Training Experience Research Articles

A new approach in insulin pump education improves glycemic outcomes: a randomized controlled trial.

To address the scarcity of continued education for insulin pump users, we developed and evaluated a new program (NP) for individuals transitioning to a different insulin pump. In a randomized, controlled 3-month study, adults with type 1 diabetes and suboptimal HbA1c received either NP or usual care program (UC). The NP was designed in collaboration with representatives of the target group and incorporated technical training, case-based learning, and peer experience sharing - encompassing two group sessions, and two follow-up telephone calls. The UC included a single training session led by the pump company with hotline assistance (clinic) but no structured follow-up. The primary endpoint was the difference in time in range (TIR) (70-180mg/dL (3.9-10.0 mmol/L)), measured by continuous glucose monitoring from baseline to 3 months post-course. Psychosocial self-efficacy was measured by the Diabetes Empowerment Scale (DES-SF). Thirty-nine participants (median age 43, 74% female) were included. Mean TIR increased significantly in the NP group and remained unchanged in the UC group (between-group difference in change was 13.5% [95% CI: 4.0 to 22.9], p = 0.0064). Psychosocial self-efficacy improved and HbA1c decreased only significantly in the NP group. Applying a novel education program at pump transition significantly improved glycemic outcomes and self-efficacy.

Impact of Live Tissue Training on Provider Confidence for Operative Trauma Management.

Readiness of military health care providers is essential to maintain a prepared fighting force and remains a central issue for today's military. Maintaining skills regarding operative management of trauma is becoming more difficult if not located at an urban trauma center. Live tissue training may be used to practice skills in a facility that does not have exposure to high acuity trauma. The goal of our live tissue skills course is to train health care providers and ancillary staff in the management of various injury complexes and improve confidence and familiarity with management using a porcine model. A live tissue skills course using a porcine model was offered to surgical residents, attendings, and operating room technicians. Before completing the course, each participant completed a survey assessing comfort level, previous training experiences, and deployments. Operative management was simulated with a standardized sequence of abdominal and thoracic injuries. After the course, each participant then completed a survey assessing comfort level, benefit of the course, and comparison to inanimate simulation training. Survey information was obtained via participant completion of a multiple-choice confidential questionnaire. Responses were collected from 34 participants at our institution. Average abdominal trauma comfort increased from 2.79 to 3.73, with no participants reporting feeling not comfortable at all post-lab. Average thoracic trauma comfort increased from 2.47 to 3.48, with one participant reporting feeling not comfortable at all post-lab. Overall, 85% of participants reported the course to be very beneficial in improving their knowledge, 83% reported the course to be very beneficial compared to inanimate simulators, and 92% reported high fidelity of the live tissue training course. Perceived as highly beneficial, live tissue training increased comfort with operative trauma management by surgical residents, attendings, and technicians supporting continued utilization. Further evaluation of live tissue courses would be advantageous in assessing surgical skill improvement, including comparison with simulation training.

MRehab: A Mixed Reality Rehabilitation System Supporting Integrated Speech and Hand Training

Integrated speech and hand-motor training is an effective post-stroke rehabilitation method. However, few interactive systems and assistive technologies were developed in this field. Driven by this challenge, we leverage Mixed Reality technology, which merges immersive virtual scenarios with physical hands-on tools in the real world, to provide patients with multi-modal interactions and engaging training experiences. Following a user-centered design approach, we first interviewed seven therapists to identify user requirements and design considerations. We further designed MRehab, an interactive rehabilitation system that allows patients to regain speech and hand skills through MR scenarios that depict daily living activities. We conducted a preliminary user test with 12 patients and 5 therapists to validate the feasibility and understand the user experience with MRehab. The results confirmed its feasibility for hand-motor training. Additionally, the patients expressed high motivation, engagement, and a positive attitude toward using MRehab. Our findings demonstrate the potential of MR technology in integrated speech and hand function rehabilitation training.

Resident and supervisor perceptions of gaining obstetrical competency in Family Medicine: a qualitative descriptive study

Introduction: Canadian Family Medicine (FM) residents, upon graduation, are disinclined to provide intrapartum care. The FM resident experience with obstetrical training has not been studied in over a decade while the FM landscape has changed. This study explored the FM resident experience in working towards their obstetrical competencies as one of the chief influences on their career decision to provide intrapartum care or not. Methods: Using a qualitative descriptive design, we conducted semi-structured interviews with second-year FM residents (n = 7) and obstetrical supervisors (n = 8) from one Ontario FM program. We coded and interpreted the transcripts for common themes. Results: FM residents working towards their intrapartum skills are influenced by the following themes: the learners’ unique and individual experience and expectations; opportunities in the training environment; and learning obstetrics in the changing FM landscape. Notably, the influence of FM maternity care role models permeated all themes. Conclusion: This study offers insight into potential areas of intervention to improve the FM residency training experience in intrapartum care. Investment in FM maternity education, in the undergraduate and postgraduate medical curricula, with continued support in practice, is critical to maintain comprehensive education and patient care, especially while Canada faces a maternity care crisis.

Effects of Carbohydrate and Caffeine Mouth Rinsing Methods on Repetitive Kick Force and Duration, and Hand Reaction Time in Karate Athletes

The effect of carbohydrate (CHO) and caffeine (CAF) solutions rinsing in the mouth in combat sports where high-intensity movements are performed intermittently despite fatigue is unknown. This research was carried out to investigate the effects of rinsing CHO and CAF solutions in the mouth on kick force, duration, and hand reaction time in karate athletes. 16 male trained karate players (average age 21.6 years, weekly training time 8.4 hours, training experience 7.8 years) voluntarily participated in the study. In a replicated, double-blind, placebo-controlled, and crossover design study, after the 10 seconds mouth rinsing of CHO (6.4% maltodextrin), CAF (1.2%), and placebo (water) solutions in sessions, repeated sprint test (6sec sprint ×10 repetitions, with 30sec rest) on a bicycle ergometer, after light stimuli kick test (consecutive 5 times), hand reaction time test (consecutive 5 times), kick test (consecutive 5 times), hand reaction time test (consecutive 5 times) were performed respectively. The results obtained from the tests in the constructed protocol by causing fatigue (peak power, average power, minimum power, power drop; kicking reaction time, strength, power, and time; hand reaction time) were compared between sessions. The highest peak power and average power outputs (W/kg) obtained from the repeated sprint test were obtained in the CAF session, and the best kick and hand reaction times (ms) were obtained in the CAF session in the 2nd set of tests. The results obtained from this study suggest that the CAF mouth rinsing method can improve kick and hand reaction time despite fatigue in karate competitions.

Digital training for self-injectable contraceptives: a feasibility and acceptability pilot study

BackgroundSelf-injectable contraceptives, namely subcutaneous depot medroxyprogesterone acetate 104 mg micronised formulation delivered via uniject system, reduce the need to travel to a facility for contraceptive access, but the initial, in-person,...

Assessment of Navy Provider Knowledge of Women's Mental Health Services, Treatment Practices, and Training.

As female active duty populations increase in all military environments, it is critical that women's health be addressed in a comprehensive manner. The study's results will be utilized to assist Navy health care leaders in addressing female force readiness policies, treatment gaps, and training specific to women's mental health. In total, 212 active duty participants were recruited from the Navy's mental health specialties. The survey was hosted on the U.S. Government's MAX.gov survey website and received Institutional Review Board and Survey Review Board approval per Navy and Defense Health Agency requirements. Participants recorded their experiences with various patient presentations using Likert scale assessments, indicated their comfort in prescribing medication to patients with 11 distinct presenting concerns, and responded to six questions regarding their training and clinical experience in the field of women's mental health. Differences were noted for provider gender, treatment setting, patient sex, provider rank, and years of independent practice. Female providers were more likely than males to report that their female patients presented with 15 of the 21 measured issues. Providers located at MTFs were significantly more likely than providers in operational billets to report female patients presenting with certain conditions and reported being more comfortable prescribing medication. Eighty percent of respondents authorized to prescribe medicine rated themselves as very or extremely comfortable prescribing medications to their patients for all specified conditions except two: women who are breastfeeding and women who are pregnant. Senior officers reported the most comfort prescribing medication to women who are planning to become pregnant and women who have experienced perinatal loss. Only a minority of providers (20%, female; 33%, males) reported receiving women's mental health education during their training. Of those who did receive training, it was limited to post-partum and pregnancy. Most participants (93%) agreed that women's mental health should be incorporated into training programs for military providers. This exploratory study highlights that provider variables impact assessment and treatment of and for patients. The study highlights the interplay of gender, treatment setting, experiences, and level of comfort are associated with provider assessment of presenting concerns. The authors hope this study will help in prioritizing women's mental health practices, mental health training, and research, and in informing policy and decision-making.

Application of Artificial Intelligence in Advanced Training and Education of Emergency Medicine Doctors: A Narrative Review

Emergency medicine (EM) demands continuous adaptation and refinement of training methodologies to equip healthcare professionals with the expertise to effectively manage complex and time-sensitive patient presentations. Artificial intelligence (AI), with its remarkable ability to process vast amounts of data, identify patterns, and make predictions, holds immense promise for enhancing the advanced training and education of EM physicians. This narrative review aims to discuss the potential of AI in transforming EM training and highlight the specific applications of AI in personalized learning, realistic simulations, data-driven decision support, and adaptive assessment, along with further exploring the benefits and challenges of AI-powered EM training. A comprehensive literature search was conducted using PubMed, MEDLINE, and Google Scholar to identify relevant studies focusing on AI applications in EM and EM training. The search terms included “artificial intelligence”, “emergency medicine”, “training”, “education”, “personalized learning”, “simulations”, “decision support”, and “assessment. Articles published in the past ten years were prioritized to ensure the inclusion of current advancements in the field. AI offers a plethora of opportunities to revolutionize EM training, including the following: Personalized learning: AI-powered systems can tailor educational content and pace to individual trainees’ needs, ensuring optimal instruction and knowledge acquisition. Realistic simulations: AI-powered simulations provide immersive experiences for trainees to practice clinical decision making under simulated pressure. Data-driven decision support: AI-powered systems analyze vast amounts of data to provide trainees with real-time recommendations and insights for informed clinical decisions. Adaptive assessment: AI-powered tools assess trainee progress dynamically, providing personalized feedback and identifying areas for improvement. Conclusions: AI integration into EM training holds immense promise for enhancing trainee learning and improving patient outcomes. By embracing AI, we can cultivate a new generation of EM physicians equipped to meet the ever-changing demands of this critical medical specialty.

A qualitative and quantitative cross-sectional study on the past, present, and future of vaginal delivery: Turkey.

The current study focused on predicting future trends in obstetrics by examining obstetricians' approaches to specific challenging vaginal delivery that require special experience, such as breech presentation, macrosomic fetus, twin pregnancy, and vacuum use, compared with their residency training experience. The cross-sectional study was conducted in two phases. The first phase was qualitative and the second phase was quantitative. The "interview" and "survey" techniques served as data collection tools. In total, 20 obstetricians participated in the interviews, and 400 obstetricians took part in the survey. Data from the interviews were analyzed using the Maxqda 2020 qualitative data analysis program, and survey data were analyzed using SPSS version 25.0. Over the past 2 decades, there has been a gradual shift from vaginal deliveries to cesarean deliveries in cases involving breech presentation, macrosomic fetus, twin pregnancy, and vacuum use. While medicolegal concerns are undeniable, the prevalent belief among obstetricians that cesarean delivery is safer than vaginal delivery significantly influences this trend. Comparatively, young obstetricians often complete their residency training without acquiring sufficient knowledge and skills in vaginal delivery. Young obstetricians currently lack adequate experience in managing vaginal deliveries for breech presentation, macrosomic fetus, twin pregnancy, and vacuum use. This experience is at risk of disappearing entirely within the next decade as senior obstetricians retire. Policymakers should take this into consideration when shaping future healthcare policies.

Graduate student perspectives on training and clinical experiences with antagonism treatment.

The objective of this preregistered study was to gather evidence on training and clinical experiences offered by clinical psychology doctoral programs on the treatment of antagonism-a construct from the personality and psychopathology literature that captures individual differences in aggressiveness, callousness, grandiosity, domineering, and manipulativeness. We surveyed current graduate students (N = 376) in APA-accredited clinical psychology doctoral programs (Mage = 28.4; 83.2% female; 65.2% White) about their experiences in training and treatment of antagonistic patients (ANT-patients) as well as experiences with patients with predominant negative affect (NA; e.g., anxious and depressed). Students reported significantly less training to treat antagonism compared to NA (|ds| = 0.43-2.88), as well as lower rates of direct clinical experience, generally poorer treatment experiences, and stronger countertransference reactions (|ds| = 0.53-1.40). These discrepancies were especially large for adult-focused students compared to child/adolescent-focused students. In fact, adult-focused students reported a mean competency rating of M = 1.71, between the scalar points not competent at all (1) and a little bit competent (2). Overall, these results indicate a lack of training and competence to treat antagonism among current graduate students, especially adult-focused students. We believe the crux of this issue is a field-wide lack of robust empirical work on antagonism treatments (for adults). Moving forward, we implore researchers and funding agencies to help address this substantial gap, which is both an ethical and practical imperative. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Study on the Teaching Efficiency of Automatic Tennis Serve-machine for Players’ Volley Technique

In this study, forty 14-16-year-old athletes from Kunming “Wangdong Wangshi” Tennis Club were selected as research participants. Several methods were used in this study, such as literature review, teaching experiment and statistical method, combined with the author’s tennis teaching and training experience to conclude whether the tennis serve-machine can or cannot improve the teaching quality of the athletes’ volley technique. After reviewing the relevant literature and three months of teaching experiments, a conclusion was drawn that the tennis serve-machine can improve the teaching quality of the athletes’ volley technique. However, the tennis serve-machine is not sophisticated enough and has several limitations as discussed in the paper.

Awareness is not enough: Developing competencies in behaviour change counselling for obesity management

BackgroundThis study describes the development and evaluation of a competency based training program in behaviour change counselling for obesity management. This was a real world study attempting to obtain evidence on the learning experience; specifically, achievement of level of competency as well as personal experiences of the integration of skills learned into practice. MethodsThis was a training effectiveness study involving a total of 28 evaluable licenced healthcare providers providing obesity care services. The design for this study is pre-experimental; specifically a one-group post-test only quasi-experimental design.Based on previous work developing a competency-based model of behaviour change counselling (developing change-based relationships, assessing and promoting readiness to change, implementing behaviour modification when ready, and addressing psychosocial determinants of behaviour) we report on training outcomes; specifically, the level of competency achieved in the various skill components of the intervention model. The model of training was based on corrective feedback, the development of peer-based learning and the creation of a mindmap to guide adaptation of interventions to the unique characteristics of individuals with obesity. Quantitative data on competency of components skills and qualitative information on the experience of training were used to evaluate the program. ResultsObjective assessment of skill competency post training demonstrated moderate to high skill in all aspects of behaviour change counselling. Learners reported frequent use of skills in clinical practice, particularly change-based relationships and readiness assessment/intervention. Qualitative interviews confirmed the value to learners in creating a safe place for corrective feedback, the development of the mindmap concept and the opportunity to teach back learned skills to peers. ConclusionProvision of competency-based behaviour change counselling in obesity management is critical to support the reformulation of obesity as a chronic disease and to be an important adjunct to medical/surgical interventions. In this paper, we have demonstrated the value of an intensive training program for obesity providers.

Becoming an Open Dialogue practitioner: a qualitative study of practitioners' training experiences and transitioning to practice.

In the context of transforming mental healthcare towards more personalised and recovery-oriented models, Open Dialogue has attracted significant international interest. Open Dialogue proposes a way of organising services and delivering care that supports an immediate response to crisis, relational continuity of care, a social network approach and the empowerment of networks through shared decision-making and a flattened hierarchy. The ODDESSI trial currently being conducted in the UK is assessing the model's clinical and cost-effectiveness. Practitioners who delivered the approach within the trial undertook a one-year Open Dialogue foundation training programme, however little is known about their training experiences. This study aimed to explore practitioners' experiences of receiving the training and transitioning to dialogic practice. Individual, joint and focus group interviews with 32 Open Dialogue practitioners were conducted. Thematic analysis was used to analyse the transcripts and transformational learning theory informed the interpretation of the findings. Two themes further divided in subthemes were generated from the data: (1) experiences and impact of formal training and (2) becoming an Open Dialogue practitioner as an ongoing learning process beyond formal training: barriers and facilitators. The one-year Open Dialogue foundation training was a transformative experience for participants due to its emphasis on self-work and its impact on a personal level. Practitioners felt adequately prepared by their training for dialogic practice, yet becoming an OD practitioner was seen as a continual process extending beyond formal training, necessitating ongoing engagement with the approach and organisational support. However, the commitment of participants to deliver optimal dialogic care was occasionally impeded by organisational constraints, resource limitations, and often having to concurrently deliver conventional care alongside Open Dialogue.

Forming and Transforming: Critical Reflection in The University Education of Professionals

Objective: In universities, a key challenge is to integrate practical work knowledge with theoretical knowledge to adapt to the changing demands of the labor market and society. In this context, the objective is to explore how the integration of theory and practice in master's programs focused on formative professions can facilitate transformative learning, enabling students to develop critical and reflective competencies applicable in both professional and personal contexts. Theoretical Framework: The research is grounded in Habermas's theory of communicative action, transformative learning, and training-action-research approaches, addressing concepts such as critical reflexivity, self-formation, and the integration of practical and theoretical experiences. Method: A qualitative methodology with an action-research design, termed training-action-research, was adopted. Twenty-five students from a master's program in education participated. Data collection involved participant observation and practice analysis, focusing on critical reflection and rational dialogue about work and training experiences. Results and Discussion: The alternation between theory and practice facilitated the development of reflective and critical competencies in the students. The study highlights implications, identified relationships, discrepancies, and limitations. Research Implications: The results can enhance teacher training, promote continuous professional development, and implement reflective and critical practices in educational and professional settings. Originality/Value: The study presents an innovative approach to professional university education, emphasizing critical reflexivity and transformative self-formation, with potential impacts on teacher training and professional practice.

A qualitative evaluation of trainee and educator experiences of Integrated Training Posts in one Vocational Training Scheme

ABSTRACT Integrated Training Posts (ITPs) were conceived in the 1990s and have recently increased in the Southwest of England. Most ITP evaluations have been small and undertaken over 13 years ago, so do not reflect the current training landscape. This qualitative study aimed to explore the views and experiences of ITPs amongst general practice trainees and educators. The location has increasing numbers of general practice trainees, International Medical Graduates (IMGs) and less-than-full-time trainees. Semi-structured interviews were undertaken with six trainees and two educators; all had experienced at least one ITP. Recordings were transcribed verbatim and coded. Thematic analysis was undertaken. Three themes were identified: ‘The role: expectations versus reality’, ‘Relevance of ITPs to future GP role’ and ‘Educational Challenges’. Most trainees valued the additional clinical experiences ITPs offered, as well as being able to trial ‘portfolio’ working. Trainee and educator expectations varied considerably, particularly whether the role was primarily service or observational. Working across multiple settings could limit contact between educator and trainee and make it difficult to identify a struggling trainee. There is a need to clarify the roles of trainees and educators involved in ITPs and whether and how this might vary between posts. Further studies could explore whether choice of ITP influences retention of general practitioners, and whether all trainees including those working less-than-full-time or IMGs benefit from ITPs.

Supplemental Material for Graduate Student Perspectives on Training and Clinical Experiences With Antagonism Treatment

Supplemental Material for Graduate Student Perspectives on Training and Clinical Experiences With Antagonism Treatment

Exploring the experiences of sonography students with simulation-based learning: A perspective from South Africa.

Simulation-based learning (SBL) is widely used in healthcare education to provide a safe environment for students to practice clinical scenarios without causing patient harm. While established in developed countries, SBL's implementation is new in South Africa; there is a lack of research addressing sonography students' experiences. This study aimed to explore and describe the experiences of Bachelor of Science (BSc) second-year sonography students using SBL for clinical training at a local University of Technology (UoT). An exploratory, qualitative and descriptive research study was conducted in 2020, with virtual one-on-one interviews due to COVID-19 restrictions. Eight BSc second-year sonography students, who had undergone SBL in their first year, participated. Data saturation was achieved, and interviews were audio recorded and transcribed verbatim. Thematic analysis revealed three themes: (1) Enhancing preparedness for the clinical environment, (2) Limitations of the tissue-equivalent phantom and (3) Suggestions for improving simulation. While students expressed positive feedback and enjoyment of the simulation tool, they also highlighted limitations, such as unrealistic representations of real patient scanning conditions. This study provides valuable insights into sonography students' experiences with SBL. Positive influence of SBL on clinical training was observed. To enhance SBL for future sonography students, consideration for high-fidelity simulators with advanced software is recommended. Funding options to invest in such simulators should be explored by radiography educators to promote more realistic training experiences.

Comparison of the incidence and causes of injuries in stand-up and ground combat-sport fighters – a narrative review

Injuries in combat sports can happen to any athlete, regardless of gender, age, training experience or whether he or she is an amateur or a professional. The range of injuries varies from superficial, short-term damage to severe injuries with serious consequences, including death. There are many types of combat sports, each with different rules and specific injuries. Amongst various divisions of combat sports, one of the basic ones is the division into ground and stand-up sports. In the following work, using the available literature, we wanted to present the specifications of several of the most popular combat sports and compare their most common locations of injuries, types of injuries and mechanisms of their formation, paying attention to which of these categories a given sport belongs to. We also discuss differences in the rate of injury for different age, genders, prevalence of injuries during situations of practice and competition. In the end, it is presented what are the possible long-term complications of injuries in combat sports and which actions such as protective gear, bans on certain techniques or behavioural changes might reduce the injury rate to protect the athletes health, well-being and decrease the economic burden on healthcare systems.

Challenges to theory-practice integration of social work education in China: theory learning

ABSTRACT Theory-practice integration is vital in social work education. This study examines China’s social work education system, focusing on challenges and solutions in theory-practice integration. Data from 90 participants (faculty, administrators, and students) across 7 schools in different regions were gathered via focus groups and individual interviews. Challenges include faculty lacking social work training and practice experience, limited teaching materials, systemic higher education constraints, and a lack of indigenous social work theory. Faculty overcome these challenges through dedication, acquiring relevant knowledge, and establishing new practice agencies. University-level recognition of social work’s practice-oriented nature and the development of indigenous theories are crucial.

How are medical students learning to care for patients with intellectual disabilities? A scoping review.

Individuals with intellectual disabilities experience barriers to quality healthcare. To reduce this disparity, equipping medical trainees with the knowledge and skills required for treating this patient population is critical. Our aim is to describe the breadth of instructional interventions and identify gaps in intellectual disability medical education curricula. Using scoping review methods, the intellectual disability programmes described in 27 articles were evaluated and their coverage of the six core competencies on disability for health care education was examined. The most frequently represented core competencies were disability conceptual frameworks, professionalism and communication, and clinical assessment, which were, in most programmes, fulfilled by activities involving individuals with intellectual disabilities. Uneven competency coverage warrants consideration. Considerable variabilities exist in medical school curricula on intellectual disabilities. Using core competencies on disability for health care education for curricular design and evaluation would provide a coherent training experience in this important area.