Training Environment Research Articles

Enhancing patient-oriented research training: participant perceptions of an online course

BackgroundPatient-oriented research is now widely regarded as key to improving health systems and patient outcomes. This shift toward meaningful patient involvement in health research has sparked a growing interest in patient-oriented research training across Canada. Yet some barriers to participation, including distance and scheduling constraints, may impede the provision of in-person patient-oriented research training. Virtual course delivery options may help surmount those barriers, as well as offer unique pedagogical advantages.ObjectiveTo help increase patient-oriented research training uptake, the research team adapted the Canadian Institutes of Health Research’s (CIHR) Strategy for Patient-Oriented Research’s Foundations for Patient-Oriented Research course to a virtual format. The course consists of three modules, which focus respectively on patient-oriented research, health research methods, and teamwork skills. The current evaluation of this virtual delivery examines how a diverse set of participants received the online course.MethodsCourse participants from a variety of professional backgrounds, including researchers, patients, clinicians, and policy decision-makers, were recruited from across Canada to participate in the adapted course. Participant and facilitator feedback was solicited via online surveys that were distributed shortly after the delivery of each module.ResultsOver the span of the current project, the online course was delivered seven times across Canada. A total of 189 learners and 12 facilitators participated in the course. We received 89 completed feedback surveys in total. These included a total of 78 responses from learners, with 22 on Module 1, 32 on Module 2, and 24 on Module 3, in addition to 11 responses from facilitators. Overall, participants and facilitators were very satisfied with the course, indicating a successful adaptation from traditional to online delivery. Survey respondents were especially pleased with the course’s co-learning elements, which exposed them to fresh perspectives and real patient voices, as well as ample opportunity for discussion. Some participants offered recommendations for minor course revisions. Future iterations of the course will reflect participant and facilitator feedback to enhance accessibility via minor changes to course format (e.g., shorter live sessions), content (e.g., more concrete examples), and workload (e.g., reduced pre-work requirements).ConclusionsSustainable and effective health care depends on health research that includes active partnerships across diverse populations. These collaborative relationships are fostered by strong capacity in patient-oriented research, which in turn hinges on widely accessible training opportunities. This online course overcomes common barriers to face-to-face training and offers the accessible, inclusive training environment required for sustained progress in patient-oriented research.

Analisis Pengaruh Pelatihan dan Lingkungan Kerja serta Kaitannya Terhadap Peningkatan Kinerja Pegawai Kementerian Ketenagakerjaan Republik Indonesia

Human resources have a very important role in determining the progress of an organization, the goals of an agency are largely determined by the performance of human resources or the performance of employees within it. To improve employee work performance, one way is to provide training to employees and pay attention to the work environment around employees. The aim of this research is to determine the effect of training and work environment simultaneously on the performance of employees of the Directorate General of Binalavotas. The method used in this research is a quantitative method which uses a sample of 50 respondents and the sampling in this research is a non-probability technique with census sampling, data collection was carried out using a questionnaire. The results of research using the t test show that the training variable partially has a positive and significant effect on employee performance, namely the value of T-count > T-table (8.581 > 2.012) with a significance level of 0.000 < 0.05 and the work environment variable partially has a positive and significant effect on employee performance, namely obtained T-count>T-table value (10,227 > 2,012) with a significance level of 0.000 < 0.05. The results of the F test for the training and work environment variables can be concluded that the training and work environment variables simultaneously have a positive and significant effect on employee performance, namely the value obtained Fcount>Ftable (58.725 > 3.20) with a significance level of 0.000 <0.05.

Smart energy management for hybrid electric bus via improved soft actor-critic algorithm in a heuristic learning framework

Deep reinforcement learning (DRL) is currently the cutting-edge artificial intelligence approach in the field of energy management for hybrid electric vehicles. However, inefficient offline training limits the energy-saving efficacy of DRL-based energy management strategies (EMSs). Motivated by this, this article proposes a smart DRL-based EMS in a heuristic learning framework for an urban hybrid electric bus. In order to enhance the sampling efficiency, the prioritized experience replay technique is introduced into soft actor-critic (SAC) for the innovative formulation of an improved SAC algorithm. Additionally, to strengthen the generalizability of the improved SAC agent to real driving scenarios, a stochastic training environment is constructed. Afterward, curriculum learning is employed to develop a heuristic learning framework that expedites convergence. Experimental simulations reveal that the designed EMS expedites convergence by 85.58 % and saves fuel by 6.43 % compared with the cutting-edge baseline EMS. Moreover, the computation complexity test demonstrates that the designed EMS holds significant promise for real-time implementation. These findings highlight the contribution of this article in facilitating fuel conservation for urban hybrid electric buses through the application of emerging artificial intelligence technologies.

Evaluating the Impact of Gender and Race on Otolaryngology Resident Experiences Across the United States.

Otolaryngology residents often encounter work-related stress and challenges during training. Sociodemographic factors influence experiences during residency; however, the impact of race and gender on otolaryngology trainee well-being during residency remains understudied. Online survey. US residency programs. An anonymous online survey consisting of 59 multiple-choice questions was sent to 104 directors of Accreditation Council for Graduate Medical Education otolaryngology residency programs to distribute to residents. Respondents were queried regarding demographics and experiences with bias. Residents self-identified gender and race. Black, Hispanic/Latinx, Middle Eastern/North African, and multiracial residents were categorized as underrepresented minorities (URM). Sixty-oneUS otolaryngology residents responded to the survey, the majority of whom were women (60.7%) and white (62%). Many residents endorsed a belief that receipt of research and training opportunities was negatively impacted by bias due to race (29.5%) or gender (45.9%). More women (27%) than men (13%) reported maximal burnout, and fewer men (17.4%) than women (40.5%) expressed low confidence in ability to independently care for patients. More male (47.8%) and white (31.6%) residents strongly agreed they were thriving. 94.6% of women and 33.3% of URM residents reported being mistaken for a nonphysician, compared to 0% of white male respondents. Otolaryngology residents perceived differential treatment based on race and gender, with women and URM residents experiencing greater exclusion and bias, as well as increased misidentification and decreased ability to thrive. Future work includes increasing sample size for generalizability and developing interventions that uphold equity in residency training environments.

Motion planning of free-floating space robots for tracking tumbling targets by two-axis matching via reinforcement learning

The increasing amount of space debris poses a persistent threat to the safety of spacecraft. These non-cooperative targets are generally in a tumbling state, which places stringent requirements on the precision of the end-effector pose for capture tasks. Moreover, there are still difficulties in exploring the orientation state space, making it impractical to track targets with complex tumbling states based on reinforcement learning. To track tumbling targets quickly with high accuracy, we propose Two-Axis Matching Path Tracking (TMPT) algorithm. Our algorithm reduces the complexity of orientation exploration and improves the convergence speed through two-axis matching and the self-guidance module. Furthermore, the training environment has been redesigned by adopting staged tumbling target environment, which expands the range of trackable targets. Comparative simulation results demonstrate the efficiency and robustness of the algorithm.

Static Factors in Sitting Comfort: Seat Foam Properties, Temperature, and Contact Pressure

The seat characteristics have high relevance in overall comfort on any transportation means. In particular, the foam’s mechanical properties, interface pressure, and contact temperature play an important role in low- or no-vibration situations regarding static comfort. The present work presents the complete protocol for a static evaluation of different foams and seat covers to assess railway seats. Based on the evaluation of the foam’s mechanical properties and interface pressure profiles, it was concluded that higher-density foam (80 kg/m3) is the most favorable. Regarding the foam cover, a thermographic assessment demonstrated that the fabric cover that induces lower temperatures at passenger interface contact promotes higher comfort levels. It should be highlighted that experiments were conducted on real train seat cushions and environments using a thermographic camera and pressure map sensor.

Auxiliary diagnostic method of Parkinson’s disease based on eye movement analysis in a virtual reality environment

Eye movement dysfunction is one of the non-motor symptoms of Parkinson’s disease (PD). An accurate analysis method for eye movement is an effective way to gain a deeper understanding of the nervous system function of PD patients. However, currently, there are only a few assistive methods available to help physicians conveniently and consistently assess patients suspected of having PD. To solve this problem, we proposed a novel visual behavioral analysis method using eye tracking to evaluate eye movement dysfunction in PD patients automatically. This method first provided a physician task simulation to induce PD-related eye movements in Virtual Reality (VR). Subsequently, we extracted eye movement features from recorded eye videos and applied a machine learning algorithm to establish a PD diagnostic model. Then, we collected eye movement data from 66 participants (including 22 healthy controls and 44 PD patients) in a VR environment for training and testing during visual tasks. Finally, on this relatively small dataset, the results reveal that the Support Vector Machine (SVM) algorithm has better classification potential.

Improving Diversity in a Rural Academic Obstetrics and Gynecology Training Program

Both the Accreditation Council for Graduate Medical Education and the American College of Obstetricians and Gynecologists advocate for greater diversity within our workforce, which starts with recruiting and retaining a diverse residency pool. Historically, applicants who are underrepresented in medicine have been more likely to apply to residency programs located in urban locations, as opposed to a rural training environment. In this commentary, we discuss a novel strategy used to attract underrepresented in medicine applicants to a rural academic obstetrics and gynecology training program. The strategy encompassed a virtual weeklong elective with the goals of bolstering their residency applications and showcasing our faculty and residency training.

Enhancing Operating Theatre Conduct through Virtual Reality Simulation

Abstract In hospital operating theatres, inadvertent violations of behavioural rules by novices may increase risk. Virtual reality (VR) can provide a training environment to ease the burden for healthcare professionals. Our work develops and tests a VR training program for correct operating room (OR) etiquette. The VR simulator incorporates realistic 3D models as well as corresponding character and object interactions. The simulator provides a comprehensive interactive educational game covering hand hygiene and disinfection, surgical attire and OR behaviour. 13 clinical trainees and experts assessed acceptance and perceived benefit of the simulator. This evaluation shows promise in supporting clinical staff education. Future developments aim to enhance effectiveness, including the integration of hand tracking and a more detailed selection of interactive tasks.

Sex diversity in spine surgery fellowship training: analysis of recent trends and program characteristics associated with increased diversity

BACKGROUND CONTEXTSex diversity in the spine surgery workforce remains limited. Accelerated efforts to recruit more female trainees into spine surgery fellowship training may help promote diversity and inclusion in the emerging spine surgery workforce. PURPOSEThis study assessed the representation of female trainees in spine surgery fellowship training and program factors associated with greater sex diversity among fellows. Study Design/SettingThis was a cross-sectional analysis of spine surgery fellows in the United States during the 2016–2017 to 2022–2023 academic years. PATIENT SAMPLEN/A. OUTCOME MEASURESRepresentation (%) and participation-to-prevalence ratios (PPRs) defined as the participation of female trainees in spine surgery fellowship training divided by the prevalence of female trainees in previous training cohorts. PPR values <0.8 indicated underrepresentation. METHODSSex diversity was assessed among spine surgery faculty, spine surgery fellows, orthopaedic surgery residents, neurosurgery residents, and allopathic medical students. Fellowship program characteristics associated with increased sex diversity were calculated with chi square tests. RESULTSThere were 693 spine surgery fellows and 41 were female (5.9%). Sex diversity in spine surgery fellowship training decreased over the study period (6.4% vs. 4.1%, p=.025). Female trainee representation in spine surgery fellowship training was less than that in orthopaedic surgery residency (14.2%, PPR=0.42), neurosurgery residency (17.1%, PPR=0.35), and allopathic medical school (47.6%, PPR=0.12) training (p<.001). There were 508 faculty at 78 spine surgery fellowships and 25 were female (4.9%). There were 3 female fellowship program directors (3.8%). Fellowship program characteristics associated with increased sex diversity included the presence of female faculty (p=.020). Additional program characteristics including geographic region, accreditation status, number of faculty and fellows were not associated with sex diversity (p>.05). CONCLUSIONSFemale representation in spine surgery fellowship training decreased over the study period and remains underrepresented relative to earlier stages of medical and surgical training. There was a positive association between female faculty and increased sex diversity among fellows. Greater efforts are needed to create training environments that promote diversity, equity, and inclusion in spine surgery fellowship training.

Authoring training scenarios “from within” in an immersive environment with the CESTATE framework

ABSTRACT Virtual reality (VR) can be used to train for complex, dynamic and dangerous situations, such as disaster response. The aim of this research is to support trainers with an immersive authoring tool that facilitates the implementation of training environments, enabling both the design and execution of complex and dynamic exercises. A systematic literature review was conducted to identify VR-based authoring tools. Each environment was assessed based on variability, reusability and design assistance, with each criterion graded on a 3-point scale. Following a model-driven approach, the work presented in this article introduces the CESTATE (Cascading Effect Simulation To Authoring Training Environments) framework. It uses a metamodel to design training exercises, thus ensuring their reusability. Inheriting from the Physics of Decisions paradigm, this metamodel can be used to describe all types of potentialities and cascading effects. This ensures the dynamic, and therefore, the plausibility of the virtual training environment. In addition, this framework supports the design of immersive training environments, at both design and run time. It is a generic approach. Its applicability is demonstrated in several iterations of a case study involving the training of practitioners on a complex and realistic crisis situation: a fire in a cathedral.

Gender gap among plastic surgery residents: the Italian experience

Aim: Despite the significant increase in the proportion of graduating female physicians in recent decades, gender representation in surgical training remains imbalanced. The initial rise in female interest in plastic surgery has reached a plateau. Gender bias, affecting women’s confidence and opportunities, negatively impacts training and career prospects. This study aims to quantify and analyze disparities in surgical training opportunities, workplace treatment, and career advancement among male and female plastic surgery residents in Italy. Methods: Our study involved all Italian plastic surgery residents contacted between February and March 2024. A 21-item survey assessed professional, surgical, and personal aspects, focusing on gender gap differences. Responses were expressed in percentages and compared utilizing the Fisher Exact test. Results: A total of 551 surveys were distributed to Italian plastic surgery residents, with 46 responses each among women and men. Gender disparities persisted in workplace treatment, with more women reporting discrimination. Significant differences were identified in treatment inequality by hospital personnel and patients, the occurrence of inappropriate comments in the workplace, inquiries regarding work-life balance and career advancement opportunities, an augmented gender gap in surgical vs . clinical programs, and the perception of a negative impact of gender on surgical training. Conclusion: In conclusion, our study emphasizes the pervasive gender inequality in plastic surgery training, urging action against systemic biases hindering female surgeons’ progress. Gender equity efforts should combat discrimination, promote work-life balance, and foster inclusive training environments. Addressing these issues can create a field that empowers all surgeons to thrive.

Evaluating the generalizability of graph neural networks for predicting collision cross section

Ion Mobility coupled with Mass Spectrometry (IM-MS) is a promising analytical technique that enhances molecular characterization by measuring collision cross-section (CCS) values, which are indicative of the molecular size and shape. However, the effective application of CCS values in structural analysis is still constrained by the limited availability of experimental data, necessitating the development of accurate machine learning (ML) models for in silico predictions. In this study, we evaluated state-of-the-art Graph Neural Networks (GNNs), trained to predict CCS values using the largest publicly available dataset to date. Although our results confirm the high accuracy of these models within chemical spaces similar to their training environments, their performance significantly declines when applied to structurally novel regions. This discrepancy raises concerns about the reliability of in silico CCS predictions and underscores the need for releasing further publicly available CCS datasets. To mitigate this, we introduce Mol2CCS which demonstrates how generalization can be partially improved by extending models to account for additional features such as molecular fingerprints, descriptors, and the molecule types. Lastly, we also show how confidence models can support by enhancing the reliability of the CCS estimates.Scientific contributionWe have benchmarked state-of-the-art graph neural networks for predicting collision cross section. Our work highlights the accuracy of these models when trained and predicted in similar chemical spaces, but also how their accuracy drops when evaluated in structurally novel regions. Lastly, we conclude by presenting potential approaches to mitigate this issue.

TBICoE approach to concussion rehabilitation in service members and veterans.

Concussion, also known as mild traumatic brain injury (mTBI), is a condition with unique ties to military service. Service members (SMs) are inherently at a higher risk for concussive injuries due to the intense physical training environment and combat operational tempo required to serve. The Traumatic Brain Injury Center of Excellence (TBICoE) is the US Department of Defense authority on this condition and provides a thorough approach to management of concussion and associated symptom sequela. This article seeks to review the TBICoE approach to the management and rehabilitation of military SMs with mTBI, and highlight resources available to military medical providers. The authors reviewed evidence and TBICoE resources to provide this comprehensive overview of the TBICoE approach to management and rehabilitation of concussion in military SMs. A progressive return to activity protocol in conjunction with symptom-guided management of common post-concussive sequelae, including headache, vestibular and oculomotor issues, sleep dysfunction, cognitive rehabilitation, and behavioral health comorbidities are essential for concussion management in the acute, post-acute and chronic phases of injury. The TBICoE approach to the rehabilitation of military SMs is comprehensive, and includes initial management with a stepwise return to duty protocol and an objective return to duty screening. The mainstays of treatment for SMs with post-acute and chronic post-concussion symptoms are headache management, vestibular and oculomotor rehabilitation, sleep interventions, cognitive rehabilitation, and early intervention for behavioral health comorbidities. These evidence-based strategies may be applied in the treatment of SMs in the US and internationally.

Adding texture to the Art of constraints-led coaching: a request for more research-informed guidelines

ABSTRACT The constraints-led approach has become an increasingly popular framework for developing functionally adaptive movement skills among athletes. Despite this popularity, the application of the constraints-led approach requires a level of conceptual, theoretical, and practical expertise, which we believe is in need of further applied research. In this paper, we aim to challenge constraints-led researchers and practitioners to provide more research-informed guidelines to support coaches who wish to become ecological designers. In doing so, we first discuss the underlying theoretical perspectives, providing a balanced account of the possible strengths and limitations of the ecological dynamics and constraints-led approaches. We then pose three questions we believe have yet to receive the empirical attention necessary to help coaches become effective ecological designers. In posing these questions, we hope to encourage greater empirical guidance about the application of the constraints-led approach in situations coaches routinely encounter in the daily training and competition environment.

Lessons for expanding virtual mentoring in academic medical institutions: a qualitative study among senior mentors

BackgroundVirtual activities, hybrid work and virtual mentoring have become part of the ongoing milieu of academic medicine. As the shift to remote mentoring continues to evolve, it is now possible to adapt, refine, and improve tools to support thriving mentoring relationships that take place virtually. This study explores strategies for virtual mentoring as a cornerstone for effective training programs among senior mentors participating in an ongoing mentoring program.MethodsWe conducted a qualitative study among prior and current participants of an ongoing “Mentoring the Mentors” program about key strategies for optimizing virtual mentoring. Data were coded and analyzed following a thematic analysis approach.ResultsRespondents were mostly female (62%), white (58%), and associate (39%) or full professors (32%). We found that, with the expansion of hybrid and fully remote work, there are now fewer opportunities for informal but important chance meetings between mentors and mentees; however, virtual mentoring provides opportunities to compensate for reduced interactivity normally experienced in the workplace. The heightened need to plan and be more deliberate in the virtual sphere was woven throughout narratives and was the foundation of most recommendations. Specifically, a central obstacle for respondents was that spontaneous conversations were harder to initiate because virtual conversations are expected to have set agendas.ConclusionsDeveloping new ways to maintain meaningful interpersonal relationships in a virtual training environment, including opportunities for serendipitous and informal engagement, is critical to the success of virtual mentoring programs.

Assessing the Influence of Safety Culture to Employee Safety Performance Mediated by Safety Communication in Coal-Fired Power Plant

This study analyzes the effect of safety culture on employee safety performance at a Coal Fired Power Plant (CFPP) in Java, as well as the mediating role of safety communication and moderating role of service years. This study aims to investigate the direct and indirect effects between the variables of safety culture, safety communication and employee safety performance. In addition, the study also explored the moderating role of service year in the relationship between safety culture and employee safety performance. Data was obtained from distributing questionnaires to CFPP employees using a stratified sampling method. SmartPLS SEM. The findings reveal that safety culture does not have a significant direct effect on employee safety performance. However, safety communication significantly mediates the relations between safety culture and employee safety performance. The service year does not moderate the relationship between safety culture and employee safety performance This indicates that other factors such as continuous training, reward system, and work environment may be more influential in this context.

Deep reinforcement learning control of combined chemotherapy and anti-angiogenic drug delivery for cancerous tumor treatment

By virtue of the chronic and dangerous nature of cancer, researchers have explored various approaches to managing the abnormal cell growth associated with this disease using novel treatment methods. This study introduces a control system based on normalized advantage function reinforcement learning. It aims to boost the body's immune response against cancer cell proliferation. This control approach is applied to provide a combination of both chemotherapy and anti-angiogenic drugs for the first time without the need for complex, predefined mathematical models. It employs a model-free reinforcement learning technique that adaptively adjusts to individual patients to determine optimal drug administration with minimum injection rates. In this regard, a comprehensive and realistic simulation and training environment is employed, with the concentrations of normal cells, cancer cells, and endothelial cells, as well as the levels of chemotherapy and anti-angiogenic agents, as state variables. Furthermore, high levels of disturbances are considered in the simulation to investigate the robustness of the proposed method against probable uncertainties in the treatment process or patient parameters. A practical reward function has also been devised in alignment with medical objectives to ensure effective and safe treatment outcomes. The results demonstrate robustness and superior performance compared to the existing methods. Simulations show that the proposed approach is a dependable strategy for effectively reducing the concentration of cancer cells in the shortest duration using minimal doses of chemotherapy and anti-angiogenic drugs.

The Influence of Training and Working Environment on the Performance of Nurses of Public Service Agency (BLUD) Inpatient Section of Ciawi Regional General Hospital (RSUD)

This study aims to determine the effect of training and work environment on the performance of Regional Public Service Agency nurses in the inpatient department at the Ciawi Regional General Hospital. The sample in this study was 65 people using a nonprobability sampling technique with purposive sampling technique, the research method used multiple linear regression with IBM SPSS software. The results of the validity and reliability tests show that all points of the statement are declared valid and reliable. The F test (simultaneous) states that there is a simultaneous positive and significant influence between training and the work environment on nurse performance. The results of the t test (partial) stated that training had a positive and significant effect on nurse performance and the work environment had a positive and significant effect on nurse performance at the Ciawi Bogor Regional General Hospital.

Validity and Reliability of a Commercially Available Inertial Sensor for Measuring Barbell Mechanics during Weightlifting

This study aimed to assess the validity and reliability of a commercially available inertial measurement unit (Enode) for measuring barbell kinematics and kinetics during a snatch. In order to assess validity and within- and between-session reliability, thirteen competitive weightlifters conducted two snatches on two separate occasions at 85% of their one-repetition maximum. The Enode sensor was attached to the barbell, with each lift recorded via the device’s native application concurrently with an 11-camera motion capture system. Passing–Bablok regression indicated fixed and proportional bias in some horizontal measures of barbell mechanics but showed no bias in all but one vertical variable. Collectively, this suggests that the Enode is a valid tool in the measurement of vertically derived, but not horizontally derived, variables from barbell kinematics. Within- and between-session reliability showed moderate to excellent ICCs, with trivial to small differences between repetitions and between sessions. However, between-session reliability showed lower levels of variability and, thus, may help coaches identify changes in technique over time (between sessions) with good accuracy. Overall the Enode offers a practical and affordable option for coaches seeking to monitor weightlifting technique in training environments.