Internal Training Research Articles

Case study: Evaluating deep-water start techniques and training demands in seated slalom waterskiing for an athlete with paraplegia.

Recreational and competitive slalom waterskiing is increasingly popular among individuals with spinal cord injuries (SCI), particularly for those with paraplegia using sit-skis. A key component of slalom skiing is the deep-water start (DWS), yet little is known about the physiological and physical demands of this activity when the athlete is seated. This study aims to fill this gap by focusing on the training requirements for a seated slalom athlete. Focusing on a young male athlete with paraplegia, this case study evaluates the effectiveness and efficiency of traditional (TDWS) and alternative (ADWS) DWS techniques during seated slalom waterskiing sessions. It assesses internal training load (TL) through heart rate (HR) zones and session rating of perceived exertion (sRPE), alongside pre- and post-session handgrip strength measurements to gauge peripheral muscle fatigue. Performing the ADWS, achieving a full success rate, proved more effective but slightly more time-consuming than TDWS, which had limited success. HR during DWS maneuvers ranged from 63.2 to 81.3% of maximal HR, with most sessions occurring below the ventilatory threshold, thus perceived as hard effort. A moderate yet non-significant correlation was found between HR and sRPE-based TL. A significant reduction in handgrip strength post-session underscores the activity's demands. These insights illuminate the technical, physiological, and physical challenges in mastering DWS for seated slalom athletes with SCI, providing valuable guidance for the development of tailored training programs and techniques in this sport.

Examining where to go: pediatric psychology trainees' perception of their graduate training in culture and diversity.

Culture and diversity-related training is critical to the development of competent pediatric psychologists. Evaluation of training efforts have been conducted at the program level, yet evaluation of trainee experiences in culture and diversity-related training remains unassessed. This trainee-led study was the first formal assessment of pediatric psychology trainee experiences of culture and diversity-related training and the impact of training on their own cultural humility. Study overview and a survey link was distributed across 2 listservs associated with the American Psychological Association (Division 53, Division 54) and sent directly to directors of graduate, internship, and fellowship training programs with a request to share with trainees. Surveys assessing integration of cultural training and trainee cultural humility were completed. Trainees also provided qualitative feedback regarding their multicultural training and development. Pediatric psychology trainees (N = 90) reported inconsistent integration of culture and diversity topics into their training. Of the 34 training areas assessed, 10 were perceived as thoroughly integrated into formal training by at least half of the respondents. Trainees often sought independent cultural training outside of their programs, and no relationship was detected between perceived integration of cultural training and trainee cultural competence. Results indicate room for improvement regarding integration of cultural training and a need to better understand driving forces behind trainees independently seeking training outside of their formal training programs. Moreover, understanding the aspects of training that are most contributory to trainee development is needed given that no relationship between training and development emerged in the current study.

Medical Education Abroad: Reflections and Experiences of a Brazilian Student in Paraguay

Medical training outside Brazil has emerged as a significant choice for many Brazilians seeking more accessible educational alternatives. This article aims to explore the reflections and experiences of Dr. Fabiana Gnoatto, a former Brazilian student who chose to study medicine in Paraguay. Her account analyzes the challenges she faced, the coping strategies she adopted and the lessons she learned throughout her academic and professional career. Among the main challenges identified was adapting to a different curriculum and varied teaching methodologies, requiring substantial academic flexibility on the part of Brazilians who chose to study medicine in Paraguay. The language barrier, marked by the need to master Spanish in order to follow classes and interact effectively, emerges as one of the greatest difficulties faced by this group. In addition, cultural integration is complex, requiring students to adapt to local customs and practices. The distance from family and friends, combined with academic and personal pressure, tends to generate high levels of stress and anxiety, making it a significant additional challenge. To mitigate these challenges, Brazilian students need to develop a range of strategies that might not be necessary if they were pursuing the same career in their home country. Advance preparation and planning for this student migration is essential to achieving efficient academic performance. Active participation in classes, combined with the formation of study groups, would facilitate understanding, assimilation of content and the exchange of experiences between these individuals who almost always share the same difficulties in adapting. The development of local support networks emerges as a crucial element, providing emotional and practical support. Maintaining constant contact with family and friends, using modern technology, would help to reduce the feeling of isolation. Seeking psychological support, which is essential for dealing with stress, complements adaptation strategies. Participating in cultural activities in the host country, adapting to local customs and lifestyle are also key to successful integration. Dr. Fabiana Gnoatto's experiences show that, with determination, appropriate strategies and support, it is possible to overcome obstacles and achieve a successful medical career without losing quality of life during academic training. Their experiences serve as a paradigmatic guide for future students, helping them to prepare more effectively and face the challenges of international medical training. In this way, they can transform a challenging experience into an opportunity for personal and professional growth, highlighting the importance of resilience and adaptation in diverse educational and cultural contexts.

MSME Development Through Simple Bookkeeping, Financial Management and Internal Control Training

This research aims to develop MSMEs in Aek Songsongan Asahan Sub-district through training in simple bookkeeping, financial management, and internal control. This research uses a qualitative research design with a field study approach. Data were collected through interviews, observation, and evaluation. Data analysis used data triangulation, which combines data from various sources. The results showed that the training improved the efficiency and effectiveness of MSME operations, and promoted financial growth and stability. A more detailed discussion compares with previous studies in the last five years that show the positive impact of training in simple bookkeeping, financial management, and internal control on MSMEs. However, this study also explores aspects of sustainability and technology integration that have not been widely discussed in previous studies. This research makes an important contribution in developing MSMEs through human resource capacity building, particularly in the aspects of simple bookkeeping, financial management, and internal control.

BRAVER challenges students in radiation protection training in an international training

The nuclear industry is currently facing a significant demand for well-trained personnel. Due to the high market demand, it is essential to raise awareness among new target groups, including high school pupils and (pre-service) STEM teachers, about the potential and opportunities of pursuing a nuclear career. With this in mind, a new strategic partnership has been established under the Erasmus+ project ‘BRAVER’ (Blended and Remote teaching Activities supported by Virtual rEality for Radiation sciences). Within this 2-year project, international staff, and students from 7 partners of the CHERNE (Cooperation of Higher Education on Radiological and Nuclear Engineering) network collaborate with industry, regulatory and research institutes in developing educational virtual tools (VR and virtual online escape rooms) for nuclear sciences and engineering. The project aims to develop blended international training programs that incorporate technical, generic, and networking skills for both students and professors. This initiative can serve as a model for other scientific fields, extending its benefits to students and educators across different disciplines.

Practice-Integrated Study Programs in Agriculture Sciences for A Better School to Work Transition in Albania and Kosovo: A Stakeholders Overview

The quality of study programs in higher education plays a crucial role in helping graduates transition from university to the labor market. There is a risk of losing qualified human resources in a knowledge-based society and economy if the education provided does not meet the needs of the labor market. This has led governments and higher education institutions in Albania and Kosovo to reconsider their academic offerings and study program curriculums to better integrate graduates into the labor market. This study examines how stakeholders, both private and public institutions, perceive the practical orientation of higher education study programs in agricultural sciences. A structured questionnaire with closed-ended questions using a Likert rating scale was used to analyze the views and expectations of employees in the public and private sectors about the practical skills that graduates in agricultural sciences should possess. The total number of analyzed questionnaires was 294. Employers in the labor market consider work-based placements, continuous training, and international training of students as "very important" to meet the demand for skills in the labor market. More than 91% of public institution executives stressed the importance of "practice" in reducing the practical skills gap for students, compared to 78% of private sector employees. The findings revealed that public employees are more aware than private sector employers that close cooperation between HEIs and work-life partners is crucial for producing a “university product” that meets future society's needs.

Training of interns in the system of medical triage of patients on the basis of the Simulation Center of the Kazakh National Medical University

Providing emergency care to patients is a basic skill for doctors of any specialty. Emergency department overcrowding is a pressing public health problem that affects countries around the world. Medical Triage or triage is the process of prioritizing medical care for patients based on the severity of their condition.

Seeking help as a strategy for ethical and professional decision-making in research: Perspectives of researchers from East Asia and the United States

ABSTRACT Background: A person’s cultural background shapes how they interpret and navigate problems. Given that large numbers of international researchers work and train in the U.S. we sought to better understand how researchers use the decision-making strategy of seeking help to navigate ethical and professional challenges.Methods: Participants (N = 300) were researchers working or training in the U.S. who were born in East Asia (EA) or born in the U.S. They completed a screening survey; then a subset completed think-aloud interviews (n = 66) focused on how they would respond to three hypothetical research scenarios.Results: Thematic analysis of the transcripts showed that seeking help was a commonly endorsed strategy, with some nuances between groups. Themes included seeking help in the form of getting advice, seeking someone to help solve the problem, and gathering information. Endorsement of the seeking help strategy frequently depended on participants’ relationships; desiring to seek help from people they trusted. Notably, EA participants tended to prefer seeking help in ways that avoided reputational harm to others.Conclusion: A better understanding of how researchers from different cultural backgrounds use decision-making strategies can inform how to make educational programs more inclusive and comprehensive to more effectively develop researchers’ ethical and professional decision-making skills.

Improving dynamic prognostication of patients with hepatocellular carcinoma by node fusion algorithm equipped survival path mapping.

e13594 Background: Patients with hepatocellular carcinoma (HCC) always require routine surveillance and repeated treatment. Our previous work (1) developed a machine learning methodology called “Survival Path Mapping”, which converted the time series data into a cascading survival map to facilitate dynamic prognosis prediction and treatment planning. However, in previous work, the exponential growth of paths raised challenges of exhausting limited cohort and over-fitting risk. Novel algorithm enhancing data utilization in the Survival Path Mapping was in urgent need. Methods: A node fusion algorithm was designed. First, feature selection algorithm bifurcated each parent-nodes into temporary child-nodes, which constitutes temporary child-nodes set. Then, clustering was performed within temporary child-nodes set according to key features of each child-node. Finally, in each cluster, multiple child-nodes would be merged into one if there was no significant difference in survival. For nodes with bifurcation, a treatment recommendation algorithm was developed. A total of 19446 patients with newly diagnosed primary HCC at Sun Yat-sen University Cancer Center (SYSUCC) between 2008 and 2023 were retrospectively included as internal cohort (divided into internal train and holdout validation cohort); meanwhile 1135 patients from five hospitals were included as multicenter external validation cohort. Dedicated natural language processing program was developed to extract structured features from medical imaging reports. The time series data of patients were converted into data of time slices, with an interval of 3 months. Results: The original survival path mapping (raw-SP) consists of 463 different nodes, while the node fusion survival path mapping (fusion-SP) consisted of 84 nodes (81.8% decrease from raw-SP). The 3-year c-index of fusion-SP were 0.745 (95% CI 0.717-0.772), significantly better (p<0.001) than that of raw-SP: 0.725 (95% CI 0.696-0.755), in the internal holdout validation. Both raw-SP and fusion-SP significantly (p < 0.001) outperformed conventional BCLC and CNLC staging. In the multicenter external validation, the fusion-SP also demonstrated better performance than raw-SP and BCLC staging system. The recommended therapy calculated based fusion-SP system for patients receiving second-line or subsequent treatment had superior or non-inferior efficacy compared to BCLC guideline’s recommendation. Conclusions: The proposed node fusion algorithm solved exponential growth of paths in previous survival path algorithm, improving the accuracy and external validity of dynamic prognosis prediction for HCC patients. The fusion-SP model also retained its transparency and could be used to guide dynamic treatment planning, with its effectiveness in treatment guidance evaluated in prospective trials in the future. 1. Nat Commun 9, 2230; 2018.

Empowering tomorrow's oncologists: Establishing an oncology student interest group to propel careers in cancer care.

e21014 Background: In cancer care, smaller academic community hospitals play a crucial role in serving local and underserved populations. However, these institutions often need help providing comprehensive mentorship opportunities for internal medicine residents interested in pursuing careers in oncology. Limited resources, smaller clinical teams, and a focus on delivering patient care often precede research and scholarly activity. To help with this goal, ASCO has a program known as OSIG, which stands for Oncology Student Interest Group, which provides resources for medical students and residents to meet regularly, network with academic faculty, learn about cancer care, and learn about opportunities in oncology. Methods: This observational study employed a cross-sectional survey design to investigate the perceived benefits of establishing an oncology interest group among internal medicine residents. The survey aimed to collect quantitative and qualitative data on residents' opinions regarding the potential advantages, challenges, and overall impact of initiating an ASCO affiliated oncology-focused student interest group [OSIG] within an academic community hospital internal medicine residency program in Worcester, MA. Results: Of the total strength of 75 residents, a total of 17 residents were surveyed for this project, with 7 [41%] female, and 10 [59%] male residents. 6 [35%] PGY1, 2 [11%] PGY2, and 9 [52%] PGY3 residents participated in the survey. 15 [88%] residents were 'very likely' interested in a career in oncology. 16 [94%] residents replied that participating in the oncology interest group meetings enhanced their understanding of cancer care and treatment options. 17 [100%] replied that networking with oncology professionals was 'very important' for their career development. 15 [88%] replied that the support provided by the OSIG helped find them mentorship opportunities 'to a large extent'. 15 [88%] replied that the oncology interest group could assist in clarifying their career goals within oncology by 'a lot'. The survey included two questions with room for subjective answers aboutpotential challenges or concerns, and additional thoughts, suggestions, or comments. Conclusions: The results indicate that residents recognize the potential of an ASCO-affiliated interest group to significantly enhance their understanding of cancer care and treatment options, providing a valuable supplement to their internal medicine training. The prospect of networking with established oncologists by spurring collaboration among residents, attending national and local conferences in the field is deemed crucial for career development, as is the belief that mentorship opportunities within the interest group could play a pivotal role in shaping future careers in oncology.

Fifteen Years of Integrated Terrestrial Environmental Observatories (TERENO) in Germany: Functions, Services, and Lessons Learned

AbstractThe need to develop and provide integrated observation systems to better understand and manage global and regional environmental change is one of the major challenges facing Earth system science today. In 2008, the German Helmholtz Association took up this challenge and launched the German research infrastructure TERrestrial ENvironmental Observatories (TERENO). The aim of TERENO is the establishment and maintenance of a network of observatories as a basis for an interdisciplinary and long‐term research program to investigate the effects of global environmental change on terrestrial ecosystems and their socio‐economic consequences. State‐of‐the‐art methods from the field of environmental monitoring, geophysics, remote sensing, and modeling are used to record and analyze states and fluxes in different environmental disciplines from groundwater through the vadose zone, surface water, and biosphere, up to the lower atmosphere. Over the past 15 years we have collectively gained experience in operating a long‐term observing network, thereby overcoming unexpected operational and institutional challenges, exceeding expectations, and facilitating new research. Today, the TERENO network is a key pillar for environmental modeling and forecasting in Germany, an information hub for practitioners and policy stakeholders in agriculture, forestry, and water management at regional to national levels, a nucleus for international collaboration, academic training and scientific outreach, an important anchor for large‐scale experiments, and a trigger for methodological innovation and technological progress. This article describes TERENO's key services and functions, presents the main lessons learned from this 15‐year effort, and emphasizes the need to continue long‐term integrated environmental monitoring programmes in the future.

Higher education and graduates' success in the labor market

This study reflects one of the aspects of social stratification; the relationship between education and economic remuneration is traced. The purpose of the study is to reveal the correlation of skills and competencies acquired during education and the graduates' employment. Over time, universities have begun to pay more attention to social and cognitive skills that are considered important for the modern labor market: critical thinking, teamwork, communication, problem solving without micromanagement. The data show the current state of affairs in higher education and in the labor market, where universities, to a greater extent, focus on competencies related to research and scientific activities, without relying on the opinions of employers. On the other hand, employers want to see graduates with a set of professional competencies that will allow them to perform their job duties without a long period of internal training. The work uses general scientific approaches to the study of the transformation of higher education, in particular, the method of institutional analysis was applied. The analyzed data allow us to take a look at the tasks that higher education faces at this stage. It was found that the link between diplomas and real skills, as well as economic rewards, is optional. Over time, universities have begun to pay more attention to social and cognitive skills that are considered important for the modern labor market: critical thinking, teamwork, communication, problem solving without micromanagement. At the same time, the problem of the slow response of higher education to the changing reality remains, in this regard, recommendations are given on monitoring feedback from graduates and employers (using quantitative and qualitative methods), so that universities will be able to adapt the courses taught more effectively. Especially important is the interaction of universities with public and private organizations that will immerse students in real work processes corresponding to the specialty.

Proactive efforts to eliminate sexual harassment by clients

Companies need to focus on eliminating sexual harassment of their employees by clients. Sexual harassment by clients can push valuable employees out of the company and result in liability for the employer. There are proactive steps that companies should take to ensure clients can be held accountable for sexual harassment with the ultimate goal of eliminating the harassment. This article provides recommendations for such proactive steps, including internal benchmarking, targeted policy-making, effective internal training, and the utilization of contract provisions to increase accountability.

Evaluation of Preclinical Dentistry Students' Perspectives Towards Disabled Individuals Before Clinical Internship Training

Objective: This study aims to evaluate the perspectives of preclinical dentistry students (1st, 2nd and 3rd year) towards disabled individuals before starting their clinical internship training. Methods: Our study was planned on 217 preclinical dentistry students studying at a dentistry faculty in Turkey. Survey form: It consists of 46 questions in total, including 6 questions that introduce students and 40 questions that constitute the Attitude Scale towards People Affected by Disabilities. The questions were directed to students in the Fall semester of the 2023-2024 academic year. For the analysis of the study; Power analysis, Frequency analysis, Normality test (Shapiro-Wilk), Independent T test, One-Way Analysis of Variance (ANOVA) and Tukey test were used. The significance level was accepted as α=0.05. Results: 179 students; 111 females and 68 males participated in the study. The participation rate was found to be 82.49%. With the perspectives of preclinical dentistry students towards disabled individuals; there wasn’t significant difference in terms of their gender (p>0.05), education level (p>0.05), attendance at any training/seminar on disabled individuals (p>0.05), presence of a disabled individual among their acquaintances (p>0.05) and living in the same house with a disabled individual (p>0.05). However, a statistical difference was detected in terms of the frequency of meeting with disabled individuals (p

Knowledge and awareness among dental and life science students towards research: A questionnaire based cross-sectional study

The aim of this study was to assess the knowledge and attitudes towards research and explore career interests among dental and life science students following their participation in an internship training program in bioresearch. The materials and methods involved a questionnaire-based survey conducted among CRI (Compulsory rotatory internship) dental students, postgraduate MDS students, and life science students who took part in the internship program organized by the Central Research Laboratory. Prior to the internship, participants were administered the questionnaire. The results revealed an overall research knowledge rate of 66% among participants, with CRI dental students demonstrating a higher rate at 72%. Additionally, 72% of the participants expressed positive views regarding research as a viable career option in their respective fields. This study primarily aimed to analyse research knowledge and attitudes among dental and life science students. Findings indicated a strong interest in research among students, highlighting the importance of targeted training in biomedicine and statistics. In conclusion, the study suggests that tailored training programs focusing on research methodology and statistics would be beneficial for medical and dental students entering the field.

The perception of the scope of oral and maxillofacial surgery and differentiation from similar specialities among dental students, medical students, trainee interns and pre-vocational junior doctors

PurposeTo explore the ability of Dental Students (DS), Medical Students (MS), Trainee Interns (TI) and Pre-vocational Junior Doctors (JD) in identifying procedures performed by Oral and Maxillofacial Surgery (OMS), the scope of practice (SOP) of OMS and ability to differentiate OMS from similar specialities.MethodsThe study included 282 complete responses to a survey consisting of: 9 demographic questions, 11 OMS awareness, professional ambition, teaching and exposure, confidence in identifying and referring questions and 70 procedural/scenario questions across four domains. Collected data was qualitatively and statistically analysed using SPSS V29.ResultsOMS awareness was limited. 92.2% reported None to Small amount of OMS teaching and exposure during university, with 66.0% preferring to have had a Fair to Significant amount. DS experienced more than medical respondents (2.1 vs. 1.5, p < 0.001). Most respondents reported No to Low confidence in identifying the SOP and procedures performed by OMS (67.7%) and referring to OMS (62.4%) compared to similar specialities (32.4% and 33.2%, respectively). 52.9% of procedures performed by OMS were correctly identified as being performed by OMS. The ability to identify the OMS SOP (8.7%) and differentiate OMS from similar specialities (5.0%) was low, however better among DS than medical respondents (14.9% vs. 6.3%, p = 0.002 and 12.2% vs. 2.2%, p < 0.001).ConclusionThe study has highlighted a deficit in the understanding of OMS with potential implications in the public and private healthcare sector. Identification of procedures, OMS SOP and ability to differentiate OMS from similar specialities is limited however slightly better among DS.

A multi-method approach to drafting candidate entrustable professional activities for a general internal medicine residency programme.

Entrustable professional activities (EPAs) are units of concrete daily clinical tasks that trainee physicians should be able to handle with increasing autonomy during their postgraduate training. EPAs are gaining international recognition as an essential component of competency-based medical training programmes. The process of developing EPAs for a nationwide training programme is complex and requires an in-depth understanding of EPAs as a concept and good knowledge of appropriate development processes. This article provides a detailed description of the methodology and results of a multi-step approach for developing a list of candidate EPAs for Switzerland's postgraduate training programme in general internal medicine (GIM). We took a multi-step approach including a systematic review of international literature, four national focus groups, a national consensus process using a RAND appropriateness method, and a quality check of the selected candidate EPAs using EQual criteria. These steps generated a final list of 247 candidate EPAs in general internal medicine that were submitted for the national consensus process. After two rounds of rating, experts agreed on the appropriateness for general internal medicine postgraduate training of 225 candidate EPAs. Twenty-two were deemed inappropriate, and disagreement persisted only for two EPAs. This multi-step programme is one of the few describing in detail the process of developing a list of EPAs and providing evidence of validity at each step. The clinical breadth of our candidate EPAs, together with the detailed description of our methodology, could serve as a useful starting point from which medical education specialists or clinicians could develop or revise applicable lists of EPAs, particularly for postgraduate training programmes in either general internal medicine or family medicine.

The Impact of the Opening of China-Europe Railway Express On the Development of Foreign Trade in Anhui Province

Since the "Belt and Road" initiative was put forward, China-Europe freight trains, as an important international transport channel for the Eurasian continent connectivity, have enhanced the level of bilateral trade facilitation and economic and trade cooperation, and had a profound impact on the development of foreign trade. Central trains is China to Europe and the "Belt and Road" international transport trains, central trains opening is the "Belt and Road" initiative China strengthen and countries along the important measures of connectivity, is an important gripper to promote the "Belt and Road" initiative, is an important part of "unicom" facilities, the opening of changed the previous central trains rely solely on maritime transport of export, greatly improve the level of export facilitation and management efficiency, for the improvement of foreign trade development provides strong conditions. The performance of China-Europe freight trains is even more impressive under the epidemic. As a huge potential mode of transportation between Europe and Europe, its importance is gradually emerging.

Impact of COVID-19 on China Railway Express: A More State-led Approach to Develop Freight Train

The China Railway Express (CR Express) is an international railway freight train organised by China Railway Corporation, which has been travelling between China and Europe since 2011. Since its inception, the volume of the CR Express train has increased year by year and the variety of foreign trade goods has been enriched. During the COVID-19, traditional transport channels such as sea and air transport were severely hit, while the volume and product range of the CR Express grew against the trend. Under the impact of the epidemic, the booming development of the CR Express trains could not have been achieved without the guidance and support of the state, i.e. the CR Express trains moved towards a more state-led development model.

A Study on the Application of Python in Corporate Financial Analysis

This article examines the application value, current status, and challenges of Python in corporate financial analysis and proposes targeted solutions to enhance its extensive use in financial practices. Currently, despite Python being recognized as a key tool to bolster corporate financial analysis due to its robust capabilities in data processing and analysis, its application in finance departments is limited by several core issues: a general lack of programming knowledge among finance professionals, insufficient operational training, and a lack of policy guidance for digital technology transformation. To address these issues, the paper puts forward five recommendations: 1) leverage the guiding role of governments and accounting associations; 2) continuously improve higher education programs for finance and accounting talent, integrating programming skills with traditional accounting courses; 3) strengthen university-enterprise cooperation and deepen teachers' enterprise practice; 4) develop comprehensive internal training and incentive mechanisms within companies; and 5) transition from abstract application guidelines to detailed application instructions. These strategies aim to significantly enhance the Python application skills of finance personnel, drive the digital transformation of the financial industry, and thereby generate greater value for businesses.