Health Professions Training Programs Research Articles

Decolonizing Mental Health Services for Indigenous Clients: A Training Program for Mental Health Professionals.

Culturally appropriate mental health services are essential for Indigenous people who suffer the greatest mental health disparities of any ethnic group in the U.S. However, few mental health professionals receive training to work with this population. To fill this gap, a 90-minute training was created to increase knowledge of and empathy for Indigenous people and culture and therefore, improve mental health services for Indigenous patients. This training is grounded in cultural competency, cultural humility, and decolonialism. The training is presented here for mental health professionals, agencies, and administrators to use as a guide. The training aims to increase knowledge, awareness, and skills and has been implemented in a variety of settings receiving positive feedback from participants and administrators.

Childhood Mental Health Problems in Primary Care

The present population study aimed at identifying the prevalence of mental health problems (MHP) and describing health services use in a sample of children attending Primary Healthcare Units (PHU) in the city of Sao Paulo. Caregivers of 825 6-11 years old children were assessed. MHP were assessed with the Strength and Difficulties Questionnaire and health services use with an adapted version of the Client Receipt Inventory Children`s version. Prevalence of internalizing and externalizing MHP was 30.7% and 18.3%, respectively. Pediatricians were the most consulted health professional (56.7%) and psychologists the most consulted mental health professional (7.9%). Only 3 children were under medication treatment for MHP. The high prevalence of MHP among children in the primary care setting and the low rate of treatment constitute a public health problem. Training programs for health professionals are relevant to help identify and refer MHP cases.

Addressing healthcare for migrants and ethnic minorities in Europe: A review of training programmes

Background: The global phenomenon of migration has dramatically changed the social context in which healthcare professionals operate. European states are facing a growing need to effectively train healthcare professionals to understand and respond appropriately to the diverse needs of migrants and ethnic minorities. While many European Union (EU) countries have adopted specific initiatives, there is considerable variation in these activities and few examples of evaluation of the quality of these training courses. Aims: This article describes findings from a review conducted as a part of the ‘Training packages for health professionals to improve access and quality of health services for migrants and ethnic minorities, including the Roma (MEM-TP)’ project, which sought to identify and assess training programmes for health professionals delivered in Europe between 2004 and 2013. Methods: The review and analysis of training materials comprised three components: (1) a review of the published and unpublished literature, (2) a survey addressing national contact persons, and representatives of international organisations and non-governmental organisations and (3) an assessment of the quality of the training programmes identified. Results: The review showed that training programmes tend to be characterised by low levels of participant involvement in training development, delivery and evaluation. Training programmes often lacked an explicit pedagogical approach, did not systematically focus on outcomes in training design, implementation and evaluation, and were poorly linked to key organisational and policy support. Finally, while cultural competence continues to be the broad conceptual approach used in training programmes, alternate approaches such as intersectionality, equity and person-centred care are emergent. Conclusion: Training programmes in Europe can be further improved in order to ensure an effective response to the diverse needs of patients, carers, health professionals and the community.

Fit and Feasibility: Adapting a Standardized Curriculum to Prepare Future Health Professionals to Address Alcohol Misuse

Standardized screening, brief intervention, and referral to treatment (SBIRT) is effective when used by health care professionals to assess, educate, and intervene to address risky alcohol use. To accelerate SBIRT training within academic settings, the Substance Abuse and Mental Health Services Administration funded implementation of its SBIRT curriculum to promote its use by future health care professionals. We report on how SBIRT content was implemented within nursing, social work, psychology, and family medicine residency programs at a state university. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) evaluation framework was used to compare delivery of SBIRT curriculum across health professions. Survey data measured changes in student knowledge, confidence, and responsibility to use SBIRT for alcohol and drugs, pre- and post-SBIRT training. Twelve months postgraduation follow-up surveys examined maintenance of outcomes and SBIRT use in practice. Observational data explored fidelity and adaptations made to curriculum content and delivery logistics. Results indicated that instructor adoption, fidelity, and format varied across health professional training programs, with adaptations made to improve fit, role alignment, and cultural relevance. Despite variation in curriculum delivery, students demonstrated significant gains in knowledge and confidence, ( p < .001). Key implementation and maintenance challenges included time constraints, instructor buy-in, competing accreditation requirements, and costs for using the university simulation laboratory to practice SBIRT. Strengths supporting maintenance included flexibility to adapt curriculum, department champions, and electronic resources to support curriculum delivery. Results suggest that adaptations maximizing the feasibility and fit of SBIRT within existing courses enhanced its adoption and maintenance potential without sacrificing effectiveness.

Development of understanding of DOHaD concepts in students during undergraduate health professional programs in Japan and New Zealand.

Evidence in support of the Developmental Origins of Health and Disease (DOHaD) hypothesis has reached the level where it can appropriately be used to inform practice. DOHaD informed interventions supporting primary noncommunicable disease risk reduction should target the pre- and periconceptional periods, pregnancy, lactation, childhood and adolescence. Such interventions are dependent on a health workforce (including dietitians, nurses, midwives, doctors, and nutrition teachers), that has a deep understanding of DOHaD concepts. This study assessed development of awareness of DOHaD concepts during undergraduate health professional training programs. Using a cross-sectional design, a standardized questionnaire was completed by Year 1-4 undergraduate students studying nutrition in Japan (n=309) and Year 1-3 nursing students in New Zealand (n=151). On entry to undergraduate study, most students had no awareness of the terms 'DOHaD' or 'First 1000 Days'. While awareness reached 60% by Year 3 in courses that included DOHaD-related teaching, this remains inadequate. More than 95% of Year 1 undergraduates in both countries demonstrated an appreciation of associations between maternal nutrition and fetal health. However, awareness of associations between parental health status and/or nutritional environment and later-life health was low. While levels of awareness increased across program years, overall awareness was less than optimal. These results indicate evidence of some focus on DOHaD-related content in curricula. We argue that DOHaD principles should be one pillar around which health training curricula are built. This study indicates a need for the DOHaD community to engage with faculties in curriculum development.

Equitable Access to Health Professional Training in Uganda: A Cross Sectional Study.

Objective:We set out to assess inequalities to access health professional education, and the impact of an education improvement program supported by MEPI (Medical Education Partnership Initiative). Inequalities in the higher education system in sub-Saharan Africa remain despite some transformative policies and affirmative action.Methods:We reviewed enrollment data from four universities for the period 2001–2014 for various health professional training programs, and conducted group discussions through an iterative process with selected stakeholders, and including a group of education experts. Two time periods, 2001–2010 and 2011–2014, were considered. In 2010–11, the MEPI education program began. Gender ratios, regional representation, secondary schools, and the number of admissions by university and year were analysed. We used SPSS version 17 software to analyse these data with level of significance p < 0.05. We collated qualitative data along predetermined and emerging themes.Results:The overall male-to-female ratio among the student population was 2.3:1. In total, there were 7,023 admissions, 4,403 between 2001–2010 (440 per annum) and 2,620 between 2011–2014 (655 per annum) with p = 0.018. There were no significant increases in admissions in the central and western regions over the two time periods, 1,708 to 849 and 1,113 to 867 respectively, both p = 0.713 and p = 0.253. We propose improving the university admission criteria and increasing enrollment to health professions training schools.Conclusion:There were significant inequalities for higher education training in Uganda by gender, regional representation and school attended. Modifying the admission criteria and increasing enrollment may reduce these inequalities.

Academic success predictors in Optometry

The success of students in health professions training programs depends on the selection process, teaching and curriculum, motivation, and student support services. However, most of the factors considered as predictors of student success in medicine and nursing include those involved exclusively in the selection process, such as grade point average (GPA), standardized entrance and aptitude test results. Similar factors have been found to predict the GPA and graduation of students in optometry programs. However, we are unaware of any systematic evaluation in an optometry training program of student aspects beyond selection factors.In this study, we propose to widen the scope of the factors involved in academic success in optometry school to include demographic aspects (like gender and race), psychological aspects (like learning style), and exam platform. We also examined the classic academic aspects like GPA and standardized entrance test (Optometry Admission Test [OAT]) scores. As the fourth year in our curriculum is exclusively clinic and includes rotations outside of the optometry school, we chose GPA at the end of their in‐house curriculum as the index measure of academic success. To this end, we recruited sixty‐five students from the second‐year class at the University of Incarnate Word Rosenberg School of Optometry and recorded the following: scores from two exams in two concomitant pathophysiological courses during their third semester in the in‐house curriculum, demographic data (gender, race, and ethnicity), undergraduate GPA, OAT scores, and optometry GPAs at the mid‐point and at the end of their in‐house curriculum. We also determined learning styles via surveys.We found that race and ethnicity were predictors of student success at the mid‐point but not at the end of the in‐house curriculum. The effect of undergraduate GPA and OAT scores was negligible. However, student performance in the pathophysiological courses during their third semester and the GPA at mid‐point of their in‐house curriculum predicted academic success (r=0.662, p&lt;0.001; r= 0.659, p&lt;0.001, respectively). Apart from academic factors, learning style—specifically the “read‐write” index—significantly and positively correlated with academic success (r=0.328, p&lt;0.08). These data suggest that additional attention to student success during the first half of the in‐house curriculum may be worthwhile and bolster academic success overall. In addition, it may be useful for optometry faculty to have knowledge of student learning styles, as students' preferred method of learning played a role in their success.Support or Funding InformationAmerican Optometric Foundation (AOF)This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Tobacco Control Training Programme for health professionals of the Catalan Network of Smoke-Free Hospitals: 11-year experience

Tobacco Control Training Programme for health professionals of the Catalan Network of Smoke-Free Hospitals: 11-year experience

Improving response rates for course and instructor evaluations using a global approach

Obtaining sufficient survey responses to make course and instructor evaluation results meaningful is a challenge in many, if not most, health professions training programs. This paper describes a series of policy changes that significantly improved data quality at one college of veterinary medicine located in the United States. The steps consisted of minimizing the number of items appearing on the instruments, providing students adequate time and space for completion, clearly explaining the purpose and value of the evaluations, simplifying data collection, collecting verbal feedback, and closing the loop with student participants by informing them of any changes that were made as a result of their feedback. The steps outlined in this model may be easily extended to other health professions programs that involve cohort models, multi-instructor courses and limited resources with respect to time and people.

O-25 Considerations on a Five Months Training Program for Health Professionals in the Transgender Theme

O-25 Considerations on a Five Months Training Program for Health Professionals in the Transgender Theme

The Role of Education on Dual Disorders: A Discussion Paper

Background: The heterogeneity of the knowledge, skills, and attitudes, in health professionals involved in treating patients with Dual Disorders (DDs), generate a negative impact in the effectiveness of the treatment programs. This situation has been associated with the limitations of the undergraduate, postgraduate, and continuing professional education training programs. The goal of this review is to provide an overview on some concepts involved in the management of patients with DDs, and to describe some initiatives that have been developed to address the lack of mental health professional training. Materials and Methods: To integrate a theoretical and conceptual base, a systematic review was conducted in specialized databases such as PUBMED, EBSCO, PsycINFO, Google Scholar, and institutional mental health collections. Results: There is a lack of scientific evidence reporting the implementation and adoption of training programs for health professionals in the treatment of Substance Use Disorders. Conclusions: Most of the scientific literature reports the need to improve the curriculum in undergraduate physician programs. Despite the scientific findings, the training programs do not emphasize on the new conceptualization of the DDs.

Case Studies of Community-Academic Partnerships Established Using the Give-Get Grid Model.

While partnerships for health delivery and improvement are frequently described by their structure, goals, and plans, less attention is paid to the interactive relationships among partners or for larger stakeholder groups' coalition memberships. The Give-Get Grid group process tool can be used to assess each stakeholders' expected benefits ("gets") and contributions ("gives") needed to establish and maintain long-term, mutually advantageous community-academic partnerships. This article describes three case study experiences using the Give-Get Grid in real-world context to understand and generate ideas to address contemporary health promotion opportunities among a variety of stakeholders. The case studies address three distinct community health promotion opportunities: prevention of school-based adolescent obesity disparities, higher education health professions training programs in rural community-based settings, and methods for engaging community coalitions in state Comprehensive Cancer Control Programs. The case studies demonstrate the Give-Get Grid's utility in both planning and evaluating partnerships and documenting key elements for progress in health promotion initiatives built on long-term community-academic relationships. Steps are explained with practical lessons learned in using the Grid.

Struggle and failure on clinical placement: a critical narrative review.

Clinical placements are crucial to the development of skills and competencies in speech-language pathology (SLP) education and, more generally, a requirement of all health professional training programmes. Literature from medical education provides a context for understanding how the environment can be vital to all students' learning. Given the increasing costs of education and demands on health services, students who struggle or fail on clinical placement place an additional burden on educators. Therefore, if more is known or understood about these students and their experience in relation to the clinical learning environment, appropriate strategies and support can be provided to reduce the burden. However, this literature does not specifically explore marginal or failing students and their experience. To review existing research that has explored failing and struggling health professional students undertaking clinical placements and, in particular, SLP students. A critical narrative review was undertaken. Three electronic databases, ProQuest, CINAHL and OVID (Medline 1948-), were searched for papers exploring marginal and failing students in clinical placement contexts across all health professions, published between 1988 and 2017. Data were extracted and examined to determine the breadth of the existing research, and publications were critically appraised and major research themes identified. Sixty-nine papers were included in the review. The majority came from medicine and nursing in the United States and United Kingdom, with other allied health disciplines less well represented. The review identified key themes with the majority of papers focused on identification of at risk students and support and remediation. The review also highlighted the absence of literature relating to the student voice and in the allied health professions. This review highlighted the limited research related to failing/struggling student learning in clinical contexts, and only a handful of papers have specifically addressed marginal or failing students in allied health professions. The complexity of interrelated factors in this field has been highlighted in this review. Further research needs to include the student's voice to develop greater understanding and insights of struggle and failure in clinical contexts.

Innovative public health training programme for health professionals in Olomouc region and beyond

Innovative public health training programme for health professionals in Olomouc region and beyond

Preparedness Training Programs for Working With Deaf and Hard of Hearing Communities and Older Adults: Lessons Learned From Key Informants and Literature Assessments.

The objectives of this study were to (1) identify available training programs for emergency response personnel and public health professionals on addressing the needs of Deaf and hard of hearing individuals and older adults, (2) identify strategies to improve these training programs, and (3) identify gaps in available training programs and make recommendations for addressing these gaps. A literature review was conducted to identify relevant training programs and identify lessons learned. Interviews were conducted by telephone or email with key informants who were subject matter experts who worked with Deaf and hard of hearing persons (n=11) and older adults (n=11). From the literature, 11 training programs targeting public health professionals and emergency response personnel serving Deaf and hard of hearing individuals (n=7) and older adults (n=4) were identified. The 4 training programs focused on older adults had corresponding evaluations published in the literature. Three (43%) of the 7 training programs focused on Deaf and hard of hearing persons included individuals from the affected communities in the development and implementation of the training. Key informant interviews identified common recommendations for improving training programs: (1) training should involve collaboration across different emergency, state, federal, and advocacy agencies; (2) training should involve members of affected communities; (3) training should be more widely accessible and affordable; and (4) training should teach response personnel varied communication techniques relevant to the Deaf and hard of hearing and older adult communities. Developing effective, accessible, and affordable training programs for emergency response personnel working with Deaf and hard of hearing persons, some of whom belong to the older adult population, will require a collaborative effort among emergency response agencies, public health organizations, and members of the affected communities. (Disaster Med Public Health Preparedness. 2018;12:606-614).

A ‘How-To-Guide’ for teaching and assessing Collaborator Role competencies in family medicine residency and health professional training programs

Introduction: Collaborative practice competencies are essential for safe, effective practice in today’s health care system. Providing learners with formal teaching and assessment opportunities is a requirement for accreditation in medicine and other health professional programs. However, identifying and assessing a trainee’s ability to competently collaborate in practice across educational contexts remains challenging. Further, without common assessment tools for collaborative practice teaching opportunities, ensuring comparability of collaborative practice learning experiences is difficult. To address these challenges, the College of Family Physicians of Canada tasked an interprofessional group of educators to develop a practical ‘How to Guide’ to support educators and facilitate practice change in how we assess and teach the Collaborator Role competencies. As educators, we are often required to work from a variety of educational frameworks: programmatic evaluation objectives, key and enabling competencies and clinical domains of care as examples. By leveraging specific observable behaviours of collaborative practice, the ‘How to Guide’ links these frameworks and provides practical strategies for teaching and assessing these behaviours across educational contexts. Through these practical tools and strategies for teaching and assessment we expect not only to facilitate these processes but also to encourage consistency of programming and to ensure that health professional learners are supported in the attainment of these collaborator competencies. Purpose: This interactive workshop is designed to support educators in medicine and other health professions with teaching and assessing collaborator competencies. With reference to the CanMEDS 2015, participants will reflect on how they teach and assess the collaborator role within their own contexts; compare these opportunities with collaborator role teaching and assessment strategies implemented in Canada; and consider how the ‘How to Guide’ for the Collaborator Role can support their teaching and assessment of collaborative practice competencies. Learning objectives: By the end of this workshop participants will be able to: 1. Identify opportunities to teach and assess the collaborator role in their teaching context. 2. Describe common teaching and assessment practices for collaborator role competencies 3. Access and apply the How to Guide to support their teaching and assessment of the collaborator role. Targeted Population and Stakeholders: Teachers / preceptors, program directors, health professional educators, medical residents and health professional learners, curriculum developers and assessment leads Timeline: This work took place from 2013 to 2016 to coincide with the release of the 2015 CanMEDS framework. The How-To-Guide will accompany the roll-out across Canada for the 2017 CanMEDS FM (Family Medicine) competency framework. Sustainability and Transferability: The How-To-Guide is relevant to all health professional educators in their role of preparing future health professionals to be competent to practice in integrated and interprofessional care models. The How-To-Guide was created by an interprofessional group of educators to ensure its relevancy to all health professional training programs. The guide is expected to be available for educators on an ongoing basis for the next decade. Its revision would likely coincide with the 10 year-review of the College of Physicians and Surgeons Canada CanMEDs framework in 2025. This workshop will be facilitated in both English and French.

ARTICULATING GENDER AND HEALTH: PROFESSIONAL QUALIFICATION WITHIN THE SCOPE OF REDE CEGONHA

Educational demands from Rede Cegonha health teams at Metropolitan Region II of Rio de Janeiro inspired a University Extension Project with the goal of contributing to health care improvement. We present a critical and reflective description of this initiative, underscore its processuality and point out its challenges, limits, and potentialities. The approach to gender as a cross-sectional theme, the shared production of knowledge in the educational process pedagogical and the work in a health network have been particularly addressed in the pedagogical policy underlying this study. Based on participatory methodologies, five meetings were held, approaching the following themes in a theoretical and practical perspective: gender and sexuality; violence; feeding and nutrition; health care during pregnancy, at childbirth and until children are two years old. There were varied degrees of gender crossings in the personal and professional lives of the participants, most of whom were women: for example, from restrictions to their choice of education or career opportunities to the current situation in which women are the sole or primary breadwinners but experience inequalities in gendered division of labor. In health services provided to pregnant women, their partners and children, one could still see potentially discriminatory practices; inexperience/embarrassment when dealing with new marital arrangements; feeding myths; reluctance to allow the father’s presence and participation. Women’s autonomy and right to choice and information were recurrently neglected – from the moment of forced fasting when she is admitted to hospital until the moment a cesarean section is induced . Therefore, it was concluded that it is crucial to include the theme of gender in health professional education and training programs, either at a specific point in time or throughout the whole program. DOI: 10.12957/demetra.2017.28661

Improvement in interprofessional student learning and patient outcomes

Abstract Background Traditional health professions training programs are seeking ways to provide experiential clinical interprofessional teamwork needed for providing population care management consistent with the Patient-Centered Medical Home (PCMH) model. Purpose Interprofessional faculty developed a longitudinal care management program for patients with uncontrolled diabetes, designed to provide interprofessional teamwork learning opportunities and improved patient care delivery. Methods Health professional learners participated in a longitudinal ambulatory outpatient diabetes care management program. In a quasi-experimental design, control and participating learners completed pre and post self-assessments of both teamwork skills and attitude. Control and participating patients completed a patient perception survey. Discussion Teamwork skills, as self-assessed by participating learners, significantly improved. Patient satisfaction scores significantly improved for participating patients; select patients demonstrated better diabetes control, smoking cessation, and lifestyle changes. Conclusions Linking learning and care delivery in an interprofessional longitudinal ambulatory care management program positively impacted patient satisfaction and learner teamwork skills.

What stage are low-income and middle-income countries (LMICs) at with patient safety curriculum implementation and what are the barriers to implementation? A two-stage cross-sectional study

ObjectivesThe improvement of safety in healthcare worldwide depends in part on the knowledge, skills and attitudes of staff providing care. Greater patient safety content in health professional education and training...

How Should Integrity Preservation and Professional Growth Be Balanced during Trainees' Professionalization?

People can experience moral distress when they regard themselves as expected to pursue a course of action they believe to be morally wrong. However, beliefs that give rise to moral distress are sometimes underdeveloped. Experiences of moral distress are not uncommon for medical trainees, who are still in the process of forming their professional identities and whose identity-constituting beliefs might therefore be subject to ongoing revision. Thus, it is important for health professions training programs to incorporate case-based ethics education sessions into their structure to help identify and alleviate trainees' moral distress, provide ethics education, and create a "safe space" for trainees to talk openly about moral concerns related to clinical practice. Such opportunities are crucial to the professional growth of trainees.