Interdisciplinary Training Program Research Articles

Forgetting the Past and Neglecting the Future. Commentary: A Crisis in Comparative Psychology: Where Have All the Undergraduates Gone?

Forgetting the Past and Neglecting the Future. Commentary: A Crisis in Comparative Psychology: Where Have All the Undergraduates Gone?

Launching an interdisciplinary “International Summer School on Ageing” (ISSA): Aims, methodology, and outcomes

ABSTRACTDespite the increasing availability of gerontological training programs, knowledge of their contents, characteristics, methods, and outcomes remains limited. However, the transition from multidisciplinarity to interdisciplinary orientations is now fundamental to such training, providing participants from diverse academic orientations and professional backgrounds with opportunities to interact across boundaries. In response to recommendations of the European Union Futurage A road map for European ageing research (FUTURAGE, 2011) concerning training and career-development needs of future cohorts of practitioners and scholars in aging, an International Summer School on Ageing (ISSA) was developed in 2012. Its aim was to initiate the practical implementation of some of the capacity building goals identified by Futurage. The design and structure of the ISSA was informed by the experience of Canada’s Summer Programme in Ageing—run by the Institute of Aging of the Canadian Institutes of Health Research—and by the cross-border academic training activities organized by Lund University (Sweden) in Scandinavian countries. As Italy has lacked a tradition of comprehensive, interdisciplinary training programs in gerontology, the Italian National Institute of Health and Science on Ageing undertook to launch the inaugural ISSA. In this article, the core aims and methodology of the ISSA are presented, together with an analysis of its main outcomes, as measured by participant evaluations. These are discussed in the context of international debate on this topic.

Expectations and requests regarding team training interventions to promote interdisciplinary collaboration in medical rehabilitation--A qualitative study.

BackgroundInterdisciplinary teamwork and team interventions are highly valued in the rehabilitation sector because they can improve outcomes of care for persons with complex health problems. However, little is known about expectations and requests regarding team interventions, especially in medical rehabilitation. This study aimed to explore how clinical managers and health professionals within multidisciplinary rehabilitation teams describe their expectations and requests regarding team-training interventions in the field of medical rehabilitation.MethodsConsidering the methodology of qualitative research, data were collected using semi-structured interviews and focus groups at five rehabilitation clinics in Germany. We conducted face-to-face interviews with 5 clinical managers and 13 department heads of health care teams as well as five focus groups with a total of 35 members of interdisciplinary rehabilitation teams. Afterwards, the data were analyzed through qualitative content analysis encompassing data coding and using inductive thematic analysis.ResultsThe exploration of team members´ and clinical managers´ descriptions showed that, to them, interdisciplinary team training programs should include a wide array of training contents. Seven common core themes emerged from the interviews, including participation of employees, leadership, communication, team meetings, team composition, coordination, and equal esteem. Additionally, 13 themes were identified by either managers or team members. The body of expectations regarding team training content in healthcare spans the continuum of changes on the team and organizational levels. On the organizational level, a number of structural factors were mentioned (e.g. improving the general conditions for team meetings, organized workshops to exchange interdisciplinary experiences, and leadership training), and on the team level, changes in procedural factors were listed (e.g. optimizing the consecutive planning and coordination of patient treatments, clarity with regard to roles and responsibilities of team members, and mutual esteem and appreciation between different professions).ConclusionsThe synthesis underscores that there is meaningful heterogeneity in team training needs; training interventions should be locally adapted for each clinic in terms of training content and training strategies. Tailored team interventions are important for rehabilitation clinics. Future work should evaluate employed team training concepts over time as well as training contents, implementation strategies, and learning outcomes. This includes using robust study designs and evaluating team-training effects.

Improving Resident Performance Through a Simulated Rapid Response Team: A Pilot Study.

The Joint Commission requires hospitals to develop systems in which a team of clinicians can rapidly recognize and respond to changes in a patient's condition. The rapid response team (RRT) concept has been widely adopted as the solution to this mandate. The role of house staff in RRTs and the impact on resident education has been controversial. At Christiana Care Health System, eligible residents in their second through final years lead the RRTs. To evaluate the use of a team-based, interdisciplinary RRT training program for educating and training first-year residents in an effort to improve global RRT performance before residents start their second year. This pilot study was administered in 3 phases. Phase 1 provided residents with classroom-based didactic sessions using case-based RRT scenarios. Multiple choice examinations were administered, as well as a confidence survey based on a Likert scale before and after phase 1 of the program. Phase 2 involved experiential training in which residents engaged as mentored participants in actual RRT calls. A qualitative survey was used to measure perceived program effectiveness after phase 2. In phase 3, led by senior residents, simulated RRTs using medical mannequins were conducted. Participants were divided into 5 teams, in which each resident would rotate in the roles of leader, nurse, and respiratory therapist. This phase measured resident performance with regard to medical decision making, data gathering, and team behaviors during the simulated RRT scenarios. Performance was scored by an attending and a senior resident. A total of 18 residents were eligible (N=18) for participation. The average multiple choice test score improved by 20% after didactic training. The average confidence survey score before training was 3.44 out of 5 (69%) and after training was 4.13 (83%), indicating a 14% improvement. High-quality team behaviors correlated with medical decision making (0.92) more closely than did high-quality data gathering (0.11). This difference narrowed during high-pressure scenarios (0.84 and 0.72, respectively). Our data suggest that resident training using a team-based, interdisciplinary RRT training program may improve resident education, interdisciplinary team-based dynamics, and global RRT performance. In turn, data gathering and medical decision making may be enhanced, which may result in better patient outcomes during RRT scenarios.

Bringing the Elephant into the Room: Integrating Risk into Interdisciplinary Water Programs

Problems that require risk management are usually cross-disciplinary in nature, which makes it difficult to educate students and professionals on common language, skills, and strategies. Recognition of the interdisciplinary nature of many water challenges in terms of quality, allocation, future supply, infrastructure, damages, etc. has led to the establishment of interdisciplinary graduate water programs. Motivated by experience in an interdisciplinary water program at Tufts University, this paper argues that explicit coverage of the subject of risk is an important component of an interdisciplinary water training program, and that understanding risk should be a core competency of a water professional. The literature on water education is reviewed, particularly regarding the core competencies of an interdisciplinary water professional. Existing interdisciplinary water graduate programs are also surveyed to identify if, and how, risk features in their program descriptions or curriculums. Our analysis found that risk was not mentioned as a core competency or key issue in any of the literature on interdisciplinary water education or training, and featured in only a few program descriptions or curriculums. Based on this analysis, we conclude that there is a significant need to address risk more centrally and explicitly in interdisciplinary water programs.

LEAH interdisciplinary training program.

This article describes the Leadership Education in Adolescent Health (LEAH) interdisciplinary training program in the United States. The Maternal and Child Health Bureau authorized by legislation provides monies to train leaders in adolescent health through a competitive grant process. Currently, seven academic medical centers have funding to provide leadership in adolescent health (LEAH) training in five core disciplines: medicine, nursing, psychology, social work and nutrition. LEAH training programs both ensure high clinical competence in core disciplines serving adolescents and prepare trainees for leadership positions in adolescent health and public health care realms. Together, these programs trained almost 1000 long-term trainees across these five disciplines, and graduates from these programs are working in 45 of the 50 states within the United States. About 90% of these graduates are working with maternal and child/adolescent health populations, and almost all have held leadership positions in the areas of public health, advocacy, public policy, academic medical centers and/or clinical care settings.

Squaring Circles: The gap for Interdisciplinary Trainees in a Discipline-Driven Academy

The growth of interdisciplinary health services research training programs across Canada has in part been due to acknowledgement of and efforts to bridge a gap between researchers, policy makers and practitioners. Consequently, a new breed of interdisciplinary health services researchers (many of which have specialization in knowledge translation) are now ready to meet complex system demands only to find limited career opportunities. We argue that the investments for advancing interdisciplinary health service training have not been paralleled in with post-training positions in academia and elsewhere, and change must occur.

Crossing Boundaries: The Design of an Interdisciplinary Training Program to Improve Care for the Frail Elderly

The Technology Evaluation in the Elderly Network (TVN) was funded in July 2012 under the Canadian Networks of Centres of Excellence program. This article highlights the development and preliminary evaluation of the TVN Interdisciplinary Training Program. This program is based on an experiential learning approach that crosses a multitude of disciplines including health sciences, law, social sciences, and ethical aspects of working with the frail elderly. Opportunities within the program include mentorship, interdisciplinary online collaborative projects, external placements, academic products, pre-grant submission, trainee-driven requirements, Network meetings, online modules/webinars, and most importantly active involvement with patients, families, and their support systems. The authors have 120 trainees from approximately 23 different disciplines including law, ethics, public policy, social work, and engineering engaged in the program. Based on our evaluation this program has been perceived as highly valuable by the participants and the community.

Workplace-based clinical leadership training increases willingness to lead.

The purpose of this paper is to reflect upon a workplace-based, interdisciplinary clinical leadership training programme (CLP) to increase willingness to take on leadership roles in a large regional health-care centre in Victoria, Australia. Strengthening the leadership capacity of clinical staff is an advocated strategy for improving patient safety and quality of care. An interdisciplinary approach to leadership is increasingly emphasised in the literature; however, externally sourced training programmes are expensive and tend to target a single discipline. Appraisal of the first two years of CLP using multiple sourced feedback. A structured survey questionnaire with closed-ended questions graded using a five-point Likert scale was completed by participants of the 2012 programme. Participants from the 2011 programme were followed up for 18 months after completion of the programme to identify the uptake of new leadership roles. A reflective session was also completed by a senior executive staff that supported the implementation of the programme. Workplace-based CLP is a low-cost and multidisciplinary alternative to externally sourced leadership courses. The CLP significantly increased willingness to take on leadership roles. Most participants (93 per cent) reported that they were more willing to take on a leadership role within their team. Fewer were willing to lead at the level of department (79 per cent) or organisation (64 per cent). Five of the 11 participants from the 2011 programme had taken on a new leadership role 18 months later. Senior executive feedback was positive especially around the engagement and building of staff confidence. They considered that the CLP had sufficient merit to support continuation for at least another two years. Integrating health-care professionals into formal and informal leadership roles is essential to implement organisational change as part of the drive to improve the safety and quality of care for patients and service users. This is the first interdisciplinary, workplace-based leadership programme to be described in the literature, and demonstrates that it is possible to deliver low-cost, sustainable and productive training that increases the willingness to take on leadership roles.

The medical home and integrated behavioral health: advancing the policy agenda.

There has been a considerable expansion of the patient-centered medical home model of primary care delivery, in an effort to reduce health care costs and to improve patient experience and population health. To attain these goals, it is essential to integrate behavioral health services into the patient-centered medical home, because behavioral health problems often first present in the primary care setting, and they significantly affect physical health. At the 2013 Patient-Centered Medical Home Research Conference, an expert workgroup convened to determine policy recommendations to promote the integration of primary care and behavioral health. In this article we present these recommendations: Build demonstration projects to test existing approaches of integration, develop interdisciplinary training programs to support members of the integrated care team, implement population-based strategies to improve behavioral health, eliminate behavioral health carve-outs and test innovative payment models, and develop population-based measures to evaluate integration.

Training program for the management of two obstetric emergencies within a French perinatal care network

ObjectivesTo evaluate the effectiveness of an interdisciplinary team training program based on simulated scenarios and focusing on two obstetrical emergency situations: shoulder dystocia and complicated breech vaginal delivery (CBVD). These situations are rare, so there are few opportunities for real-life training, yet their competent and efficient management is crucial to minimizing the risks to mother and child. Study designThe target population for training comprised the 450 professionals working in the French regional perinatal care network ELENA. An expert committee defined the topics for the training program, selected the simulated scenarios and developed the evaluation grids. The training sessions were conducted by two qualified and experienced professionals in each maternity unit. They comprised a theoretical introduction followed by practical exercises in management of simulated emergency situations by the participant teams, with the aid of a mannequin. Each team completed the exercises twice, their performances being filmed, reviewed and evaluated in each case. ResultsThe training sessions took place over 9 months between September 2012 and June 2013. A total of 298 professionals (obstetricians, residents in obstetrics, midwives and nursery nurses) were trained, representing 75% of the staff working in the ELENA perinatal care network. The results showed substantial and significant increases in the overall scores for management of the two emergency situations (from 74.5% to 91.4% for shoulder dystocia [p<0.0001], and from 67.2% to 88.4% [p<0.0001] for CBVD) as well as in the scores for all the specific areas of expertise assessed: safety, know-how, technique, team communication and communication with the patient. ConclusionThis study demonstrated the value of multidisciplinary team training for obstetric emergencies, encouraging the ELENA perinatal care network to implement an annual training program for its staff. Over and above our experience, the future establishment of a national education program to optimize the management of obstetric emergencies seems to be essential.

The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference

The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference

Charles Wagley's legacy of Interdisciplinary Graduate Research and Training Programs at the University of Florida

When Charles Wagley moved from Columbia University to the University of Florida (UF) in 1972, he established the Tropical South America Program. In this program he began an enduring legacy at UF of interdisciplinarity, collaborative research and training focused on the problems and solutions of tropical development, and support for students as future leaders. Reaching out to agricultural researchers and other social science disciplines, Wagley later co-founded and directed the Amazon Research and Training Program (ARTP), and remained active even after his retirement in 1983. The ARTP built on Wagley's strategy of supporting student research and building collaboration with partners in Latin America, and innovated in bringing in visiting professors from different disciplines, developing new interdisciplinary courses, and networking among Amazonian scholars in different countries. Wagley's most lasting contribution is the Tropical Conservation and Development (TCD) program, which grew out of the ARTP to become an internationally-recognized interdisciplinary graduate program focused on the intersection between biodiversity conservation and the well-being of people in the tropical world. Drawing on participation from over 100 faculty affiliates in 27 academic units at UF, since 1980 the ARTP and TCD programs have trained over 400 graduate students from two dozen countries.

Establishing a clinical pharmacology fellowship program for physicians, pharmacists, and pharmacologists: a newly accredited interdisciplinary training program at the Ohio State University.

Studying the effect of drugs on humans, clinical pharmacologists play an essential role in many academic medical and research teams, within the pharmaceutical industry and as members of government regulatory entities. Clinical pharmacology fellowship training programs should be multidisciplinary and adaptable, and should combine didactics, applied learning, independent study, and one-on-one instruction. This article describes a recently developed 2 year clinical pharmacology fellowship program – one of only nine accredited by the American Board of Clinical Pharmacology – that is an integrative, multi faceted, adaptable method for training physicians, pharmacists, and scientists for leadership roles in the pharmaceutical industry, in academia, or with regulatory or accreditation agencies. The purpose of this article is to provide information for academic clinicians and researchers interested in designing a similar program, for professionals in the field of clinical pharmacology who are already affiliated with a fellowship program and may benefit from supplemental information, and for clinical researchers interested in clinical pharmacology who may not be aware that such training opportunities exist. This article provides the details of a recently accredited program, including design, implementation, accreditation, trainee success, and future directions.

Barbara L. Bonner: Award for Distinguished Contributions of Applications of Psychology to Education and Training.

The Award for Distinguished Contributions of Applications of Psychology to Education and Training acknowledges psychologists who contribute to new teaching methods or solutions to learning problems through the use of research findings or evidence-based practices. Particular emphasis is placed on the use of psychological knowledge to improve learning in educational settings, including prekindergarten to Grade 12, or in communities. The 2014 recipient is Barbara L. Bonner. She is acknowledged for "her passionate determination to improve the lives of children throughout the world by training countless professionals to be leaders in the field of child maltreatment, for her leadership in establishing one of the most highly respected centers for the study of child maltreatment in the nation, and for directing an interdisciplinary training program on child maltreatment. Bonner's award citation, biography, and a selected bibliography are presented here.

Design and Modeling of a Three-axis Piezoresistive Microelectronic Accelerometer

Abstract Micro-electro-mechanical systems (MEMS) for automotive industry and biomedical applications (BioMEMS) have the fastest growth rate within the MEMS market. The Microsystems job market imposes to research laboratories and universities to respond by increasing the quality of MEMS engineering and informatics interdisciplinary training programs. In this fact, our work consists to study and develop a three-axis piezoresistive accelerometer having uniform sensitivities along to three axes. This sensor which is made of a heavy proof mass and four long beams, allow us to obtain high sensitivities, by reducing the resonant frequencies. Uniform axial sensitivities, with a transverse sensitivity, could be obtained using a three-axis sensor. The stress analysis of this sensor was performed in order to determine the positions of the piezoresistances, in the four flexure beams.

Abstract CN06-01: Molecular pathological epidemiology (MPE): Overview of its paradigm and wide applicability even without tumor tissue

Abstract This lecture illustrates “Molecular Pathological Epidemiology (MPE)” (= Molecular Pathology + Epidemiology)” (Ogino et al. J Natl Cancer Inst 2010; Chia et al. Nat Rev Clin Oncol 2012; Spitz et al. Cancer Discovery 2012, etc.) as simply as possible. In conventional epidemiology, disease is nominally regarded as a homogeneous entity, even when “omics” technologies are used for exposure assessment. However, carcinogenesis represents fundamentally heterogeneous process, differing from person to person. As implicated by the “Unique Tumor (Disease) Principle” (Ogino et al. Expert Rev Mol Diagn 2012; Ogino et al. Mod Pathol 2013; many TCGA papers), the inherent nature of disease heterogeneity has necessitated a paradigm shift in epidemiology, leading to the emergence of MPE, which is defined as “epidemiology of molecular heterogeneity of disease” (Ogino et al. Oncogene 2013). In MPE, we dissect complex interplay between environmental, dietary and lifestyle factors, molecular alterations, and disease occurrence and progression. MPE research can be conducted in any epidemiology cohort, even without tumor tissue, as heterogeneity of disease biology can be taken into analysis. MPE is a logical next step of genome-wide association studies [“GWAS-MPE Approach” (Ogino et al. Gut 2011)]. Although MPE is a promising approach (Chan et al. NEJM 2007; Chan et al. JAMA 2009; Morikawa et al. JAMA 2011; Liao et al. NEJM 2012; Nishihara et al. JAMA 2013; Nishihara et al. NEJM 2013, etc.), challenges include lack of international guidelines and standardized statistical methods to assess etiologic heterogeneity, as well as paucity of interdisciplinary expertise and training programs (Ogino et al. Am J Epidemiol 2012). Because disease heterogeneity is a ubiquitous phenomenon, the MPE paradigm should become routine to advance epidemiology in the 21st century, and move us towards personalized prevention and treatment. Citation Format: Shuji Ogino. Molecular pathological epidemiology (MPE): Overview of its paradigm and wide applicability even without tumor tissue. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr CN06-01.

Interdisciplinary Simulation-Based Training to Improve Delivery Room Communication

Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams. Obstetric and pediatric teams participated in an SBT annually during 3 academic years, 2008-2011 (Y1-Y3), in a prospective, observational study. Eligible participants (n = 228) included attendings, fellows, house staff, midlevel providers, and nurses involved in delivery room care. Simulations were videotaped and evaluated using a validated 20-item checklist of best communication practices. Checklist scores were compared across years with the Kruskal-Wallis test. Providers were also surveyed annually regarding communication during actual deliveries using a standardized questionnaire. Ratings were analyzed using two-way analysis of covariance. At least 60% of eligible providers participated in 1 or more SBT sessions and completed surveys annually. Checklist scores on communication during SBT improved from Y1 (median, 6; interquartile range, 4) to Y3 (median, 11; interquartile range, 6) (P < 0.001). Survey results showed the perception of improvement over time in interteam communication during actual deliveries by obstetric (P < 0.005) and pediatric (P < 0.0001) providers. The obstetric team also perceived improved provider communication with the family (P < 0.05). Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.

Mentoring Interdisciplinary Research Teams for the Study of Sex and Gender Differences in Health and Disease

Initiatives to hasten the translation of basic science discoveries to clinical care have necessitated the development of new approaches to interdisciplinary collaboration and training of future investigators. This has been nowhere more important than in the study of sex differences with implications for extension into areas of gender medicine. Clearly, gaining better understanding of the role that sex and gender play in health and disease is essential to the implementation of truly individualized medicine. This case report will describe our experiences in developing the Mayo Clinic Building Interdisciplinary Research Programs in Women's Health (BIRCWH) program, an interdisciplinary research and training program in women's health and sex and gender differences. We identify both our successes and the barriers we have encountered in order that others who are developing similar programs might benefit from our experiences.

Can a brief two-hour interdisciplinary communication skills training be successful in undergraduate medical education?

ObjectiveTo pilot-test feasibility, acceptance and learning-outcomes of a brief interdisciplinary communication skills training program in undergraduate medical education. MethodsA two-hour interdisciplinary communication skills program with simulated patients was developed and pilot-tested with clinical students at Hamburg University. Five psychosocial specialties facilitated the training. Composite effects were measured qualitatively and quantitatively. ResultsEighty students volunteered to participate in the pilot-program (intervention-group). Their evaluations of the program were very positive (1.1 on a six-point scale). Benefits were seen in feedback, increase of self-confidence, cross-disciplinary clinical and communication experience. Students who did not volunteer (n=206) served as the control-group. The intervention-group performed significantly better (p=0.023) in a primary care communication examination and female students performed better than males. Clinical teachers evaluated the pilot-training very positively with regard to learning-outcomes and feasibility. The positive results from the pilot-training led to implementation into the regular curriculum. ConclusionsA two-hour interdisciplinary communication skills training program is beneficial for medical students with regard to communication competencies, self-confidence and learning-outcomes. Practice implicationThe training is feasible within given time-frames and limited staff resources. The high teaching load for small-group-training are split between five specialties. The concept might be an interesting option for other faculties.