Training Outcomes Research Articles

Explainable Reverse Verification of Goodness of Classification of MRI Images by Clinical Experts.

Radiology offers a presumptive diagnosis. The etiology of radiological errors are prevalent, recurrent, and multi-factorial. The pseudo-diagnostic conclusions can arise from varying factors such as, poor technique, failures of visual perception, lack of knowledge, and misjudgments. This retrospective and interpretive errors can influence and alter the Ground Truth (GT) of Magnetic Resonance (MR) imaging which in turn result in faulty class labeling. Wrong class labels can lead to erroneous training and illogical classification outcomes for Computer Aided Diagnosis (CAD) systems. This work aims at verifying and authenticating the accuracy and exactness of the GT of biomedical datasets which are extensively used in binary classification frameworks. Generally such datasets are labeled by only one radiologist. Our article adheres a hypothetical approach to generate few faulty iterations. An iteration here considers simulation of faulty radiologist's perspective in MR image labeling. To achieve this, we try to simulate radiologists who are subjected to human error while taking decision regarding the class labels. In this context, we swap the class labels randomly and force them to be faulty. The experiments are carried out on some iterations (with varying number of brain images) randomly created from the brain MR datasets. The experiments are carried out on two benchmark datasets DS-75 and DS-160 collected from Harvard Medical School website and one larger input pool of self-collected dataset NITR-DHH. To validate our work, average classification parameter values of faulty iterations are compared with that of original dataset. It is presumed that, the presented approach provides a potential solution to verify the genuineness and reliability of the GT of the MR datasets. This approach can be utilized as a standard technique to validate the correctness of any biomedical dataset.

Dome-type extracorporeal manual morcellation during laparoscopic uterine surgery: Two years’ experience in a teaching hospital

ObjectiveThis study aims to describe the dome-type manual morcellation technique, a modified form of C-type incision, its comparative advantages over existing morcellation methods, the perioperative outcomes of trainees with varying experience levels, and the variables influencing morcellation speed based on our two years of experience. MethodsThis retrospective cohort study included women who underwent laparoscopic myomectomy or hysterectomy using dome-type morcellation for tissue extraction at a tertiary teaching hospital between May 2020 and September 2022. Morcellation was performed by either a single surgeon or a trainee (resident). Basic patient characteristics, perioperative outcomes, and morcellation time and speed were compared between the surgeon and trainee group. Regression models were employed to analyze variables influencing morcellation speed. ResultsA total of 41 women were enrolled. Among them, 20 procedures were performed by a surgeon alone, while the remaining 21 procedures were completed by trainees under the surgeon's supervision. The median weight of the specimens was 378 g (range 91–1345 g), and the median time for morcellation was 10 min (range 1–55 min). The median morcellation speed of surgeon and trainees was 70.25 and 31.7 g/min, respectively. Trainees' level of experience was found to be associated with morcellation speed, particularly for soft specimens. Additionally, both incision size and specimen stiffness were significantly associated with morcellation speed. No morcellation-related complications or bag ruptures were observed. ConclusionDome-type manual morcellation is an intuitive, efficient and safe method for specimen removal and is easy to learn for beginners.

A STUDY ON TRAINING IN CHEMICAL DISASTER MANAGEMENT FOR GOVERNMENT EMPLOYEES IN INDIA

Chemical disasters pose significant risks to public health, safety, and the environment. Effective disaster management is crucial in mitigating these risks, particularly in a rapidly industrializing country like India. This study aims to explore the effectiveness of training programs in chemical disaster management provided to government employees in India. By examining the current training practices, challenges, and outcomes, this research seeks to provide insights into the preparedness of government employees in handling chemical disasters and to offer recommendations for improving training methodologies. The study also conducted a sample survey on 100 candidates working in various government disaster agencies in Maharashtra region and Mumbai city.

Identification of subgroups of patients with oesophageal cancer based on exercise intensity during prehabilitation

Purpose To identify subgroups of patients with oesophageal cancer based on exercise intensity during prehabilitation, and to investigate whether training outcomes varied between subgroups. Materials and methods Data from a multicentre cohort study were used, involving participants following prehabilitation before oesophagectomy. Hierarchical cluster analysis was performed using four cluster variables (intensity of aerobic exercise, the Borg score during resistance exercise, intensity of physical activity, and degree of fatigue). Aerobic capacity and muscle strength were estimated before and after prehabilitation. Results In 64 participants, three clusters were identified based on exercise intensity. Cluster 1 (n = 23) was characterised by fatigue and physical inactivity, cluster 2 (n = 9) by a low training capacity, despite high physical activity levels, and cluster 3 (n = 32) by a high training capacity. Cluster 1 showed the greatest improvement in aerobic capacity (p = 0.37) and hand grip strength (p = 0.03) during prehabilitation compared with other clusters. Conclusions This cluster analysis identified three subgroups with distinct patterns in exercise intensity during prehabilitation. Participants who were physically fit were able to train at high intensity. Fatigued participants trained at lower intensity but showed the greatest improvement. A small group of participants, despite being physically active, had a low training capacity and could be considered frail.

A review of minimal access surgery provision and training within the United Kingdom

When combined with healthcare pressures, the exponential growth of robotic-assisted surgery (RAS) has impacted UK-based training outcomes, including the learning curve to competency. Aim: To ascertain the current provision of RAS and investigate differences in access to minimal access surgical (MAS) facilities and training across the UK. A two-armed electronic survey was conducted. The first arm questioned clinical leads regarding robotic practice and future training provisions. The second investigated trainee and trainers’ perceptions of MAS training and facilities. 64% (52/81) of responding trusts utilise a robotic system. The majority (68% [55/81]) have plans to expand or acquire a system within 3 years. 171 responses from 112 UK and Republic of Ireland hospitals were collected for Arm 2. Laparoscopic categories queried whether trainees had access to a formal curriculum, training days and sim-boxes. Most consultants (51.9%) and trainees (51.6%) reported that there was no formal local training curriculum for robotic surgery. Combined responses demonstrated 42.1% (n = 195/463) said “yes”, 39.5% (n = 183) “no” and 18.4% (n = 85) “don’t know”. For combined robotic categories (simulation, training days and operative lists) 28.3% (n = 134/473) responded “yes”, 51.6% (n = 244) said “no” and 20.1% (n = 95) said “don’t know”. This study provides insight into the current provision of robotic-assisted surgery at UK trusts and highlights the need to facilitate regular clinical training and equitable access to MAS simulation within a formal curriculum. This may aid regulation of training in parallel with the expansion of robotic practice and avoid a significant skill acquisition gap and risks to patient safety.

Developing a production workflow for 3D-printed temporal bone surgical simulators

Introduction3D-printed temporal bone models enable the training and rehearsal of complex otological procedures. To date, there has been no consolidation of the literature regarding the developmental process of 3D-printed temporal bone models. A brief review of the current literature shows that many of the key surgical landmarks of the temporal bone are poorly represented in models. This study aims to propose a novel design and production workflow to produce high-fidelity 3D-printed temporal bone models for surgical simulation.MethodsDevelopmental phases for data extraction, 3D segmentation and Computer Aided Design (CAD), and fabrication are outlined. The design and fabrication considerations for key anatomical regions, such as the mastoid air cells and course of the facial nerve, are expounded on with the associated strategy and design methods employed. To validate the model, radiological measurements were compared and a senior otolaryngologist performed various surgical procedures on the model.ResultsMeasurements between the original scans and scans of the model demonstrate sub-millimetre accuracy of the model. Assessment by the senior otologist found that the model was satisfactory in simulating multiple surgical procedures.ConclusionThis study offers a systematic method for creating accurate 3D-printed temporal bone models for surgical training. Results show high accuracy and effectiveness in simulating surgical procedures, promising improved training and patient outcomes.

Did COVID-19 Put Language Certificate Acquisition on Hold? Uptake and Outcomes of Language Training amongst Refugees

Most highly developed countries invest considerably in language training programmes for refugees, which are assumed to facilitate economic, social, and cultural integration. Although recent research has turned to particular patterns of host country language acquisition amongst refugees, the impact of the COVID-19 pandemic has hitherto remained understudied. Consequently, this article assesses changes in refugees’ uptake and outcomes of language training over the onset of the pandemic using longitudinal population data for Belgium (Flanders). Findings confirm theoretical expectations, as refugee cohorts entering the country after the onset of the pandemic exhibit lower Dutch language credentials, mostly due to lower enrolment and lower proficiency at intake for language courses. Furthermore, this study indicates that such changes are considerably weaker for highly educated and female refugees. These findings are interpreted in terms of increased vulnerability resulting from the pandemic as well as within-group diversity in potential barriers to integration in the host country.

Development and usability testing of an online platform for provider training and implementation of cognitive-behavioral therapy guided self-help for eating disorders.

Most individuals with eating disorders (EDs) do not receive treatment, and those who do receive care typically do not receive evidence-based treatment, partly due to lack of accessible provider training. This study developed a novel "all-in-one" online platform for disseminating training for mental health providers in cognitive-behavioral therapy guided self-help (CBTgsh) for EDs and supporting its implementation. The aim of the study was to obtain usability data from the online platform prior to evaluating its effects on provider training outcomes and patient ED symptom outcomes in an open pilot trial. Nine mental health provider participants (n = 4 in Cycle 1; n = 5 in Cycle 2) and 9 patient participants (n = 4 in Cycle 1; n = 5 in Cycle 2) were enrolled over two cycles of usability testing. In Cycle 1, we recruited providers and patients separately to complete brief platform testing sessions. In Cycle 2, we recruited provider-patient dyads; providers completed training using the platform and subsequently delivered CBTgsh to a patient for three weeks. Usability was assessed using the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), and semi-structured interviews. Interview feedback converged on two themes for providers (applicability of program for real-world use, platform structure and function) and two themes for patients (barriers and facilitators to engagement, perceived treatment effects). SUS and USE scores were in the "average" to "good" ranges across cycles. Findings from this study demonstrate preliminary feasibility and acceptability of the online platform. Data collected in this study will inform further refinements to the online platform. The platform's effects on provider training outcomes and patient ED symptom outcomes will be evaluated in an open pilot trial. Given the wide treatment gap for EDs and barriers to dissemination and implementation of evidence-based treatments, the online platform represents a scalable solution that could improve access to evidence-based care for EDs.

WBUN: an interpretable convolutional neural network with wavelet basis unit embedded for fault diagnosis

Convolutional Neural Network (CNN) is extensively applied in mechanical system fault diagnosis. However, the absence of transparent decision mechanisms in CNNs hinders credibility. To address these challenges, this paper proposes an interpretable wavelet basis unit convolutional network (WBUN). This network incorporates meticulously designed wavelet basis unit (WBU) functions into convolutional layer, creating the interpretable wavelet basis unit convolutional (WBUConv) layer. Convolutional kernels with clear physical significance enable the WBUConv layer to extract fault-related features in both time and frequency domains, enhancing diagnostic performance, and interpreting the CNN’s attention frequency along with the convolutional kernel’s training outcomes. In this paper, three WBU functions are designed to construct the corresponding WBUNs, and their effectiveness and interpretability are verified through three sets of mechanical fault diagnosis experiments. Meanwhile, experimental results demonstrate the WBUConv layer’s remarkable advantages in noise robustness, convergence speed, and strong generalization ability.

"Time is a Big Factor": Aged-Care Workforce Perspectives on Communication Partner Training for Working With Residents With Dementia.

Many individuals who reside in permanent residential aged care (RAC) have a diagnosis of dementia, with the majority experiencing a communication disorder. Existing literature has placed an emphasis on the need for staff to undertake communication partner training. This study aimed to investigate the preferences of RAC staff, and their perceived barriers and facilitators to workplace training. Through an exploratory cross-sectional online survey, a sample of RAC workers in Australia were recruited (n = 104). Descriptive statistics revealed that the majority of participants preferred training to be delivered face to face and being paid for participation. Through content analysis of open-ended questions, seven categories were identified regarding perceived barriers and facilitators for communication partner training in the workplace. These included staff shortages, time pressures, remuneration and training delivery method, and quality of the educators. Additionally, management attitudes were pertinent. These findings may inform the development and outcomes of future communication partner training in RAC.

The Application of Interactive Multimedia to Improve Student’s Learning Outcome in Property Appraisal Training

The Application of Interactive Multimedia to Improve Student’s Learning Outcome in Property Appraisal Training

Evaluating effectiveness of cadaveric arthroscopic training for orthopaedic residents: A comparison of joints and training levels.

This study aimed to evaluate the effects and interactions of training level and different joints on the outcomes of cadaveric arthroscopic training courses for orthopaedic residents. This prospective study enrolled 16 orthopaedic residents who voluntarily participated in a cadaveric training programme involving the shoulder, elbow, wrist, knee and ankle joints. Outcomes were quantitatively assessed using task-specific checklists and the Arthroscopic Surgery Skill Evaluation Tool. Two-way analysis of variance (ANOVA) was conducted to determine the significance of the interactions between joint and years of training. Resident scores significantly increased after the dedicated lectures in all five joints (p = 0.003 for the shoulder module, p < 0.001 for the other joints). Two-way ANOVA revealed that the progress made after the dedicated lectures was significantly impacted by the joint (p = 0.006) and training level × joint interaction (p = 0.005) but not by the training level (p = 0.47). The simple effect of the joint was examined using Sidak's multiple comparison test. Among junior residents, the dedicated lectures resulted in more substantial progress in elbow and wrist arthroscopy when compared to shoulder arthroscopy (p = 0.020 and p = 0.043, respectively). The results suggest that, in cadaveric arthroscopic training courses for orthopaedic residents, training outcomes are primarily impacted by the specific joint being trained rather than the training level. Specifically, junior residents demonstrated greater improvement with training in procedures that are less commonly encountered during on-the-job training, such as elbow and wrist arthroscopy. These findings suggest the need to prioritise wrist and elbow arthroscopic training for junior residents to optimise educational outcomes. Level III.

Predictors of Standardized Exam Outcomes in Vascular Surgery Training

Predictors of Standardized Exam Outcomes in Vascular Surgery Training

Youth-like brain activation linked with greater cognitive training gains in older adults: Insights from the ACTOP study

This study investigates the relationship between inter-individual neurofunctional differences in older adults and cognitive training efficacy, with a specific focus on the association between youth-like task-related brain activation and improvements in working memory (WM) training. The data is part of the Attentional Control Training for Older People (ACTOP) study, 30 older adults completed 12 half-hour WM training sessions. The WM performance slope, assessed at the conclusion of sessions 1 through 6 and sessions 7 to 12, determined early- and late-stage training gains, respectively. Transfer measures were taken before (PRE), midway (MID), and after (POST) training, and the differences in MID-PRE and POST-MID on transfer tasks were used to determine early- and late-stage transfer effects, respectively. The Goodness of Fit (GOF) metric was used to quantify the similarity between each older adult's activation pattern, as measured with functional magnetic resonance imaging (fMRI), to that of a group of younger adults. GOF scores were calculated for activation during low-load (1-0back) and high-load (2-0back) N-back tasks. The results indicated that larger GOF scores in the low-load condition were associated with greater training gains in both the early and late learning stages, and that larger GOF scores in the high-load condition were associated with greater training gains during the late-stage. These findings suggest that a youth-like brain activation pattern in older adults is associated with greater cognitive training benefits, underscoring the role of inter-individual neurofunctional differences to account for variations in training outcomes among older adults. Trial registrationClinicalTrials.gov NCT03532113; https://clinicaltrials.gov/ct2/show/NCT03532113.

Enhancing Training Precision: Unveiling the Barbell Velocity's Role in Tailoring the Resistance Load for the China Badminton Team.

Velocity-based resistance training is a fundamental component of sports science, offering a systematic approach to investigating the load variables of resistance exercises. This research focused on assessing the load across various resistance exercises by examining the barbell velocity during the concentric phase. The study involved 11 male athletes representing the China badminton team, who underwent 1RM testing for bench press, hip thrust, back squat, and single leg press exercises and the maximum repetition testing at load intensities of 60%, 70%, 80%, and 90% of 1RM. Simultaneously, measurements were taken of the barbell's concentric phase velocity during each exercise. The findings revealed a robust negative correlation between barbell velocity and load intensity. Furthermore, exercises engaging greater muscle strength displayed smoother fitting curves. Analysis of velocity loss rates indicated that the hip thrust exhibited a higher completion percentage compared to the back squat and the bench press. Similarly, the non-dominant leg press showed a higher completion percentage than the dominant leg press. The study emphasizes the significance of delineating barbell velocity distributions in resistance training involving large muscle groups, as well as the accurate determination of load intensity. Precise load determination can be facilitated by employing fitting curves derived from distinct movement patterns and varying load intensities. The utilization of velocity data offers a quantifiable approach to achieving targeted training outcomes.

A New Construct in Undergraduate Medical Education Health Humanities Outcomes: Humanistic Practice.

Proposed educational outcomes for the health humanities in medical education range from empathy to visual thinking skills to social accountability. This lack of widely agreed-upon high-level curricular goals limits humanities educators' ability to design purposeful curricula toward clear, common ends and threatens justifications for scarce curricular time. We propose a novel approach to the hoped-for outcomes of health humanities training in medical schools, which has the potential to encompass traditional health humanities knowledge, skills, and behaviors while also being concrete and measurable: humanistic practice. Humanistic practice, adapted from the concept of ethical sensitivity, is an intentional process of applying humanities knowledge and skills to a clinical scenario by 1) noticing that the scenario requires humanities knowledge or skills, 2) informing one's clinical and interpersonal strategy and behavior with humanities knowledge or skills, 3) reflecting on the effectiveness of the strategy and behavior, and 4) reorienting to develop new approaches for future practice. The construct of humanistic practice may help address some of the foundational problems in health humanities outcomes research since it transcends the traditional diverse content domains in the health humanities, can link patient and provider experiences, and may bridge the divide among the additive, curative, and intrinsic epistemic positions of humanities to medical education.

Social Media Use Training for Adults with Intellectual Disabilities: A Pilot Study

Social Media Use Training for Adults with Intellectual Disabilities: A Pilot Study

The Effect of Employee Performance on Telecommunication Industry in Bangladesh

The study delves into the intricate relationship between employee training and performance outcomes within the telecommunications sector, particularly focusing on Bangladesh. It underscores the crucial role of employee training in driving innovation, maintaining competitiveness, and enhancing organizational performance in an ever-evolving industry landscape. The study defines training effectiveness as the extent to which training programs contribute to improving employee performance across various dimensions such as technical skills, customer service, sales, compliance, and innovation. Using a mixed-methods approach, including survey data and qualitative insights from industry professionals, the study aims to uncover the mechanisms through which training impacts employee performance. It emphasizes the need for robust analysis methods beyond traditional statistical tests like the F-test to capture the complexity of these relationships. Firstly, it provides an overview of the research background, significance, and methodology, setting the stage for subsequent chapters. It identifies the research problem, formulates research questions, and outlines the study's structure, emphasizing the importance of a comprehensive literature review to inform theoretical perspectives and hypothesis formulation. Moreover, the study explores the theoretical basis underlying employee training and performance, defining core concepts such as training effectiveness, performance, satisfaction, and contribution. It discusses theories like Training Value Management Theory, Innovation Theories of Training, and Core Competitiveness Theories of Training, which inform the understanding of how training influences organizational outcomes. Then, it delves into the mechanisms and hypotheses formulation for empirical testing. The research methodology, including sample selection, data collection, and model construction, is discussed, ensuring methodological rigor and ethical considerations. It also presents the data analysis and findings, incorporating both quantitative regression analysis and qualitative insights from interviews. It discusses the effectiveness of training initiatives, challenges faced, and implications for practice, along with limitations and future research directions. Lastly, it offers a comprehensive discussion of the findings, highlighting theoretical and practical implications for organizations in the telecommunications sector. It emphasizes the role of management in optimizing training programs and fostering a culture of continuous learning. Overall, the study sheds light on the critical role of training in shaping employee performance and organizational success in the telecommunications industry of Bangladesh. It offers valuable insights for practitioners, policymakers, and scholars, contributing to the understanding of training effectiveness and its implications in a rapidly evolving digital age.

Federated variational generative learning for heterogeneous data in distributed environments

Distributedly training models across diverse clients with heterogeneous data samples can significantly impact the convergence of federated learning. Various novel federated learning methods address these challenges but often require significant communication resources and local computational capacity, leading to reduced global inference accuracy in scenarios with imbalanced label data distribution and quantity skew. To tackle these challenges, we propose FedVGL, a Federated Variational Generative Learning method that directly trains a local generative model to learn the distribution of local features and improve global target model inference accuracy during aggregation, particularly under conditions of severe data heterogeneity. FedVGL facilitates distributed learning by sharing generators and latent vectors with the global server, aiding in global target model training from mapping local data distribution to the variational latent space for feature reconstruction. Additionally, FedVGL implements anonymization and encryption techniques to bolster privacy during generative model transmission and aggregation. In comparison to vanilla federated learning, FedVGL minimizes communication overhead, demonstrating superior accuracy even with minimal communication rounds. It effectively mitigates model drift in scenarios with heterogeneous data, delivering improved target model training outcomes. Empirical results establish FedVGL's superiority over baseline federated learning methods under severe label imbalance and data skew condition. In a Label-based Dirichlet Distribution setting with α=0.01 and 10 clients using the MNIST dataset, FedVGL achieved an exceptional accuracy over 97% with the VGG-9 target model.

COVID Recovery Laparoscopic Simulation Program for Gynecological Registrars—Trainee Perceptions of Regional Model

Study ObjectiveThe acquisition of gynecological operating skills can be challenging for trainees given the conflicting demands of clinical work. Alternative models of surgical skill training such as laparoscopic simulation is, therefore, required. This study demonstrates the development of a regional gynecological surgery laparoscopic simulation program and trainee perceptions of such an approach. DesignAn intervention-based cohort study. SettingA regional model based in West Midlands training region. Patients/ParticipantsResponses from 64 trainees in the training region who participated in this regional program were included. InterventionsA 3-stream curriculum was developed to deliver key training outcomes as required by the Royal College of Obstetricians and Gynaecologists (RCOG) core curriculum as a component of a COVID Recovery Program. Courses were held in 7 teaching hospitals. Courses consisted of both theory and practical teaching. MeasurementsA structured feedback tool was used to collect trainee perceptions of the program. Trainee satisfaction was measured on the Likert scale of 1 to 3. A qualitative thematic analysis was conducted with rank-order analysis of coded free-text responses. Main ResultsOverall, the majority of trainees 92% (n = 58/64) were very satisfied with the course. Rank-order analysis demonstrated hands-on-practice to be the key perceived benefit of laparoscopic simulation among basic and intermediate trainees, while feedback on procedural skills was felt most useful among advanced trainees. ConclusionA regional approach to laparoscopic simulation training is both achievable and acceptable. Trainee perceptions of usefulness are altered by seniority and experience. This should be accounted for in the development of laparoscopic simulation programs.