Broad-based Training Research Articles

The role of apprenticeship in skills development of construction artisans to achieving Sustainable Development Goal 8: stakeholders’ unexplored approach

PurposeStudies show that apprenticeships can enhance skills development and economic growth. There is a paucity of academic literature concerning apprenticeship’s role in developing Nigerian construction artisans’ skills, especially regarding achieving Sustainable Development Goal 8 (Decent Work and Economic Growth). Thus, this study aims to appraise the role of apprenticeship in developing construction artisans’ skills and suggest measures to improve skills development for artisans’ on-the-job training mechanisms to achieve Goal 8.Design/methodology/approachGiven the unexplored nature of the problem, the study utilised face-to-face data collection via a qualitative research approach. It covered two major cities in Nigeria and achieved saturation at the 29th chosen interviewee. Also, the study adopted a thematic method to analyse the data from selected construction artisans, construction firm management staffers and consultant experts in skills matters.FindingsEnhancing skills development, replacing the ageing workforce through practical broad-based skills training, bridging skills gaps, enhancing work-integrated learning and economic upliftment emerged as apprenticeship’s role in developing artisans’ skills in the Nigerian built environment if well implemented. Apprenticeship to develop skills in the built environment is not without hindrances. The perceived 34 barriers were re-clustered into employee, employer and government-related. Findings show that achieving Goal 8 may be threatened if these hindrances are not mitigated. They suggest improving skills development for artisans’ on-the-job training mechanisms to achieve Goal 8.Originality/valueThis study demonstrates that apprenticeship’s role in developing construction artisans’ skills should be all-inclusive. Also, the three stakeholders must do more concerning training programmes to improve artisans’ skills development to achieve Goal 8.

Sustained benefits of a generalist training programme for UK doctors: a survey-based follow-up study

ObjectivesThe study aimed to conduct a follow-up of all broad-based training (BBT) trainees who participated in the original evaluation completed in 2017. The follow-up study explored the impact of BBT...

Evaluation of an online modular eating disorders training (PreparED) to prepare healthcare trainees: a survey study

BackgroundEating disorders (EDs) are serious, complex disorders for which broad-based clinical training is lacking. This study aimed to evaluate the efficacy of a free, brief, web-based curriculum, PreparED, in increasing comfort and confidence with, and knowledge about EDs in healthcare trainees, and to obtain program feedback from key stakeholders (i.e., learners).MethodsThis programmatic evaluation study was designed as a quantitative, repeated measures (i.e., pre- and post-test intervention) investigation. A convenience sample of two groups of healthcare trainees across geographically diverse training sites completed an anonymous survey pre- and post- engagement with PreparED. The survey included items to assess prior exposure to EDs, as well as program feasibility. The main educational outcomes included (1) Confidence and Comfort with EDs and (2) Knowledge of EDs. User experience variables of interest were likeability, usability, and engagement with the training modules. Mixed effects linear regression was used to assess the association between PreparED and educational outcome variables.ResultsParticipants (N = 67) included 41 nutrition graduate students and 26 nurse practitioner students recruited from Teacher’s College/Columbia University in New York, NY, USA, Columbia University School of Nursing in New York, NY, USA and North Dakota State University School of Nursing in Fargo, ND, USA. Confidence/Comfort scores and Knowledge scores significantly improved following engagement with PreparED (β = for effect of intervention = 1.23, p < 0.001, and 1.69, p < 0.001, respectively). Neither training group nor prior exposure to EDs moderated the effect on outcomes. All learners agreed the program was easy to follow; the overwhelming majority (89.4%) felt the length of the modules was “just right.” All participants perceived that PreparED had increased their knowledge of EDs, and the majority (94.0%) reported greater confidence in and comfort with caring for people with these disorders, including assessment of symptoms, awareness of associated medical complications, and likelihood of future screening.ConclusionsFindings suggest that brief, user-friendly, online courses can improve knowledge and attitudes about EDs, filling a critical gap in healthcare training.

‘A Unique opportunity to test things out’: a qualitative study of broad-based training in Scotland

ObjectivesA recent review recommended UK postgraduate medical education should produce doctors capable of providing general care in broad specialties across a range of different settings. Responding to this, broad-based training...

Leading at the Edge During COVID-19: Challenges, Opportunities, and Future Pandemic Preparedness

In this paper, we describe how the Department of Kinesiology and Integrative Physiology at Michigan Technological University assembled a COVID-19 pandemic response team to help protect the health of the campus and rural community. Specifically, our team worked to (a) enhance public health messaging, (b) manage the university contact tracing program, (c) expand health science curricula, (d) promote and facilitate physical activity as a key mitigation strategy, and (e) provide professional development opportunities for students. We also consider strategies to prepare for subsequent COVID-19 surges and future health emergencies. Leveraging our broad-based training in health science and “leading at the edge” was a critical asset for the campus and community and may serve as a model for other kinesiology departments and rural colleges and universities.

Spatial thinking of students when studying graphic disciplines

The article examines the problems that students face when studying graphic disciplines. At present, the task of further improving the quality of professional training of students has been set as the most important task for higher and secondary specialized institutions. This involves broad-based training of future specialists and the complex nature of mastering modern theoretical and applied knowledge, the ability to apply the knowledge gained in practice, possession of the necessary skills in a related field. A specialist with a higher education, but without knowledge and skills to receive and process graphic information, may turn out to be incompetent in professional activities. The preparedness of students for graphic activity is determined by the complex of knowledge acquired by them in the learning process, skills of reproductive and creative activity, which in the future determine their successful professional activity. A future engineer must have a high level of general and technical intelligence, well-developed spatial thinking, and have a high level of theoretical knowledge in the field of professional activity. In the system of training specialists for engineering specialties, one of the main places is occupied by the academic disciplines «Engineering Graphics» and «Descriptive Geometry». They contribute to the development of the future engineer of spatial representation, logical and constructive thinking, the ability to analyze and synthesize. Well-developed spatial awareness and imagination are prerequisites for successful learning in many academic disciplines. And the disciplines «Descriptive geometry» and «Engineering graphics» by their content make high demands on the level of development of spatial representations. This article reveals the reasons for the weak development of spatial representations among first-year students of universities. It is proposed to use the developed approach, including tasks, methods and system of exercises, tasks and tests, as one of the ways to successfully develop spatial representations in the study of graphic disciplines. Each group of exercises of this system is aimed at the conscious and active work of students and solves a specific problem arising from the theoretical foundations of the development of spatial representations.

Addressing the Opioid Crisis: A Dynamic Case-Based Module Set for Interprofessional Educators, Learners, and Clinicians.

IntroductionIn 2017, the opioid crisis was declared a public health emergency in the United States. The CDC has called for a multifaceted, collaborative approach to address the opioid epidemic. Though many resources have been made available for provider education, much of what has been published to date has focused narrowly on specific contexts and/or has become outdated.MethodsTo address the need for more up-to-date and broad-based training, we designed a dynamic, module-based curriculum aligned with the 2016 CDC Opioid Prescribing Guideline. The three-part module set addresses safe opioid prescribing, recognizing and treating opioid use disorders, and opioids and pain management. Each module contains interactive content and assessments and culminates in case-based applications. The modules provide an anchor point for supplemental activities that can be utilized in various contexts.ResultsAs of May 2021, we recorded 3,529 module completions (≥80% performance on module assessments). A 6-month follow-up survey revealed that the majority of respondents had used the strategies they had learned to improve their prescribing practice and believed they had improved outcomes for patients.DiscussionThe modules and supplementary resources can be used by clinicians and educators to combat the opioid epidemic with best practices in patient care and by meeting many state licensure requirements. Included supplemental resources are ideal for learners, providing a comprehensive understanding of the opioid crisis as well as tools for medication-assisted treatment that create capacity to immediately address these issues once learners become fully licensed.

TP8.2.27 Unlocking growth options in surgical education and training during the pandemic

IntroductionThe COVID-19 pandemic brought widespread disruption to structured surgical education and training. The knee-jerk reaction is often pessimism about surgical training’s future, particularly in the Improved Surgical Training (IST) pilot’s context. However, Einstein famously once said, “In the midst of every crises lies great opportunity”. Unlocking growth during periods of high uncertainty is a premise of real options theory; one utilised by supply chain managers and decision scientists, but novel to medical education. This study explores the growth options that have resulted from new operational models during the pandemic.MethodsUsing qualitative case study approach, data were obtained from interviews with core surgical trainees across Scotland. Data coding and inductive thematic analysis were undertaken.ResultsForty-six trainees participated. Analysis from trainees’ perspective revealed: unexpected fulfilment from redeployment to non-surgical specialties, benefits to personal development from the unintended broad-based training across surgical specialties, improved collaborative teamworking between specialties and allied healthcare professionals, and enhanced supervised learning opportunities. Institutional growth options reported by trainees included: rapid uptake of telemedicine and digital technology, implementation of single hospital episode encounters for minor conditions, streamlined processes in theatre and acute admissions, and changes in working culture towards rationalising and teamworking.ConclusionGrowth options have been deliberately and unintentionally unlocked due to individual and institutional adaptions and innovations in response to exogenous disruption. While some changes may be temporary, hopefully structured reflection on these changes and responders to them will drive surgical education and training into a new sustainable and resilient post-pandemic era.

1253 Unlocking Growth Options in Surgical Education and Training During the Pandemic

IntroductionThe COVID-19 pandemic brought widespread disruption to structured surgical education and training. The knee-jerk reaction is often pessimism about surgical training’s future, particularly in the Improved Surgical Training (IST) pilot’s context. However, Einstein famously once said, “In the midst of every crises lies great opportunity”. Unlocking growth during periods of high uncertainty is a premise of real options theory; one utilised by supply chain managers and decision scientists, but novel to medical education. This study explores the growth options that have resulted from new operational models during the pandemic.MethodUsing a qualitative case study approach, data were obtained from interviews with core surgical trainees across Scotland. Data coding and inductive thematic analysis were undertaken.ResultsForty-six trainees participated. Analysis from trainees’ perspective revealed: unexpected fulfilment from redeployment to non-surgical specialties, benefits to personal development from the unintended broad-based training across surgical specialties, improved collaborative teamworking between specialties and allied healthcare professionals, and enhanced supervised learning opportunities. Institutional growth options reported by trainees included: rapid uptake of telemedicine and digital technology, implementation of single hospital episode encounters for minor conditions, streamlined processes in theatre and acute admissions, and changes in working culture towards rationalising and teamworking.ConclusionsGrowth options have been deliberately and unintentionally unlocked due to individual and institutional adaptions and innovations in response to the exogenous disruption. While some changes may be temporary, hopefully structured reflection on these changes and responders to them will drive surgical education and training into a new sustainable and resilient post-pandemic era.

Breast Imaging Boot Camp Meets Milestones 2.0: A Match Made in Clinic

Designed to provide broad-based training in all aspects of imaging, the diagnostic radiology residency program must provide educational experiences that not only provide technical training, but also meet accreditation standards. With the breadth of material to cover during training, carefully orchestrated educational experiences must be planned. This manuscript reports a breast imaging boot camp curriculum with longitudinal outcomes, highlighting the boot camp's pedagogy and adaptability for residencies to meet the challenges of the Accreditation Council for Graduate Medical Education (ACGME) Diagnostic Radiology Milestones Second Revision. Breast block curriculum analysis, faculty leader preparation, and evaluation of all objective external benchmarks were undertaken commencing in 2012 and continuing through 2019. Specific curriculum changes include fundamental didactic lectures and self-study education modules, hands-on simulation activities, and team-building time. Upon publication of The Diagnostic Radiology Milestones Second Revision December 2019, all competencies were assessed in the context of the boot camp resident educational experiences. Following curriculum implementation, resident anonymous evaluation scores of the breast block, resident in-training examination scores, American Board of Radiology Core examination scores, and radiology residency educational website analytics all increased immediately and significantly. The curriculum meets twenty-four Diagnostic Milestones per participating resident when mapped against the newly implemented ACGME requirements. Breast imaging boot camp is a successful innovative curriculum, readily meeting our learners' needs in all objective benchmarks. Further, the adaptable model has the potential to play important roles in assisting residencies to meet the challenges of the ACGME Diagnostic Radiology Milestones Second Revision July 1, 2020 implementation date.

Changes in Community Clinicians' Attitudes and Competence following a Transdiagnostic Cognitive Behavioral Therapy Training.

Although the literature suggest that attitudes toward evidence-based practices (EBPs) are associated with provider use of EBPs, less is known about the association between attitudes and how competently EBPs are delivered. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Program evaluation data was collected during implementation of an EBP in a large community mental health network. Clinicians (N=891) received intensive training in cognitive behavioral therapy followed by six months of consultation. Attitudes were assessed using the Evidence-Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data were analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase). Latent change models identified significant improvement in attitudes (Ms latent change≥1.03, SEs≤ 0.18, zs≥6.55, ps< .001) and competence (Ms latent change ≥14.16, SEs≤3.10, zs≥2.82, ps<.001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop and across training (bs≥1.62, SEs≤0.90, z≥1.09, p<.04, β≥0.10); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in consultation (b=1.62, SE=0.86, z=1.87, p=.06, β=0.09). Change in attitudes and change in competence in the training period and within the two phases were not significantly correlated. Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training. Following participation in in itial training workshops, other factors such as subjective norms, implementation culture, or system-level policy shifts may be more predictive of change in competence through consultation.

Implementing Goals-of-Care Conversations: Lessons From High- and Low-Performing Sites From a VA National Initiative

ContextThe Veterans Health Administration (VA) National Center for Ethics in Healthcare implemented the Life-Sustaining Treatment Decisions Initiative, including policy and practice standards, clinician communication training, a documentation template, and central implementation support to foster advance care planning via goals-of-care conversations for seriously ill veterans in 2014, spreading nationally to other Veterans Health Affairs (VA) sites in 2017. ObjectivesOur goal was to describe the range of early implementation experiences among the pilot sites, and compare them with spread sites that implemented LSTDI about two years later, identifying cross-site best practices and pitfalls. MethodsWe conducted semistructured interviews with 32 key stakeholders from 12 sites to identify cross-site best practices and pitfalls related to implementation. ResultsThree primary implementation themes emerged: organizational readiness for transformation, importance of champions, and time and resources needed to achieve implementation. Each theme's barriers and facilitators highlighted variability in success based on complexity in terms of vertical hierarchy and horizontal cross-role/cross-clinic relationships. ConclusionLearning health care systems need multilevel interdisciplinary implementation approaches to support communication about serious illness, from broad-based system-level training and education to build communication skills, to focusing on characteristics of successful individual champions who listen to critics and are tenacious in addressing concerns.

Is the malaria short course for program managers, a priority for malaria control effort in Nigeria? Evidence from a qualitative study.

A Malaria Short Course (MSC) was conceptualized to build the capacity of program managers for malaria control due to the lack of a single comprehensive broad-based programmatic training in Nigeria. Prior to its implementation, a needs assessment was conducted based on the perspectives of stakeholders to plan and develop the curriculum. This was an exploratory qualitative study. Fifty-six purposively selected stakeholders at local, state and national levels were interviewed. Opinions on the need for training, its perceived impact, priority focus, likelihood of participation, sustainability of and planned support for the MSC were explored using a pretested researcher-designed interview guide. Interviews were audiotape recorded, and the transcripts were subjected to thematic content analysis. Participants included Directors of Primary Health Care (50%), State Malaria Program Officers (8.9%), State Directors of Public Health Services (7.1%) and Roll Back Malaria Officers (5.4%). Participants' mean number of years of experience in their current positions was 6.2 (SD 4.7) years. The dominant view was "malaria remains a problem in Nigeria, exacerbated by poor funding, knowledge deficit, lack of training opportunities for program managers and prioritized training budget". A common viewpoint was "to achieve the malaria policy goals, MSC should focus on improving program managers' knowledge of the disease, novel interventions, data audit and use of data for decision making, supportive supervision as well as leadership and management skills. The prioritized thematic areas were malaria epidemiology, case management and data management. The consensus opinion was the MSC would have a positive impact on the performance of program managers. All managerial participants were willing to release their staff for the MSC and encouraged step-down training. However, most participants opined they could not guarantee that their institutions would provide financial support to the MSC attendees. Implementing the MSC for program managers was considered essential towards achieving malaria control. Moreover, there is need for prioritized funding and sustainability mechanisms to actualize the implementation of the course.

Same-Sex Couples and the Police: A 10-Year Study of Arrest and Dual Arrest Rates in Responding to Incidents of Intimate Partner Violence

Despite concern, little research has been conducted on whether victims in same-sex relationships receive disparate treatment from law enforcement. Utilizing 2000 through 2009 National Incident-Based Reporting System data, the authors examine the police response to incidents involving same-sex and heterosexual couples in 2,625,753 cases across 5,481 jurisdictions in 36 states and Washington, D.C. Results show that incidents with same-sex couples are less likely to result in arrest, but far more likely to result in dual arrests, in most incident configurations. Racial effects were also observed. The policy implications of these findings are discussed with the need for broad-based training highlighted.

Wpływ kwalifikacji właścicieli na sposób zarządzania małymi i średnimi firmami rodzinnymi

Celem artykułu jest określenie związku pomiędzy poziomem wykształcenia formalnego właścicieli firm rodzinnych, ich doświadczeniem zawodowym, pracą zgodną z wyuczonym zawodem, pracą na stanowisku kierowniczym i udziałem w szkoleniach a sposobem zarządzania i finansowania ich firm. Sposób zarządzania charakteryzują cele działalności, przeznaczenie wypracowanego zysku, liczba godzin pracy w firmie oraz delegowanie zadań. Pod uwagę wzięto także stopień wykorzystania kredytów, aplikowanie o środki z funduszy UE oraz ogólne wyniki finansowe firmy. W opracowaniu wykorzystano materiał empiryczny zebrany za pomocą kwestionariusza ankietowego na celowo dobranej próbie 135 firm rodzinnych z terenu południowej Wielkopolski, reprezentujących sektor małych i średnich przedsiębiorstw. Badanie zostało przeprowadzone przez studentów drugiego roku studiów licencjackich z Państwowej Wyższej Szkoły Zawodowej w Kaliszu w ramach zajęć z przedsiębiorczości. Badanie zostało przeprowadzone w roku 2017, natomiast pozyskane informacje o działalności firm dotyczyły lat 2014–2016. Zgromadzony materiał empiryczny opracowano za pomocą metod statystyki opisowej, korelacji rang gamma oraz testu niezależności chi-kwadrat. Uzyskane wyniki wskazują na istotny statystycznie wpływ udziału przedsiębiorcy w różnych formach szkoleń na sposób zarządzania i finansowania badanych firm rodzinnych oraz uzyskiwane przez nie wyniki finansowe.

South African General Surgeon Preparedness for Humanitarian Disasters.

Humanitarian medical organizations provide surgical care for a broad range of conditions including general surgical (GS), obstetric and gynecologic (OBGYN), orthopedic (ORTHO), and urologic (URO) conditions in unstable contexts. The most common humanitarian operation is cesarean section. The objective of this study was to identify the proportion of South African general surgeons who had operative experience and current competency in GS, OBGYN, ORTHO, and URO humanitarian operations in order to evaluate their potential for working in humanitarian disasters. This was a cross-sectional online survey of South African general surgeons administered from November 2017-July 2018. Rotations in OBGYN, ORTHO, and URO were quantified. Experience and competency in eighteen humanitarian operations were queried. There were 154 SA general surgeon participants. Prior to starting general surgery (GS) residency, 129 (83%) had OBGYN, 125 (81%) ORTHO, and 84 (54%) URO experience. Experience and competency in humanitarian procedures by specialty included: 96% experience and 95% competency for GS, 71% experience and 51% competency for OBGYN, 77% experience and 66% competency for ORTHO, and 86% experience and 81% competency for URO. 82% reported training, and 51% competency in cesarean section. SA general surgeons are potentially well suited for humanitarian surgery. This study has shown that most SA general surgeons received training in OBGYN, ORTHO, and URO prior to residency and many maintain competence in the corresponding humanitarian operations. Other low- to middle-income countries may also have broad-based surgery training, and the potential for their surgeons to offer humanitarian assistance should be further investigated.

Exploring service providers\u2019 perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

BackgroundFetal alcohol spectrum disorder (FASD) is among the leading causes of developmental and intellectual disabilities in individuals. Although efforts are being made toward the prevention and management of FASD in South Africa, the prevalence remains high. The sustained high prevalence could be attributed to several factors, including the lack of policy for a coordinated effort to prevent, diagnose and manage FASD nationally. In this study, our aim was to explore the perspectives of service providers (health and allied professionals, teachers, social workers) on the prevention and management of FASD towards developing a guideline to inform policy.MethodGuided by the exploratory qualitative research design, we purposively sampled relevant service providers in the field of FASD prevention and management for focus group discussions. Nine of these discussions were conducted with to eight participants per discussion session. The discussants were asked various questions on the current and required interventions and practices for the prevention and management of FASD. Following the Framework Method, data were transcribed verbatim and analysed using the thematic content analysis approach.ResultsOur findings show that aspects of the prevention and management of alcohol-related conditions are present in various policies. However, there is no clear focus on coordinated, multi-sectoral efforts for a more comprehensive approach to the prevention and management of FASD. The participants recognized the need for specific requirements on broad-based preventive awareness programs, training and support for parents and caregivers, inclusive education in mainstream schools and training of relevant professionals.ConclusionComprehensive and coordinated prevention and management programs guided by a specific policy could improve the prevention and management of FASD. Policy formulation demonstrates commitment from the government, highlights the importance of the condition, and elaborates on context-specific prevention and management protocols.

Enhancing the quality and safety of care through training generalist doctors: a longitudinal, mixed-methods study of a UK broad-based training programme

ObjectiveChanging patient demographics make it ever more challenging to maintain the quality and safety of care. One approach to addressing this is the development of training for generalist doctors who...

Palliative care for respiratory disease: An education model of care.

That palliative care improves quality of life for seriously ill patients and their families is well known – but how can healthcare providers ensure that the palliative needs of all patients are being assessed and addressed? A growing number of curricula in core palliative care practices have been developed to ensure that clinicians from all specialties and disciplines have the necessary training to manage pain and symptoms and discuss care goals with patients and families. Through broad-based training in core palliative care skills, combined with referral to specialty palliative care for high-need patients, providers can improve quality of life for their patients with respiratory disease.

Communication Training, Adverse Events, and Quality Measures: 2 Retrospective Database Analyses in Washington State Hospitals.

Washington State's HealthPact program was launched in 2011 as part of AHRQ's Patient Safety and Medical Liability Reform initiative. HealthPact delivered interdisciplinary communication training to health-care professionals with the goal of enhancing safety. We conducted 2 exploratory, retrospective database analyses to investigate training impact on the frequency of adverse events (AEs) and select quality measures across 3 time frames: pretraining (2009-2011), transition (2012), and posttraining (2013). Using administrative data from Washington State's Comprehensive Hospital Abstract Reporting System (CHARS) and clinical registry data from the Surgical Care and Outcomes Assessment Program (SCOAP), we compared proportions of AEs and quality measures between HealthPact (n = 4) and non-HealthPact (n = 93-CHARS; n = 48-SCOAP) participating hospitals. Risk ratios enabled comparisons between the 2 groups. Multivariable logistic regression enabled investigation of the association between training and the frequency of AEs. Approximately 9.4% (CHARS) and 7.7% (SCOAP) of unique patients experienced 1 AE or greater. In CHARS, the odds of a patient experiencing an AE in a HealthPact hospital were initially (pretraining) higher than in a non-HealthPact hospital (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.10-1.17), lower in transition (OR, 0.80; 95% CI, 0.76-0.83) and posttraining (OR, 0.72; 95% CI, 0.69-0.75) periods. In SCOAP, ORs were consistently lower in HealthPact hospitals: pretraining (OR, 0.87; 95% CI, 0.80-0.95), transition (OR, 0.75; 95% CI, 0.70-0.81), and posttraining (OR, 0.63; 95% CI, 0.58-0.68). The proportion of at-risk patients that experienced each individual AE was low (<1%) throughout. Adherence to quality measures was high. Interprofessional communication training is an area of intense activity nationwide. A broad-based training initiative may play a role in mitigating AEs.