Intensive Training Course Research Articles

Technology use and mathematics teaching: teacher change as discursive identity work

Teacher change towards developing competences for technology use in mathematics teaching has been the focus of current educational reforms worldwide. However, a considerable amount of research denotes the extent to which teachers resist a full integration of technology in mathematics classrooms. The present paper is based on an ethnographic study and focuses on how mathematics teachers – as they participate in an intensive training course – perform identity work whilst collectively articulating meanings concerning the potential of technology-based mathematics learning. By means of discourse theory, we analyse how they try to fix meaning as they engage and interact with varied discourses of ‘change’. Our findings indicate that mathematics teachers' attempts to articulate meaning are organised around discourses that concern directly societal and learning issues of technology use in mathematics teaching.

Factors influencing microsurgical skill acquisition during a dedicated training course

Proficient microsurgical skills are considered essential in plastic and reconstructive surgery. Specialized courses offer trainees opportunity to improve their technical skills. Trainee aptitude may play an important role in the ability of a trainee to acquire proficient skills as individuals have differing fundamental abilities. We delivered an intensive 5-day microsurgical training course. We objectively assessed the impact of the course on microsurgical skill acquisition and whether aptitudes as assessed with psychometric tests were related to surgical performance. Sixteen surgical trainees (male = 10 and female = 6) participated in the courses. Trainees' visual spatial, perceptual, and psychomotor aptitudes were assessed on day 1 of the course. The trainees' performance of an end-to-end arterial anastomosis was assessed on days 2 and 5. Surgical performance was assessed with objective structured assessment of technical skills(OSATS) and time to complete the task. The trainees showed a significant improvement in OSATS scores from days 2 to 5 (P < 0.001) and the time taken to complete the anastomosis (P < 0.001). Aptitude scores correlated strongly with objectively assessed microsurgical skill performance for male trainees but not for females. We demonstrated that participating in a microsurgical training course results in significant improvement in objectively assessed microvascular surgical skills. The degree of skills improvement was strongly correlated with psychomotor aptitude assessments scores for male trainees.

109 Bedside Ultrasonography Training and Barriers to Utilization in Chiapas, Mexico

109 Bedside Ultrasonography Training and Barriers to Utilization in Chiapas, Mexico

Undergraduate medical students’ perceptions, attitudes, and competencies in evidence-based medicine (EBM), and their understanding of EBM reality in Syria

BackgroundTeaching evidence-based medicine (EBM) should be evaluated and guided by evidence of its own effectiveness. However, no data are available on adoption of EBM by Syrian undergraduate, postgraduate, or practicing physicians. In fact, the teaching of EBM in Syria is not yet a part of undergraduate medical curricula. The authors evaluated education of evidence-based medicine through a two-day intensive training course.MethodsThe authors evaluated education of evidence-based medicine through a two-day intensive training course that took place in 2011. The course included didactic lectures as well as interactive hands-on workshops on all topics of EBM. A comprehensive questionnaire, that included the Berlin questionnaire, was used to inspect medical students’ awareness of, attitudes toward, and competencies’ in EBM.ResultsAccording to students, problems facing proper EBM practice in Syria were the absence of the following: an EBM teaching module in medical school curriculum (94%), role models among professors and instructors (92%), a librarian (70%), institutional subscription to medical journals (94%), and sufficient IT hardware (58%). After the course, there was a statistically significant increase in medical students' perceived ability to go through steps of EBM, namely: formulating PICO questions (56.9%), searching for evidence (39.8%), appraising the evidence (27.3%), understanding statistics (48%), and applying evidence at point of care (34.1%). However, mean increase in Berlin scores after the course was 2.68, a non-statistically significant increase of 17.86%.ConclusionThe road to a better EBM reality in Syria starts with teaching EBM in medical school and developing the proper environment to facilitate transforming current medical education and practice to an evidence-based standard in Syria.

Rebuilding the body through violence and control

In this article, I examine the bodily changes that soldiers undergo in an intensive counter-terrorism military training course. I argue that military draftees develop control and violent capabilities through Violent Reflexive Bodily Practices (VRBPs), a concept I introduce here. VRBPs, which form the core of training in this elite military unit, are simultaneously recursive, reflexive and reconstructive: they are expressed by the soldier’s body and inflicted upon his body, by using them more violence is created, and their aim is not breaking the body apart, but rebuilding it into a new entity. VRBPs are concrete body techniques that are not discussed through a broad theoretical or cultural approach but as a material and concrete experience that reconstructs individuals’ bodies. This article shows how ‘techniques of the body’ ( Mauss, 1973 ) can be changed in a short period and reveals possible dynamics of habitually instilled capabilities.

Geritalk: Communication Skills Training for Geriatric and Palliative Medicine Fellows

Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n=18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P<.001). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills.

A Predeployment Trauma Team Training Course Creates Confidence in Teamwork and Clinical Skills: A Post-Afghanistan Deployment Validation Study of Canadian Forces Healthcare Personnel

The 10-day Intensive Trauma Team Training Course (ITTTC) was developed by the Canadian Forces (CFs) to teach teamwork and clinical trauma skills to military healthcare personnel before deploying to Afghanistan. This article attempts to validate the impact of the ITTTC by surveying participants postdeployment. A survey consisting of Likert-type multiple-choice questions was created and sent to all previous ITTTC participants. The survey asked respondents to rate their confidence in applying teamwork skills and clinical skills learned in the ITTTC. It explored the relevancy of objectives and participants' prior familiarity with the objectives. The impact of different training modalities was also surveyed. The survey showed that on average 84.29% of participants were "confident" or "very confident" in applying teamwork skills to their subsequent clinical experience and 52.10% were "confident" or "very confident" in applying clinical knowledge and skills. On average 43.74% of participants were "familiar" or "very familiar" with the clinical topics before the course, indicating the importance of training these skills. Participants found that clinical shadowing was significantly less valuable in training clinical skills than either animal laboratory experience or experience in human patient simulators; 68.57% respondents thought that ITTTC was "important" or "very important" in their training. The ITTTC created lasting self-reported confidence in CFs healthcare personnel surveyed upon return from Afghanistan. This validates the importance of the course for the training of CFs healthcare personnel and supports the value of team training in other areas of trauma and medicine.

Dos años de historia clínica electrónica. Experiencia en un hospital comarcal

The introduction of computerised medical records in public hospitals is, without a doubt, one of the biggest changes made in patient health care in the last few years. It is a gradual process and is not exempt from difficulties, but it will surely set a challenge in the way information is handled in health care. Taking this path, in November 2008, the computer program SELENE, from the multinational company Siemens, was purchased in the centre were we carry out our surgical activities.The introduction of this program was preceded by an intensive training course for all the workers in the hospital. At the start, it was decided that the computer application would come into operation throughout the entire hospital, replacing the handwritten records. There were difficult days during its gradual introduction, but the computerised medical record has been well accepted by the great majority of the workers at the centre. After the initial stage of becoming accustomed, design problems started to be seen in the application, as well as their possible solutions.Currently, the use of the SELENE program has led to fluid health care within the hospital, although there are problems which can be resolved with adequate funding.

Intensive laparoscopic training course for surgical residents: program description, initial results, and requirements

The Department of Surgery at the University of Arizona has created an intensive laparoscopic training course for surgical residents featuring a combined simulation laboratory and live swine model. We herein report the essential components to design and implement a rigorous training course for developing laparoscopic skills in surgical residents. At our institution, we developed a week-long pilot intensive laparoscopic training course. Six surgical residents (ranging from interns to chief residents) participate in the structured, multimodality course, without any clinical responsibilities. It consists of didactic instruction, laboratory training, practice in the simulation laboratory, and performance (under the direction of attending laparoscopic surgeons) of surgical procedures on pigs. The pigs are anesthetized and attended by veterinarians and technicians, and then euthanized at the end of each day. Three teams of two different training-level residents are paired. Daily briefing, debriefing, and analysis are performed at the close of each session. A written paper survey is completed at the end of the course. This report describes the results of first 36 surgical residents trained in six courses. Preliminary data reveal that all 36 now feel more comfortable handling laparoscopic instruments and positioning trocars; they now perform laparoscopic surgery with greater confidence and favor having the course as part of their educational curriculum. A multimodality intensive laparoscopic training course should become a standard requirement for surgical residents, enabling them to acquire basic and advanced laparoscopic skills on a routine basis.

Pediatric Intensive Care Simulation Course: A New Paradigm in Teaching

True pediatric emergencies are rare. Because resident work hours are restricted and national attention turns toward patient safety, teaching methods to improve physician performance and patient care are vital. We hypothesize that a critical-care simulation course will improve resident confidence and performance in critical-care situations. We developed a monthly pediatric intensive care unit simulation course for second-year pediatric residents that consisted of weekly 1-hour sessions during both of the residents' month-long pediatric intensive care unit rotations. All scenarios used high-fidelity pediatric simulators and immediate videotape-assisted debriefing sessions. In addition, simulated intraosseous line insertion and endotracheal intubations were also performed. All residents improved their comfort level and confidence in performing individual key resuscitation tasks. The largest improvements were seen with their perceived ability to intubate children and place intraosseous lines. Both of these skills improved from baseline and compared to third-year-resident controls who had pediatric intensive care unit rotations but no simulations (P = .05 and P = .07, respectively). Videotape reviews showed only 54% ± 12% of skills from a scenario checklist performed correctly. Our simulation-based pediatric intensive care unit training course improves second-year pediatric residents' comfort level but not performance during codes, as well as their perceived intubation and intraosseous ability. Videotape reviews show discordance between objective performance and self-assessment. Further work is necessary to elucidate the reasons for this difference as well as the appropriate role for simulation in the new graduate medical education climate, and to create new teaching modalities to improve resident performance.

Application of standardized patients in intensive training of clinical skills for general practice trainees and its effectiveness

Objective To explore application of standardized patients (SPs) in intensive training of clinical competency for general practice trainees. Methods Fifty-three general practice trainees in Shanghai Zhongshan Hospital were enrolled in the study, randomly assigned to intervention and control groups. Control group proceeded in routine clinical rotation, while intervention group accepted intensive training course with SPs as trainers. Three months after intervention, clinical skills of the two groups were compared in a simulated medical environment. Results There was no statistically significant difference in their baseline characteristics between the two groups (P ＞0.05). Competency in history taking, physical examinations,communication with patients, comprehensive consultation, medical record writing as well as case-analysis,improved significantly in intervention group after intervention, as compared to those before it ( P ＜ 0. 01 ),with the highest score of communication skill of 82 ± 10. Although competency of history taking, physical examinations, comprehensive consultation, medical record writing also improved significantly three months later in control group as compared to their baselines (P ＜ 0. 01 ), while no statistically significant difference in their communication skills was found ( P ＞ 0. 05 ). Scores of skills in physician-patient communication,comprehensive consultation as well as medical record analysis were significantly higher in intervention group than those in control one after intervention ( P ＜ 0. 01 ), but no significant difference in physical examinations was found between the two groups ( P ＞ 0. 05 ). Conclusions Application of SP in intensive training course for clinical competency can remarkably improve their competency in interpersonal communication and comprehensive consultation for general practice trainees. Key words: Teaching ; Patient,simulation ; Clinical skills ;

Medium term results on introducing colorrectal laparoscopic surgery into clinical practice after having an intensive training course

IntroductionEndoscopic surgery has characteristics that increase the difficulties of learning. Five years ago, an intensive colorectal laparoscopic surgery course was designed to offer training in the technical bases of this type of surgery. The aim of this article is to determine the impact of the colorectal surgery course on clinical practice, and to investigate the factors that limit its applicability and the training preferences of the surgeons. Material and methodsTwenty-two courses of four days duration, with 36hours of lessons (4 in seminar form and 32 in the surgery), and with 7 trainees, were held between June 2005 and December 2010. A survey was sent out in December 2010 to assess the impact of the course on the colorectal laparoscopic surgery activity of the trainee, to find out the difficulties encountered in its application, and to evaluate the training expectations in endoscopic surgery in this group of surgeons. ResultsThe questionnaire was sent to 148 surgeons, with 74 (50%) responses received. The mean period after the course was 26.5 (2–60) months. A monthly increase of more than 5 cases was observed in 70% of the centres. The course enabled them to consolidate the activity in local hospitals, while in university and general hospitals it served to re-launch an initial experience.Among the obstacles that made it difficult to introduce were care load and the availability of a surgeon, particularly in general and university hospitals (P=.001), and in local hospitals it was the availability of patients. The majority of surgeons (70%) believed that specific training was required, preferring a short period in a hospital with experience. ConclusionsAn intensive course on colorectal laparoscopic surgery enabled the activity to be consolidated or increased in this area. Training in colorectal laparoscopic surgery requires additional teaching efforts, which are currently unstructured.

A web‐based training approach for the structural steel design

AbstractFortunately the design processes of steel buildings across Europe is eventually covered by a unified code: The Eurocode 3: “Design of steel structures.” Nevertheless, although Eurocodes will soon become mandatory documents, designs will not be standardized because each country has a set of National Annexes which must be taken into account when designing in that particular country. Furthermore, every country also has its own body of non‐conflicting complementary information. A problem then arises when engineers need to produce designs in other European countries, either for a company based in one state or as individuals. Also, allowing engineers time out of the office for attendance at the intensive training courses which are required for earning experience on the new codes of design, frequently represents an obstacle for their employers. In an attempt to solve these problems, a strong trans‐national partnership has been working to develop an ICT‐supported, flexible training approach to allow designers to apply Eurocodes in accordance with the national regulations and practices of different member states. The resulting material in seven languages shows how to design a typical building according to the different national contexts. The developed portal incorporates facilities for course presentation, forums, blogs and on‐line translation. The students thought that the portal was an effective tool that helped them to improve the quality and efficiency of their studies. In their opinion the web‐course is well structured and they found the forum for discussion and the web‐based tutoring system very helpful. © 2010 Wiley Periodicals, Inc. Comput Appl Eng Educ 21: 448–458, 2013

Videogestütztes Training in Gesprächsführung für Ärzte

The aim of an "intensive training course in communication skills for physicians" is to train the perception of behaviour and of emotions in the doctor-patient communication. Core elements of the training are role plays on topics perceived as difficult and brought in by participants. From the group discussions arises a rich array of observations. The identical reproduction of a situation in time and space by means of video permits a variety of ways to check the perception of a situation and the communication skills. The approach is illustrated by an example taken from one exercise. 26 physicians participated in three courses. The repetition of the scene played at the first day is repeated with the same actors at the end of a training. Progress can be measured by comparing the two scenes. An evaluation by means of a structured questionnaire was carried out at the end of the training, after three and twelve months. The higher degree of self confidence on the part of the physicians could be seen from the analysis of the videos, from the comparison of the two videos and also from the questionnaires. Training by means of video takes time and energy. From the view of the authors and also from the participants this didactic approach to training is very effective. The training can be a building block towards a better care for patients.

Cosmetic Procedures Intensive Training Course, 17thor 24thJanuary 2009, Exeter Medical, Exeter, UK

Cosmetic Procedures Intensive Training Course, 17^thor 24^thJanuary 2009, Exeter Medical, Exeter, UK

Peer Review and Manuscript Management in Scientific Journals: Guidelines for Good Practice

Peer Review and Manuscript Management in Scientific Journals: Guidelines for Good Practice

Introduction of a portable ultrasound unit into the health services of the Lugufu refugee camp, Kigoma District, Tanzania.

BackgroundDiagnostic imaging services are scarce in much of the developing world. Ultrasound is a low-cost, safe, and widely applicable imaging modality.AimsWe delivered a portable ultrasound machine to the Lugufu refugee camp in Tanzania and conducted a course on its use in order to assess the feasibility of introducing this technology into a very low-resource setting.MethodsWe conducted an intensive 4-day ultrasound training course for health care providers at Lugufu and established an exam logbook to track the frequency of use, distribution of ultrasound applications, and gender and age distribution of patients.ResultsBetween 4 October 2005 and 1 November 2007 547 separate ultrasound exams on 460 patients were recorded at Lugufu. Overall, 86% of patients studied were female. Pregnancy-related exams accounted for 24.1% of total usage. The 20- to 29-year-old age group accounted for over one third of total exams performed.ConclusionUltrasound is a feasible and sustainable imaging modality in a very low-resource setting such as the Lugufu refugee camp in Tanzania.

Mapping the Scope of Theory in TESOL

I worked for 13 years as a teacher and teacher trainer in a number of settings in England and Australia before I became a researcher working in graduate-level TESOL and applied linguistics programs. It was in midcareer as a TESOL teacher, teaching EFL to adults in a private language school in London, that I discovered theory, working on my master's degree in applied linguistics at the University of London, and I found it had a liberating influence on my teaching. I had been teaching full time for 6 years when I began my master's degree, and I found that theory broke up a lot of old concrete in my head. It challenged most of my cherished beliefs about language teaching and learning and as a result made the classroom a much more interesting place. As well as carrying out my usual practice, I became an observer in my own classroom, of myself and, in particular, of my students, and kept thinking about what I was doing and what alternatives there might be. Once I had developed an appetite for that understanding, it never left me. To learn that a site of practice was also a site for thinking gave a dimension to my experience of teaching which has remained with me. Theory was also helpful for another practical reason. I had begun delivering short intensive practical TESOL teacher training courses under what came to be known as the Cambridge CELTA (Certificate in English Language Teaching to Adults), and I found that engagement with theory gave me the metaview of teaching and learning that I needed in order to know the material I was presenting and in order to understand what I was observing going on between the teachers I was training and their learners.

Surgical Training in the Netherlands

Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nationwide programme has been modernized further and now involves a systematic, competency-based education with structural training courses, formalized assessment and room for reflection by residents under the supervision of surgical teaching groups. To this end, a uniform web-based digital portfolio is being introduced to facilitate monitoring of the individual resident's progress. Though requiring inspirational leadership, commitment, and determination, this modernization has sparked enthusiasm among trainees and teachers.

Gender-based dimorphic pattern for interleukin-1 receptor antagonist in type 2 diabetes mellitus

Adipose tissue secretes a variety of cytokines, some of which are increased in the serum of obese patients. The anti-inflammatory interleukin-1 receptor antagonist (IL-1Ra) is the most highly elevated known cytokine in human obesity, and its serum levels are strongly associated with the degree of insulin resistance in non-diabetic patients. Aim The present study examined serum levels of IL-1Ra in type 2 diabetic patients (T2DM) and their relationships with three other adipokines (leptin, interleukin-6 [IL-6], adiponectin). Their correlation with anthropometric and biochemical variables was examined, as well as their intraindividual fluctuations. Methods Fifty T2DM patients, aged 58 ± 13 years, were consecutively recruited among those electively hospitalized for a one-week intensive training course with our Diabetes Education Service. Anthropometric measurements and blood samples were taken after an overnight fast on admission (baseline) and after four days. Results Mean serum levels of IL-1Ra and leptin, but not of IL-6 and adiponectin, were significantly higher in women than in men ( P < 0.0006), and this difference persisted after correction for body mass index (BMI) ( P < 0.0004). In addition, IL-1Ra and leptin were strongly correlated with the BMI ( P < 0.0004). By contrast, no significant correlations were observed between IL-1Ra and glucose-control parameters. Finally, all four adipokines exhibited wide interindividual variability, but with limited intraindividual fluctuations over the short time period. Conclusion IL-1Ra, leptin and adiponectin serum levels exhibit marked interindividual variation with high intraindividual consistency. A gender-based dimorphic pattern for IL-1Ra, independent of the degree of adiposity and glucose control, was also found.