Physical Skills Training Research Articles

Physical Activity, Sitting, Quality of Life, and Resilience in Inflammatory Bowel Disease

ABSTRACTBackground: Inflammatory bowel diseases (IBD) are a group of autoimmune diseases characterized by the cyclical nature of flare and remission periods that can affect health-related quality of life (HRQOL). Physical activity can benefit HRQOL in the general population and in individuals with chronic diseases. However, there is a paucity of data on physical activity and HRQOL in IBD. The purpose was to characterize physical activity, sitting, HRQOL, and resilience levels in people with IBD (in remission and disease flare) compared with healthy controls.Methods: Participants with IBD (n = 242; 96 in disease flare and 146 in disease remission) and healthy controls (n = 265) reported levels of physical activity, sitting, HRQOL, and resilience. Data were analyzed using analysis of covariance, with demographic variables as covariates.Results: IBD participants reported lower physical activity and resilience than controls (P < 0.05) with no differences between disease states. Time spent sitting was not different across groups (P = 0.07). There were lower scores of physical and mental HRQOL in people with IBD (44.2 ± 9.7 and 40.7 ± 11.7, respectively) than controls (55.9 ± 6.0 and 48.1 ± 10.0, respectively; P < 0.001).Conclusion: Our findings suggest that people with IBD have lower levels of physical activity, HRQOL, and resilience than healthy controls but no difference in time spent sitting. There were no apparent negative consequences of a disease flare on physical activity and resilience levels; however, those in a flare reported reduced HRQOL. Research should begin to focus on physical activity or mental skills training interventions for improving HRQOL in people with IBD, particularly those in a disease flare.

NOTHING FOR ME WITHOUT ME: CAREGIVER TRAINING NEEDS

Over 34 million informal caregivers provide care to an adult aged 50 or older with over 15 million caregivers caring for a person with dementia. People often become caregivers unexpectedly. For most caregivers little training is available, and most skills are learned “on the job”. The objective of this study is to determine the training needs of caregivers. An anonymous survey was conducted at two caregiver conferences. Caregivers were asked to name up to 5 training needs. For this abstract we report the percent of responses by caregivers. Seventy-nine caregivers completed the survey. Seventy-seven percent (77%) of the caregivers cared for a person over age 50. Increased knowledge of health issues (17%) and resources (17%) were the highest responses. Training in physical caregiving skills i.e. bathing (10%), transfers (8%) and diaper changes (4%) were voiced as important. Training for improving personal interactions with the care recipient was important (9%) as well as how to practice patience, kindness and compassion (7%). Two areas where training is available but perhaps not accessible – caregiver support (9%) and care recipient behaviors (8%) were all important to caregivers. Healthy eating (9%) and stopping or limiting driving by the care recipient (2%) were enunciated as areas requiring training. Many of the training needs should be addressed by healthcare professionals in their interactions with caregivers and care recipients. Programs are available online, but caregivers are not accessing this training. To improve outcomes for both caregivers and care recipients targeted training for caregivers is needed.

Effects of Module Development and Role Play Course on Clinical Practice Examination Scores during a 4th Year Clerkship.

BackgroundAfter introduction of clinical skills assessment in the Korean Medical Licensing Examination, medical schools have reinforced both experiential learning with real patients and preparatory programs. This study was conducted to investigate whether a clinical practice examination (CPX) preparation program improves students' CPX score in terms of case specificity.MethodsOne hundred and thirteen senior students in a medical school participated in this study. During the fourth-year clerkship, 28 students (24.8%) from three rotation groups took a 3-day CPX preparation course consisting of module development, role play, and comprehensive physical exam skills training. Eleven rotation groups (n=85) were compared as control. Both the intervention and control group took two comprehensive CPXs before and after the clerkship was completed.ResultsThere was no significant difference in age, sex, and school type between the two groups. On pre-test CPX, there was no significant difference in total and sectional scores between the two groups. On post-test CPX, total scores of the intervention group were higher than those of the control groups (69.5±4.3 vs. 67.5±4.4, P<0.05). History taking scores were higher in intervention groups (70.0±6.0 vs. 66.0±6.6, P=0.01). The station scores of vaginal discharge with case similarity were higher in the intervention groups (73.0±6.3 vs. 68.9±9.3, P=0.03).ConclusionA short CPX preparation course improved history taking ability, but its effect was greater only in a specific case, similar to the pre-course case. Whether this effect was due to the test experience or true improvement in competency requires further investigation.

“Good Athletes Have Fun”: a Foucauldian reading of university coaches’ uses of fun

Fun is deeply ingrained in the ways we talk about and understand sport: Having fun is what makes sport positive and healthy. Drawing on a Foucauldian perspective, we problematize how fun, a psychological construct, informs coaches’ practices. Interviews with 10 varsity coaches from a Canadian university indicated that the coaches used fun to overcome the ‘grind’ of physical skill training. In addition, fun was used to develop and naturalize a need for athletes’ positive psychological traits and skills. In their training contexts, thus, the coaches clearly employed fun to reinforce their use of a number of dominant disciplinary training practices. As a result, instead of operating as a positive force for athlete engagement, the incorporation of fun further legitimized and perpetuated coaches’ ‘normal’ training practices.

Improving Medical Student Confidence in Clinical Skills through a Peer-Facilitated Workshop

University of Maryland, School of Maryland’s (UMSOM) curriculum does not provide training in physical exam skills to first year medical students (MS1s). A peer assisted learning model offered a unique way to address this deficiency. We aimed to design, implement, and evaluate a clinical skills workshop facilitated by upper-level medical students (upper MSs) that could be replicated by other medical schools. Faculty provided a one-hour training session to upper MSs. These students then facilitated a two-hour workshop for MS1s providing instruction on select elements of the physical exam. We theorized that upper MSs would have increased confidence in their abilities to perform the physical exam by learning to teach these skills. Additionally, we hypothesized that MS1s would have increased confidence in their abilities to perform the same skills after participating in the peer-facilitated workshop. We tested these hypotheses using a paired pre- and post-survey model and used paired sample t test analyses to determine statistical significance. We used thematic analyses to analyze free response answers. After training, upper MSs (n = 43) reported a significant improvement (p < .01) in self-reported confidence for each item: measure radial pulse, respiratory rate, and blood pressure, and auscultate lung fields and heart valves. There was a significant improvement (p < .01) in self-reported confidence by MS1s (n = 47) for the same items after the workshop. Students reported positive feedback regarding the use of peer assisted learning. Implementing a peer-facilitated workshop led to increased self-confidence in performing clinical skills by MS1s and upper MSs with minimal faculty demand. Similar models could be feasibly implemented at other institutions.

Yoga Training in Junior Primary School-Aged Children Has an Impact on Physical Self-Perceptions and Problem-Related Behavior.

The present pilot study investigated the effects of yoga training, as compared to physical skill training, on motor and executive function, physical self-concept, and anxiety-related behavior in junior primary school-aged children. Twenty-four participants with a mean age of 8.4 (±1.4) years completed either yoga or physical skill training twice a week for 6 weeks outside of regular school class time. Both forms of training were delivered in an individualized and child-oriented manner. The type of training did not result in any significant differences in movement and executive function outcomes. In terms of physical self-concept, significant group differences were revealed only for perceived movement speed such that yoga training resulted in perceptions of being slower while physical skill training resulted in perceptions of moving faster. Analysis of anxiety related outcomes revealed significant group effects only for avoidance behavior and coping strategies. Avoidance behavior increased following yoga training, but decreased following physical skill training. In addition, following yoga training, children showed an increased use of divergent coping strategies when facing problematic situations while after physical skill training children demonstrated a decrease in use of divergent coping strategies. Changes in overall physical self-concept scores were not significantly correlated with changes in avoidance behavior following yoga training. In contrast, following physical skill training increased physical self-concept was significantly correlated with decreases in avoidance behavior. In sum, exposure to yoga or physical skill training appears to result in distinct effects for specific domains of physical self-concept and anxiety-related behavior. Further studies with larger samples and more rigorous methodologies are required to further investigate the effects reported here. With respect to future studies, we address potential research questions and specific features associated with the investigation of the effects of yoga in a sample of school-aged children.

Effect of physical activity, social support, and skills training on late-life emotional health: a systematic literature review and implications for public health research.

Given that emotional health is a critical component of healthy aging, we undertook a systematic literature review to assess whether current interventions can positively affect older adults' emotional health. A national panel of health services and mental health researchers guided the review. Eligibility criteria included community-dwelling older adult (aged ≥ 50 years) samples, reproducible interventions, and emotional health outcomes, which included multiple domains and both positive (well-being) and illness-related (anxiety) dimensions. This review focused on three types of interventions - physical activity, social support, and skills training - given their public health significance and large number of studies identified. Panel members evaluated the strength of evidence (quality and effectiveness). In all, 292 articles met inclusion criteria. These included 83 exercise/physical activity, 25 social support, and 40 skills training interventions. For evidence rating, these 148 interventions were categorized into 64 pairings by intervention type and emotional health outcome, e.g., strength training targeting loneliness or social support to address mood. 83% of these pairings were rated at least fair quality. Expert panelists found sufficient evidence of effectiveness only for skills training interventions with health outcomes of decreasing anxiety and improving quality of life and self-efficacy. Due to limitations in reviewed studies, many intervention-outcome pairings yielded insufficient evidence. Skills training interventions improved several aspects of emotional health in community-dwelling older adults, while the effects for other outcomes and interventions lacked clear evidence. We discuss the implications and challenges in moving forward in this important area.

Short Communication: Final Year Students’ Deficits in Physical Examination Skills Performance in Germany

The physical examination of patients is an important diagnostic competence, but little is known about the examination skills of final-year medical students. To investigate physical examination skills of final-year medical students. In a cross-sectional study, 40 final-year students were asked to perform a detailed physical examination on standardized patients. Their performances were video-recorded and rated by independent video assessors. Video ratings showed a mean success rate of 40.1% (SD 8.2). As regards accompanying doctor-patient communication, final-year students achieved a mean of no more than 36.7% (SD 8.9) in the appropriate use of the corresponding communication items. Our study revealed severe deficits among final-year medical students in performing a detailed physical examination on a standardized patient. Thus, physical examination skills training should aim to improve these deficits while also paying attention to communicative aspects.

Research on Countermeasure of Badminton Competition Athletics Rhythm Phenomenon

Badminton is the traditionally advantageous event in China. According to the results of all matches, our overall strength of badminton has been still in the leading position in the world. In order to increase the competitive ability, it is essential to strengthen the researches on theories and practices of the process of badminton games. In this paper, the factors affecting sports rhythm include athletic ability, venue environment, and spot command of coach. Comprehensively improve their competitive ability which mainly refers to the following aspects. Firstly, strengthen the physical training, technical training and psychological skills training. Secondly, strengthen the simulation of venue atmosphere of badminton athletes.

Effect of Bedside Physical Diagnosis Training on Third-Year Medical Students' Physical Exam Skills

Background: Graduating medical students, when surveyed, noted a deficit in training in physical examination skills. Purposes: In an attempt to remedy this deficit we implemented a pilot program for 3rd-year medical students consisting of twice-weekly bedside diagnosis rounds as part of their 8-week medicine clerkship. Methods: To assess the success of this program we reviewed students’ objective structured clinical exam (OSCE) scores at the completion of the clerkship compared with prior years’ students who did not have the bedside physical diagnosis training. Results: Students who were trained (n = 109) had an overall higher OSCE physical exam score (p < .01) than students without the training (n = 85). Conclusions: Bedside physical diagnosis rounds appear to have elevated the overall OSCE score for 3rd-year medical students.

Physical skill training increases the number of surviving new cells in the adult hippocampus.

The dentate gyrus is a major site of plasticity in the adult brain, giving rise to thousands of new neurons every day, through the process of adult neurogenesis. Although the majority of these cells die within two weeks of their birth, they can be rescued from death by various forms of learning. Successful acquisition of select types of associative and spatial memories increases the number of these cells that survive. Here, we investigated the possibility that an entirely different form of learning, physical skill learning, could rescue new hippocampal cells from death. To test this possibility, rats were trained with a physically-demanding and technically-difficult version of a rotarod procedure. Acquisition of the physical skill greatly increased the number of new hippocampal cells that survived. The number of surviving cells positively correlated with performance on the task. Only animals that successfully mastered the task retained the cells that would have otherwise died. Animals that failed to learn, and those that did not learn well did not retain any more cells than those that were untrained. Importantly, acute voluntary exercise in activity wheels did not increase the number of surviving cells. These data suggest that acquisition of a physical skill can increase the number of surviving hippocampal cells. Moreover, learning an easier version of the task did not increase cell survival. These results are consistent with previous reports revealing that learning only rescues new neurons from death when acquisition is sufficiently difficult to achieve. Finally, complete hippocampal lesions did not disrupt acquisition of this physical skill. Therefore, physical skill training that does not depend on the hippocampus can effectively increase the number of surviving cells in the adult hippocampus, the vast majority of which become mature neurons.

Assessment of structured physical examination skills training using a retro-pre-questionnaire

Purpose:The effectiveness of physical examination skills (PES) training is very rarely assessed using the “post-then-pre” approach. In this study, a retro-pre-questionnaire was used to study the effect of structured physical examination skills training (SPEST) imparted to second-year undergraduate medical students.Methods:KIST Medical College (KISTMC) affiliated to Tribhuvan University Nepal admitted its first batch of MBBS students in November 2008. The university curriculum recommends the involvement of Medicine and Surgery Departments in PES training, but the methods for teaching and assessment are not well defined. KISTMC has made training more structured and involved the Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics, ENT, Ophthalmology, Paediatrics, and Family Medicine Departments. SPEST includes the teaching/learning of basic PES for 210 minutes once a week for 28 weeks. Self-assessment is done by using a retro-pre-questionnaire at the end of the last session of training, and these data are analysed using SPSS.Results:Out of 100 students, 98 participated in the objective structured clinical examination (OSCE); 82 completed the retro-pre-questionnaire. Forty-six skills representing various systems were selected for inclusion in the retro-pre-questionnaire from among the many skills taught in different departments. The average perceived skills score (maximum score, 46×4=184) before training was 15.9 and increased to 116.5 after training. The increase was statistically significant upon the application of a paired t-test.Conclusion:The students perceived that their level of skills improved after the training. The retro-pre- instrument seems to be useful for assessing the learners’ self-reported changes in PES after training if a large number of skills need to be assessed. However, it should be noted that although a retro-pre-questionnaire may reveal valuable information, it is not a substitute for an objective measure or gold standard.

Psychosocial interventions for the promotion of mental health and the prevention of depression among older adults

The aim of this review was to assess the effectiveness of psychosocial interventions for the promotion of mental health and prevention of depression among older people. A systematic review of prospective controlled trials was conducted including 69 studies. The studies were divided into physical exercise, skill training, reminiscence, social activities, group support and multicomponent interventions. Data from 44 trials contributed to a meta-analysis of effectiveness. Overall, psychosocial interventions had a positive effect on quality of life and positive mental health. The pooled interventions also had a statistically significant effect on reduction in depressive symptoms. Social activities significantly improved positive mental health, life satisfaction and quality of life and reduced depressive symptoms. Based on the results of this study, duration of interventions is of importance, since interventions lasting for >3 months exhibited more positive effects compared with shorter interventions. Meaningful social activities, tailored to the older individual's abilities and preferences should be considered in aiming to improve mental health among older people.

Sport and re/creation: what skateboarders can teach us about learning

This paper explores the role of digital media and creativity in the processes of learning that occur in groups of urban skateboarders. In particular, it examines how the production and consumption of amateur videos contribute to both skaters’ mastery of the techniques of the sport and their integration into the culture of the sport. The data come from an ethnographic study of skateboarders in Hong Kong, which included in-depth interviews, participant observation and the collection of texts and artifacts like magazines, blog entries and amateur skating videos. Skateboarders use video in a number of ways that significantly impact their learning and integration into their communities. They use it to analyze tricks and techniques, to document the stages of their learning and socialization into the group, to set community standards, to build a sense of belonging with their ‘crews’ and to imagine ‘idealized futures’ for themselves and their communities. Understanding the value and function of such ‘semiotic mediation’ in learning and socialization into sport cultures, I suggest, can contribute to helping physical educators design tasks that integrate training in physical skills with opportunities for students to make meaning around their experiences of sport and physical education.

Physical and Motor Skill Training for Children with Intellectual Disabilities

This study investigated the effectiveness of using special training machines for children with intellectual disabilities to strengthen their body's inner muscles and improve their ability to maintain standing posture and improve walking movement. The participants were 23 high school age boys with intellectual disabilities who had difficulties expressing greetings, and needed to be led by the hand when walking. Four special training machines were used for walking movements, for standing and walking balance, for leg-hip extension, and for ipsilateral movement in a sitting position. Each participant underwent 30 min. of training once a week over a 3-mo. period during school time. Body control ability required to perform each training exercise was improved over the training period. A significant improvement was observed in the 50-m dash, mean 10-m walk time, and 10-m obstacle course walk. The hip joint split angle showed a significant increase. Legal guardians all reported their child had "improved and/or progressed" for each of the targeted movements.

Simulation-Based Teaching to Improve Cardiovascular Exam Skills Performance Among Third-Year Medical Students

Background: Evidence supports the need for improvement in cardiac physical examination skills training. Purpose: This study evaluates whether the addition of simulation offers added benefit over training utilizing standardized patients only. Methods: All 124 third-year students who completed the required clerkship in one academic year received cardiac examination skills training utilizing a standardized patient and a cardiac simulator. The control group, comprising 281 students from 2 previous academic years, received training utilizing a standardized patient only. All students’ physical exam skills were assessed in an objective structured clinical examination. Results: Students trained with cardiac simulation performed significantly better than the control group in all 5 cardiac skills. The number of students who correctly performed all 5 cardiac exam skills increased significantly (p= .004). Pulmonary exam skills were unchanged. Conclusion: The use of simulation in addition to standardized patient teaching can improve students’ performance of cardiac examination skills.

Teacher perceptions of desired qualities, competencies and strategies for clinical skills teachers

Introduction: Clinical skills centres (or Skillslabs) prepare students for patient-encounters. Evidence on teaching skills in these centres is lacking. What teaching skills do teachers view as effective in supporting the acquisition of physical examination skills in undergraduate medical training?Method: Structured interviews of 10 teachers (1/3 of staff of Maastricht University, Skillslab) were conducted. Selection was based on even representation of age, years teaching experience, gender and previous experience at Maastricht University. A topic grid was used to ensure comparability. Interviews (average 70 min, range 33–95 min) were recorded and transcripts were analyzed independently by two researchers.Results: Teaching skills identified include the ability to adapt content of the training, level of depth and teaching method according to the needs of any particular group. Thorough comprehension of students’ context (level of knowledge, prior experience and insight in the curriculum) is considered helpful. Explicitly inviting students to ask questions and providing relevant literature is seen to stimulate learning. Providing constructive feedback is essential, as is linking physical examination skills training to clinical situations. The ideal attitude includes appropriate dress and behaviour, as well as the use of humour. Affinity for teaching is regarded as the most important reason to work as a teacher.Conclusion: Desired characteristics for undergraduate skills teachers resemble findings in other teaching roles. Affinity for teaching and flexibility in teaching methods are novel findings.

Relationship Between Physical Fitness and Playing Ability in Rugby League Players

This study investigated the physiological, anthropometric, and skill characteristics of rugby league players and determined the relationship between physical fitness and playing ability in these athletes. Eighty-six rugby league players (mean +/- SD age, 22.5 +/- 4.9 years) underwent measurements of standard anthropometry (height, body mass, and sum of 4 skinfolds), muscular power (vertical jump), speed (10-, 20-, and 40-m sprint), agility (L run), and estimated maximal aerobic power (multistage fitness test). In addition, 2 expert coaches independently assessed the playing ability of players using standardized skill criteria. First-grade players had significantly greater (p < 0.05) basic passing and ball-carrying ability and superior skills under fatigue, tackling and defensive skills, and evasion skills (i.e., ability to beat a player and 2 verse 1 skills) than second-grade and third-grade players. While no significant (p > 0.05) differences were detected among playing levels for body mass; skinfold thickness; height; 10-, 20-, or 40-m speed; agility; vertical jump height; or estimated maximal aerobic power, all the physiological and anthropometric characteristics were significantly (p < 0.05) associated with at least 1 measure of playing ability. The results of this study demonstrate that selected skill characteristics but not physiological or anthropometric characteristics discriminate between successful and less successful rugby league players. However, all physiological and anthropometric characteristics were related to playing ability. These findings suggest that while physiological and anthropometric characteristics do not discriminate between successful and less successful rugby league players, a high level of physical fitness contributes to effective playing ability in these athletes. A game-specific training program that incorporates both physical conditioning and skills training may facilitate a greater transfer of physical fitness to competitive performances in rugby league.

Performance Anxiety: Loss of the Spoken Edge

The study aimed to assess whether a specific training program in vocal and physical skills could reduce the level of perceived performance anxiety. Eighteen undergraduate performing arts students were divided into two even groups. The experimental group experienced 10 two-hour sessions in a specialized vocal and physical skills training program. The control group received the same number of sessions in text analysis by the same teacher. Ten weeks after the training period, both groups were videotaped delivering a short speech of general interest. The videotaped material was assessed by four judges, using a visual analog scale (VAS). Perceptual variables considered were eight vocal and physical features: physical ease, physical presence, effective gesture use, effective eye contact, correct breath use, suitable pace, vocal variety, speech clarity, and one performance feature: perceived performance anxiety. Results indicated that the particular vocal and physical skills training program used showed positive results in effectively reducing the level of perceived performance anxiety. The experimental group scored significantly higher on each of the eight vocal and physical features and significantly lower on the perceived anxiety feature than the control group. This research has implications for those affected by performance anxiety in vocal presentation.

Do Our Current Assessments Assure Competency in Clinical Breast Evaluation Skills?

Background: The focus of teaching for clinical breast evaluation has been the technique of breast examination. This study questions the relationship between breast examination technique and the ability to detect physical findings. Methods: This study examines the relationship between breast examination skills of 66 graduating primary care physicians as measured during an objective structured clinical examination (OSCE) and lump detection sensitivity and specificity on breast models. Results: Overall breast examination performance revealed 50% of maneuvers performed correctly. Mean breast model sensitivity for lump detection was 40% and the mean breast model specificity was 77%. While a mild correlation existed between breast examination skills and lump detection sensitivity ( r = .34, P = 0.01), no relationship was found between lump detection specificity and examination skills. Conclusions: There is a limited relationship between correct performance of breast examination maneuvers and the ability to detect a breast lump when present. Breast examination skills and palpation skills to detect masses may represent independently acquired skills with need for separate instructional methodology. These results raise serious concerns about the reliance on standardized patients alone for training in physical examination skills.