, SD = 2.3) were assigned to a control group or an intervention group (with 3 hr of neurofeedback training). FMT increased from baseline during the neurofeedback training sessions (p ≤ .05). However, there were no Group × Pre–post training (test) interactions for FMT or shooting performance (p &gt; .05). There was a small Group × Test effect for attentional focus (p = .07, ), indicating a potential benefit of neurofeedback training. Superior shooters were more proficient at increasing FMT during neurofeedback training, but this did not translate to greater improvements in shooting performance. Our findings suggest that the effects of neurofeedback training are transient and do not necessarily benefit performance.

Impact Assessment of Training on Entrepreneurship Development though Scientific Mushroom Cultivation under Arya Project in Krishi Vigyan Kendra of Lakhimpur District of Assam, India

Mushroom is a highly nutritive food which consumption imparted numerous health benefits; hence now a days demand for mushrooms has been increasing among people which opens the path for business for farmers especially for the rural youths. To take mushroom cultivation as a successful enterprise and to earn higher profit training plays an important role and one must have handful knowledge and skills on it. The present study was conducted to assess the status of knowledge gain and skill development through pre and post training evaluation of mushroom cultivation training on the basis of a structured questionnaire. The feedback of the trainees were also taken to bring improvement in the near future. In the present study 162 nos. of trainees were selected from ARYA (Attracting and retaining youth in agriculture) villages of Lakhimpur districts of Assam and also the farmers who are associated with the KVK, Lakhimpur and showed interests in participation on such trainings. Apart from knowledge and skill developments, the farmers especially rural youths were motivated to develop entrepreneurship by showing the future prospects and profitability of the mushroom enterprise.

Performance management algorithm of financial shared service center based on Internet of Things public cloud privacy protection.

The Internet of Things (IoT) refers to the use of various communication technologies to achieve the interconnection of everything in cyberspace, and to achieve smart home and intelligent transportation, thus generating unprecedented amounts of data. In the financial sharing center, all businesses can extract effective data from these massive databases for analysis, and use data analysis tools to collect business, financial, human, process, knowledge and social data. At present, various types of IT (Internet Technology) systems have been widely used in financial sharing centers. However, a large number of sensitive data have also been generated. In order to protect these sensitive data, there is a high requirement for the personal information of IT system operation and financial sharing center personnel. In order to protect user data privacy, the optimal and most effective use of IT systems is an important issue that must be considered in privacy management. At present, there are many algorithms to protect data and privacy, but the effect is not ideal. Considering the balance between privacy issues, this paper proposed a K-means clustering algorithm based on IoT public cloud privacy protection technology to analyze the performance management of financial sharing center. The research results showed that before the improvement, the average number of employees who were dissatisfied with the post training ability and information platform construction ability of the financial sharing center was 57.9 and 57.8% respectively, more than half of them. After the improvement of IoT based public cloud privacy protection, the average number of employees dissatisfied with the post training ability and information platform construction ability of the financial sharing center was 5 and 3.9%, far less than the data prior to the improvement. It showed that IoT public cloud privacy protection was conducive to the performance management of the financial sharing center, and the relationship between the two was positive.

Impact of Strategic Adaptations Due to COVID-19 Pandemic on a Capacity Building Program: Insights From a DRTB Program Under NTEP in India

Introduction: India has experienced high burden of drug resistant tuberculosis, under par treatment success rate and very high loss to follow-up despite continuous efforts to develop evidence-based policy to treat DRTB patients. However, it is challenging to translate policies into practice. The goal of this program was to build capacity of the program staff for effective management of DRTB in public sector through workshops, capacity building exercises, creation and dissemination of information, education and communication materials. Methodology: The program was implemented in seven states; 11 state-level kick-off trainings were planned to reach 660 National TB Elimination Program staffs. Due to COVID-19 pandemic, on-field activities were replaced with virtual trainings with a set of 4-5 webinars per state. Pre and post training assessments were done to evaluate uptake of knowledge. Number of trainings conducted, staff trained and knowledge improvement were the indicators used to assess the outcome. Results: A total of 34 webinars were conducted on revised Programmatic Management of Drug- Resistant Tuberculosis guidelines and 3000 staff was trained. The program organized three times more training and five times more staff were trained. Although retention of participants and their attention was challenging, transition to virtual platform provided increased coverage and targeted outputs. Proportion of participants answering correctly in pre/post-training assessments, increased from 47% to 65%. Conclusion: Use of virtual trainings is an efficient high yielding method to build capacity of NTEP staff. Lessons learnt can help improve such interventions, benefit health programs and the end beneficiaries - the patients.

USING CONNECTED LEARNING THEORY GUIDED ADOPTION IN SUCCESSFUL IMPLEMENTATION OF 4MS AGE-FRIENDLY CARE

Abstract As one of the HRSA funded Geriatric Workforce Enhancement recipients, the Arkansas Geriatric Education Collaborative worked with the Reynolds Institute on Aging Thomas and Lyons Longevity Clinic to implement Age Friendly care. An adult learning theory was used to develop trainings on the 4M’s of Age-Friendly Healthcare and to pursue Age-Friendly Certification from The Institute for Healthcare Improvement. The Connected Learning Theory is a proven method to reliably help a trainee’s adoption of new principles and ideas by connecting familiar relationships which are easily recognized. This theory supports various learner pathways and proposes that students learn best when they form familiar connections to the materials. In an effort to provide enhanced training to healthcare professionals who were already familiar with much of the content, associations were made between M&amp;M’s candy with each of the 4Ms, What Matters, Mobility, Mind and Medications of Age-Friendly Care. Baseline and 6-months post training data on two Merit-Based Incentive Payment Systems (MIPS) measures, depression and falls risk screening, were used to evaluate outcomes. Staff were satisfied with the 4Ms Age-Friendly Framework and found it easily applicable to their older adult patient workflow. MIPS evaluation of data showed significant changes in depression screens with a 23% improvement and a 3% improvement in screenings for future fall risk 6 months after training. This clinic achieved Level I Age-Friendly Certification in June 2021. Although the staff were already specialists in geriatrics, the training increased application of the 4 M’s, improved staff acceptance, and improved knowledge via M&amp;M connections.

Becoming an Agile Change Conductor.

It takes decades and millions of dollars for a new scientific discovery to become part of clinical practice. In 2015, the Center for Health Innovation & Implementation Science (CHIIS) launched a Professional Certificate Program in Innovation and Implementation Sciences aimed at transforming healthcare professionals into Agile Change Conductors capable of designing, implementing, and diffusing evidence-based healthcare solutions. In 2022, the authors surveyed alumni from the 2016-2021 cohorts of the Certificate Program as part of an educational quality improvement inquiry and to evaluate the effectiveness of the program. Of the 60 alumni contacted, 52 completed the survey (87% response rate) with 60% of graduates being female while 30% were an under-represented minority. On a scale from 1 to 5, the graduates agreed that the certificate benefited their careers (4.308 with a standard deviation (SD) of 0.612); expanded their professional network (4.615, SD of 0.530); and had a large impact on the effectiveness of their leadership (4.288, SD of 0.667), their change management (4.365, SD of 0.742), and their communication (4.392, SD of 0.666). Graduates claimed to use Agile Processes (Innovation, Implementation, or Diffusion), storytelling, and nudging weekly. On a scale from 0 to 10 where 10 indicates reaching a mastery, the average score for different Agile competencies ranged from 5.37 (SD of 2.80) for drafting business proposals to 7.77 (SD of 1.96) for self-awareness. For the 2020 and 2021 cohorts with existing pre and post training competency data, 22 of the 26 competencies saw a statistically significant increase. The Graduate Certificate has been able to create a network of Agile Change Conductors competent to design, implement, and diffuse evidence-based care within the healthcare delivery system. Further improvements in building dissemination mastery and program expansion initiatives are advised.