Skills Intervention Research Articles

The effects of a manipulative skills intervention programme on the motor proficiency of adolescents with intellectual disabilities

With this study we aimed to investigate the impact of a 12-week manipulative skills exercise programme on the motor proficiency of young individuals with intellectual disabilities. A total of 32 learners diagnosed with mild intellectual disabilities, with an average age of 17.81 ± 1.44 years, were divided into 2 equal-sized groups: a control group and an experimental group engaged in a manipulative skills intervention programme. Motor proficiency was assessed using the short form of the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT™-2), while the participants’ coordination level was evaluated using the Body Coordination composite of the BOT™-2. Results show that the manipulative skills intervention programme led to significant improvements in the experimental group’s total motor proficiency score on the short form BOT™-2 (45.31 ± 12.01 vs. 37.12 ± 7.00, ANCOVA: F = 48.65, p = 0.00) as well as the Body Coordination composite (42.69 ± 11.31 vs. 39.84 ± 11.75, ANCOVA: F = 44.35, p = 0.00). These findings suggest that the experimental exercise programme had a positive effect on enhancing the motor proficiency of young individuals with mild intellectual disabilities.

O pensamento computacional, como suporte ao pensamento matemático, na Instituição Educacional Santo Domingo Sávio de Chinchiná (Caldas – Colômbia)

The present research evaluated the improvement of mathematical thinking, from a computational skills intervention in eighth grade adolescent students of the Santo Domingo Savio Educational Institution of Chinchiná (Caldas-Colombia), of socio-economic stratum 1, 2 and 3, with ages between 12 and 17 years old. The work was prepared in the years 2020 and 2021, it was conceptually based on Computational Thinking proposed by Jeannette Marie Wing, for the process it was considered as the independent study variable and the Theory of Cognitive Development of Jean William Fritz Piaget was referenced, specifically on mathematical thinking, which in the study is the dependent variable. The research developed is of a quasi-experimental type, with an intentional nonprobabilistic sampling, we worked with experimental groups, one group for each year, to whom the “intervention program” was applied for four months; Before and after the intervention program, pretest and posttest tests were applied, using international tests called the “Binet-Simón and Wechsler mathematical intelligence test,” for the purposes of comparing evidence. Finally, through hypothesis tests, using the normal and Student’s t distributions, it is concluded that computational thinking (independent variable) has a statistically significant effect on the improvement of mathematical thinking (dependent variable).

Three-dimensional simulation for interventional cardiology procedures: Face and content validity

Introduction and objectivesThree-dimensional (3D) model simulation provides the opportunity to manipulate real devices and learn intervention skills in a realistic, controlled, and safe environment. To ensure that simulators provide a realistic surrogate to real procedures they must undergo scientific validation. We aimed to evaluate the 3D-printed simulator SimulHeart® for face and content validity to demonstrate its value as a training tool in interventional cardiology (IC). MethodsHealth professionals were recruited from sixteen Portuguese IC units. All participants received a 30-minute theoretical introduction, 10-minute demonstration of each task and then performed the intervention on a 3D-printed simulator (SimulHeart®). Finally, a post-training questionnaire focusing on the appearance of the simulation, simulation content, and satisfaction/self-efficacy was administered. ResultsWe included 56 participants: 16 “experts” (general and interventional cardiologists), 26 “novices” (cardiology residents), and 14 nurses and allied professionals. On a five-point Likert scale, the overall mean score of face validity was 4.38±0.35 and the overall mean score of content validity was 4.69±0.32. There was no statistically significant difference in the scores provided by “experts” and “novices”. Participants reported a high level of satisfaction/self-efficacy with 60.7% considering it strongly improved their skills. The majority (82.1%) “agreed” or “strongly agreed” that after the simulation they felt confident to perform the procedure on a patient. ConclusionThe 3D-printed simulator (SimulHeart®) showed excellent face and content validity. 3D simulation may play an important role in future IC training programs. Further research is required to correlate simulator performance with clinical performance in real patients.

Implementation of a lifestyle and life‐skills intervention to prevent weight‐gain and cardiometabolic abnormalities in young people with first‐episode psychosis as part of routine care: The Keeping the Body in Mind program

AbstractObjectivesIn 2013, a cluster‐controlled pilot study found the 12‐week Keeping the Body in Mind (KBIM) lifestyle and life skills intervention was able to prevent weight gain in a small sample of youth experiencing first‐episode psychosis (FEP) with fewer than 4 weeks of antipsychotic exposure. This study aims to evaluate the effectiveness of KBIM as routine care on anthropometry and metabolic biochemistry in a larger sample of youth with FEP across three community mental health services.MethodThis retrospective chart audit was conducted on youth with FEP, prescribed a therapeutic dose of antipsychotic medication, and who engaged with KBIM between 2015 and 2019. Primary outcomes were weight and waist circumference. Secondary outcomes were blood pressure, blood glucose, and blood lipids. Outcomes were collected in at baseline and at 12 weeks. Data on program engagement were obtained from the participant's medical file.ResultsOne‐hundred and eighty‐two people met inclusion criteria, and up to 134 people had baseline and 12‐week data on one or more outcome. Mean number of sessions attended was 11.1 (SD = 7.3). Increases in weight and waist circumference were limited to 1.5 kg (SD = 5.3, t(133) = 3.2, p = .002) and 0.7 cm (SD = 5.8, t(109) = 1.2, p = .23) respectively. Eighty‐one percent of participants did not experience clinically significant weight gain (>7% of baseline weight). There were no significant changes in blood pressure or metabolic biochemistry.ConclusionThe prevention of substantial gains in weight and waist circumference observed in the initial pilot study was maintained with implementation of KBIM as part of routine clinical care for youth with FEP.

Enhancing pastoralist women's knowledge of danger signs through home-based life-saving skills intervention in Northern Kenya: A quasi experimental study

BackgroundMaternal recognition of obstetric danger signs is crucial for reducing maternal mortality and delays in seeking emergency care. However, there is insufficient knowledge about obstetric danger signs among women in rural Kenya, especially in the hard-to-reach pastoralist communities. This study aimed to determine whether home-based life-saving skills intervention improves knowledge about obstetric danger signs among women in Marsabit County, Kenya. MethodsWe conducted a quasi-experimental study with pre-posttests among 256 pregnant women, allocated to intervention and control groups. We implemented sensitization of pregnant women on obstetric danger signs and basic life-saving actions as components of home-based life-saving skills intervention. While the control group continued with routine services. Descriptive statistics was used to analyze demographic data. The chi-square test and Difference-in-Difference analysis were used to compare the intervention's proportion differences and net effect. ResultsAt baseline, no significant differences in the knowledge level existed. Proportions of women who were knowledgeable of >3 danger signs increased significantly during pregnancy [(89.7%) vs. (62.5%), p < .0001], birth [(86.5%) vs. (75.0%), p = .022], postpartum [(92.1%) vs. (74.2%), p < .000] and neonatal period [(96.8%) vs. (66.7%), p < .0001] in the intervention group than the control group at end-line. ConclusionThese results imply that it is possible to improve knowledge of obstetric danger signs among women from hard-to-reach pastoralist communities as part of home-based life-saving skills interventions. Our work contributes to the United Nation's sustainable development goal 3, which focuses on equity and commitment to reaching people needing health services regardless of where they live and their circumstances.

Examining the Impact of Group-Based Social Skills Intervention in Autistic Children Aged Eight to 15 Years.

Introduction Autism spectrum disorder (ASD) is a neurological and developmental disorder, which poses challenges to social communication and behavior, particularly affecting social functioning. Individuals with ASD face significant social challenges, including difficulty understanding social cues and body language, limited ability to engage in reciprocal social interactions, and challenges with establishing empathy. A preference for routines and repetitive behaviors limits their ability to adapt to new or unexpected social situations. These problems tend to escalate during adolescence. These often cause distress to the individual as well as the caregivers. Group-based social skills interventions (GSSIs) are a widely used and effective modality for addressing core social impairments in children with autism. This study aims to assess the impact of GSSI on the broad age group of eight to 15 years, involving parents to enhance the transferability of children's social skills. Methods This was a single-arm interventional studywhere 30 verbal autistic children, aged eight to 15 years, withintelligence quotient (IQ) > 70 were enrolled after utilizing theBinet Kamat Test of Intelligence (BKT) to assess IQand the Indian Scale for Assessment of Autism (ISAA) tograde severity of autism. The children received GSSI frominterdisciplinary therapists for 12 sessions, on a weekly basis, lasting 90 minutes each for a period of three months. After each therapy session, parents received summaries of each session and were delegated reinforcing homework assignments to enable generalization and maintenance of the skills taught. Outcome measures were taken at three points in time by utilizing the Social Communication Questionnaire (SCQ) and the parent-rated Social Responsiveness Scale 2 (p-SRS-2):T1: pre-therapy at the time of enrolment; T2: immediately post-therapy at the end of three months of training; and T3: long-term follow-up, three months after the end of training. Results Mean SCQ scores were as follows: T1 = 21.87, T2 = 18.57, and T3 = 18.57 (p = 0.000). This progressive decline at T1, T2, and T3indicated a decreasing trend in the severity of difficulties in the social communication domain. Mean p-SRS-2 scores were as follows: T1 = 73.00, T2 = 64.57, and T3 =64.30 (p < 0.0001). This declining trend at T1, T2, and T3suggested a statistically significant decrease in the severity of difficulties faced in various social aspects tested by the p-SRS-2, i.e., social awareness, social cognition, social communication, and social motivation, along with a reduction in restricted interests and repetitive behaviors (RRBs). Very strong correlation coefficients were obtained for SCQ scores (T1-T2 = 0.921, T1-T3 = 0.921, and T2-T3 = 1.000), as well as for p-SRS-2 scores (T1-T2 = 0.743, T1-T3 = 0.746, and T2-T3 = 0.989), which reinforced the statistical significance of the data. Conclusion GSSI is an effective parent-assisted intervention foradolescents with ASD, with effects lasting up to three months post-intervention.

Empowered Relief, cognitive behavioral therapy, and health education for people with chronic pain: a comparison of outcomes at 6-month Follow-up for a randomized controlled trial.

We previously conducted a 3-arm randomized trial (263 adults with chronic low back pain) which compared group-based (1) single-session pain relief skills intervention (Empowered Relief; ER); (2) 8-session cognitive behavioral therapy (CBT) for chronic back pain; and (3) single-session health and back pain education class (HE). Results suggested non-inferiority of ER vs. CBT at 3 months post-treatment on an array of outcomes. Here, we tested the durability of treatment effects at 6 months post-treatment. We examined group differences in primary and secondary outcomes at 6 months and the degree to which outcomes eroded or improved from 3-month to 6-month within each treatment group. Empowered Relief remained non-inferior to CBT on most outcomes, whereas both ER and CBT remained superior to HE on most outcomes. Outcome improvements within ER did not decrease significantly from 3-month to 6-month, and indeed ER showed additional 3- to 6-month improvements on pain catastrophizing, pain bothersomeness, and anxiety. Effects of ER at 6 months post-treatment (moderate term outcomes) kept pace with effects reported by participants who underwent 8-session CBT. The maintenance of these absolute levels implies strong stability of ER effects. Results extend to 6 months post-treatment previous findings documenting that ER and CBT exhibit similarly potent effects on outcomes.

Striving Towards Independent Living: The Trials and Tribulations of Institutionalised Adolescents in Malaysia

This phenomenological study explores how five institutionalised Malay adolescents used adaptive strategies towards independent living upon being released from welfare institutions. Five 17-year-old Malay Muslim adolescents, three males and two females, were recruited via purposive sampling for a focus group discussion to gather insights into their plans and strategies to cope with life challenges after being released from their respective welfare institutions. Thematic analysis of the FGD data extracted six themes that portrayed the adolescents’ adaptive strategies for facing challenges in life. The themes include making personal preparations, acquiring personal strengths, setting a career direction, exploring the support of friends and outsiders, feeling of being complete, searching for personal necessities and having a sense of responsibility. The findings highlight the need for developing a comprehensive life skills intervention for institutionalised adolescents and psychoeducation counselling modules to alleviate the adolescents’ uncertainties in going through the adjustment phase outside welfare institutions.

Empowering and Equipping Parents with the Basic Intervention Skills in Handling their Children with Special Learning Needs

Parents of children with special learning needs face challenges balancing family needs without sacrificing care. For remote communities, difficulty accessing support compounds struggles. This qualitative phenomenological study explored an extension intervention program's effectiveness empowering parents of children with special needs. Through interviews with participating parents, thematic analysis revealed the program helped in three key empowerment dimensions. Firstly, parents transitioned from limited disability understanding to increased knowledge through educational resources. Secondly, feelings of isolation changed to supportive social networks via connections. Finally, the program equipped parents with resilience skills/mindsets moving from hopelessness towards effective coping. The multidimensional model addressed interrelated cognitive, social and emotional issues impacting parenting. Findings provide valuable insights how holistic, community programs successfully empower/support these families. Further research understands long term impacts and relationships to child outcomes. Keywords: Coping skills, Disability intervention, Family-centered care, Parental empowerment, Resilience, Special needs children.

Associated Factors that Supporting Toilet Training for Children with Intellectual Disabilities: A Systematic Review

The basic aspect that must be mastered by children with intellectual disabilities before mastering other self-development skills is doing toilet training independently. Learning for children with intellectual disabilities in carrying out toilet training activities requires a separate technique and needs to pay attention to the factors that support the success of the program. This study aims to describe the associated factors that support toilet training for children with intellectual disabilities. This study uses a qualitative approach with a type of literature review research that seeks to describe the related factors that support toilet training for children with intellectual disabilities. This literature review was conducted from August to December 2022 using PRISMA. The authors conducted searches in online databases with large repositories of academic studies and fully accessible by the authors. The results showed that: (1) the toilet training program was made based on the results of an assessment containing the abilities, needs, and potential of children with intellectual disabilities, (2) knowledge and intervention skills possessed by parents provide a great opportunity for successful toilet training for children , and (3) there is collaboration between parents and teachers regarding the implementation of toilet training. The success of toilet training for children with intellectual disabilities is influenced by many factors so that the toilet training process requires intensive assistance, especially for parents.

Secondary Transition Interventions in Rural Communities: A Systematic Literature Review

Nearly 1 million students with individualized education programs (IEPs) live in rural communities in the United States and, to date, no reviews have examined the transition literature related to supporting students in rural settings. The purpose of this review was to examine transition-related functional skill interventions conducted in rural settings. We conducted a systematic review of the experimental literature and identified 19 articles. Interventions reviewed included transition curricula, skill-based interventions, or other interventions (e.g., occupational therapy, interagency collaboration). Few articles included substantive reporting on rurality or the effects of community context on intervention design and implementation. We discuss the paucity of rural transition research and provide recommendations for conducting and reporting future research. Understanding best practice for conducting transition interventions in rural settings requires a framework that considers how the multidimensional elements of a given community influence postsecondary needs and outcomes.

Development and validation of a new tool for assessment of trainees' interventional musculoskeletal ultrasound skills.

Interventional musculoskeletal ultrasound (MSUS) procedures are routinely performed in rheumatology practice. However, the efficacy and safety of the procedures rely on the competence of the physician, and assessment of skills is crucial. Thus, this study aimed to develop and establish validity evidence for a tool assessing trainees' interventional MSUS skills. An expert panel of rheumatologists modified an existing tool for assessing competences in invasive abdominal and thoracic ultrasound procedures. The new tool (the Assessment of Interventional Musculoskeletal Ultrasound Skills (AIMUS) tool) reflects the essential steps in interventional MSUS. To establish validity evidence, physicians with different levels of interventional MSUS experience were enrolled and performed two procedures on a rubber fantom, simulating real patient cases. All performances were video recorded, anonymized, and assessed in random order by two blinded raters using the AIMUS tool. Sixty-five physicians from 21 different countries were included and categorized into groups based on their experience, resulting in 130 videos for analysis. The internal consistency of the tool was excellent, with a Cronbach's alpha of 0.96. The inter-case reliability was good with a Pearson's correlation coefficient (PCC) of 0.74 and the inter-rater reliability was moderate to good (PCC 0.58). The ability to discriminate between different levels of experience was highly significant (p< 0.001). We have developed and established validity evidence for a new interventional MSUS assessment tool. The tool can be applied in future competency-based educational programs, provide structured feedback to trainees in daily clinical practice, and ensure end-of-training competence.

Research on the Influence of Competency on the Job Performance of College Counsellors

Introduction: This study aims to explore the impact of counselor competencies on work performance, specifically focusing on the provision of academic and personal development support to college students. The research process involved a systematic review of academic databases, including ERIC, JSTOR, and ProQuest, using search terms such as competency, job performance, college counselors, and education management. Theoretical Framework: The study emphasizes the importance of counselor competencies in determining job performance. Counselors excelling in crisis intervention, career counseling, active listening, and interpersonal skills tend to perform better, effectively addressing students' needs and guiding them in academic and personal development. Methodology: Academic databases and publications were systematically reviewed to ensure the retrieval of relevant and recent material. Strict selection criteria were applied to guarantee the caliber and applicability of chosen sources. Results: The findings underscore the significance of counselor competencies in enhancing job performance. Counselors proficient in key areas exhibit effective interaction with students, catering to their needs, and fostering academic and personal development. Conclusion: The study highlights the need to prioritize the evaluation and improvement of counselor competencies. Tailoring counselor training programs to enhance critical abilities can benefit educational institutions, ensuring better support for students' academic and personal growth.

Improving Motor Proficiency in Children with Developmental Delays: A Meta-Analysis Evaluating the Impact of Motor Skills Interventions

This study investigated the impact of motor skill interventions in improving motor proficiency among children with developmental delays following Preferred Reporting Items for Systematic Reviews and Meta-analysis “PRISMA” recommendations. The included studies were searched on four databases: Google Scholar, PEDro, MEDLINE, and Cochrane Library. Studies published during the year 2012 to 2022 were selected. The data was extracted by defining the publication year, type of study design, targeted population, and type of physical therapy intervention. The outcome measures included four components of motor proficiency: bilateral coordination, balance, speed and agility, and strength. The results revealed statistically significant findings and a large effect size for bilateral coordination (SMD=1.003, CI=95%) and speed and agility (SMD=0.854, CI=95%). However, a smaller effect size with significant findings was observed in the balance domains (SMD=0.333, CI=95%) and strength (SMD=0.337, CI=95%). Despite the promising results of the analyzed interventions, some of the included studies observed a high risk of bias. However, it is evident from the analysis that protocols directed toward advanced approaches have shown more promising results than traditional physical exercise regimens.

The effects of Student Success Skills on attendance and emotion regulation

AbstractThis study examines the effects of the Student Success Skills (SSS) intervention, an Advocating Student‐within‐Environment‐informed intervention, on Hispanic students’ (N = 681) school attendance and emotion regulation. The study variables reflected students’ attendance, self‐regulation, and test anxiety. The school counselors in the treatment group (n = 15) delivered the SSS program, while those in the control group (n = 15) did not. The results of multivariate analyses of covariance (MANCOVA) tests revealed significant differences in school attendance and test anxiety 30 weeks following the fifth SSS lesson. Statistical significance for self‐regulation was found only 2 weeks after the fifth SSS lesson.

Virtual Reality Utilized for Safety Skills Training for Autistic Individuals: A Review.

In recent years, virtual reality technology, which is able to simulate real-life environments, has been widely used in the field of intervention for individuals with autism and has demonstrated distinct advantages. This review aimed to evaluate the impact of virtual reality technology on safety skills intervention for individuals with autism. After searching and screening three databases, a total of 20 pertinent articles were included. There were six articles dedicated to the VR training of street-crossing skills for individuals with autism, nine articles focusing on the training of driving skills for individuals with ASD, and three studies examining the training of bus riding for individuals with ASD. Furthermore, there were two studies on the training of air travel skills for individuals with ASD. First, we found that training in some complex skills (e.g., driving skills) should be selected for older, high-functioning individuals with ASD, to determine their capacity to participate in the training using scales or questionnaires before the intervention; VR devices with higher levels of immersion are not suitable for younger individuals with ASD. Second, VR is effective in training safety skills for ASD, but there is not enough evidence to determine the relationship between the level of VR immersion and intervention effects. Although the degree of virtual reality involvement has an impact on the ability of ASD to be generalized to the real world, it is important to ensure that future virtual reality settings are realistic and lifelike. Again, adaptive models that provide personalized training to individuals with ASD in VR environments are very promising, and future research should continue in this direction. This paper also discusses the limitations of these studies, as well as potential future research directions.

Opening up the ‘black-box’: what strategies do community mental health workers use to address the social dimensions of mental health?

PurposeCommunity-based workers promote mental health in communities. Recent literature has called for more attention to the ways they operate and the strategies used. For example, how do they translate biomedical concepts into frameworks that are acceptable and accessible to communities? How do micro-innovations lead to positive mental health outcomes, including social inclusion and recovery? The aim of this study was to examine the types of skills and strategies to address social dimensions of mental health used by community health workers (CHWs) working together with people with psychosocial disability (PPSD) in urban north India.MethodsWe interviewed CHWs (n = 46) about their registered PPSD who were randomly selected from 1000 people registered with a local non-profit community mental health provider. Notes taken during interviews were cross-checked with audio recordings and coded and analyzed thematically.ResultsCHWs displayed social, cultural, and psychological skills in forming trusting relationships and in-depth knowledge of the context of their client's lives and family dynamics. They used this information to analyze political, social, and economic factors influencing mental health for the client and their family members. The diverse range of analysis and intervention skills of community health workers built on contextual knowledge to implement micro-innovations in a be-spoke way, applying these to the local ecology of people with psychosocial disabilities (PPSD). These approaches contributed to addressing the social and structural determinants that shaped the mental health of PPSD.ConclusionCommunity health workers (CHWs) in this study addressed social aspects of mental health, individually, and by engaging with wider structural factors. The micro-innovations of CHWs are dependent on non-linear elements, including local knowledge, time, and relationships. Global mental health requires further attentive qualitative research to consider how these, and other factors shape the work of CHWs in different locales to inform locally appropriate mental health care.

Study Skills Intervention to Address Underachievement in Rural Elementary School in Maros, Indonesia

This research aims to identify the effectiveness of study and learning skill training to increase student comprehension, as interventions for underachievement. The study was conducted at Imam Nawawi Elementary School, in Maros, Indonesia, on 24 May - 24 July 2023, using a before-after experimental study design with additional qualitative information analysis. Five fourth-grade students identified as underachievers from a series of assessments were given intervention in the form of reading, listening and note-taking skills training, with the assumption that if students' ability to grasp lesson material increases with the intervention, it will consequently increase achievement. The intervention was carried out in thirteen group sessions. Intervention effectiveness was evaluated using quantitative data from the pre-test and post-test scores as well as qualitative data from interviews with each participant. The results indicate that this intervention has not been completely effective in improving student comprehension, which was assumed to be the stepping stone toward increasing achievement. The gap between students' understanding of the content and several aspects of the delivery of the material is assumed to be the main obstacles to effective intervention. Further elaborations are discussed.

The Effect of an Early Life Motor Skill Intervention on Physical Activity in Growth-Restricted Mice.

Early life growth restriction significantly increases the risk of adulthood physical inactivity and thereby chronic disease incidence. Improvements in motor skill acquisition could result in greater physical activity engagement in the growth-restricted population, thus reducing chronic disease risk. The purpose of this study was to implement an early life motor training intervention to improve physical activity engagement in control and growth-restricted mice. Mice were growth restricted in early life utilizing a validated nutritive model or remained fully nourished in early life as a control. All mice were tested throughout early life for various components of motor skill acquisition. On postnatal day 10, mice were randomly assigned to engage in an early life motor skill intervention daily until postnatal day 21 or remained as a sedentary control. All mice were given access to an in-cage running wheel from postnatal days 45-70. Growth-restricted group (PGR) mice had impaired trunk and postural control, coordination/vestibular development, and hindlimb strength in early life compared with control mice. There were no differences in wheel running behavior between the trained and sedentary mice, although control mice ran at a faster average speed compared with PGR mice. Control female mice ran more than PGR female mice during the week 2 dark cycle. Early life growth restriction reduced motor skill attainment throughout early life, which may be associated with reduced ability to engage in physical activity in adulthood. The early life motor skill intervention did not elicit changes in body weight or physical activity engagement in control or PGR mice, indicating that a more intense/different intervention specifically targeting skeletal muscle may be necessary to counteract the detrimental effects of early life growth restriction.

Learning needs of junior doctors in otolaryngology: a qualitative study.

There is concern that junior doctors are not prepared for their post-graduate attachments in ENT. The aims of this study were to capture the learning priorities of those in the ENT first on-call role and facilitate further educational opportunities to address these needs. Semi-structured interviews were undertaken to explore the learning needs of junior doctors with seven junior and two senior ENT clinicians. The thematic analysis generated three themes: the role of the ENT Junior; the perceived, expressed and prescribed learning needs; and attitudes towards future learning. These themes explored the misalignment between undergraduate training and post-graduate expectations, the lack of competence in ENT practical skills and the need for focused ENT training prior to commencing on-call shifts. All interviewees identified the need for greater experience in practical interventional skills prior to their ENT attachments and expressed interest towards a standardised, bootcamp-style induction with simulated emergency experience.