Providing Skills Training Research Articles

Development of strategic international industry links to promote undergraduate vocational training and postgraduate research programmes

After centuries of protectionism in international trade, the course is inexorably set for trade amongst nations without borders. More and more countries are joining the World Trade Organization and companies are repositioning themselves for the conduct of their activities in an environment free from physical borders and national legislative restrictions. Commercial activity is as old as humanity itself and touches every aspect of human endeavour. The raison d’être for academic institutions, which provide skills training for the labour force of the community of nations, lies, to a large extent, in fulfilling the requirements of commercial activity. Any profound change in the manner in which commerce is conducted, logically, requires an equally profound change in the philosophy of developing the skills of the labour force. This paper therefore discusses the challenges which academic institutions face in restructuring their curricula to meet the demands of the globalized economy of the future. The paper describes the general principles necessary to develop the attributes of a globally employable graduate and reports, in particular, on activities already being undertaken by the Royal Melbourne Institute of Technology (RMIT), in association with industry partners within and outside Australia to meet these challenges. The prime mover of these activities is a programme called the RMIT International Industry Experience and Research Program (RIIERP), which was established in 1992 by the author.

Health Libraries as Joint Use Libraries: Serving Medical Practitioners and Students

Libraries, whether medical or healthcare, in higher education (HE) institutions or the National Health Service (NHS), provide services to all types of healthcare students and professionals. Many of these are delivered through contracts, in the form of service-level agreements, between the two key organizations. The challenge to librarians is ensuring that users are provided with access to the resources they need and the skills to use those resources to the benefit of a patient-centered environment. External drivers such as developments in education, a continuously modernizing health service, and new technology have infiuenced the development of services. Issues regarding the access to electronic information for the different user groups still exist. Librarians have to support the differing user groups, who may have varying levels of computer and library skills, and provide skills training on a wide variety of resources from their own institution and from nationally provided content.

General practitioners’ and family physicians’ negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review

To estimate the proportion of general practitioners (GPs) and family physicians (FPs) with negative beliefs and attitudes towards discussing smoking cessation with patients. A systematic review. All studies published in English, in peer-reviewed journals, which allowed the extraction of the proportion of GPs and FPs with negative beliefs and attitudes towards discussing smoking cessation. Negative beliefs and attitudes were extracted and categorised. Proportions were synthesized giving greater weight to those obtained from studies with larger samples. Those assessed in two or more studies are reported. Across 19 studies, eight negative beliefs and attitudes were identified. While the majority of GPs and FPs do not have negative beliefs and attitudes towards discussing smoking with their patients, a sizeable minority do. The most common negative beliefs were that such discussions were too time-consuming (weighted proportion: 42%) and were ineffective (38%). Just over a quarter (22%) of physicians reported lacking confidence in their ability to discuss smoking with their patients, 18% felt such discussions were unpleasant, 16% lacked confidence in their knowledge, and relatively few considered discussing smoking outside of their professional duty (5%), or that this intruded upon patients' privacy (5%), or that such discussion were inappropriate (3%). In addition to providing skills training, interventions designed to increase the implementation of smoking cessation interventions by primary care physicians may be more effective if they address a range of commonly held negative beliefs and attitudes towards discussing smoking cessation. These include beliefs and values that influence primary care physicians' judgements about whether discussing smoking is an effective use of their time.

Joined-up teaching

Summary: In the UK, interprofessional working is becoming a cornerstone of social care practice. This article outlines how the authors, both academics in a university’s health and social care department, are developing the teaching of interprofessional skills as an integral component of effective child protection education. This has become particularly pertinent in light of the recent legislative and policy shifts highlighted within the Laming Report (2003) and Every Child Matters (DfES, 2003). The proposed interprofessional children’s teams will provide new challenges to all professions who hold child protection responsibilities. For students who exhibit high levels of anxiety about working in this area of practice, we have implemented an innovative and responsive educational programme to facilitate the development of knowledge and skills of interprofessional working within the field of child protection. By providing skills training in a professional setting, we aim to enable students to gain interprofessional knowledge through experience with practice.

Team Awareness, Problem Drinking, and Drinking Climate: Workplace Social Health Promotion in a Policy Context

(1) To determine the effectiveness of classroom health promotion/prevention training designed to improve work climate and alcohol outcomes; (2) to assess whether such training contributes to improvements in problem drinking beyond standard workplace alcohol policies. A cross-sectional survey assessed employee problem drinking across three time periods. This was followed by a prevention intervention study; work groups were randomly assigned to an 8-hour training course in workplace social health promotion (Team Awareness), a 4-hour informational training course, or a control group. Surveys were administered 2 to 4 weeks before and after training and 6 months after posttest. Employees were surveyed from work departments in a large municipality of 3000 workers at three points in time (year, sample, and response rates are shown): (1) 1992, n = 1081, 95%; (2) 1995, n = 856, 97%; and (3) 1999, n = 587, 73%. Employees in the 1999 survey were recruited from safety-sensitive departments and were randomly assigned to receive the psychosocial (n = 201), informational (n = 192), or control (n = 194) condition. The psychosocial program (Team Awareness) provided skills training in peer referral, team building, and stress management. Informational training used a didactic review of policy, employee assistance, and drug testing. Self-reports measured alcohol use (frequency, drunkenness, hangovers, and problems) and work drinking climate (enabling, responsiveness, drinking norms, stigma, and drink with co-workers). Employees receiving Team Awareness reduced problem drinking from 20% to 11% and working with or missing work because of a hangover from 16% to 6%. Information-trained workers also reduced problem drinking from 18% to 10%. These rates of change contrast with changes in problem drinking seen from 1992 (24%) to 1999 (17%). Team Awareness improvements differed significantly from control subjects, which showed no change at 13%. Employees receiving Team Awareness also showed significant improvements in drinking climate. For example, scores on the measure of coworker enabling decreased from pretest (mean = 2.19) to posttest (mean = 2.05) and follow up (mean = 1.94). Posttest measures of drinking climate also predicted alcohol outcomes at 6 months. Employers should consider the use of prevention programming as an enhancement to standard drug-free workplace efforts. Team Awareness training targets work group social health, aligns with employee assistance efforts, and contributes to reductions in problem drinking.

A support group intervention for at-risk female high school students.

School nurses have an opportunity to engage in early intervention with high-risk adolescents. School-based support groups for depressed adolescents have been effective when aimed at providing skills training as well as emotional support. In this practice improvement project, 14 high-risk female adolescents from two high schools were identified on the basis of signs associated with depression. The students completed a questionnaire about risk and protective factors during the assessment and at the end of the intervention. Twelve students participated in a weekly support group designed to enhance coping skills and to provide emotional support. Assessment revealed that the students were at suicide risk. At the conclusion of the group intervention, there was a 55% decrease in suicidal ideation, a 27% decrease in perceived stress, and a 26% decrease in family distress. In addition, most of the students became engaged in formal treatment for the first time.

A Support Group Intervention for At-Risk Female High School Students

School nurses have an opportunity to engage in early intervention with high-risk adolescents. School-based support groups for depressed adolescents have been effective when aimed at providing skills training as well as emotional support. In this practice improvement project, 14 high-risk female adolescents from two high schools were identified on the basis of signs associated with depression. The students completed a questionnaire about risk and protective factors during the assessment and at the end of the intervention. Twelve students participated in a weekly support group designed to enhance coping skills and to provide emotional support. Assessment revealed that the students were at suicide risk. At the conclusion of the group intervention, there was a 55% decrease in suicidal ideation, a 27% decrease in perceived stress, and a 26% decrease in family distress. In addition, most of the students became engaged in formal treatment for the first time.

A Support Group Intervention for At-Risk Female High School Students

School nurses have an opportunity to engage in early intervention with high-risk adolescents. School-based support groups for depressed adolescents have been effective when aimed at providing skills training as well as emotional support. In this practice improvement project, 14 high-risk female adolescents from two high schools were identified on the basis of signs associated with depression. The students completed a questionnaire about risk and protective factors during the assessment and at the end of the intervention. Twelve students participated in a weekly support group designed to enhance coping skills and to provide emotional support. Assessment revealed that the students were at suicide risk. At the conclusion of the group intervention, there was a 55% decrease in suicidal ideation, a 27% decrease in perceived stress, and a 26% decrease in family distress. In addition, most of the students became engaged in formal treatment for the first time.

Changes in the Labor Market and International Migration since the Economic Crisis in Thailand

The economic crisis in July 1997 led to a sharp increase in unemployment and underemployment, particularly among workers with primary and lower secondary education, a drop in real earnings, and an increase in poverty incidence. Labor surplus and poverty pressures during the economic downturn likely boosted labor migration. New government measures in promoting overseas employment and the facilitation of recruitment agencies and migrants' social networks encouraged the outflows. Data from the Ministry of Labor indicate higher levels of overseas labor migration, especially to Taiwan. Most Thai overseas workers have a primary education and are engaged in unskilled labor. Although the government has started to provide skills training to help workers adjust to the needs of the labor market, more measures are needed to promote sustainable employment and human resource development, especially in the rural areas. Better protection for Thai workers overseas is another priority.

The design and evaluation of a simulated-patient teaching programme to develop the consultation skills of undergraduate pharmacy students.

This study aimed to identify the key skills and knowledge required for the delivery of an ideal patient consultation in order to develop a training programme (using simulated-patients) to teach consultation skills to undergraduate pharmacy students. Participants included all third year undergraduate Pharmacy students (MPharm, level III) at the School of Pharmacy & Biomolecular Sciences, University of Brighton (from October 1999 to March 2000). Working in groups of 12, students participated in two 4 hour seminars. A structured questionnaire was designed to assess students' perceptions of the difficulty of conducting a consultation and their confidence in delivering a structured consultation. Questionnaires were administered before and after delivery of the teaching programme to assess changes in students' confidence and ability to consult with patients. Twelve volunteers satisfied the criteria set to serve as simulated patients and then received appropriate training. Six scenarios were developed which focused on the key skills and knowledge identified from the adherence and consultation skills literature. A total of 91 students participated in the programme (mean age = 23 years, SD = 4.5). Following participation in the programme students' perceived 'confidence' for conducting an effective consultation significantly increased (t = -5.9, p < 0.01) while a statistically significant decrease was seen in students' perceived level of 'difficulty' when conducting a consultation (t = 4.0, p < 0.01). This study has shown that the use of a structured teaching programme improves students' perceptions of their ability and confidence in conducting an effective consultation. Providing skills training around the consultation process, using simulated patients, provides pharmacists with a good framework around which to practice pharmaceutical care.

Introducing behavior therapy into a disease-model dual-diagnosis treatment program

Rates of alcohol and drug abuse among individuals seeking psychiatric treatment exceed those of the general population, and there has been increasing attention to meeting the treatment needs of such dually diagnosed persons. Social-skills training shows promise as one aspect of integrated treatment for dually diagnosed inpatients, but poses practical questions of implementing behavior therapy in settings where a disease model of addictive behavior and psychopathology dominates. A case is made for integration of behavior therapy within the prevailing medical model and supported by the author's experience providing skills training groups for inpatients. Clinical techniques for providing social skills training to patients with severe, heterogeneous presenting problems in the context of everbriefer hospitalizations are described, as are means for increasing the value of the behavioral approach in a medical-model setting.

An experiment in family reunification: Correlates of outcomes at one-year follow-up

The purpose of this article is to describe findings from an evaluation of a program developed to reunify foster children with their biological parents. In a study with random assignment of foster children to a “routine services” control group or an experimental family reunification service, the experimental condition was found to be effective in returning children to their homes. This report focuses on the rate at which children in experimental and control groups returned home during the service period and afterwards. In addition, the correlates of reunification during the treatment period and return to foster care during the follow-up period are examined. The data suggest that relatively brief and intensive family-centered services can significantly affect reunification rates. The experimental service was superior to routine reunification at the close of treatment and throughout the one-year follow-up period. Consisting of building strong and motivating alliances with family members, the provision of skills training, and assistance with meeting family members' concrete needs, family reunification services appear to offer new promise to children who are placed in family foster care.

Youth Apprenticeship in Britain: Lessons for the United States

Britain's effort to introduce youth apprenticeships over the past decade offers important general lessons about the role of employers in school‐to‐work initiatives. In particular, the incentives facing employers work against efforts to provide skills training. Alternative arrangements for such programs are suggested that create incentives for employers to improve the skills of youth apprentices.

Health-Oriented Telecommunication A COMMUNITY RESOURCE

Telecommunication networks that link medical information with the community can support home caregivers while providing skills training and crisis intervention to prevent unnecessary hospitalization. Health-oriented telecommunications direct the traditional focus from intervention to prevention. Consumers become empowered with knowledge allowing them to participate in their healthcare and lifestyle decisions.

Value-added services that increase physicians' intent to refer patients to an outpatient nutrition clinic

We surveyed 378 practicing physicians to identify value-added services that would increase their patient referrals to registered dietitians at an outpatient nutrition clinic. One hundred thirty-nine completed surveys were used in compiling the results. In the survey we presented 16 value-added services specifically designed to overcome physicians' barriers to referral as noted in the literature, and we requested demographic information. Frequency distributions revealed that the services physicians most strongly agreed would increase their referrals were help patients receive reimbursement from third-party payers (92.1%), provide a free initial meeting with the patient (82.4%), and offer group cooking classes (81.3%). The services physicians most strongly disagreed would increase their referrals were provide a list of physicians currently using the outpatient nutrition clinic who can provide recommendations (33.1%) and provide a free consultation for the physician (30.2%). Our findings indicate that (a) value-added services most likely to stimulate referrals are those that moderate the cost of nutrition counseling, document its effectiveness, and provide skills training in the form of cooking classes, and (b) value-added services least likely to stimulate referrals are those that require physicians' time.

Continuing education questionnaire for RDs and DTRs

<h2>Abstract</h2> We surveyed 378 practicing physicians to identify value-added services that would increase their patient referrals to registered dietitians at an outpatient nutrition clinic. One hundred thirty-nine completed surveys were used in compiling the results. In the survey we presented 16 value-added services specifically designed to overcome physicians' barriers to referral as noted in the literature, and we requested demographic information. Frequency distributions revealed that the services physicians most strongly agreed would increase their referrals were help patients receive reimbursement from third-party payers (92.1%), provide a free initial meeting with the patient (82.4%), and offer group cooking classes (81.3%). The services physicians most strongly disagreed would increase their referrals were provide a list of physicians currently using the outpatient nutrition clinic who can provide recommendations (33.1%) and provide a free consultation for the physician (30.2%). Our findings indicate that (a) value-added services most likely to stimulate referrals are those that moderate the cost of nutrition counseling, document its effectiveness, and provide skills training in the form of cooking classes, and (b) value-added services least likely to stimulate referrals are those that require physicians' time.

Development planning for women: The case of the Indonesian transmigration program

In the 1970s, evidence of the detrimental effects of many development schemes on women and the conclusion that this was linked to their neglect in policy and planning led to efforts to ensure that women were included in development programs. However, most policies to integrate women into development have had little effect on improving their situation. This paper discusses the case of the Indonesian transmigration scheme. Planning in this program, whether it is within the women's section or the mainstream planning bureaucracy, is still based on orthodox economic and statistical concepts which devalue women's economic contribution and anchor them firmly in the domestic arena. A number of projects specifically for women provide skills training in areas which are overwhelmingly domestic-centered, and family welfare and subsistence-oriented. They offer women meagre and uncertain benefits. In mainstream planning, there has been an upsurge of interest in harnessing women's potential labour because of concern with low productivity in the settlements. However, there is no consideration as to whether, or how, women themselves will actually benefit if they increase their labour. To understand the outcomes of development projects for women it is essential to question the development planning process, its underlying premises, and the ways in which women and their activities are perceived and defined in planning practice.

Structuring HIV prevention service delivery systems on the basis of social science theory.

In order to identify the optimal configuration of HIV prevention programs, it is necessary to examine different theoretical models of behavior change. Cognitive/decision-making theories of human behavior change are compared to social learning theories vis-a-vis their influence on the structure of service delivery systems. Cognitive/decision-making theories ascribe behavior change to the provision of new information and favor the development of homogeneous interventions providing clients with information about risk behaviors. These interventions are easily standardized across delivery sites and various target populations. Social learning theories view behavior change as a series of stages and recognize the influence of sociocultural variables. They favor multiple heterogeneous interventions in a variety of settings, with the provision of skills training as well as information. Ongoing HIV prevention research indicates that social learning theories provide a more accurate paradigm of human behavior change for the complex behaviors related to HIV risk. Public health agencies must therefore continue to strengthen organizational and referral relationships with community-based organizations that can provide the specialized prevention interventions called for by social learning theory. This will require ongoing collaboration and technical assistance.

AIDS prevention in homosexual and bisexual men

This study evaluates two AIDS risk-reduction interventions targeted at homosexual and bisexual men. Participants were randomized into two peer-led interventions: both involved a lecture on 'safer sex', and one provided a skills-training component during which men could discuss and rehearse the negotiation of safer sexual encounters. Follow-up data collection assessed self-reported changes in sexual behavior at 6 and 12 months. Skills training increased condom use for insertive anal intercourse. In sessions providing skills training, condom use increased, on average, by 44% between pre-test and second follow-up compared with only 11% on average in sessions which did not provide such training.

AIDS prevention in homosexual and bisexual men

This study evaluates two AIDS risk-reduction interventions targeted at homosexual and bisexual men. Participants were randomized into two peer-led interventions: both involved a lecture on ‘safer sex’, and one provided a skills-training component during which men could discuss and rehearse the negotiation of safer sexual encounters. Follow-up data collection assessed self-reported changes in sexual behavior at 6 and 12 months. Skills training increased condom use for insertive anal intercourse. In sessions providing skills training, condom use increased, on average, by 44% between pre-test and second follow-up compared with only 11% on average in sessions which did not provide such training.