Improved Training Methods Research Articles

Comparative evaluation of two cohorts of final year residents on perception of curricular improvements after the Bologna Declaration at Yerevan State Medical University

Objective: To assess the difference in evaluation between final year residents of 2008 and 2010 cohorts at a state-run medical school in Armenia after implementing a new curriculum in postgraduate physician education and training according to the Bologna Declaration we conducted a pilot survey. Methods: One hundred and ninety-nine trainees were surveyed on their perception of residency program components via a self-employed structured questionnaire. Findings: Analysis of survey data revealed statistically significant differences (P < 0.05) in residents perceptions on supervisors motivation (P = 0.002) and fair grading (P = 0.005); use of group work (P = 0.017), role play (P = 0.049) and case discussion (P = 0.010) as interactive teaching methods; evaluation of training site equipment (P = 0.021); participation in problembased learning (P = 0.017) and conferences (P = 0.008). Resident’s evaluation of oral exams as the best method for knowledge assessment (P = 0.030) and in department rotation system is different (P = 0.027). Conclusion: In this survey, most differences in evaluation may be explained by introduction of improved training methods and curricula, introduction of individual supervisor system and more opportunities for interactive teaching methods. Current findings may serve a basis for countries facing challenges in post-graduate medical education system regionally and internationally under the Bologna process and for further improvement in residency program planning locally.

Dimensions of Temperament Modulate Cue-Controlled Behavior: A Study on Pavlovian to Instrumental Transfer in Horses (Equus Caballus)

Pavlovian to instrumental transfer (PIT) is a central factor in how cues influence animal behavior. PIT refers to the capacity of a Pavlovian cue that predicts a reward to elicit or increase a response intended to obtain the same reward. In the present study, using an equine model, we assessed whether PIT occurs in hoofed domestic animals and whether its efficacy can be modulated by temperamental dimensions. To study PIT, horses were submitted to Pavlovian conditioning whereby an auditory–visual stimulus was repeatedly followed by food delivery. Then, horses were submitted to instrumental conditioning during which they learned to touch with their noses an object signaled by the experimenter in order to obtain the same reward. During the PIT test, the Pavlovian conditioned stimulus was presented to the animal in the absence of reward. At the end of the experiment, a battery of behavioral tests was performed on all animals to assess five temperamental dimensions and investigate their relationships with instrumental performance. The results indicate that PIT can be observed in horses and that its efficacy is greatly modulated by individual temperament. Indeed, individuals with a specific pattern of temperamental dimensions (i.e., higher levels of gregariousness, fearfulness, and sensory sensitivity) exhibited the strongest PIT. The demonstration of the existence of PIT in domesticated animals (i.e., horses) is important for the optimization of its use by humans and the improvement of training methods. Moreover, because PIT may be implicated in psychological phenomena, including addictive behaviors, the observation of relationships between specific temperamental dimensions and PIT efficacy may aid in identifying predisposing temperamental attributes.

Research on the related problems of extended alternating projection neural network

The paper studies several related problems of the Extended Alternating Projection Neural Network (EAPNN). Firstly the mathematical relation between the interconnection matrix and the library pattern matrix, and the stability of the EAPNN with infinite precision data have been studied, strictly mathematical proofs for them have been given. After analyzing the finite precision influence on the training method of the EAPNN, the paper proposes an improved training method for the EAPNN with finite precision data and gives a practical threshold-value determination method. Then the mathematical relation among the factors influencing the association times has been studied and the mathematical expression of the association times for reaching the expected association precision, while network being used for CAM, has been deduced. Finally simulation experiments have been designed and simulation results demonstrate the validity of theoretical analyses.

Paper 251: Wavelet-EMG Analysis of the Leg Muscles in Fencing During a Flèche Attack

Fencing is highly demanding on the coordinative skills of athletes. The timing of the muscular activation during a flèche attack is one factor of a successful touch during an attack in a fencing bout. The goal of this study was to analyze the muscular activation sequences of the main leg muscles during flèche attacks and to help to improve training methods in fencing. Kinematics of the whole body [Romkes et al, 2007Romkes et al.J Pediatr Orthop B. 2007; 16: 175-180Crossref PubMed Scopus (67) Google Scholar] (VICON MX, 240 Hz), ground reaction force during the push-off phase (Kistler, 6000 Hz) and EMG data (Biovision, 6000 Hz, SENIAM-Standard) of the M. Tibials anterior, (TA), M. Gastrocnemius Medialis (GM), M. Vastus Medialis (VM), M. Rectus Femoris (RM), M. Semitendinosus (HAM) of both legs and of the M. Vastus lateralis (VL) of the front leg was recorded of 7 volunteer male expert fencers. The data of 10 trials/subject were averaged using EMG Wavelet-Transformation (WT-EMG) [von Tscharner, 2000von Tscharner J Electromyogr Kinesiol. 2000; 10: 433-445Abstract Full Text Full Text PDF PubMed Scopus (271) Google Scholar]. The test setup simulates a competition situation. The subject was doing small vertical bouncing jumps on the 2 force plates. The start for flèche attack was given by a visual signal at the target. The distance between the force plate and the target was 2.5 m. The beginning of the forward movement of the center of mass was set as movement start (t = 0 sec). The movement was initialized by lowering the center of mass and shifting it slightly in direction of the target. The actual push-off movement started with an activation of the RF, VM and GM of the rear leg. After taking off the rear foot a short co-contraction of the RF and HAM occur to stabilize the position of the hip joint. [Nene, 2004Nene A. Gait & Posture. 2004; 20: 1-13Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar]. The push-off movement of the front leg started before the muscular activation of the rear leg was finished. It started with the RF, VL, VM, GM and slight co-contraction of the RF and HAM after the foot left the ground. Prior to landing all measured muscles of the rear leg were activated, a co-contraction was seen for the ankle joint by the GM and TA and for the hip and knee-joint by the RF, VM and HAM. The co-contraction of the RF and HAM after take-off of the rear leg is needed to keep the leg in the desired position. While the co-contraction of the RF, VM and HAM and the TA and GM prior to landing is a mus¬cular pre-activation which is needed to con¬trol angular position of the joint and to ab¬sorb the impact force of the landing of the rear foot after hitting the target. The main landing impact was first absorbed by TA and slight later by GM and VM, with a clear higher muscular activation. The result of this study shows that the flèche attack is a highly demanding movement for the muscular coordination.

Emergency airway management: Training and experience of chief residents in otolaryngology and anesthesiology

Resident training in emergency airway management is not well described. We quantified training and exposure to airway emergencies among graduating Otolaryngology-Head and Neck Surgery and Anesthesiology residents. The methods used for this study were a national web-based survey of chief residents. The response rate was 52% (otolaryngology) and 60% (anesthesiology). More otolaryngology residents rotated on anesthesiology than anesthesia residents on otolaryngology (33% vs 8%). More anesthesiology chiefs never performed an emergency surgical airway than otolaryngology (92% vs 18%). The most common self-rating of competency was "9," with 82% overall self-rating "8" or higher (10 = "totally competent"). Otolaryngology and anesthesiology emergency airway management experience/training is heterogeneous and nonstandardized. Many chief residents graduate with little exposure to airway emergencies, especially surgical airways. Resident confidence levels are high despite minimal experience. This high confidence-low experience dichotomy may reflect novice overconfidence and suggests the need for improved training methods.

Assessment of Dog Guides by Users in Japan and Suggestions for Improvement

Dog guide users in Japan were mostly satisfied with and used their dogs frequently; however, they requested some improvements in training and in basic guiding work. The findings of the study suggest the need for further improvement of training methods, considering cultural factors and individual users’ needs.

Training to improve reading speed in patients with juvenile macular dystrophy: a randomized study comparing two training methods

In this study, we examined the clinical application of two training methods for optimizing reading ability in patients with juvenile macular dystrophy with established eccentric preferred retinal locus and optimal use of low-vision aids. This randomized study included 36 patients with juvenile macular dystrophy (35 with Stargardt's disease and one with Best's disease). All patients have been using individually optimized low-vision aids. After careful ophthalmological examination, patients were randomized into two groups: Group 1: Training to read during rapid serial visual presentation (RSVP) with elimination of eye movements as far as possible (n = 20); Group 2: Training to optimize reading eye movements (SM, sensomotoric training) (n = 16). Only patients with magnification requirement up to sixfold were included in the study. Training was performed for 4 weeks with an intensity of ½ hr per day and 5 days a week. Reading speed during page reading was measured before and after training. Eye movements during silent reading were recorded before and after training using a video eye tracker in 11 patients (five patients of SM and six of RSVP training group) and using an infrared reflection system in five patients (three patients from the SM and two patients of RSVP training group). Age, visual acuity and magnification requirement did not differ significantly between the two groups. The median reading speed was 83 words per minute (wpm) (interquartile range 74-105 wpm) in the RSVP training group and 102 (interquartile range 63-126 wpm) in the SM group before training and increased significantly to 104 (interquartile range 81-124 wpm) and 122, respectively (interquartile range 102-137 wpm; p = 0.01 and 0.006) after training, i.e. patients with RSVP training increased their reading speed by a median of 21 wpm, while it was 20 wpm in the SM group. There were individual patients, who benefited strongly from the training. Eye movement recordings before and after training showed that in the RSVP group, increasing reading speed correlated with decreasing fixation duration (r = -0.75, p = 0.03), whereas in the SM group, increasing reading speed correlated with a decreasing number of forward saccades (r = -0.9, p = 0.01). Although the median effect of both training methods was limited, individual patients benefited well. Our results may indicate a difference in the training effect between both methods on the reading strategy: the RSVP method reduces fixation duration, the SM method decreases the number of forward saccades. Patients can apply their newly learned reading strategy in the natural reading situation, e.g. in page reading without special presentation of the text. These results can be used as a basis for further improvement in training methods for optimizing reading performance in patients with a central scotoma.

Towards Defining Dental Drilling Competence, Part 2: A Study of Cues and Factors in Bone Drilling

The study of expertise in surgery aims to facilitate the development of improved training methods by understanding the characteristics of expert practitioners. In this article and its companion, we present our study of the characteristics of competence and expertise in the field of oral surgery. We observed participants of different skill levels as they performed an ex vivo drilling task designed to test the psychomotor skill of distinguishing the material boundaries between tooth and bone. Part 1 of this study examined the physical characteristics of drilling performance, while this article examines the cognitive aspects of performance. In this article we investigate the psychomotor cues used for decision making during drilling and explore other factors that affect a participant's ability to distinguish tooth from bone. Our results suggest that visual and tactile cues were the most important cues guiding drilling performance in all participant groups. Our results also suggest that when compared to experts, novices relied more on visual cues rather than tactile cues and lacked the psychomotor skills required to utilize the broader range of cues used by experts.

An Intelligent Power Plant Fault Diagnostics for Varying Degree of Severity and Loading Conditions

Practical fault diagnosis of a thermal system is very important in ensuring safe and reliable operation of a power plant. However, it is a difficult task due to the structural complexity of a thermal system, varying degree of severity of a fault, and the wide range of operation of the power generating unit. An artificial neural network combined with optimal zoom search is proposed in this paper for recognizing varying degrees of faults in a power plant thermal system operating at different load level. The zoom search technology is based on the similarity rules of the feature variables to a same fault with different severity when the system topological structure does not change with fault or with different loading conditions. Two different types of symptoms, a trend symptom and a semantic symptom, are calculated and jointly used for on-line fault recognition, which results in a faster and more stable fault diagnosis. A feedforward neural network structure is adopted and an improved training method is introduced. A high-pressure feedwater heater system is taken as a target system for investigation. Several simulation tests for diagnosing a multidegree fault under different operating conditions are carried out on a 300-MW power plant simulator to demonstrate the validity of the method.

Maximal Aerobic Capacity in Horses: A Retrospective Study to Identify the Age-Related Breakpoint

Previous studies of the effect of age on maximal aerobic capacity (VO2max) in the horse have only broadly grouped horses for statistical analysis and have not accounted for the age continuum. Those experiments were not designed to determine a breakpoint due to age. PURPOSE: To retrospectively analyze longitudinal cardiorespiratory fitness data in Standardbred mares to determine the nature of the age- related decline in VO2max and to determine whether there is a breakpoint for deterioration of VO2max. METHODS: Data were acquired from untrained Standardbred mares (N=50) ranging in age from 4-29 yrs and used in a retrospective regression analysis in order to characterize the age-related decline in VO2max. All VO2max values were measured using the same incremental exercise test protocol, which consisted of an initial speed of 4 m·s-1 for 60s followed by a 1 m·s-1 increase every 60s until fatigue. Grade remained fixed at 6%. Curvilinear regression was used to analyze the nature of the age/VO2max relationship. Ages were then grouped in 2 yr intervals and simple contrasts were used to analyze the age-related breakpoint in relation to the values achieved at 4-5 yrs. RESULTS: The quadratic function for age accounted for 56.1% of the variance in VO2max (P<.001). Simple contrasts revealed a breakpoint for VO2max decline between 20-21 yrs (95.1 ml·kg-1·min-1) when compared to 4-5 yrs (121.5 ml·kg-1·min-1), P<.001. CONCLUSION: The regression analysis demonstrated a quadratic trend for the decline in VO2max with age in horses. Furthermore, the downturn in cardiorespiratory function occurred between 20-21 yrs of age. These results demonstrate the similarity in the aging response of the cardiovascular system between horses and humans and have implications for improving training methods in active older horses.

Naturalistic Decision Making for Power System Operators

Investigations of large-scale outages in the North American interconnected electric system often attribute the causes to three t's: trees, training, and tools. To document and understand the mental processes used by expert operators when making critical decisions, a naturalistic decision making (ndm) model was developed. Transcripts of conversations were analyzed to reveal and assess ndm-based performance criteria. An item analysis indicated that the operators' situation awareness levels, mental models, and mental simulations can be mapped at different points in the training scenario. This may identify improved training methods or analytical/visualization tools. This study applies for the first time the concepts of recognition primed decision making, situation awareness levels, and cognitive task analysis to training of electric power system operators. The ndm approach provides a viable framework for systematic training management to accelerate learning in simulator-based training scenarios for power system operators and teams.

Maximal aerobic capacity (VO2max) in horses: a retrospective study to identify the age-related decline

Previous studies of the effect of age on maximal aerobic capacity (maximal rate of oxygen consumption, VO2max) in horses have only grouped horses (young, middle-aged and old) for statistical analysis. Those experiments were not designed to determine a break point due to age. The purpose of this study was to utilize data collected over the last 15 years to test the nature of the association between age and VO2max, and secondarily, to determine whether there is a ‘breakpoint’ in the age-related decline in aerobic capacity. Data were acquired from 50 unfit Standardbred mares ranging in age from 4 to 29 years, and were used in a retrospective regression analysis in order to characterize the age-related decline in VO2max. All VO2max values were measured using the same incremental graded exercise test protocol. The data were analyzed using a curvilinear regression analysis predicting VO2max from age, and the break point was determined using univariate simple contrasts. There was a significant decline in VO2max with age (R2 = 0.554; P &lt; 0.001). The data analysis demonstrated a notable downturn in cardiopulmonary function between the ages of 18 and 20 years (P &lt; 0.001). Such results indicate similar responses to age between humans and horses. These results have implications for improving training methods in active older horses.

Forecasting chaotic time series based on improved genetic WNN

The chaotic time series forecast using Wavelet Neural Networks(WNN) was researched in this paper.An improved training method for WNN was presented.This method combines the Genetic Arithmetic(GA) and gradient descent BP method,and the BP method was embedded in the GA operation in order to resolve the GA's limitation in detail search capability.In the last step of this method the WNN trained by GA searches the best solution using BP method once again.The experiment on predicting the chaotic time series from Henon map validates the performance of the method in this paper;the experimental result also shows the method could assure the WNN convergence and have high forecasting precision.

A note on the effects of a commercial tryptophan product on horse reactivity

Tryptophan supplements are marketed worldwide as calmatives for fearful or excitable horses, although there are no scientific publications that support the efficiency of tryptophan on horses. Here, we investigate whether a commercial feed additive with tryptophan reduces the reactions of horses in standardised fear and handling tests. In two different experiments with 2-year-old stallions ( N = 16) and mares ( N = 12) we found no significant effects of a single dose feed additive with 6.0 g l-tryptophan on voluntary approach to novel stimuli, behaviour or heart rate during tests or ease of handling. We conclude that one should not rely on an acute dose of tryptophan to calm horses. Better understanding of the causes of fearful behaviour, as well as improving training methods for habituation of horses to stressful situations are at present more reliable ways of reducing reactivity.

Knowledge discovery in high-dimensional data: case studies and a user survey for the rank-by-feature framework

Knowledge discovery in high-dimensional data is a challenging enterprise, but new visual analytic tools appear to offer users remarkable powers if they are ready to learn new concepts and interfaces. Our three-year effort to develop versions of the Hierarchical Clustering Explorer (HCE) began with building an interactive tool for exploring clustering results. It expanded, based on user needs, to include other potent analytic and visualization tools for multivariate data, especially the rank-by-feature framework. Our own successes using HCE provided some testimonial evidence of its utility, but we felt it necessary to get beyond our subjective impressions. This paper presents an evaluation of the Hierarchical Clustering Explorer (HCE) using three case studies and an e-mail user survey (n = 57) to focus on skill acquisition with the novel concepts and interface for the rank-by-feature framework. Knowledgeable and motivated users in diverse fields provided multiple perspectives that refined our understanding of strengths and weaknesses. A user survey confirmed the benefits of HCE, but gave less guidance about improvements. Both evaluations suggested improved training methods.

Vacuum extraction: is there any need to improve the current training in the UK?

The objective of this study was to assess the use and efficacy of delivery by vacuum extraction or ventouse in routine clinical practice and to assess some aspects of the procedure that may reflect the quality of training in this technique. Women's demographic profiles and delivery details were collected in both the prospective (B) and retrospective (A) arm of the study. In addition, in the prospective arm of the study two custom-designed forms were used: the obstetrician recorded their perception of where the vacuum cup had been placed on one form while on a second form the pediatrician indicated the actual site of the cup placement as observed from the position of the chignon. All the diagrams of cup placement were reviewed by one of the authors, who was blinded to the outcome of the procedure. The vacuum extractor was the first instrument to be used in 79% and 87% of the instrumental deliveries in groups A and B, respectively, with corresponding failure rates of 20% and 21%. Although an occipito-posterior position was diagnosed in 11% of cases of group A and 14% of cases of group B, the specifically designed occipito-posterior cup was not used at all. The vacuum cup was considered to have been applied suboptimally in 40% of the cases where attempted vacuum delivery failed. The high rate of inappropriate positioning of the cup may reflect difficulty in accurately applying the cup, perhaps due to caput or malposition, but may also represent poor assessment of the orientation and position of the fetal skull and therefore be indicative of a need for improvement in training methods.

Vacuum extraction: is there any need to improve the current training in the UK?

Objective. The objective of this study was to assess the use and efficacy of delivery by vacuum extraction or ventouse in routine clinical practice and to assess some aspects of the procedure that may reflect the quality of training in this technique. Materials and methods. Women's demographic profiles and delivery details were collected in both the prospective (B) and retrospective (A) arm of the study. In addition, in the prospective arm of the study two custom-designed forms were used: the obstetrician recorded their perception of where the vacuum cup had been placed on one form while on a second form the pediatrician indicated the actual site of the cup placement as observed from the position of the chignon. All the diagrams of cup placement were reviewed by one of the authors, who was blinded to the outcome of the procedure. Results. The vacuum extractor was the first instrument to be used in 79% and 87% of the instrumental deliveries in groups A and B, respectively, with corresponding failure rates of 20% and 21%. Although an occipito-posterior position was diagnosed in 11% of cases of group A and 14% of cases of group B, the specifically designed occipito-posterior cup was not used at all. The vacuum cup was considered to have been applied suboptimally in 40% of the cases where attempted vacuum delivery failed. Conclusion. The high rate of inappropriate positioning of the cup may reflect difficulty in accurately applying the cup, perhaps due to caput or malposition, but may also represent poor assessment of the orientation and position of the fetal skull and therefore be indicative of a need for improvement in training methods.

Discrimination learning based on relative size concepts in horses ( Equus caballus)

This study explored whether or not horses ( Equus caballus) could respond to stimuli using a concept based on relative size. In Experiment 1, after learning to respond to the larger of the two stimuli for six sets of two-dimensional (2D) training exemplars, one horse was tested for size transposition that used novel larger and smaller stimuli as well as three-dimensional (3D) objects (5 two-dimensional sets and 5 three-dimensional sets with large, medium, small, and tiny sizes). The horse correctly chose (significantly above chance) the larger of two stimuli regardless of novelty or dimension or combination. In Experiment 2, two additional horses were tested using a subset of the stimuli from Experiment 1. One horse was required to select the larger stimulus—as in Experiment 1—and the other the smaller stimulus. After learning the task, both horses responded correctly to new stimuli and showed size transposition. These results suggest that at least some horses are capable of solving problems based on relative size concepts. Moreover, they are able to generalize across situations that vary from flat, black shapes to objects of different materials and colors including balls, flower pots, and PVC connectors. These findings support earlier research that showed that horses could categorize certain stimuli, and provide new evidence that they are capable of using some form of concept for problem solving. Understanding that horses have more advanced learning abilities than was previously believed should help improve training methods and management.

Experiential Training in Group Counseling: Humanistic Processes in Practice

D. A. Kolb's (1984) 4 processes of experiential education are presented as guidelines for humanistically based training in group counseling. Specific training activities are described, and recommendations for improving training methods are outlined. The authors present qualitative data obtained from graduate counseling students who participated in these activities and provide recommendations for research.

Improved Training Methods through the Use of Multimedia Technology

The workforce within the U.S. is increasingly culturally diverse and mobile. Coupled with the fact that technological change is occurring more rapidly, a critical issue that has emerged for the 1990s is how organizations can improve their training methods to adapt to these conditions. Effective learning systems enable employees to adapt more easily to change, thereby increasing their effectiveness. Multimedia systems can be the solution to enhancing performance effectively and efficiently by accelerated learning. This paper examines such a system developed by Holiday Inn Worldwide for the implementation of a new information system.Individuals' performance and attitudes were tracked for two primary groups: those receiving training on a new information system using traditional training methods and those using a multimedia CDROM to acquire mastery of the same system. 826 employees participated, 467 of which were trained by the multimedia system. Attitude measures included attitudes toward self, job, training, and technology. Individual performance was measured by standardized tests on employees' knowledge of the new information system. Our findings demonstrated a significant improvement in employees' scores on system knowledge for employees in multimedia-trained sites when compared with traditionally trained employees. This paper reports the results of the performance issue only.