Formal Training Courses Research Articles

Interpreter training for medical students: pilot implementation and assessment in a student-run clinic.

BackgroundTrained medical interpreters are instrumental to patient satisfaction and quality of care. They are especially important in student-run clinics, where many patients have limited English proficiency. Because student-run clinics have ties to their medical schools, they have access to bilingual students who may volunteer to interpret, but are not necessarily formally trained.MethodsTo study the feasibility and efficacy of leveraging medical student volunteers to improve interpretation services, we performed a pilot study at the student-run clinic at the Icahn School of Medicine at Mount Sinai. In each fall semester in 2012–2015, we implemented a 6-h course providing didactic and interactive training on medical Spanish interpreting techniques and language skills to bilingual students. We then assessed the impact of the course on interpreter abilities.ResultsParticipants’ comfort levels, understanding of their roles, and understanding of terminology significantly increased after the course (p < 0.05), and these gains remained several months later (p < 0.05) and were repeated in an independent cohort. Patients and student clinicians also rated participants highly (averages above 4.5 out of 5) on these measures in real clinical encounters.ConclusionsThese findings suggest that a formal interpreter training course tailored for medical students in the setting of a student-run clinic is feasible and effective. This program for training qualified student interpreters can serve as a model for other settings where medical students serve as interpreters.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0760-8) contains supplementary material, which is available to authorized users.

Foreign body removal in children: Recommendations versus real life-A survey of current clinical management in Germany.

Task forces of the European Respiratory Society (ERS, 2003) and the American Thoracic Society (ATS, 2015) both recommend rigid bronchoscopy for foreign body removal in children. However, there is an increasing number of publications recommending flexible bronchoscopy as primary method for foreign body removal in children. We therefore initiated a nationwide survey, investigating the routinely used method of foreign body removal in children in different centers in Germany. In total, 259 centers took part in the survey. Twenty percent used flexible bronchoscopy as primary method of choice for foreign body removal. Of note, only 40% of the respondents reported that they had attended formal training courses in flexible bronchoscopy, 15% in rigid bronchoscopy, and 42% had never attended a formal training. Twenty-five percent indicated that they had already encountered an emergency situation during or after foreign body removal, requiring intensive care. Published data shows that rigid bronchoscopy involves fewer complications and is more successful in foreign body removal in children. It is consequently questionable, why 20% of the medical centers report a preference for the flexible method. One reason might be the poor availability of rigid bronchoscopy and the difficulty gaining sufficient expertise in rigid bronchoscopy in Germany. Pediatr Pulmonol. 2017;52:656-661. © 2016 Wiley Periodicals, Inc.

Abstract PR077

Background & Objectives: Mountainous terrain, poverty, lack of doctor anesthestists, and poor retention of healthcare workers in general all hinder the Nepal government’s (GoN) objective of providing continuous operative services to rural communities (83% of the population). As in more than half of the world [McAuliffe, 1996] and endorsed by the 2015 Lancet Commission, Nepal has turned to non-doctors (anaesthesia assistants, AAs) to deliver rural anesthesia services. We report Nepal’s history of AA training and the latest survey in 2014. Materials & Methods: Beginning in 2002, the GoN conducted a formal 6-month AA training course for multiple levels of nurses and paramedicals. In 2011, this was upgraded to a 12-month Anesthesia Assistant Course (AAC) with entry limited to higher-trained cadres (health assistant and staff nurse), under the authority of the National Academy of Medical Sciences (NAMS). The Nick Simons Institute (NSI) worked with NAMS to create the course and continues to support its 7 training sites. In August 2014, we conducted a telephone survey that attempted to contact all AAs who had graduated since 2002. Results: By 2014, a total of 124 AAs have been trained: 94 in the 6-month program and 30 in the current 12-month program. We were able to contact 100 AAs of whom 82% were still working in hospitals capable of providing surgical services and 66% were actively providing anesthesia. Of the actively working AAs, 69% were providing anesthesia service outside the Kathmandu valley. The reported reasons why 34% of trained AAs were not able to utilize their training included: no operating doctor in the AA’s hospital, inappropriate posting of the AA to non-hospital facility, management issues, personal health, and old age. Only 48 of 100 GoN hospitals designated as providing operative services were doing so in the 2014 survey; two thirds of these (62%) had AAs as their main anesthesia provider. Conclusion: Nepal’s anesthesia assistants work as the sole anesthesia provider in rural, district-level hospitals and as a main provider at all levels of the national system. Twelve years after Nepal government AA training courses began, two thirds of graduates were still actively providing anesthesia. To assure that this essential training does not go wasted, AAs must be posted to facilities that have a complete surgical team.

Making Milestones: Development and Implementation of a Formal Socioeconomic Curriculum in a Neurosurgical Residency Training Program.

Improved training in the socioeconomic aspects of medicine is a priority of the Accreditation Council for Graduate Medical Education and the American Board of Neurological Surgeons. There is evidence that young neurosurgeons feel ill equipped in these areas and that additional education would improve patient care. To present our experience with the introduction of a succinct but formal socioeconomic training course to the residency curriculum at our institution. A monthly series of twelve 1-hour interactive modules was designed to address the pertinent Accreditation Council for Graduate Medical Education-American Board of Neurological Surgeons outcomes-based educational milestones. Slide-based lectures provided a comprehensive overview of social, legal, and business issues, and a monthly forum for open discussion allowed residents to draw on their applied experience. Residents took a 20-question pre- and postcourse knowledge assessment, as well as feedback surveys at 6 and 12 months. Residents were able to participate in the lectures, with an overall attendance rate of 91%. Residents felt that the course goals and objectives were well defined and communicated (4.88/5) and rated highly the content, quality, and relevance of the lectures (4.94/5). Performance on the knowledge assessment improved from 58% to 66%. Our experience demonstrates the feasibility of including a formal socioeconomic course in neurosurgical residency training with positive resident feedback and achievement of outcomes-based milestones. Extension to a 2-year curriculum cycle may allow the course to cover more material without compromising other residency training goals. Online modules should also be explored to allow for wider and more flexible participation. ABNS, American Board of Neurological SurgeonsACGME, Accreditation Council for Graduate Medical Education.

PTH-134 Setting Up An Endoscopy Unit in Northern Malawi

Introduction There is a major need for endoscopic services in Malawi due to the very high incidence of both variceal bleeding related to schistosomiasis and gastro-oesophageal cancer. The availability of facilities and trained staff to perform variceal band ligation (VBL) and endoscopic stent insertion would benefit local patients. The aim of this project was to set-up an endoscopy unit at Mzuzu Central hospital (MCH), the regional hospital in Northern Malawi, which serves a population of approximately 2 million. Methods After an initial assessment visit, four on-site training visits (two accompanied by endoscopy nurse trainers) were undertaken by a UK endoscopy trainer between 2012–2015. Endoscopy equipment was donated and shipped out from Glasgow. The local endoscopists and endoscopy nurses also attended formal endoscopy training courses at the recognised regional training centre in Blantyre. Malawi-adapted DOPS and unit GRS were undertaken and numbers of procedures audited. Results During this period, six donated endoscopes and many accessories were delivered to MCH. Local clinicians and nurses had four weeks of on-site intensive training and attended five formal training courses. Skills in diagnostic endoscopy and VBL were taught and there was an introduction to stent insertion. A total of 20 DOPS were undertaken showing a gradual improvement in endoscopic skills. The unit GRS assessment improved with regard to patient consent, clinical monitoring, reporting and audit. A nine-month audit of consecutive endoscopic procedures at MCH revealed either varices or upper GI cancer in 28% cases. Over the total study period, the annual number of endoscopies undertaken at MCH increased from 108 to 376, with VBL cases increasing from 17 to 51. Conclusion A functioning endoscopy unit has been set up at MCH with introductory skills provided to local endoscopists and nurses, by both on-site training and attendance at formal training courses. Advanced training of more endoscopists in therapeutic endoscopy and ongoing equipment support is required to ensure the unit becomes sustainable. Disclosure of Interest None Declared

P101: Needs assessment study for the inter-professional procedural sedation course: methods of adult procedural sedation (MAPS)

Introduction: Procedural sedation and analgesia (PSA) is a common practice for non-anaesthesiologists. While complication rates for PSA are low, many of them are preventable. Professional regulatory body requirements state that practitioners should have adequate knowledge and skills to safely administer PSA. However, no certification process currently exists to develop and maintain these competencies. A standardized PSA training course would help close the gap between the best evidence for safe administration of PSA and its implementation in everyday practice. Therefore, we conducted a needs assessment to guide the development of such a PSA training course. Methods: Using modified Dillman methodology, an electronic survey was sent to a convenience sample of 50 potential learners and two groups of stakeholders: 20 hospital administrators and 35 experts in PSA. Questions assessed practice demographics, experience as well as support and interest in the development and attendance of a PSA training course. Prior to distribution, the questionnaire was peer reviewed and pilot-tested for feasibility and comprehension. Responses were stratified based on clinical role. Results: 35 potential learners completed the needs assessment (70% response rate): 15 emergency physicians, 19 registered nurses and 1 nurse practitioner. 48% have been in practice for over 10 years and over 90% participate in PSA at least weekly. 38% received informal training in PSA while 16% obtained no training at all. 86% strongly supported the development of a PSA certification course and were in favour of an inter-professional format. 13 experts responded to the questionnaire within the departments of anesthesia, emergency medicine (EM) and respiratory therapy (37% response rate). 80% supported the need for a PSA training course. 6 hospital administrators responded to the questionnaire within the departments of anesthesia, EM, gastroenterology and respirology (30% response rate). All agreed that standardization of PSA is an important part of patient safety and 80% stated certification in PSA should be a prerequisite for granting privileges to health care professionals to participate in PSA. 60% believed the course should be developed and supported by hospital funds. Conclusion: There is strong support from potential learners and stakeholders for the development of a formal PSA training course.

A National Biofeedback Practitioners Service Evaluation: Focus on Chronic Idiopathic Constipation

IntroductionWithin the UK, there is anecdotal evidence of disparity in the training, practice, supervision and perception of efficacy among practitioners of biofeedback therapy for chronic constipation.AimsTo establish the current knowledge,...

Teaching Lifelong Research Skills in Residency: Implementation and Outcome of a Systematic Review and Meta-Analysis Course.

There is rising concern that fundamental scientific principles critical to lifelong learning and scientific literacy are not sufficiently addressed during residency. We describe the development, implementation, and evaluation of a systematic review and meta-analysis course designed to improve residents' research literacy. We developed and implemented a novel, interactive, web-enhanced course for third-year psychiatry residents to provide the theoretical and methodological tools for conducting and reporting systematic reviews and meta-analyses. The course is based on Bloom's learning model, and established criteria for reporting systematic reviews and meta-analyses. Eight sequential learning objectives were linked to 8 well-specified assignments, with the objectives designed to build on one another and lead to the creation of a scientific manuscript. From 2010-2014, 54 third-year psychiatry residents (19 unique groups) successfully completed the course as part of a graduation requirement. The majority rated the course as being good or very good, and participants reported a statistically significant increase in their confidence to conduct systematic reviews (χ(2) = 23.3, P < .05) and meta-analyses (Fisher exact test, P < .05). Estimated total dedicated resident and faculty time over a period of 36 weeks was 36 to 72 hours and 60 hours, respectively. Residents' academic productivity included 11 conference presentations and 4 peer-reviewed published manuscripts, with 2 residents who were awarded honors for their projects. A formal training course in systematic reviews and meta-analyses offers a valuable learning experience, which enhances residents' research skills and academic productivity in a feasible and sustainable approach.

Conserving and managing mosaics in Libya (CaMMiL): the final project review

AbstractThis is a review of a project aimed at assisting the Libyan Department of Archaeology with the conservation and management of their mosaic heritage. Over the course of a year we undertook an evaluation trip along the coast of Libya and then put on two workshops for the Department's staff to help build capacity. The workshops disseminated complementary content on the protection of mosaics and their management to two different contingents: managers and technicians. The teaching was intended to empower Libyans by giving them the confidence to make simple and sound decisions, and to encourage them to join more formal training courses run by major international organisations. The project was a collaboration with the Department and was supported by the Getty Foundation, King's College London and the Society for Libyan Studies.

Education in Psychopathology in Europe: Results from a Survey in 32 Countries.

The aim of the present paper is to assess the current status of training on psychopathology in Europe and to identify the unmet needs of training on psychopathology. An online survey was carried out during the period July-December 2013. Forty-one representatives of early career psychiatrists of their national associations were invited to participate. Each respondent was asked to provide the collective feedback of the association rather than that of any of its individual officer or member. Thirty-two associations returned the questionnaire out of the 41 contacted (response rate, 78%). All respondents recognized psychopathology as a core component of training in psychiatry. According to respondents, the primary aims of psychopathology are (a) to assess psychiatric symptoms (47%), (b) to understand patients' abnormal experiences (33%), and (c) to make nosographical diagnosis (20%). A formal training course in psychopathology is available in 29 out of the 32 surveyed countries. In most countries, (a) there is not a defined number of hours dedicated to psychopathology, (b) teaching is mainly theoretical, and (c) a structured training on psychometric tools is missing. At the end of the training, about half of trainees is not satisfied with received training in psychopathology. According to European early career psychiatrists, there is the need to rethink training in psychopathology, which should be at the heart of training in psychiatry and the key element of psychiatric practice. Education in psychopathology is affected by several unmet needs, such as lack of appropriate training in the use of psychometric instruments, lack of supervision, and lack of practical skills.

G551(P) Introducing a paediatric mentorship scheme for trainees in the south west region

Context We developed a mentorship scheme for new paediatric doctors (Specialty Training Level 1) in our deanery. Mentoring is “a process of helping, supporting and encouraging paediatricians to develop their skills and to maximise their potential performance”. 1 The deanery is responsible for training 150 paediatric doctors across seven hospital trusts. Specific problem Maintaining focus on a paediatric trainee’s individual career interests can be challenging in light of higher clinical workload, staffing shortages and increasing requirement for continuous standardised assessments. Assessment of problem Paediatric services require large-scale transitions in the context of increasing workload pressures coupled to huge economic limitation. 2 It is essential the workforce approaches these changes in a positive, motivated way. Mentoring is well-established throughout different industries and organisations. It is a cost-effective, powerful personal development tool that encourages, supports and guides trainees in their individual goals. We anticipate this will benefit all parties: Junior trainees can readily access a friendly, reliable and supportive mentor with good working knowledge of the deanery, helpful contacts and experience of taking projects forward Senior trainees will improve mentoring, coaching and supervisory skills through a formal training course and develop these through practical application Patients and colleagues will benefit from motivated and enthusiastic trainees whose own educational and training needs are being considered A recent study from the London Paediatric Deanery 3 highlighted “a high demand for peer mentoring in paediatrics”. Their programme was highly valued by participants, who gained “significant benefits including acquisition of transferable skills and positive changes in behaviour”. Intervention We arranged a mentor training day for senior trainees from the region (ST4-ST8). A full-day workshop was organised, and fully funded, by the Southwest Leadership Academy. Twelve trainees wished to provide mentoring and were able to attend the course, many others registered their interest for future workshops. Delivered content included an introduction to the mentor role, approaches to effective mentoring, mentoring models, and contracting a mentor relationship. An interactive session followed to discuss how the mentoring programme should be developed. We produced a mentor handbook with further information on the mentor role and detail regarding the programme. We received excellent written feedback from the day (all trainees would recommend the workshop to colleagues). Programme design Trainees who successfully completed the mentor workshop were asked to write a 250-word statement about themselves (11/12 completed, one withdrew for maternity leave). We did not provide further guidance on statement structure or content as we wished to promote individuality and personality. We delivered a presentation at the ST1 induction day to advertise the scheme. We received very positive feedback, all ST1 trainees (14/14) wished to participate. We asked mentees to review all statements and rank them in order of preference. We were able to match all mentees to one of their “top-three” preferred mentors. We have arranged an evening for all participants to meet together. Following this, mentor-mentee pairs will meet 2–3 monthly. We anticipate that mentor relationships will continue throughout the ST1–3 period. Evaluation Feedback will be collected quarterly to evaluate the programme and guide future development. We aim to establish a successful rolling programme that offers effective mentoring to all future ST1 trainees starting in the deanery. Acknowledgements We benefitted from the experiences of Sarah Eisen and Seema Sukhani, who developed a mentor scheme in the London Deanery. We are grateful for their support and guidance. References Mentoring and clinical supervision for paediatricians. Paediatrician’s Handbook, Chapter 4.6, RCPCH, 2013 RCPCH. Facing the future – A review of paediatric services. April 2011 Eisen S, Sukhani S, Brightwell A, Stoneham S, Long A. Peer mentoring: evaluation of a novel programme in paediatrics. Arch Dis Child 2014;99:142–146, doi:10.1136/archdischild-2013-304277

Diagnostic criteria for temporomandibular disorders: self-instruction or formal training and calibration?

BackgroundTo investigate the difference in diagnostic reliability between self-instructed examiners and examiners taught in a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) course and if the reliability of self-instructed examiners improves after the course.MethodsSix examiners were divided into three groups: (1) formal two-day training and calibration course at a DC/TMD training center (Course group), (2) self-teaching through documents and movie (Self group) with three examiners on each and the Self group later participated in the course (Self + course group). Each group examined sixteen subjects, total of 48 volunteers (36 patients with TMD and 12 asymptomatic) and the reliabilities in relation to the diagnoses derived by a Reference Standard Examiner were compared by Cohen’s Kappa coefficient.ResultsThe reliability was good to excellent in all three groups of examiners for all DC/TMD diagnoses, except for Myofascial pain with referral in the Self + course group. The course seemed to improve the reliability regarding Myalgia and Arthralgia at the same time as the examiners experienced the course to be valuable for self-perceived ability and confidence.ConclusionsThis study shows that the diagnostic reliability of formal DC/TMD training and calibration and DC/TMD self-instruction are similar, except for subgroups of Myalgia. Thus, self-instruction seems to be possible to use to diagnose the most common TMDs in general dental practice. The course further improves the reliability regarding Myalgia and Arthralgia at the same time as the examiners experienced the course to be valuable for self-perceived ability and confidence.

Training in Psychopathology in Europe: Results From a Survey

Introduction Recently the need for modern psychiatrists to have strong psychopathological bases has been repeatedly affirmed. Objectives To provide a general overview on the current status of training and practice in psychopathology across Europe. Aims 1) to describe the current status of training on psychopathology;2)to identify the unmet needs of European residents in psychiatry;3)to suggest future perspectives of training in psychopathology. Methods An online survey, promoted by the EPA Section on Philosophy and Psychiatry, was carried out during the period July-December 2013. Forty-one representatives of early career psychiatrists of their national associations were invited to participate. Each respondent was asked to provide the collective feedback of the association rather than that of any of its individual officer or member. Results Thirty-two associations returned the questionnaire out of the 41 contacted (response rate: 78%). All respondents recognize psychopathology as a core component of training in psychiatry. The primary aims of psychopathology are to assess psychiatric symptoms, to understand patients' abnormal experiences, and to make nosographical diagnoses. A formal training course in psychopathology is available in almost all surveyed countries. In most countries:1)there is not a defined number of hours dedicated to psychopathology;2)teaching is mainly theoretical;3)a structured training on psychopathological rating scales is missing. At the end of the training, about half of respondents is not satisfied with received training in psychopathology. Conclusions European early career psychiatrists clearly recognize the need to rediscover psychopathology, which represents the heritage of European Psychiatry. Initiatives to improve training and practice of psychopathology should be addressed by national and international psychiatric organizations.

The importance of informal learning at work

Although early human capital theory recognized the relevance of workers’ experience, its focus was on education and formal training. Recent studies find that much of the performance of newly hired workers is driven by learning by doing or learning from peers or supervisors in the workplace. Descriptive data show that workers learn a lot from the various tasks they perform on the job. Informal learning at work seems to be relevant for all age groups, although it drives more of the performance of younger workers. Informal learning is far more important for workers’ human capital development than formal training courses.

'Tea trolley' difficult airway training.

The 4th National Audit Project (NAP4) recommended that the airway skills of trainee and consultant anaesthetists are maintained with regular education and training 1. We have developed a difficult airway ‘tea trolley’ for practising asleep/awake fibreoptic intubation and needle cricothyroidotomy that provides a cheap alternative to formal training courses (Fig. 1). Each ‘tea trolley’ teaching session is run by two anaesthetists, one of whom takes over the intra-operative care of a stable patient, releasing the listed anaesthetist for a 15-min teaching session in the anaesthetic room with the other, after which tea and cake are provided.

Educating science editors: is there a comprehensive strategy?

The article considers available options to educate science editors in the fast-transforming digital environment. There is no single course or resource that can cover their constantly changing and diversifying educational needs. The involvement in research, writing, and reviewing is important for gaining editing skills, but that is not all. Membership in editorial associations and access to updated scholarly information in the field are mandatory for maintaining editorial credentials. Learned associations offer access to a few widely-recognized periodicals. There are also formal training courses covering issues in science writing and ethical editing, but no high-level evidence data exist to promote any of these. Networking with like-minded specialists within the global and regional editorial associations seems a useful strategy to upgrade editorial skills and resolve problems with the quality control and digitization of scholarly periodicals.

Performance of physical examination skills in medical students during diagnostic medicine course in a University Hospital of Northwest China.

This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (p<0.001). The average error frequency per student in females (0.875) was lower than in males (1.375) although the difference was not statistically significant (p = 0.167). The average error frequency per student in cardiac (1.267) and pulmonary (1.389) examinations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (p<0.001). These data suggest that PE skills in cardiac and pulmonary examinations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students.

Academic training in radiation safety awareness and practice among Iranian residents/fellows

ObjectiveTo determine the current state of radiation safety awareness and practice among Iranian radiology/cardiology residents.MethodsIn this cross-sectional study, 725 Iranian cardiology/radiology fellows/residents (685 residents and 40 fellows) were studied. Radiation...

Supporting Reflective Practice in Software Engineering Education through a Studio-Based Approach

Learning is a lifelong process, especially in the fast-paced software industry. In addition to formal training courses, good software developers continually learn by reflecting on what they've done in the past. However, reflective practice is rarely taught explicitly in university software engineering education. One way to teach reflective techniques from the start is through studio-based learning.

PWE-172 A National Biofeedback Practitioners Service Evaluation

IntroductionWithin the UK, there is anecdotal evidence of disparity in the training, practice, supervision, and perception of efficacy amongst practitioners of biofeedback therapy for chronic constipation.MethodsBetween October 2012 and October...