Impact Of Formal Training Research Articles

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.

The Impact of Formal Training and Certification on the Relationship Between Volume and Outcomes in Percutaneous Coronary Interventions.

Little data are available on the impact of formal training and certification on the relationship between volumes and outcome in percutaneous coronary interventions (PCIs).The objective of this report is to study the relationship between PCI volume and outcome for a formally trained interventional cardiologist who is certified by the American Board on Internal Medicine - Interventional Cardiology subspecialty board. The operator witnessed 3 different PCI volumes/yr over a 15-year practice period (2000-2014): <50 PCI/yr (years 2000-2006; n = 179), 50-100 PCI/yr (years 2007-2010; n = 256), and >100 PCI/yr (years 2011-2014; n = 427). Angiographic and procedural success rates were compared between the 3 volume groups, as well as in-hospital cardiovascular events (death, recurrent myocardial infarction, repeat PCI, stroke, or coronary artery bypass surgery). The in-hospital mortality rate throughout the study period was 0.8% and was not statistically significant among the 3 volume groups. There was also no significant difference among the 3 groups with respect to recurrent myocardial infarction or repeat PCI. There was a slightly higher rate of same-stay elective coronary artery bypass grafting in the early low-volume period compared with the other 2 groups (2.2% vs. 0.8% vs. 0.2%; P = 0.04). The overall angiographic and procedural success rates were 97.3% and 96.5%, and they were not significantly different among the 3 groups. Our study shows that the angiographic and procedural success rates of PCI, as well as the in-hospital mortality, do not seem to be dependent on the annual volume for formally trained and certified interventional cardiologists.

Impact of formal training on agreement of videofluoroscopic swallowing study interpretation across and within disciplines.

Formal agreement studies on interpretation of the videofluoroscopic swallowing study (VFSS) procedure among speech-language pathologists, radiology house officers, and staff radiologists have not been pursued. Each of these professions participates in the procedure, interprets the examination, and writes separate reports on the findings. The aim of this study was to determine reliability of interpretation between and within the disciplines and to determine if structured training improved reliability. Thirteen speech-language pathologists (SLPs), ten diagnostic radiologists (RADs) and twenty-one diagnostic radiology house officers (HOs) participated in this study. Each group viewed 24 VFSS samples and rated the presence or absence of seven aberrant swallowing features as well as the presence of dysphagia and identification of oral dysphagia, pharyngeal dysphagia, or both. During part two, the groups were provided with a training session on normal and abnormal swallowing, using different VFSS samples from those in part one, followed by re-rating of the original 24 VFSS samples. A generalized estimating equations (GEE) approach with a binomial link function was used to examine each question separately. For each cluster of tests, as example, all pairwise comparisons between the three groups in the pretraining period, a Hochberg's correction for multiple testing was used to determine significance. A GEE approach with a binomial link function was used to compare the premeasure to postmeasure for each of the three groups of raters stratified by experience. The primary result revealed that the HO group scored significantly lower than the SLP and RAD group on identification of the presence of dysphagia (p = 0.008; p = 0.001, respectively), identification of oral phase dysphagia (p = 0.003; p = 0.001, respectively), and identification of both oral and pharyngeal phase dysphagia, (p = 0.014, p = 0.001, respectively) pretraining. Post training there was no statistically significant difference between the three groups on identification of dysphagia and identification of combined oral and pharyngeal dysphagia. Formal training to identify oropharyngeal dysphagia characteristics appears to improve accuracy of interpretation of the VFSS procedure for radiology house officers. Consideration to include formal training in this area for radiology residency training programs is recommended.

Certification in good clinical practice and clinical trial quality: A retrospective analysis of protocol adherence in four multicenter trials in the USA

Background: The value of training in Good Clinical Practice (GCP) for clinical research professionals is unknown. The objective of this study was to assess the impact of formal training in GCP on the quality of clinical trials. Methods: Retrospective analysis of data collected from four multicenter trials conducted in the US in 2008. Certification as Physician Investigator (CPI) or Clinical Research Coordinator (CCRC) was used as proof of formal training in GCP. Protocol adherence was used as a proxy for the quality of clinical trials and quantified by the number of protocol deviations. The primary variable for analysis was the number of protocol deviations per randomized subject and site. Results: A total of 1,418 subjects were randomized by 101 investigators (29% CPI) and 109 clinical research coordinators (29% CCRC), with 520 protocol deviations. Compared to “no certification”, the Odds Ratios (OR) for the incidence of protocol deviations were OR = 1.20 (95% Confidence Interval [0.852–1.688]; p NS) for “CCRC-only”, OR = 0.70 ([0.513–0.953]; p = 0.0256) for “CPI-only”, and OR = 0.37 ([0.273–0.507]; p < 0.0001) for “CCRC + CPI”. Conclusions: This pilot study showed that formal training in GCP has the potential to improve protocol adherence and clinical trial quality.

Workplace Disability Management: International Trends and Perspectives

The social and economic costs of injury and disability in the workplace has had an adverse impact on employers and societies throughout the world. International trends in worksite disability management policies and practices, as surveyed by the International Labor Organization, are explored. The impact of formal training for Disability Management Coordinators is discussed, as relates to reductions in unnecessary lost time and workplace disability costs. A disability management audit system is summarized, as a strategic planning process for developing return-to-work programs for workers with disabilities.

The Occupational Mobility of Young Men, 1965–1970

Examination of the extent to which racial differences in occupational advancement can be attributed to differences in formal education in the United States from 1965 to 1970. Framework of the analysis; Impact of formal training on the level of occupational attainment; Sources of racial differentials. (Abstract copyright EBSCO.)