Trainee Scores Research Articles

The effectiveness of a flipped learning-based educational unit in acquiring basic clothing finishing techniques knowledge and skills for female technical college trainees

This research aims to achieve the following: build a proposed educational unit based on Flipped Learning to acquire basic knowledge and skills of garment finishing techniques. In addition, measuring the effectiveness of the proposed educational unit in providing the trainees with basic knowledge and skills, as well as measuring the attitude of trainees towards the proposed educational unit that based on Flipped Learning. Moreover, the research aims to provide a suggested learning environment (flipped classroom environment) as one of the rotating learning models which considered a type of the flipped learning strategy. The research used the descriptive and experimental method due to its relevance to achieving goals and verifying its hypotheses. The research sample consisted of (21) trainees from the Department of Garment and Textile Technology-Level Two, at the Technical College for Girls in Jeddah that affiliated to the General Organization for Technical and Vocational Training (TVTC) in the Kingdom of Saudi Arabia, for the academic year (1438 - 1439 ). A single group system was used (Per and Post ) method. Objective: The research aimed at achieving the following: -Building a learning unit based on Flipped Learning to acquire basic knowledge and skills (for the course of garment finishing techniques. -Measuring the effectiveness of the educational unit based on Flipped Learning in acquiring basic knowledge and skills for garment finishing techniques. -Measuring the attitude towards the Flipped Learning after the participation. -Improving the performance of trainees using modern learning strategies. Hypotheses : - There are statistically significant differences between the average scores of female trainees before and after the participation in; The cognitive achievement in favor of the post participation The skill performance in favor of the post participation. The proposed educational unit in favor of the post participation

Teaching vs learning: Impact of deliberate practice and formative feedback on developing point of care ultrasound skills.

The study investigators hypothesized that Point of Care Ultrasound (POCUS) training through bolus didactic and workshop experiences may be sufficient for trainees to learn the cognitive aspects, while an extended period of exposure with formative feedback is responsible for developing the psychomotor skills critical for POCUS. The investigators studied trainees over the course of an academic year. They compared trainees' performance on written (cognitive) and observed image acquisition (psychomotor) exams at baseline and at each subsequent quarter, using a stepped-wedge design. They performed linear regression analysis to determine which variables contributed to knowledge and psychomotor skill development. Twenty-six trainees met the study requirements and participated in the POCUS curriculum. Participating in a POCUS rotation was consistently associated with an increase in psychomotor scores. There was no consistent variable to predict an increase in trainee's score on written knowledge assessments. Extended exposure to POCUS over a 4-week rotation with direct and indirect formative feedback can explain difference in scores on psychomotor skills assessments. Trainees scored similarly on the written assessment with or without a POCUS rotation. Training through didactic and workshop experiences may be sufficient to learn the cognitive aspects, but not psychomotor skills required for POCUS.

Objective assessment of surgical trainees’ non-technical skills: Improved performance following a two-year program of instruction

BackgroundNon-technical skills (NTS) encompass personal skills such as communication, situational awareness, decision making, teamwork and leadership. Poor performance of these skills has been shown to contribute to medical error. The Royal College of Surgeons in Ireland (RCSI) has delivered a mandatory program of instruction in NTS to all surgical trainees since 2005. We investigated whether the NTS of surgical trainees improved after the first two years of this program. MethodsBaseline data was collected in a three-station OSCE assessment of NTS at the beginning of Year one and again at end of Year two of surgical training. ResultsTrainees’ mean percentage NTS scores improved significantly over the two-year period for the NTS assessment (P < .001). A significant difference was demonstrated using within-subject (paired) t-tests between the Year one and two time points for all three OSCE stations: Consent (−5.39; P < .001); Colleague Conflict (−8.63; P < .001); and Disclosure of Error (−7.56; P < .001). ConclusionsRCSI offers a unique mandatory program of instruction in NTS. There was a statistically and practically significant improvement in the NTS scores of surgical trainees over the two-year period of the program.

Portable Ultrasound Device Usage and Learning Outcomes Among Internal Medicine Trainees: A Parallel-Group Randomized Trial.

Little is known about how to effectively train residents with point-of-care ultrasonography (POCUS) despite increasing usage. This study aimed to assess whether handheld ultrasound devices (HUDs), alongside a year-long lecture series, improved trainee image interpretation skills with POCUS. Internal medicine intern physicians (N = 149) at a single academic institution from 2016 to 2018 participated in the study. The 2017 interns (n = 47) were randomized 1:1 to receive personal HUDs (n = 24) for patient care vs no-HUDs (n = 23). All 2017 interns received a repeated lecture series regarding cardiac, thoracic, and abdominal POCUS. Interns were assessed on their ability to interpret POCUS images of normal/abnormal findings. The primary outcome was the difference in end-of-the-year assessment scores between interns randomized to receive HUDs vs not. Secondary outcomes included trainee scores after repeating lectures and confidence with POCUS. Intern scores were also compared with historical (2016, N = 50) and contemporaneous (2018, N = 52) controls who received no lectures. Interns randomized to HUDs did not have significantly higher image interpretation scores (median HUD score: 0.84 vs no-HUD score: 0.84; P = .86). However, HUD interns felt more confident in their abilities. The 2017 cohort had higher scores (median 0.84), compared with the 2016 historical control (median 0.71; P = .001) and 2018 contemporaneous control (median 0.48; P < .001). Assessment scores improved after first-time exposure to the lecture series, while repeated lectures did not improve scores. Despite feeling more confident, personalized HUDs did not improve interns' POCUS-related knowledge or interpretive ability. Repeated lecture exposure without further opportunities for deliberate practice may not be beneficial for mastering POCUS.

Developing sustainable capacity-building in mental health research: implementation outcomes of training of trainers in systematic reviewing

ABSTRACT Less than 1% of biomedical research papers originate in Africa. Locally relevant mental health research, including synthesis of existing evidence, is essential for developing interventions and strengthening health systems, but institutions may lack the capacity to deliver training on systematic reviewing for publication in international journals. This paper describes the development and implementation of a training-of-trainers (ToT) course on systematic reviewing. The ToT prepared junior faculty (‘trainers’) from universities in Ethiopia, Malawi, and Zimbabwe to lead a five-day systematic reviewing workshop. Using an evaluation framework based on implementation science outcomes, the feasibility of the ToT was assessed by tracking the number of workshops the trainers subsequently conducted and the number of trainers and trainees who participated; acceptability was assessed through post-workshop surveys on trainee perspectives; impact was evaluated through trainee scores on a 15-item multiple choice test on systematic reviewing concepts; and sustainability was assessed based on whether the workshop was integrated into university curricula. Twelve trainers (86% of those trained) facilitated a total of seven workshops in their home countries (total 103 trainees). The first workshop run in each country was evaluated, and there was a significant improvement in mean knowledge scores between pre- and post-tests among trainees (MD= 3.07, t= 5.90, 95% CI 2.02–4.11). In two of the three countries, there are efforts to integrate the systematic review workshop into university curricula. The cost of the workshop led by the international trainer was $1480 per participant, whereas the trainer-led workshops cost approximately $240 per participant. Overall, ToT is relatively new to research capacity building, although it has been used widely in clinical settings. Our findings suggest ToT is a promising, low-cost way to develop both technical skills of individuals and the pedagogical capacity of universities, and to promote sustainability of research capacity building programs that often have time-limited grant funding.

Development of proficiency-based knot-tying and suturing curriculum for otolaryngology residents: A pilot study

ObjectiveBasic surgical skills such as knot-tying and suturing are important for all otolaryngologists, regardless of subspecialty. The present study was undertaken in order to assess basic surgical techniques such as knot-tying and suturing required for novice otolaryngology residents with taking the variety of subspecialties into consideration, and evaluate the impact of a proficiency-based training curriculum based on these techniques. MethodsA prospective study was performed for developing of proficiency-based knot-tying and suturing curriculum for otolaryngology residents in the third post-graduate year (PGY-3). The proficiency-based training curriculum was developed based on the tasks selected by RAND/UCLA method with expert panel, which is an iterative and anonymous survey used to establish consensus among participants. Expert panelists were selected from various divisions to reflect variety of their subspecialties. PGY-3 residents trained with the developed curriculum that included proctored pre-test, self-training to proficiency, and proctored post-test. Visual analogue scale (VAS) of trainees’ overall competence in the operating room was self-assessed by each resident, before and after completing the training curriculum. ResultsNine PGY-3 residents were enrolled as trainees. Eleven experts chosen as panelists had various subspecialty, including 2 from otology, 2 from rhinology, 2 from laryngology, 2 from head and neck surgery, and 3 from general otolaryngology. Seven tasks were selected from RAND/UCLA method and used to develop the curriculum. Trainee scores at pre-test were significantly lower than expert scores for all 7 tasks (p < 0.01) and each coefficient of variation of trainee score was larger than that of expert score (p < 0.05), supporting construct validity. The mean of composite scores between pre-test and post-test had statistical significance (68.6 ± 11.6 vs 95.9 ± 3.6, p < 0.01), documenting substantial improvement after training. Self-assessment VAS was also improved pre- to post-training (1.2 ± 0.9 vs 4.5 ± 1.4, p < 0.01). A follow-up questionnaire showed that trainees felt the educational curriculum to be beneficial. ConclusionIn the present study, seven basic technical skills were selected using the RAND/UCLA method and used to create a proficiency-based training curriculum. Our results indicate that this curriculum significantly improves proficiency of basic surgical skills of junior otolaryngology residents.

Development and Validation of a Test for Competence in Evidence-Based Medicine.

Medical educators need valid, reliable, and efficient tools to assess evidence-based medicine (EBM) knowledge and skills. Available EBM assessment tools either do not assess skills or are laborious to grade. To validate a multiple-choice-based EBM test-the Resident EBM Skills Evaluation Tool (RESET). Cross-sectional study. A total of 304 medicine residents from five training programs and 33 EBM experts comprised the validation cohort. Internal reliability, item difficulty, and item discrimination were assessed. Construct validity was assessed by comparing mean total scores of trainees to experts. Experts were also asked to rate importance of each test item to assess content validity. Experts had higher total scores than trainees (35.6 vs. 29.4, P < 0.001) and also scored significantly higher than residents on 11/18 items. Cronbach's alpha was 0.6 (acceptable), and no items had a low item-total correlation. Item difficulty ranged from 7 to 86%. All items were deemed "important" by > 50% of experts. The proposed EBM assessment tool is a reliable and valid instrument to assess competence in EBM. It is easy to administer and grade and could be used to guide and assess interventions in EBM education.

Efficacy evaluation of China trauma care training program

Objective To understand the current situation of trauma and evaluate the training effect and influencing factors of China Trauma Care Training (CTCT) by investigating the trainees who participated in the course. Methods A total of 1660 trainees who participated in training from May 2017 to May 2018 were selected as the subjects of this study. Through questionnaires, the general information (gender, occupation, professional title, discipline source, length of time engaged in trauma treatment), the situation of trauma in their hospitals (hospital level, trauma mode, number of severe trauma cases each year), the recommended model of trauma treatment, learning methods of trauma knowledge, and the trauma training interval were obtained. The trainees took tests before and after the training, and the test results were used to evaluate the training effect and analyze the influencing factors. Results (1) There were 1 230 males (74.10%), 1 356 physicians (81.93%), 1 247 with intermediate title or lower levels (75.12%), 756 from emergency department/emergency surgery (45.54%), and 899 who were engaged in trauma for more than five years (54.16%). (2) There were 1 068 trainees from tertiary hospitals (64.34%). The main mode of severe trauma in hospitals was emergency+ consultation+ triage (1 198 trainees, 72.17%). A total of 1014 trainees treated less than 200 severe trauma patients each year (61.08%). A total of 1210 trainees recommended emergency/emergency surgery (72.89%) and 350 trainees recommended trauma surgery/trauma hospital (21.08%) as the main mode of treatment. (3) There were various approaches to acquire trauma knowledge, including 1 029 person-times (61.99%) through department internal guidelines, 924 person-times (55.66%) through case discussion, 879 person-times (52.95%) through self-teaching, 767 person-times (46.20%) through lectures, 382 person-times (23.01%) through trauma courses and 285 person-times through further studies at home and abroad (17.17%). A total of 951 trainees recommended 1-2 years as the training interval (57.3%). (4) The average test score before training was (67.5±14.5)points, which were influenced by the hospital level, discipline source, title of trainees, length of time engaged in trauma treatment, and amount of severe trauma cases each year in their hospitals. The hospital level and discipline source were the main effect factors. (5) The average test score after training was (83.8±11.6)points, which was significantly higher than that before training (P<0.01), and the scores of trainees in different subgroups were all improved. The main factors influencing the test score included hospital level, number of severe trauma cases each year, discipline source, professional title, number of severe trauma cases each year treated in the hospital. The major effect factor was the amount of severe trauma cases each year. Conclusions The main mode of trauma in hospitals involved in this study is multi-disciplinary consultation+ decentralized treatment . Few trainees have received systematic trauma training, and their trauma knowledge level and the test scores before training is influenced by hospital level, the case number of severe trauma treatment, discipline source, and trainees’qualifications. After the standardized and standardized trauma training course CTCT , the scores of students from different backgrounds have been significantly improved, and the gap between students has been significantly narrowed. Key words: Wounds and injuries; Questionaires; Trauma training

A Novel Low-Cost Surgical Simulation Tool for Pinning Supracondylar Humerus Fractures.

Simulation-based training is one way to improve basic competence for surgical trainees and thus improve patient safety. Closed reduction and percutaneous pinning of a supracondylar humerus fracture is a common procedure that encompasses many basic orthopaedic skills and has been identified as a residency milestone. Despite this, no quantitative tools exist to help learners attain this basic skill. This study seeks to validate a quantitative, low-cost simulation-based training tool for teaching orthopaedic surgery trainees the fundamentals of fracture stabilization with pins. Two low-cost models were developed with simulated cancellous bone blocks and cortical bone sheets: a pinning agility tool to teach pin placement and redirection, and a low-cost construct stability tool to replicate pinning. A high-cost construct stability tool was cut using a pediatric supracondylar humerus model to simulate pinning a real fracture. Construct stability was assessed by adding weight until ∼1.6 mm of displacement was observed. Participants were tested naively on all 3 models and then completed a training session using only the low-cost models. Performance following training was then assessed and compared with fellowship-trained pediatric orthopaedic surgeons. Participants also rated their preintervention and postintervention confidence, skill, and knowledgeability. A total of 18 novice trainees participated (10 PGY1 and PGY2 orthopaedic surgery residents and 8 medical student members of the orthopaedic surgery interest club), whereas the reference group consisted of 7 orthopaedic surgery attendings. The subjects significantly improved their scores on both the low-cost (P=0.002) and high-cost (P<0.001) construct stability tools after the training with only the low-cost tools. Compared with the attending benchmark, trainee scores improved on the high-fidelity model from 31% preintervention to 86% postintervention and their pinning times decreased by 38%. Trainees reported increased knowledge, skill, and confidence after the intervention (P<0.001). A novel, low-cost simulation model and training session for supracondylar humerus fracture pinning resulted in improved performance in stabilizing a supracondylar humerus model and increased trainee knowledgeability, confidence, and skill. Level II-economic.

RELATIONSHIP OF MOTIVATION AND MIDWIFE TRAINING IN LONG TERM CONTRACEPTION SERVICE

Introduction: Given the large number of births per year, efforts are needed to control birth through family planning using contraception, especially long-term ones. The use of long-term contraceptives (MKJP) includes IUDs, Implants and MOW / MOP. The aim of the study: to find out the relationship between motivation and the results of midwifery training test results in long-term contraceptive method services in Lumajang district. Research method: quantitative research using Spearman correlation test. Results: there was a low positive relationship between motivation and written test scores of trainees (r = 0.391, p = 0.033). Conclusion: The training participants 'motivation is mostly good and the trainees' written test scores are mostly good. So even though the motivation and results of the training have a low relationship, but with the maximum ability of the training participants it can still motivate participants when providing long-term contraceptive services.&#x0D; &#x0D;

424 POEM Training and Skills Evaluation Tool: A Pilot Study

INTRODUCTION: Hands-on training for Per-Oral Endoscopic Myotomy (POEM) in the United States is limited and without a structured curriculum and assessment tool. Training to competency in POEM is critical and POEM trainees must acquire multiple cognitive and technical skills to achieve proficiency. METHODS/METHODS AND AIM: The aim of this study was to develop a POEM training and skills evaluation tool. This pilot study was performed at a tertiary academic medical center in the US from 5/2018 – 11/2018. The training protocol included initial swine explant models followed by live human cases, proctored by a single endoscopist experienced in POEM who graded trainees for each task on a 5-point scale (1 = trainer had to take over, 2 = trainer provided technical assistance, 3 =trainer provided substantial verbal guidance, 4 =trainer provided minimal verbal guidance, and 5 =trainee performed completely independently). Three trainees were prospectively graded on specific cognitive (identification of GE junction, incision site selection, identification of esophageal wall layers, recognition of planes during tunneling, identifying structures at GEJ and cardia in the tunnel, and identification of circular and longitudinal muscles) and technical skills (entry into the submucosal space, submucosal tunneling, myotomy and hemostasis) essential for successful POEM completion. Competency was considered at skill level ≥ 4 for each skill. RESULTS: Three trainees (interventional endoscopy fellows) completed a total of 18 cases (8 cases on animal explant models and 10 human cases) and were evaluated by one expert supervisor. Cognitive skills were acquired early in training with trainee scores of ≥ 4 by the 3rd swine explant case and 3rd human case. Technical skills required more cases and direction. Level ≥ 4 in technical skills was achieved by the 8th human case. Entry of the endoscope into the submucosal space was the most difficult step. No adverse events occurred in the human cases. CONCLUSION: This pilot study introduces a POEM training and skills evaluation tool for training to competency. Submucosal entry, tunneling and myotomy were the most challenging to learn while cognitive skills were learned early in training. The main limitations of this study include single site study with small number of trainees and procedures, and a single instructor. Evaluation of POEM procedures performed by more trainees at multiple sites will be necessary to further validate the utility of this tool.

THE EFFECTIVENESS OF THE CORT PROGRAM TO DEVELOP ENVIRONMENTAL LITERACY AND THINKING SKILLS AMONG DIRECTORS OF GOVERNMENT SECTORS

The current study aimed at developing the environmental and thinking skills of the directors of governmental sectors through the effectiveness of the CoRT program. In achieving this goal, the previous studies and research related to the subject of the study were reviewed and the research tools were used by the current study. The study was based on a semi-experimental approach using some tools such as questionnaire to conduct a survey to determine the current state of environmental and thinking skills of the study sample and to prepare a proposed scenario for a training program for the purpose of developing environmental and thinking skills through the CoRT program. The study also drives at holding a content analysis for identifying how far dimensions of environmental and thinking skills of the programs provided by the Center are available; designing a scale measuring environmental and testing of thinking skills to determine the extent to which the objectives of the proposed program are achieved and to verify the validity and reliability of the study’s experimental group of managers of sectors who are representing (36) trainees, associating the Central Authority for Organization and Management of Egypt. A pre-application of scale of environmental and test of thinking skills were administered on the experimental group. The activities of the proposed program were implemented using CoRT program, and a re-application of the test and the scales were used at the end of the program. The study was concluded by a number of results, the most important of which: - There is a statistically significant difference between the average scores of trainees regarding the pre/post application of the environmental scale as a whole, in favor of the post application. - There is a statistically significant difference between the average scores of trainees regarding the pre/post application of the thinking test as a whole and in each skill separately, in favor of the post-application. One of the most important recommendations of the study is including the training program You are a partner in the environmental literacy to the group of programs provided to the managers of the center, the establishment of a database and information containing documented books and references on environmental and thinking skills that enable managers to refer to and benefit from their scientific content.

Portable Ultrasound Device Usage and Learning Outcomes Among Internal Medicine Trainees: A Parallel-Group Randomized Trial

BACKGROUND: Little is known about how to effectively train residents with point-of-care ultrasonography (POCUS) despite increasing usage. OBJECTIVE: This study aimed to assess whether handheld ultrasound devices (HUDs), alongside a year-long lecture series, improved trainee image interpretation skills with POCUS. METHODS: Internal medicine intern physicians (N = 149) at a single academic institution from 2016 to 2018 participated in the study. The 2017 interns (n = 47) were randomized 1:1 to receive personal HUDs (n = 24) for patient care vs no-HUDs (n = 23). All 2017 interns received a repeated lecture series regarding cardiac, thoracic, and abdominal POCUS. Interns were assessed on their ability to interpret POCUS images of normal/abnormal findings. The primary outcome was the difference in end-of-the-year assessment scores between interns randomized to receive HUDs vs not. Secondary outcomes included trainee scores after repeating lectures and confidence with POCUS. Intern scores were also compared with historical (2016, N = 50) and contemporaneous (2018, N = 52) controls who received no lectures. RESULTS: Interns randomized to HUDs did not have significantly higher image interpretation scores (median HUD score: 0.84 vs no-HUD score: 0.84; P = .86). However, HUD interns felt more confident in their abilities. The 2017 cohort had higher scores (median 0.84), compared with the 2016 historical control (median 0.71; P = .001) and 2018 contemporaneous control (median 0.48; P &lt; .001). Assessment scores improved after first-time exposure to the lecture series, while repeated lectures did not improve scores. CONCLUSIONS: Despite feeling more confident, personalized HUDs did not improve interns’ POCUS-related knowledge or interpretive ability. Repeated lecture exposure without further opportunities for deliberate practice may not be beneficial for mastering POCUS.

Computerized model for objectively evaluating cutting performance using a laparoscopic box trainer simulator.

Laparoscopic box trainer simulator has recently become a tool for assessment of physicians' surgical and laparoscopic skills, and training using such a simulator has been incorporated into the curricula of surgery syllabus. With the increased use of box trainer simulators, there is a great need for obtaining reliable and objective evaluations of the trainees' performances. Here, we introduce an automated tool for assessing laparoscopic cutting performance by using image-processing algorithms. Twenty-seven interns specializing in the fields of gynecology, urology and general surgery participated in 4-6 training sessions, in which each trainee cut a circular patch positioned inside a low-cost laparoscopic box trainer simulator. The trainees' performances were analyzed using software that we developed. The analysis of the trainees' performances was based upon quantitative measurements of the following four parameters obtained in each training session: standard deviation, circle-cutout area, skewness, and number of peaks. We believe that high performance in terms of a combination of the four parameters provides a reliable measure of good laparoscopic skills, and therefore we developed the software so as to generate, for each session, a score of a trainee's laparoscopic circle-cutout performance that results from achievements related to the four parameters in combination. On average, the total score of experienced interns was higher than the total score of inexperienced interns. Also, some improvement from session-to-session in the scores of novice trainees was detected. Our proposed scoring system, which is based on various image-processing algorithms, can evaluate cutting performances of trainees and classify residents by their experience. This allows each trainee to improve his/her performance by analyzing errors indicated by our software.

Skills acquisition for novice learners after a point-of-care ultrasound course: does clinical rank matter?

BackgroundFew studies have compared the effectiveness of brief training courses on point-of-care ultrasound (POCUS) skill acquisition of novice attending physicians vs. trainees. The purpose of this study was to evaluate the change in POCUS image interpretation skills and confidence of novice attending physicians vs. trainees after a 1-day POCUS training course.MethodsA 1-day POCUS training course was held in March 2017 in Japan. A standardized training curriculum was developed that included online education, live lectures, and hands-on training. The pre-course assessment tools included a written examination to evaluate baseline knowledge and image interpretation skills, and a physician survey to assess confidence in performing specific ultrasound applications. The same assessment tools were administered post-course, along with a course evaluation. All learners were novices and were categorized as trainees or attending physicians. Data were analyzed using two-way analysis of variance.ResultsIn total, 60 learners attended the course, and 51 learners (85%) completed all tests and surveys. The 51 novice learners included 29 trainees (4 medical students, 9 PGY 1–2 residents, 16 PGY 3–5 residents) and 22 attending physicians (6 PGY 6–10 physicians, and 16 physicians PGY 11 and higher). The mean pre- and post-course test scores of novice trainees improved from 65.5 to 83.9% while novice attending physicians improved from 66.7 to 81.5% (p < 0.001). The post-course physician confidence scores in using ultrasound significantly increased in all skill categories for both groups. Both trainees and attending physicians demonstrated similar improvement in their post-course test scores and confidence with no statistically significant differences between the groups. The course evaluation scores for overall satisfaction and satisfaction with faculty members’ teaching skills were 4.5 and 4.6 on a 5-point scale, respectively.ConclusionsBoth novice trainees and attending physicians showed similar improvement in point-of-care ultrasound image interpretation skills and confidence after a brief training course. Although separate training courses have traditionally been developed for attending physicians and trainees, novice learners of point-of-care ultrasound may acquire skills at similar rates, regardless of their ranking as an attending physician or trainee. Future studies are needed to compare the effectiveness of short training courses on image acquisition skills and determine the ideal course design.

How preferred learning approaches change with time: a survey of GPs and GP Specialist Trainees

ABSTRACTBackground The Approaches and Study Skills Inventory for Students (ASSIST) questionnaire assesses whether learners prefer a deep, strategic or surface approach to learning. This study aimed to establish the effect of time since qualification, gender and work role on ASSIST scores of General Practitioners (GPs) and GP Specialist Trainees (GPSTs).Methods An anonymous online questionnaire with demographic questions and the ASSIST survey was completed by 1005 GPs and GPSTs from across the United Kingdom.Results Of the 544 GPs and 461 GPSTs completing the survey, 96.5% preferred a deep and/or strategic approach to learning. There was a significant increase in the preference for a deep approach with time from graduation and significantly less preference for a surface approach. There was no significant change in any of the scores over the GPST years. Men had significantly higher scores for a deep approach than women.Conclusions GPs and GPSTs prefer deep and strategic approaches to a surface approach. While higher levels of GP experience are associated with a higher deep approach score and a lower surface approach score, this change is not seen during progression through GP training. Men have higher scores for a deep approach than women.

Impact of night shifts on emergency medicine resident resuscitation performance

AimEmergency medicine (EM) trainees often work nightshifts. We sought to measure how this circadian disruption affects EM resident performance during simulated resuscitations. MethodsThis retrospective cohort study enrolled EM residents at a single Canadian academic centre over a six-year period. Residents completed twice-annual simulation-based resuscitation-focused objective structured clinical examinations (OSCEs) with assessment in four domains (primary assessment, diagnostic actions, therapeutic actions and communication), and a global assessment score (GAS). Primary and secondary exposures of interest were the presence of a nightshift (late-evening shifts ending between midnight and 03h00 or overnight shifts ending after 06h00) the day before or within three days before an OSCE. A random effects linear regression model was used to quantify the association between nightshifts and OSCE scores. ResultsFrom 57 residents, 136 OSCE scores were collected. Working a nightshift the day before an OSCE did not affect male trainee scores but was associated with a significant absolute decrease in mean total scores (−6% [95% CI −12% to 0%]), GAS (−7% [−13% to 0%]), and communication (−9% [−16% to −2%]) scores among women. Working any nightshift within three days before an OSCE lowered absolute mean total scores by 4% [−7% to 0%] and communication scores by 5% [−5% to 0%] irrespective of gender. ConclusionOur results suggest that shift work may impact EM resident resuscitation performance, particularly in the communication domain. This impact may be more significant in women than men, suggesting a need for further investigation.

Validity of In-Training Evaluation Report (ITER) in Saudi Pediatric Residency Training. Single center experience

This article was migrated. The article was not marked as recommended. Objective: The study aimed to examine validity evidence of in-training evaluation report (ITER) at King Abdulaziz University Hospital (KAUH)'s pediatric residency program. Predictive validity of ITERs, to assess learner acquisitions of required competencies were studied. We used ITER scores to identify trainees with unprofessional conduct. Methods: One-year data for 35 residents in pediatric residency training program at KAUH were reviewed. Data were extracted from 360 ITERs completed by faculty members and specialists. ITERs' reliability was evaluated using Cronbach's alpha. ITERs scores were correlated with final Objective Structured Clinical Examinations (OSCE) and written exams scores. Professionalism composite scores from ITERs were compared with scores of trainees reported for unprofessional attitude. Results: Specialists had high variability in scoring competencies with average standard deviations (SD) of 0.85 compared with 0.15 by faculty. Reliability of ITER scores using Cronbach's alpha was 0.895. Good correlation was observed between competencies ranging between 0.86 to 0.29. There was fair correlation between ITER composite scores and those of final OSCE and written exams. There was no correlation between professionalism scores and residents reported for unprofessional conduct. Conclusion ITER scores had good validity and reliability despite variability observed between faculty and specialist when scoring competencies. ITERs failed to detect trainees with unprofessional conduct.

Developing a state-wide infrastructure for safe sleep promotion

ObjectivesSleep-related deaths are the third leading cause of infant death in Kansas. This manuscript describes implementation of an infrastructure of regional trainers to educate on the American Academy of Pediatrics safe sleep recommendations. DesignProspective evaluation of training program on knowledge transfer. SettingInstructors were recruited from throughout the state of Kansas and trained to provide safe sleep education in their communities. ParticipantsInstructors were a mix of healthcare workers and community members. Their trainees encompassed both professionals and caregivers. InterventionInstructors attended a 2-day training, including completing 18-item pre and post-training knowledge tests, a training evaluation survey, and performing a portion of the structured safe sleep presentation and crib demonstration for feedback. MeasurementInstructors were evaluated before and after training. After conducting trainings in their region, instructors submitted trainees' pre and post-test results. Scores were compared using t-test. ResultsTwenty-three instructors were trained. Scores averaged 13.5 (SD=2.4) for the pre-test and 15.3 (SD=2.4) for the post-test. Those scoring <80% post-training (n=6) received additional instruction. In the subsequent year, 13 trainers provided safe sleep education at 21 events to a total of 378 trainees. Trainee scores averaged 11.4 (SD=2.7) on the pre-test and increased to 13.9 (SD=2.5) on the post-test (P<.001). Findings were consistent when adjusting for variation between individual trainers. ConclusionsSafe sleep instructors can be trained to disseminate safe sleep guidelines; however, only half provided at least 1 training within 1 year. Future recommendations include over-recruiting potential instructors, incorporating trainings into existing positions or otherwise incentivizing trainers.

In search of the working memory advantage in conference interpreting – Training, experience and task effects

Aims and Objectives: The purpose of the study was to disentangle the effects of simultaneous interpreting experience and training on working memory, to examine the effect of language, modality and recall on working memory scores, and to associate memory scores of trainees with interpreting quality. Design: Working memory scores were compared in the L2 reading span task (performed by professional conference interpreters, bilingual controls and interpreter trainees tested before and after training) and in the L1 reading span task and L1 listening span task (performed by interpreters and controls). Data and Analysis: Data was collected from 68 participants in experiment 1 and from 51 participants in experiment 2. It was analysed by means of linear models, regressions and t-tests. Findings: Professional interpreters consistently outperformed controls on all working memory tasks. They performed better in L1 than L2, and their scores were not affected due to modality (visual vs. auditory presentation) and recall mode (serial vs. free). Interpreter training improved working memory scores. Trainees’ higher scores predicted better interpreting performance. Originality: This was the first study to adopt a longitudinal design to examine the effect of training on memory of conference interpreter trainees. Significance: The study shows that interpreter training (but not experience) improves working memory capacity and predicts interpreting performance.