Proportions Of Trainees Research Articles

Implementation of an Alternative Training Method for Cardiac Blood Collection in Mice.

Training personnel to work with animals presents a variety of challenges, both logistically and with regard to animal welfare. These issues make training an ideal opportunity to evaluate practices and to implement the 3R principles (refinement, replacement, and reduction). Cardiac blood collection from mice is a procedure that can compromise the 3Rs by requiring repeated practice and animal euthanasia. The development of a non-animal training model would promote the 3R principles. Our goals for the development of a new training model for cardiac blood collection from mice were to reduce the number of mice needed to achieve competency, improve our culture of care, and refine the training approach by improving competency. The training model was developed using commonly available materials. The total cost of the model was less than $15 USD per model. Two training curricula were conducted concurrently over a 5-mo period: 1) a curriculum in which trainees used the model before progressing to live mice and 2) the traditional curriculum, which used euthanized mice throughout. The measured variables included the total number of mice used, proportions of trainees who reached competency, the time needed to reach competency, method comprehension, quality of skill performance, trainer and trainee feedback, and training costs. The alternative group used at least 10 fewer mice per technician as compared with the traditionally trained group. The alternative group had a higher competency rate, with 82% (9 of 11 trainees) reaching competency compared with 60% (3 of 5 trainees) in the traditional group. Skill comprehension and quality were superior in the alternative group, as evidenced by fewer gross lesions at necropsy. Overall, personnel in the alternative group provided positive feedback with regard to the use of fewer mice, acquisition of both skill and confidence, and benefits for compassion fatigue. The use of this model is now our standard approach for training personnel in cardiac blood collection in mice. Our results demonstrate that the use of models in training curricula can enhance skill development and reduce the use of mice.

The role of AFB microscopy training in improving the performance of laboratory professionals: analysis of pre and post training evaluation scores

BackgroundTuberculosis (TB) remains major cause of morbidity and mortality due to any one of infectious agent worldwide. In low income countries, Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment. In order to have efficient AFB microscopy centers, it is imperative to have continuous refresher training for laboratory professionals and strong External Quality Assessment (EQA) system). However, very little data exists as to the effect of in-service training on performance of laboratory personnel in Ethiopia.The objective of this study was to investigate the role of AFB microscopy refresher training on the performance of laboratory professionals.MethodsA cross-sectional retrospective study was conducted to appraise theoretical and practical performance of laboratory professionals before and after AFB microscopy training. Theoretical assessment was based on standard questions while practical assessment was based on smear reading of 10 standard slides. Data on eight rounds of a five days training at Adama regional laboratory on AFB microscopy in 2009 was obtained and analyzed using SPSS 16.0 statistical software.ResultThe pre-training mean score of the theoretical knowledge and practical skills were 61.8% and 75.7%, respectively. The post training mean scores were 84.2% and 89.2% for theoretical knowledge and practical skills, respectively. The increase in mean score of both theoretical and practical assessment was statistically significant (p < 0.0001). Post training mean score of theoretical knowledge was higher among diploma holders trainees than the BSc degree counter parts (p = 0.001). The mean scores on practice before and after training was dependent on participation in previous AFB microscopy trainings (p < 0.0001). Proportions of trainees with both major and minor errors were found to decrease after they were trained. Trainees who have had previous training were found to commit less errors than those who were not participated in previous training (p < 0.0001).ConclusionTraining has improved theoretical and practical performance of laboratory professionals. Pre-placement and continuous training irrespective of lab professionals qualification and service year and sustainable EQA are highly recommended to ensure quality of AFB microscopy service.

Frequency and confidence in performing clinical skills among medical interns in Kuwait

Background: Several investigations suggest inadequate emphasis of basic clinical procedures during internship training. Many trainees had reported lack of competence, while some expressed confidence to manage conditions although not sufficiently experienced.Aims: This study aimed at ascertaining the perceptions of new medical graduates regarding the performance of core clinical skills during training and confidence of performing them later. It also aimed at determining any gender variability in the confidence in performing selected clinical skills in Obstetrics & Gynaecology.Methods: Interns trained during 2005/06 responded anonymously to a questionnaire that listed 48 core clinical skills. The 124 subjects eligible for the study comprised graduates from Kuwait (64), other Gulf Cooperation Council countries (29), Ireland (27) and Egypt. They indicated whether they felt confident to perform the skills in future, and the number of times they had performed them during training. We received 91 completed questionnaires.Results: The majority felt confident in performing routine skills (basic ECG and X-ray interpretations, insertion of intravenous line, inserting urethral catheter and nasogastric feeding). Approximately two thirds had performed generic skills related to emergency resuscitation, with a half of them confident in performing them in the future. A third felt confident in performing artificial ventilation and endotracheal intubation. The confidence to perform common skills in Obstetrics & Gynaecology varied, with no significant gender variation. Approximately a fifth was confident in performing lumbar puncture, needle aspiration of joints, insertion of thoracic drainage, insertion of central venous catheter, venous cut-down and indirect laryngoscopy. A small proportion reported confidence in performing different clinical procedures although they had not undertaken them during training.Conclusions: Substantial proportions of trainees lacked confidence in performing emergency resuscitative measures and some routine clinical skills. Training needs to be closely monitored and interns who are not competent identified early for taking remedial measures.