Current Training Practices Research Articles

Training needs assessment of fishermen on Oman’s Batinah coast: using exploratory factor analysis

Oman’s 3165-km-long coastline, which includes bays, islands and lagoons, has been rich in fish and crustaceans. In spite of this, the fishing sector and fishermen in Oman have not developed well. The fishermen have just managed to subsist and their motivation to stay in the traditional or artisanal fishery has declined. Assuming that the assessment of fishermen’s training needs could be one of the possible solutions, this paper attempts to identify, categorise and prioritise training needs of fishermen on the Batinah coast. Questionnaires were administered to 1934 fisher folks in the eight coastal regions on Batinah coast. Training needs were identified using the exploratory factor analysis technique for data reduction over a previously compiled list of 93 items of interest. This analysis extracted (categorised) 30 key factors, which were further classified into technical and/or behavioural needs. The outcomes suggested that some of the training needs of fishermen are as diverse as the groups of identified factors. It would be worthwhile training the fishermen on most of these aspects. The discussion revealed some vulnerability in the current training practices and recognised a need for educating and training these fishermen differently. Development of specific training programmes and policies are expected.

Graduated driver licensing: searching for the best composition of components

Young drivers 16-19 years have a relative accident risk of 9-10 compared to drivers aged 55-64 years. Education and training of young drivers, which could reduce the death toll, have been an issue for many decades, but without much success regarding the effects on accidents. A more promising trend, which started in the mid-1980s, is generally known as graduated driver licensing (GDL). Many different layouts are put into practice in several countries and more than 20 different components have been developed. Jurisdictions need advice from research to elaborate and propose the best composition of GDL-components. The paper gives an overview of GDL-components. Summary effects for some of the most important components are calculated by means of meta-analysis, based on empirical accident studies. Finally, the paper discusses potentials of improvement of current Brazilian driver training practices and provides recommendations about combinations of components that contribute most to the effectiveness of GDL-programs.

Technical note: Comparison of two methods to quantify exercise energy expenditure in trotters

This study aimed at quantifying energy expenditure during 4 specific training exercises, that is, promenade, jogging, parcours, and interval exercises, using field measurements of oxygen consumption and heart rate in trotters. Six animals performed 2 preliminary tests to determine their individual maximum velocity and to establish their individual oxygen consumption/heart rate relationship from an incremental test. Then, they undertook each of the 4 specific exercises separated by 1 wk to avoid fatigue. The intensity of the 4 exercises was expressed in percent of individual maximum velocity as well as duration and distance set according to current training practices of French trotter trainers. Throughout the incremental test and the 4 exercises, oxygen consumption and heart rate were continuously recorded using a portable respiratory gas analyzer. Energy expenditure of the 3 different phases (warm-up, exercise, and recovery) of the 4 exercises and the total energy expended during exercises (sum of energy expended during the 3 phases) were calculated from direct oxygen uptake measurements and from estimated oxygen uptake using heart rate and O caloric equivalent. The quantification of total energy expenditure from the 2 methods was not significantly different. However, estimated energy expenditure was significantly lower from estimated oxygen consumption than direct oxygen uptake method concerning the warm-up and exercise phase of parcours. Our results indicate that the estimated oxygen uptake from heart rate measurements could be used to evaluate total energy expenditure of exercises in trotters. Whereas this method requires previous establishment of an individual oxygen consumption/heart rate curve, it is easy to record using commercially available instruments under practical conditions and opens new perspectives to assess energy balance in trotters' nutrition.

Clinical supervision: the state of the art.

Since the recognition of clinical supervision as a distinct professional competence and a core competence, attention has turned to ensuring supervisor competence and effective supervision practice. In this article, we highlight recent developments and the state of the art in supervision, with particular emphasis on the competency-based approach. We present effective clinical supervision strategies, providing an integrated snapshot of the current status. We close with consideration of current training practices in supervision and challenges.

Training for Collaborative Problem Solving

Increasing complexity in socio-technological systems of domains such as aviation, aerospace, and the military gives rise to equally complex problems. Solving these complex problems requires the collaborative efforts of teams who are able to not just integrate their collective knowledge, but also to monitor and regulate their collective problem solving performance. Unfortunately, current training practices have not yet been developed to promote the metacognitive processes necessary for teams to successfully solve problems in these complex domains. In this paper, we outline a theoretical framework based on the systematic use of metacognitive prompting to improve collaborative problem solving. Our goal is to explicate a theoretically and empirically grounded instructional strategy with testable propositions in support of the development and empirical evaluation of training for complex problem solving.

Re: a comparative study of contrasting surgical residency programs.

The article from the groups in London and Philadelphia [1] seeks to highlight differences in surgical training between the UK and US healthcare systems. This report is timely for those working in the UK, where the recent publication of the Shape of Training report by Professor David Greenaway [2] has proposed a new model for future postgraduate medical training. The rather disappointing response rate in the study and the use of self-reported data undermine the quality of the study that, nonetheless, allows broad comparison of surgical training in two continents. It might have been more valuable to have seen a like-for-like comparison with surgical training records or logbooks at equivalent stages of training. The duration of UK surgical training may come as a shock to some, particularly since past reforms were aimed at aligning more closely the UK-based programmes to those in the USA. However, these changes came at the same time as the working week became subject to European working time restrictions, and the length of training has not changed significantly. Although the concept of competency-based training has been introduced with more emphasis on work place-based assessments (WPBAs), there remains a time-based indicative length of training that means the UK graduate will typically undertake a minimum of 10 years of postgraduate training before practicing independently. It is an interesting observation that although the US trainees spend more time in the operating room, there was no significant difference in the number of elective cases undertaken, and the UK trainees performed significantly more emergency cases. The drivers for this pattern of training may have been as much service driven as trainee focused due to the requirements of the 48-hour working week legislation in the UK, with more experience being gained in London in the emergency setting. Concerns have been raised previously regarding the lack of supervision in the emergency setting in UK practice, and while some autonomy may provide the senior trainee with valuable insight as they move towards independent practice, this study does not provide data on the appropriateness of the level of supervision or any information around patient safety issues. There are indeed considerable discrepancies between the transatlantic training experiences with a greater emphasis on endoscopy experience in London but more simulated training and elective surgery in Philadelphia. The question arises as to what sort of surgeon is required to deliver service needs in the respective countries. The increasing tendency to sub-specialization may have appeal to the trainee but may not sit well with the requirement of the health service in the UK. Health service management require generalists to manage the pressures imposed by increasing emergency admissions. The Shape of Training report in the UK envisages a shorter, broader, and more generalist training in surgery, with a move towards credentialing to deliver and maintain subspecialty training. Making the transition to independent practice from a supportive training environment has always been a challenge. This study presents us with more questions than answers but provides useful insight into current training practice. O. J. Garden (&) R. W. Parks Royal Infirmary, University of Edinburgh, Edinburgh EH16 4SA, UK e-mail: ojgarden@ed.ac.uk

Applications of Cognitive Transformation Theory

Complex domains require cognitive work for which current approaches to training may be ill-suited. To improve training for cognitive work, Klein and Baxter have proposed Cognitive Transformation Theory (CTT), a learning theory that characterizes sensemaking processes as essential to the development of expertise. The objectives of this research were to compare CTT with the instructional strategies of two expert air traffic control instructors to evaluate the relevance of CTT’s four teaching practices, propose refinements to CTT, and identify potential instructional strategies to serve as guidance for the application of CTT. Data were collected using cognitive task analysis methods, including course observation, artifact examination, and knowledge elicitation with two instructors and seven of their students. Data were coded using categories derived from theory and patterns emergent within the data. Results suggest that many of the instructional strategies used were consistent with the teaching practices of CTT and that learning was aligned with the active sensemaking claims of CTT. An integrated set of instructional strategies and a few refinements to CTT are advanced to further its application to training in complex domains. Although this set of strategies may benefit current training practices, further research is needed to evaluate their effectiveness.

Innovation in clinical pharmacy practice and opportunities for academic--practice partnership.

Clinical pharmacy has a rich history of advancing practice through innovation. These innovations helped to mold clinical pharmacy into a patient-centered discipline recognized for its contributions to improving medication therapy outcomes. However, innovations in clinical pharmacy practice have now waned. In our view, the growth of academic–practice partnerships could reverse this trend and stimulate innovation among the next generation of pioneering clinical pharmacists. Although collaboration facilitates innovation,academic institutions and health care systems/organizations are not taking full advantage of this opportunity. The academic–practice partnership can be optimized by making both partners accountable for the desired outcomes of their collaboration, fostering symbiotic relationships that promote value-added clinical pharmacy services and emphasizing continuous quality improvement in the delivery of these services. Optimizing academic–practice collaboration on a broader scale requires both partners to adopt a culture that provides for dedicated time to pursue innovation, establishes mechanisms to incubate ideas, recognizes where motivation and vision align, and supports the purpose of the partnership. With appropriate leadership and support, a shift in current professional education and training practices, and a commitment to cultivate future innovators, the academic–practice partnership can develop new and innovative practice advancements that will improve patient outcomes.

Training and labour needs of young workers in Vietnamese organisations

Purpose – The purpose of this paper is report on findings from a survey of Vietnamese employers in 2008 highlighting key tends in training and future labour needs. Design/methodology/approach – This paper uses data collected from a survey of Vietnamese employers during 2008. The survey was design by the authors and the fieldwork undertaken by representatives of the Vietnamese Chamber of Commerce and Industry (VCCI) with support from the International Labour Organisation (ILO). Findings – The survey shows that Vietnamese organisations understand the importance of training for their young workers but require more support from government and the VCCI to ensure effective training. Practical implications – The paper contains a number of practical implications for Vietnamese employers and the VCCI. Originality/value – Despite some opening of trade between Vietnam and the west, relatively little is still known about work, employment and training in Vietnam and there a few opportunities to undertake research of this nature. The main contribution of this paper is to report on current training practices and labour needs in Vietnam.

Low-cost assessment tools for the development of psychomotor competency in procedural surgical skills

Abstract. While didactic training is a crucial element of education in the health care profession, current technologies leveraging low cost data acquisition and processing may provide an attractive alternative means for rapid, objective assessment of the foundational skills. When these technologies are leveraged towards improving the procedural surgical skill set, there is a strong opportunity for enhancing current training practices. While the proctor will still play a crucial role in the refinement of clinical judgment, affordable options for rapid training of procedural skills may serve as an avenue to free an expert proctor to focus on the more nuanced elements of medical training. Here we propose and implement a system for the low cost assessment and training of procedural surgical skills. A knot-tying module and a tool articulation module were created using affordable sensing technologies, and initial validation with a trained clinician showed that the devices could discriminate correctly and poorly tied knots. The system lays the framework for a modular experiential component of skills development in the training of health professionals.

Evaluation of Upper Limb Spasticity towards the Development of a High Fidelity Part-task Trainer

Upper limb spasticity is commonly seen in conditions of upper motor neuron pathology, of which includes traumatic brain injury, stroke, high cervical spinal cord injury and Cerebral Palsy. Trained physicians, physiotherapists and occupational therapists are needed for the rehabilitation of such patients. To obtain skills in addressing spasticity, current practice in training of students utilizes patients as primary learning subjects. Novices without the required skills put the patient safety at stake. Further, physicians and therapists evaluate spasticity using the Tardieu, Ashworth, and Modified Ashworth Scale which can vary dependent on experience. Variability in rater scores suggest that training can be improved. To tackle this issue, an upper limb part-task trainer that is capable of consistently emulating spasticity symptoms is proposed for pre-clinical training of physicians, therapists and medical students. In order to obtain clinical data for the emulation of upper limb spasticity symptoms, a non-invasive evaluation procedure has been designed deploying a goniometer and a manual muscle tester. The goniometer measures the angle of elbow joint of the patient while the manual muscle tester measures the force applied by the rehabilitation physician on the patient's forearm. The elbow joint angle and its resistance force are recorded in real time via a data acquisition interface and NI LabVIEW software. The evaluation procedure was carried out by a rehabilitation physician during a routine rehabilitation session to the patients with symptoms of upper limb spasticity.

Formateurs d'enseignants et éducation à la santé : de leurs conceptions à leur identité professionnelle

The objective of this study was to determine why some teacher educators use health education actions as part of their teacher training. We therefore studied the educators' discourse in order to identify factors affecting declared practices and adhesion to health education training. The study was conducted in two steps. Teacher educators were interviewed by telephone using a questionnaire and teacher training curricula were reviewed to assess current teacher training practices. A qualitative analysis was then conducted by structured telephone interviews of 16 teacher educators. The teacher educators interviewed in this study presented a holistic approach to health and health education, focusing on the individual, which had a positive impact on implementation of health education training. All of the teacher educators interviewed had also adopted health education as part of their professional identity: they felt competent in health education, and considered it to be part of their job. However, most teacher trainers reported concepts and declared practices according to an application-based model, focussing on acquired knowledge, or a didactic model, focussing on implementation of projects. The holistic model, focussing on individual health, remained very marginal and was not part of teacher educators' perceptions of their role in the training future teachers.

Staff training makes a difference: improvements in neonatal illicit drug testing and intervention at a tertiary hospital

Objective: This project explored the impact of staff training on the rates of perinatal maternal and neonatal illicit drug testing.Methods: Controlled, retrospective chart review on 1186 newborn and mother dyads from 2006 (pre-training control group) and on 1861 dyads from 2009 (post-training study group) was completed. Differences between rates of infant and mother drug testing were compared.Results: Increased drug testing rates for the mothers and infants led to increased case finding that tripled both for the mothers (13–3.7%, p < 0.001) and for the infants (0.9–2.9%, p < 0.001). Missed opportunities for newborn testing was reduced by 35 times (20.9–0.6%, p < 0.001).Conclusion: This retrospective study led to an increase in the number of documented drug-exposed newborns. This research emphasizes the importance of and encourages other hospitals to analyze the efficacy of their current protocol and staff training practices in place to ensure the best child protection services.

P291 Is The Training Provided To Professionals Caring For People With Alzheimer’s Disease Adequate According To CPG Recommendations?

BackgroundDespite the rapid increase in the knowledge of epidemiology, genetics, risk factors and underlying neuropathological mechanisms of Alzheimer’s disease (AD) and the rising number of consensus statements and guidelines for...

A Systematic Review of Evidence for Education and Training Interventions in Microsurgery

Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

The Current State of Sleep Medicine Education in US Neurology Residency Training Programs: Where Do We Go from Here?

To evaluate the current state of sleep medicine educational resources and training offered by US neurology residency programs. In 2010, a 20-item peer reviewed Sleep Education Survey (SES) was sent to neurology residency program directors surveying them about sleep medicine educational resources used in teaching residents. Pearson product momentum correlation was used to determine correlation of program attributes with resident interest in pursuing a career in sleep medicine. Of the programs completing the survey, 81% listed a formal sleep rotation and 24% included a forum for sleep research. A variety of innovative approaches for teaching sleep medicine were noted. Program directors noted that 5.7% residents entered sleep medicine fellowship training programs in the preceding 5 years. Programs that had a more substantial investment in sleep medicine teaching resources were more likely to report residents entering a sleep medicine training program. This is the first report providing an analysis of the current state of sleep medicine training in US Neurology Residency Programs. Our data provide evidence that investment by the residency program in sleep education may enhance the ultimate decision by the neurology trainee to pursue a career in sleep medicine.

Lactate Response to Different Volume Patterns of Power Clean

The ability to metabolize or tolerate lactate and produce power simultaneously can be an important determinant of performance. Current training practices for improving lactate use include high-intensity aerobic activities or a combination of aerobic and resistance training. Excessive aerobic training may have undesired physiological adaptations (e.g., muscle loss, change in fiber types). The role of explosive power training in lactate production and use needs further clarification. We hypothesized that high-volume explosive power movements such as Olympic lifts can increase lactate production and overload lactate clearance. Hence, the purpose of this study was to assess lactate accumulation after the completion of 3 different volume patterns of power cleans. Ten male recreational athletes (age 24.22 ± 1.39 years) volunteered. Volume patterns consisted of 3 sets × 3 repetition maximum (3RM) (low volume [LV]), 3 sets × 6 reps at 80-85% of 3RM (midvolume [MV]), and 3 sets × 9 reps at 70-75% of 3RM (high volume [HV]). Rest period was identical at 2 minutes. Blood samples were collected immediately before and after each volume pattern. The HV resulted in the greatest lactate accumulation (7.43 ± 2.94 mmol·L) vs. (5.27 ± 2.48 and 4.03 ± 1.78 mmol·L in MV and LV, respectively). Mean relative increase in lactate was the highest in HV (356.34%). The findings indicate that lactate production in power cleans is largely associated with volume, determined by number of repetitions, load, and rest interval. High-volume explosive training may impose greater metabolic demands than low-volume explosive training and may improve ability to produce power in the presence of lactate. The role of explosive power training in overloading the lactate clearance mechanism should be examined further, especially for athletes of intermittent sport.

Current Sales Training Practices in the Commercial Retail Banking Industry in Malaysia

Sales training practices were examined in the Malaysian banking industry. Banking sales personnel completed 292 surveys out of 750 distributed, yielding a response rate of 38.7%. Commercial banks in Malaysia followed a joint-trainer approach and utilized evaluators from middle and upper management positions to assess sales training program. Training programs used low-participative methods, like on-the-job training and lectures. Product- and service-oriented topics and result-based sales training evaluation methods were commonly practiced within the industry. Future challenges include developing flexible online training methods and selling relationships in a multiethnic country. Managerial implications are provided.

Training of Paraeducators for Physical Education for Children with Visual Impairments

Introduction Children with visual impairments are often behind their peers in physical and motor skills. It is often necessary for these children to work one to one with a paraeducator to gain the benefits of physical education, improve physical activity and motor skills, and attain the basic standards of the Expanded Core Curriculum (ECC). Paraeducators are trained to work in classrooms, yet are rarely, if ever, trained in the subject of physical education. The purpose of the study presented here was to determine current training practices for paraeducators in the classroom and what is needed to ensure proper training for physical education for paraeducators who work with children with visual impairments. Methods In the study, 143 professionals and parents were given a validated questionnaire related to the training needs of paraeducators for physical education. Results The results indicated that although the majority of children with visual impairments attended physical education classes with their paraeducators, only 11% of the paraeducators were trained in physical education. The participants thought that the training should consist of safety practices, guiding techniques, teaching strategies, information on visual impairments, and most areas of the ECC. They thought that this information should be delivered in the form of a video or guest speakers and that the children with visual impairments should be included when possible. Discussion Because of the large and varied sample in the study, the information gained could be used to create a training video for paraeducators who work with children with visual impairments in physical education. Implications for practitioners The results of the study highlight areas that should be included as the foundation of training paraeducators for physical education.

Urology Resident Experience with an Elective in Interventional Radiology: A Pilot Evaluation

The objective of the study was to evaluate the initial experience with an elective in interventional uroradiology. Seven urology residents completed a minimum 2-month elective in interventional radiology (IR). A survey was administered before and immediately after the elective. The survey sought information on proficiency in uroradiology procedures and the role of IR in current training and future practice based on a 5-point ascending Likert response scale. Procedures performed during the elective were reviewed and recorded from the resident case logs. Urology residents reported an increased proficiency in all interventional procedures after the IR rotation. Endovascular techniques, ablative therapies, and needle biopsy had significant increases in performance proficiency (P=0.031). On completion, residents strongly agreed that interventional uroradiology should be a part of residency training, and image-guided therapies will play a significant role in the future of urology. Residents performed on average 14.9 arterial interventions, 28.5 venous interventions, 15.8 genitourinary interventions, and 3.1 tumor ablations per month. In addition, urology residents performed image-guided biopsies, drainages, as well as gastrointestinal and biliary interventions gaining experience with performing and interpreting ultrasonography, fluoroscopy, and CT. Interventional uroradiology provides urology residents invaluable experience with image-guided procedures, increasing comfort with performance and interpretation. Residents believed that interventional uroradiology should be incorporated into the residency curriculum.