Selection Training Research Articles

Perception of the Tribal Farmers towards KVK Training

KVK as an innovative institution imparting skill training on agriculture and allied vocations for the farmers, farm women, rural youth and school drop outs for generating income and self employment. A study has been conducted with fifty tribal farmers in Dhanakauda block of sambalpur district in Odisha during 2012 to assess their perception towards KVK training programmes. It has been observed that appropriate selection of trainees, content addressing the local needs, easily understandable, immediate use and emphasis on skill up-gradation. Group discussion and exercise, encouraging interaction, circulation of reference materials and more audio-visuals are to be used while conducting training. Long duration training programmes of one week to one month has to be organized for rural youth during lean period and duration to be fixed as per the lesson plan formulated. Clear understanding and confidence over the message, liasoning for the availability of inputs, credit and market support along with well furnished hostel with library facilities and enhancement of meals for training to motivate tribal farmers to attend KVK training.

Correlation Between Trainee Candidate Selection Criteria and Subsequent Performance

The objective of trainee recruitment is to identify candidates likely to perform well as trainees and subsequent faculty. The effectiveness of this process has not been established. The goal of this study was to identify trainee selection criteria predictive of excellent performance. Twenty-nine microsurgery fellows were enrolled from 2008 to 2012. Each candidate was interviewed and rated based on presentation, plastic surgery (PS) training experience, academic potential, personality, social skills, communication skills, and ability to be a team player. An unadjusted rank list was generated based on weighted averages, and an adjusted rank list was then generated at a faculty meeting. At the conclusion of fellowship, each fellow was rated based on the ACGME core competencies. Spearman correlation coefficients (r) were used to measure the correlations between fellow selection criteria and fellow performance. Plastic surgery training and academic potential had, by far, the strongest correlation to overall performance (r: 0.678, p < 0.001 and r: 0.56, p < 0.002), and to all ACGME competencies. When reformulated to weight PS training and academic potential more heavily than subjective criteria, the scoring system was significantly more predictive of excellent performance (r: 0.49 vs 0.70). The unadjusted rank list was more predictive of excellent performance than the adjusted rank list (r: 0.45 vs 0.65). Plastic surgery training experience and academic potential were better predictors of performance than any subjective information ascertained during the interview. Adjustments to the rank list based on faculty discussion resulted in lower performance candidates moving up in ranking. Ranking criteria and interview techniques must be refined to improve predictive power. It may be beneficial for semi-objective criteria to carry more weight than subjective criteria and raw scores to remain unadjusted by extraneous information.

Problem Confrontation of the FFS Farmers in Participating Farmer Field School Training Session

The study was conducted to identify and describe the problems of FFS farmers in participating FFS training sessions. Data and information were collected from 100 FFS farmers of selected three unions of Muktagacha Upazila of Mymensingh district in Bangladesh from 10 to 30 April, 2013. Among ten selected problems “Inadequate trials and training materials” got the highest score (PCI-176) while “Biasness in trainee selection” got the lowest score (PCI-48). The highest proportion of the FFS farmers (53%) had low problem in participating FFS training session, while 40% and 7% had medium and high problem, respectively. Findings indicate that a majority i.e. more than four fifth of the FFS farmers faced low to medium problems in participating FFS training sessions. The selected characteristics of the FFS farmers, such as year of schooling, farming experience, extension media contact, risk orientation and knowledge on soil and crop management showed significantly negative relationship with problem confrontation in participating FFS training sessions by the FFS farmers. Therefore, it can be mentioned that there is no significant problems associated with the FFS training sessions. So, necessary steps need to be taken to enhance the existing activities of FFS that could improve the sustainable crop production as well as the livelihood of the FFS farmers.DOI: http://dx.doi.org/10.3329/pa.v24i1-2.19179 Progress. Agric. 24(1&amp;2): 273 - 280, 2013

Measuring Sense of Presence and User Characteristics to Predict Effective Training in an Online Simulated Virtual Environment

Virtual-reality solutions have successfully been used to train distributed teams. This study aimed to investigate the correlation between user characteristics and sense of presence in an online virtual-reality environment where distributed teams are trained. A greater sense of presence has the potential to make training in the virtual environment more effective, leading to the formation of teams that perform better in a real environment. Being able to identify, before starting online training, those user characteristics that are predictors of a greater sense of presence can lead to the selection of trainees who would benefit most from the online simulated training. This is an observational study with a retrospective postsurvey of participants' user characteristics and degree of sense of presence. Twenty-nine members from 3 Air Force National Guard Medical Service expeditionary medical support teams participated in an online virtual environment training exercise and completed the Independent Television Commission-Sense of Presence Inventory survey, which measures sense of presence and user characteristics. Nonparametric statistics were applied to determine the statistical significance of user characteristics to sense of presence. Comparing user characteristics to the 4 scales of the Independent Television Commission-Sense of Presence Inventory using Kendall τ test gave the following results: the user characteristics "how often you play video games" (τ(26)=-0.458, P<0.01) and "television/film production knowledge" (τ(27)=-0.516, P<0.01) were significantly related to negative effects. Negative effects refer to adverse physiologic reactions owing to the virtual environment experience such as dizziness, nausea, headache, and eyestrain. The user characteristic "knowledge of virtual reality" was significantly related to engagement (τ(26)=0.463, P<0.01) and negative effects (τ(26)=-0.404, P<0.05). Individuals who have knowledge about virtual environments and experience with gaming environments report a higher sense of presence that indicates that they will likely benefit more from online virtual training. Future research studies could include a larger population of expeditionary medical support, and the results obtained could be used to create a model that predicts the level of presence based on the user characteristics. To maximize results and minimize costs, only those individuals who, based on their characteristics, are supposed to have a higher sense of presence and less negative effects could be selected for online simulated virtual environment training.

Competency and practice: selection of specialty GP trainees for the 21st century

In this article we explore the ongoing development of selection processes for GP training and identify the opportunities that might be realised. These include the need to develop the recruitment process to reflect the revised competencies in a valid and reliable way; being able to identify those who may be in need of additional support through their training; a specific need to ensure that those entering GP training are capable of dealing with the rigours of GP training and working as a GP; and developing values-based recruitment in line with current government policy.

An Objective Evaluation of a Multi‐Component, Competitive, Selection Process for Admitting Surgeons into Higher Surgical Training in a National Setting

Changing work practices make it imperative that surgery selects candidates for training who demonstrate the spectrum of abilities that best facilitate learning and development of attributes that, by the end of their training, approximate the characteristics of a consultant surgeon. The aim of our study was to determine the relative merits of components of a program used for competitive selection of trainees into higher surgical training (HST) in general surgery. Applicants (N = 98, males 69, mean age 31 years [range 29-40]) to the Royal College of Surgeons in Ireland program for HST in general surgery between 2006 and 2008 were assessed. Clinical, basic surgical training, logbook, research performance, and reference scores were evaluated. A total of 51 candidates were shortlisted and completed a further objective assessment of their technical skills and interview performances. Shortlisted candidates performed better (p < 0.003) on all assessed parameters. Compared with candidates who were not selected for HST, those who were selected (N = 31) significantly outperformed on individual assessments and overall (p < 0.0001). Logistic regression analysis showed that clinical, technical skills, and research assessments, but not interview, predicted (92.2 %) HST selection outcomes. Candidates selected for the national HST program in Ireland consistently outperformed those who were not. The assessments reliably and consistently distinguished between candidates, and all of the assessed parameters (except interview) contributed to a highly predictive selection model. This is the largest reported dataset from an objective, transparent, and fair assessment program for selection of the next generation of surgeons.

Reply to Bajona

I thank Bajona [1] for his interest in the article regarding a European Training Programme in Cardiothoracic Surgery [2] and the comments by Hamilton [3], and for the caveats raised. The selection of appropriate trainees for a training programme is of vital importance, equal to having the appropriate trainers and training programmes as one of three sides of a successful training programme triangle. The selection of trainees according to all criteria but merit is widespread and allows certain individuals in authority to manipulate and exploit training and trainees. This can only be eliminated by developing a structured, transparent and robust selection procedure with clear and valid personal and professional specifications and qualifying criteria. I certainly agree with Bajona [1] that for basic training, it could be region- or country-based, but for advanced training it should be Europewide [2] to allow trainees to optimize their training in the field of their choice in the best programme available. This competition can only help to raise the standard of training offered by various training centres across Europe to attract trainees of high calibre into their programmes. Competence should certainly be measured in an unbiased and accurate fashion using appropriate validated and reliable tools and methods. The tools chosen should have face, predictive, construct and content validity proven by educational research and be reliable enough to avoid inter- and intraobserver variations. The latter can be improved by incorporating training in the use of assessment methods in Train the Trainer Courses to produce trainers versed in modern training theory and practices. The assessment process can be made more sound by triangulation, removing the need for independent surgeons from a different country to perform the assessment. Manpower planning and optimal provision of trained cardiothoracic surgeons of high calibre for Europe are difficult to accurately forecast, but should at least be attempted. Non-European citizens wishing to train in Europe can be given the opportunity, but will have to compete on equal footing with all other applicants for entry both into the basic and advanced training programmes if places are available. The European Board examination is in need of urgent review, upgrade and reform, to be of a standard acceptable as a qualifying exit examination that can be recognized across Europe and the world. The harmonization of training programmes will eliminate the inequality of access to Board certification. The division of the training programme into basic and advanced stages not only ensures the optimization of the provision of training programmes, but also provides structured and achievable targets for trainees and Training Programme Directors. All trainees should have adequate surgical experience appropriate to their level. Basic qualification does not allow stand-alone practice, and only trainees who complete the advanced training would have the opportunity to become independent surgeons. This will allow the production of fully trained surgeons that can be independent of departmental chiefs. It is high time for the people in leadership positions in our speciality across Europe to act to achieve a European Training Programme in Cardiothoracic Surgery.

The Health of Geriatrics in Canada —More Than Meets the Eye

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Editorial Comment: Time to end the disparity of training in Europe

Free movement of people (and so workers) is one of the four economic freedoms guaranteed under the internal market of the European Union (the others being goods, capital and services). It is a fundamental principle of European Law that each of the 27 member states must recognize professional qualifications granted in another country. The details relating to this mutual recognition are set out in the Directive 93/16/EEC of 5 April 1993. This only makes sense if we have a common training programme which produces surgeons with equivalent knowledge and skills. Yet, we all know that there are marked variations, not only in the content and delivery of training but also in the selection, assessment and accreditation of trainees. The current situation is nonsensical. The paper, published in this issue, by Loubani et al. [1] is a valuable contribution to the debate which we must have if we are to make any progress towards harmonization of training. The authors rightly compare the organization of training in other countries with the wide variation in Europe. The practice of cardiothoracic surgery is evolving rapidly with a significant move towards subspecialization (to the benefit of patients who must remain our key focus), and so, the way we train the next generation must change. They make a good argument for a modularbased system with an initial broad-based ‘basic’ programme with later specialization. As things stand at present, the UEMS (Union Europeenne des Medecins Specialistes) is the representative organization of all medical specialists in the EC [2]. As it is the legal entity, we must work through UEMS. A ‘European Board’ is a body set up by the relevant UEMS/Specialized Section with the purpose of guaranteeing the highest standards of care in the speciality concerned in the EC member states by ensuring that the training of specialists is raised to an adequate level. This might seem to be a rather unwieldy and bureaucratic system, but it is the only mechanism we have to work with. I believe it is something the National Societies can use to work together towards a common European training system. The Canadians, the Americans and the Royal Australasian College have all managed to agree their own common training programmes. So, surely it is time that we in Europe took up the challenge. Continuing with the current nonsensical situation is unacceptable and does our speciality (and our future trainees) a disservice—it makes a mockery of the law. If patients understood the reality, they would expect better from us.

Selection of clinical psychology trainees: A job analysis and competence model

This paper reports on a job analysis and a competence model suitable for adoption by the UK training community for the purposes of selection. It includes the results of a survey of trainers, trainees, supervisors and service users.

AS34-01 - Training in Europe. different systems and similar challenges

“Children are not simply small adults”, states the UEMS CAPP training Logbook. Nevertheless, the core identity of Child and Adolescent Psychiatry (CAP) has been at stake for the last few decades in Europe. CAP is now an independent specialty in 23 countries and a subspecialty in 8 countries, but 5 countries do not have any structured CAP training. Training differences are marked even within the EU member countries, and are not only in terms of content of training programs, but are also relevant to duration, trainee selection, and graduation procedures. More importantly, while almost half of the countries have integrated structured psychotherapy training as a full component of CAP training, the other half has not. Within the UEMS, CAP psychiatrists used to be represented in the section and board of Psychiatry until recently: it is only in 1994 that UEMS established the European Child and Adolescent Psychiatry/Psychotherapy (CAPP) Section and Board. The idea behind this initiative to split among UEMS was to promote high standards of mental health care for children across Europe, both directly and indirectly, by establishing standards and improving the quality of postgraduate CAP training, with a particular focus on training in psychotherapy. The UEMS CAP Board published a Training Logbook, which has already proven to be important in helping new EU member countries to develop their own training program in CAP. We will discuss the discrepancies and similarities in CAP training programs across Europe, and the challenges that have arisen through harmonization processes.

The interactive category schema of candidate competence: An Australian experience

The Education Committee of the Australian Psychoanalytic Society, inspired by David Tuckett’s research, relating to the measurement of candidate competence, conducted a similar study that, they believe, added value to his earlier work. The indicators of analytic competence were more numerous and specific, and greater emphasis was placed on how these criteria could further be operationalized. Besides being used in the measuring of candidate competence, the author makes a case for how the criteria can be adapted for use in the selection of prospective trainees; the defining of teaching and supervisory objectives and processes; and as a basis for further research. The close resonance that the qualitative research method used has with analytic thought and practice is highlighted. It is proposed that this synchrony reduces the resistance that analysts often have in participating in such research. There were definite advantages that arose out of the Australian project aside from producing a society‐specific schema of candidate capacities. The research process opened up a space for dialogue, debate and experimentation that increased group cohesion and society identity. Including the candidates in the survey facilitated the increase of transparency between candidates and members, contributing to the strengthening of the educational alliance.

Emotional Intelligence and Stress in Medical Students Performing Surgical Tasks

Poor stress management skills can compromise performance in the operating room, particularly in inexperienced trainees. Little is known about individual differences in managing stress. This study aimed to explore the relationship between trait emotional intelligence (EI) and objective and subjective measures of stress in medical students faced with unfamiliar surgical tasks. Seventeen medical undergraduates completed an unfamiliar laparoscopic task on a simulator during January to April 2008. Subjective stress before, during (retrospectively), and after the task was measured using the self-report State-Trait Anxiety Inventory. Objective stress was measured using continuous heart rate (HR) monitoring. Participants also completed the Trait Emotional Intelligence Questionnaire short form (TEIQue-SF). The authors computed scores for global trait EI and the TEIQue-SF four factors and carried out descriptive and correlational analyses. The highest levels of subjective stress were reported during the task and correlated positively with trait EI as well as with the trait EI factors of well-being and emotionality. Objective stress (mean HR) during the task was positively related to the sociability factor of trait EI. Higher trait EI scores were also associated with better after-task recovery from stress experienced during the task. Students with higher trait EI are more likely to experience stress during unfamiliar surgical scenarios but are also more likely to recover better compared with their lower-trait-EI peers. Trait EI has implications for the design of effective stress management training tailored to individual needs and potential applications to surgical trainee selection and development.

Selecting the future in obstetrics and gynaecology: Are we stuck in the past?

Selection of specialist trainees in obstetrics and gynaecology has traditionally been hospital based. To report the outcomes of a state-wide selection process and suggest possibilities for future trainee selection. Applicants were screened for interview using a standardised curriculum vitae (CV) and referee reports, and the highest-ranked applicants were offered an interview. Scores from CV, interview and references were collated to give an overall score for each candidate. The candidates were then ranked in order of merit and integrated training program (ITP) hospitals ranked their preferences for candidates. The candidates were then offered positions based on a preference-matching system. Scores for selection components were correlated. Selection matching and trainee retention rates are reported. In a 4 year period, 155 unique applicants made 183 applications, 65% were interviewed and 43% offered a position; 76% of the successful candidates were preference matched to theirs and the ITP's first choice. The retention rate to date is 92%. A state-wide selection process offers a transparent and meritorious means of selection of trainees in obstetrics and gynaecology. It has significant advantages over an individual hospital-based selection process for both trainees and hospitals. Outcome data for the optimal trainee to be selected are difficult to define. Reporting and reviewing data with a national selection process are imperative. The current selection process does not address issues that may be important for selection such as manual dexterity or psychological preparedness for the speciality of obstetrics and gynaecology.

Performance in the Duke–Elder ophthalmology undergraduate prize examination and future careers in ophthalmology

Cognitive factors (eg, academic achievement) have had a significant role in selecting postgraduate surgical trainees in the past. This project sought to determine the role of a national undergraduate ophthalmology prize examination (Duke-Elder examination) in the selection of postgraduate ophthalmology trainees. This would also serve as a quality assurance exercise for the assessment, in which the ultimate aim is to encourage trainees into ophthalmology. A retrospective analysis of the top 20 ranked candidates in the Duke-Elder examination from 1989 to 2005 (except 1995) was carried out to determine which of them subsequently entered the ophthalmic training and General Medical Council Specialist Registers. Out of the top 20 candidates in the exam, 29.5% went into specialist training in ophthalmology. Some appeared in the top 20 more than once, with 56% of them going into ophthalmic training, but they had a similar median time to enter training as those who appeared in the top 20 once. There was no significant evidence to suggest that the overall median ranking scores between the UK medical schools differed (P=0.23; Kruskal-Wallis test). However, there was a marked difference in frequency of top 20 candidates from each medical school, which could not be explained by the size of the medical school alone. It is difficult to conclude from these findings the importance that the Duke-Elder examination has in the selection of trainees into ophthalmology. The role of cognitive factors in selection into postgraduate medical/surgical training is discussed, along with the potential academic criteria, which may influence interview scores.

Midwifery training in post-conflict Afghanistan: tensions between educational standards and rural community needs

To compare the performance of students selected for midwifery education by three methods: community mobilization in rural Afghanistan, a regional examination by the Institute of Health Sciences (IHS), and the National University Entrance Examination (NUEE). A retrospective survey was conducted in January 2009 on academic records of 178 midwives trained at the IHS in Herat, including 147 graduates from 2003-08 and the cohort of 31 final-semester students graduating in March 2009. An interview survey of the 31 final semester students was also conducted. Outcome variables included knowledge, skills and employment status, stratified by method of selection. Individual attributes including completion of high school, marital status, age and urban/rural residence were also assessed. Data analysis used STATA version 2009. Significance was measured by appropriate statistical tests. Findings were verified by key informant interviews. Ninety-six per cent of midwifery graduates selected by communities were employed, compared with 74% chosen by the IHS and 82% by the NUEE. Sixty-three per cent of community-selected graduates were working in rural locations, compared with 43% recruited by IHS and 9% by the NUEE. While fewer midwifery graduates selected by communities had completed high school and their academic performance was slightly lower during training, there was no difference in their pass rates and acquisition of practical skills. Community mobilization for local selection of trainees achieved significantly higher employment levels of trained midwives in high-risk rural communities than usual selection methods, without compromising quality of skills.

Virtual reality laparoscopy: which potential trainee starts with a higher proficiency level?

Minimally invasive surgery requires technical skills distinct from those used in conventional surgery. The aim of this prospective study was to identify personal characteristics that may predict the attainable proficiency level of first-time virtual reality laparoscopy (VRL) trainees. Two hundred and seventy-nine consecutive undergraduate medical students without experience attended a standardized VRL training. Performance data of an abstract and a procedural task were correlated with possible predictive factors providing potential competence in VRL. Median global score requirement status was 86.7% (interquartile range (IQR) 75-93) for the abstract task and 74.4% (IQR 67-88) for the procedural task. Unadjusted analysis showed significant increase in the global score in both tasks for trainees who had a gaming console at home and frequently used it as well as for trainees who felt self-confident to assist in a laparoscopic operation. Multiple logistic regression analysis identified frequency of video gaming (often/frequently vs. rarely/not at all, odds ratio: abstract model 2.1 (95% confidence interval 1.2; 3.6), P = 0.009; virtual reality operation procedure 2.4 (95% confidence interval 1.3; 4.2), P = 0.003) as a predictive factor for VRL performance. Frequency of video gaming is associated with quality of first-time VRL performance. Video game experience may be used as trainee selection criteria for tailored concepts of VRL training programs.

The use of the flying aptitude test for the selection of surgical trainees

The use of the flying aptitude test for the selection of surgical trainees

International standards for programmes of training in intensive care medicine in Europe

To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.

Training and using mid-level eye care workers: early lessons from Timor-Leste

A 12-month Diploma of Eye Care course for mid-level eye care workers was initiated in 2007 as part of Timor-Leste's National Eye Health Strategy. This paper reports the development and implementation of this course, examines its initial results and makes suggestions for improvements to the training and deployment of these workers. Course curriculum development and delivery, trainee selection and candidate assessment were examined. Graduate clinical knowledge retention at 6 months after course completion was investigated using clinical vignettes to determine diagnosis, management and patient counselling knowledge for common primary eye health conditions. Graduate workplace environments and activities were appraised. Development of the course curriculum and its delivery were in response to local circumstance, and according to education best practice teaching and learning strategies. Four rural nurses successfully completed the inaugural course. Although all remained in rural eye care services at 6 months after graduation, there was considerable variation in activity. Substantial depletion of clinical competency was revealed across the cohort. Adherence to current best practice in the design and delivery of the curriculum and course was insufficient to ensure productive graduates of ongoing clinical competency, positioned to make an impact on eye health. Attention needs to be directed to postgraduation integration into the workplace, and continuing support once there. The efficacy of this mid-level cadre and its impact on eye health requires further evaluation.