Cost-effectiveness Of Training Research Articles

Development and evaluation of a de-escalation training intervention in adult acute and forensic units: the EDITION systematic review and feasibility trial.

Development and evaluation of a de-escalation training intervention in adult acute and forensic units: the EDITION systematic review and feasibility trial.

Simulation training technique for performing percutaneous endoscopic gastrostomy

The OBJECTIVE was to create a simulator for practicing manual skills of performing percutaneous endoscopic gastrostomy (PEG).METHODS AND MATERIALS. A patient simulator has been developed. It has a mouth, oropharynx, removable esophagus, stomach, and anterior abdominal wall that allows performing all stages of the operation. To objectify tension force of the gastrostomy tube during fixation and transmitting the proper manual sensations, a measuring device – bezmen was used. Initially, we used a single-use gastrostomy kit Freka PEG, FR 20 for the simulation. It increased the cost of the simulation. Therefore, instead of disposable kits, the Pezzer catheter No. 24 with a developed metal coneshaped tip was used as a gastrostomy tube (patent RU 2669483, 11.10.2018). Simulation was performed with reusable surgical instruments. At the final stage, an additional external pressure plate and a connector with a cover were used.RESULTS. The developed method of simulation training for PEG imposition allows performing all stages of endoscopic gastrostomy imposition. The simplicity of manufacturing and the possibility of replacing worn elements allows multiple implementation of the method. Using reusable instruments and a Pezzer catheter with a designed reusable tip increases the cost-effectiveness of training. The use of a measuring device allows to convey the necessary sensations of tension of the gastrostomy tube during fixation with an external pressure plate, corresponding to the sensations in real clinical simulation.CONCLUSION. The developed method of training for PEG imposition with the simulator allows to effectively work out manual skills and reduce the risk of iatrogenic complications during surgery on the patient.

Affecting patients with work-related problems by educational training of their GPs: a cost-effectiveness study

BackgroundAssessing the cost effectiveness of training aimed at increasing general practitioners’ (GP) work awareness and patients’ work-related self-efficacy and quality of life.MethodsA cluster randomized controlled trial in twenty-six GP practices in the southeast of the Netherlands with 32 participating GPs. GPs working in an intervention group practice received training and GPs working in a control group practice delivered usual care. The training intervention consisted of lectures and workshops aimed at increasing GPs’ work awareness and more proactive counseling for patients with work-related problems (WRP). Subjects were working age patients with paid work for at least 12 h per week, who visited one of the participating GPs during the study period. As outcome measures we used the Return to Work Self Efficacy scale to assess patients’ work-related self-efficacy and the Euroquol to assess quality of life. We also measured health care costs and productivity costs. With a 4-item questionnaire we asked patients to assess their GPs’ work awareness. Data were collected at baseline, after 6 and 12 months.ResultsData of 280 patients could be analyzed. The patient related outcomes did not improve after GP training. The change in GP work awareness and the overall mean cost difference (of €770) in favor of the intervention group were not significant.ConclusionsThe training intervention presented in this paper was not cost-effective. Training which is further personalized and targeted at high risk groups with respect to WRP, is more likely to be cost effective.

Approaches to the development of non-financial indicators determining method at the preparation of the applicants for higher education

The subject of the study is the process of preparing applicants for higher education in the context of assessing its effectiveness. The purpose of the study is to develop a balanced system of non-financial indicators suitable for analyzing the costs of training applicants for higher education. Method or methodology of the work.General scientific methods (scientific abstraction, comparison, analysis, synthesis, generalization) and a specific method of key performance indicators (KPI). The results.The article describes modern approaches to understanding the phenomenon of nonfinancial indicators applied to the education system effectiveness analysis in Ukraine, in particular it deals with the issues of the higher education applicants training effectiveness. The key elements of the strategic goals of educational institutions are considered. Author reveals basic stages of non-financial indicators balanced system formation including formation of strategy, determination of the most important factors of success, definition of efficiency indicators system, which corresponds to the needs and opportunities of the institution of higher education. The main risks and peculiarities of the implementation of non-financial indicators are investigated. An indicative list of key performance indicators is proposed, which can become the basis for effective monitoring of the cost effectiveness of training for higher education. Scope of the results: for development of a strategy for managing higher education at the macro and micro levels by state and regional authorities. Conclusions.The method of key performance indicators is acceptable for analyzing the cost-effectiveness of training applicants for higher education. Existing methodological approaches allow to develop a system of efficiency analysis both at the macro level (analysis of the entire higher school) and at the level of individual institutions. Using developed system of indicators, it is possible to go beyond the naive quantitative assessment of indicators and to achieve a real assessment of the return on state investment in training.

Economic evaluation of emergency obstetric care training: a systematic review

BackgroundTraining healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings.MethodsPeer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness.ResultsFourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult.ConclusionsEconomic evaluations of EmOC training are limited. There is a need to scale-up and standardise processes that capture both cost and effectiveness of training and to agree on suitable economic evaluation models that allow for comparability across settings.Trial registrationPROSPERO_CRD42016041911.

A Pilot Evaluation of Therapist Training in Cognitive Therapy for Psychosis: Therapy Quality and Clinical Outcomes

Historically, it has been difficult to demonstrate an impact of training in psychological interventions for people with psychosis on routine practice and on patient outcomes. A recent pilot evaluation suggested that postgraduate training in Cognitive Behavioural Therapy for Psychosis (CBTp) increased the delivery of competent therapy in routine services. In this study, we evaluated clinical outcomes for patients receiving therapy from therapists who successfully completed training, and their association with ratings of therapist competence and therapy content. To characterize the therapy delivered during training and to inform both a calculation of effect size for its clinical impact, and the development of competence benchmarks to ensure that training standards are sufficient to deliver clinical improvement. Paired patient-reported outcome measures (PROMS) were extracted from anonymized therapy case reports, and were matched with therapy ratings for each therapist. Twenty clients received a course of competent therapy, including a high frequency of active therapy techniques, from nine therapists. Pre-post effect size for change in psychotic symptoms was large (d = 1.0) and for affect, medium (d = 0.6), but improved outcomes were not associated with therapist competence or therapy content. Therapists trained to research trial standards of competence achieved excellent clinical outcomes. Therapy effect sizes suggest that training costs may be offset by clinical benefit. Larger, methodologically stringent evaluations of training are now required. Future research should assess the necessary and sufficient training required to achieve real-world clinical effectiveness, and the cost-effectiveness of training.

Musculoskeletal medicine training cost-effectiveness: Reduction in secondary-care referrals

AbstractAimTo determine whether cost-savings result from postgraduate education for general practitioners in musculoskeletal medicine.MethodThree separate days of postgraduate education in musculoskeletal medicine were carried out for general practitioners, covering early diagnosis and management of common musculoskeletal disorders, with emphasis on clinical examination and aspiration and injection techniques. Following the course, the practitioners were asked to keep a diary noting cases which did not need referral to secondary care as a result of the knowledge obtained and skills learnt from the training. These details were collected and costed by the commissioning group who had paid for the training.ResultsFigures were available from 17 of the 23 doctors attending the training. Two hundred and twenty-six referrals to secondary care were avoided, the treatments given including injections. The equivalent secondary-care costings were calculated to be £64 952–£148 002, compared with the £50 413 cost of pri...

A Primer on Determining the Cost Effectiveness of Training – Part 1

Increasingly, training professionals are being asked to justify whether training is a worthwhile investment. Discusses the need to justify training expenditures with documented benefits. Provides details, along with examples, on how to calculate the direct, indirect, and full costs of a training course or programme. Also describes the feasibility of linking training outcomes to organizational improvements and the selection of training outcomes (benefits) to be measured and quantified.

Concepts for Generic Software for the Computer Control of Maintenance Simulation

This paper reviews the effectiveness and application of computer controlled simulation for maintenance training, and discusses an approach to enhance the training cost-effectiveness and life-cycle affordability through the development of generic, “tailorable” software for simulation control and implementation. A multi-leveled, generic software architecture is described a high level of abstraction, and suggestions for developing an initial capability for generic simulation software are presented.

Application of a set of learning curve models to repetitive tasks

As part of a research project into the cost effectiveness of training, various experiments were held in telephone exchanges in the UK. Data from those experiments and from other sources in the literature were used to compare the efficiency of a selection of models of learning.The method of comparison was based on an extension of an iterative two-parameter curve-fitting algorithm which used a Taylor series approximation of the function of the model of learning investigated.The most practical model found was the time-constant model sometimes known as the Bevis model.

The cost effectiveness of training: a case study of operator training

The cost effectiveness of training: a case study of operator training