Knowledge Training Research Articles

Perceptions and goals of preoperative planning conversations between anesthesiology residents and attending physicians

Study objectiveTo systematically evaluate anesthesiology resident and attending perceptions of preoperative planning conversations (POPCs) and to generate understanding for improving the educational and clinical value of this practice. Designcross-sectional study. Settingtwo large Northeastern US academic residency training programs. Participantsclinically practicing anesthesiology residents and attendings. InterventionsAn electronic survey was administered to 303 anesthesia attendings and 168 anesthesia residents across two academic institutions between June and July 2014. MeasurementsSurvey questions addressing phone call frequency and duration, clinical value, educational value and intended purpose of POPC were administered to both groups. Chi-squared tests were used to evaluate differences in responses between groups, with p < 0.05 as statistically significant. Main resultsResponses were collected from 93 attending physicians (31%) and 80 trainee physicians (48%) for an overall response rate of 37%. 99% of residents reported paging their attendings to engage in the POPC the evening prior to all operations and 95% of trainees reported almost always receiving a call back from the attending. Trainees overwhelmingly reported attendings would believe they were unprofessional or negligent if they did not initiate a POPC (73% vs 14%, chi-square = 60.9, p < 0.001). Attendings were much more likely to view the POPC as a very important tool to discuss perioperative events (60% vs 16%, chi-square = 37.3, p < 0.001) and necessary for the majority or every case (59% vs. 31%, chi-square = 13.5, p < 0.001). The majority of attendings and trainees did not find the POPC to be a very important educational tool in terms of assessing trainee knowledge base (14% vs. 6%, chi-square = 2.76, p = 0.097), discussing teaching opportunities (26% vs. 9%, chi-square = 8.5, p = 0.004), or establishing rapport (24% vs. 7% trainees, chi-square = 8.3, p = 0.004). ConclusionsSignificant discrepancies exist between how anesthesia attendings and residents perceive the purpose of the POPC, with trainees less likely to view the POPC as having clinical value and neither group perceiving the conversation as a very useful educational tool. The results highlight the need to reexamine the value of the daily POPC as a deliberate educational practice to meet expectations of both trainees and attendings.

The Perspectives of Preservice Kinesiology Students Concerning Autism and Physical Activity: Differences by Adapted Physical Activity Exposure.

This study investigated the effect of an adapted physical activity (APA) course on knowledge and perceptions of preservice trainees regarding physical activity (PA) and autism spectrum disorder in 3 areas: knowledge/perspectives, importance and ease of improving developmental domains, and importance and ease of improving motor skills. Four hundred upper-level undergraduate students were recruited to participate in this survey-based study (251 APA students and 149 non-APA students participated). Survey data were analyzed using multivariate analyses of variance. Participants estimated that the moderate to vigorous PA recommendations are 39.34minutes per day, that 46.65% of moderate to vigorous PA occurs during school, and that 61.03% of children have motor difficulties. Participants perceived activities of daily living, sleep habits, and heart health as the easiest domains to improve, and problem behaviors, social skills, and self-esteem as the most difficult domains to improve. Knowledge/perspectives regarding autism spectrum disorder and PA were different by APA exposure (F12,324 = 3.11, P < .001). Differences included self-efficacy in providing PA advice, knowledge of PA guidelines, and willingness to provide motor assessment referrals. Students differed by APA exposure in the importance of developmental domains (F8,381 = 4.37, P < .001) but not ease of improving those domains. Results suggest that APA education and contact with children with disabilities improves self-efficacy, perspectives, and knowledge of PA and motor concerns in children with autism spectrum disorder.

Simulation to improve trainee knowledge and comfort in managing maternal cardiac arrest

Maternal cardiac arrest is a rare outcome, and thus there are limited opportunities for specialists in obstetrics and gynecology to acquire the skills required to respond to it through routine clinical practice. This study aimed to evaluate gaps in medical education in maternal cardiac arrest and whether a simulation-based training program improves resident knowledge and comfort in the diagnosis and treatment of maternal cardiac arrest. A 2-hour training for obstetrics and gynecology residents at an academic medical center was conducted, consisting of a didactic presentation, defibrillator skills station, and 2 high-fidelity simulations. Consenting residents completed a 21-item pretest followed by a 12-item posttest exploring knowledge of and exposure to maternal cardiac arrest. The McNemar and Wilcoxon signed-rank tests were used to compare pre- and posttest data. Of 21 residents, 15 (71.4%) had no previous education about maternal cardiac arrest, and 17 (81.0%) had never responded to a maternal code. Participants demonstrated increased knowledge about maternal cardiac arrest after the session, providing more correct answers on the reversible causes of pulseless electrical activity arrest (median 4 vs 7 correct responses; P<.01). After the training, more residents were able to identify the correct gestational age to perform a cesarean delivery during maternal cardiac arrest (19.0% vs 90.5%; P<.01) and the correct location for this procedure (52.4% vs 95.2%; P<.01). All residents reported that maternal cardiac arrest training was important and that they would benefit from additional sessions. Median composite comfort level in managing maternal cardiac arrest significantly increased after participation (pretest, 24.0 [interquartile range, 21.5-28.0]; posttest, 37.0 [interquartile range, 34.3-41.3]; P<.01). Residents report limited exposure to maternal cardiac arrest and desire more training. Simulation-based training about maternal cardiac arrest is needed during residency to ensure that graduates are prepared to respond to this high-acuity event.

Knowledge, attitudes, and beliefs of oncology trainees on function and cancer rehabilitation medicine.

Improved function is associated with reduced morbidity and mortality in patients with cancer. Cancer rehabilitation medicine (CRM) is a subspecialty of physical medicine and rehabilitation (PM&R) that focuses on improving function in patients with cancer. One of the barriers to patients accessing CRM services is the lack of referrals from oncology providers. Understanding the knowledge, attitudes and beliefs of oncology trainees regarding the importance of function and the role of CRM is essential to reducing educational gaps and improving patients' access to essential rehabilitation services. To determine oncology trainees' knowledge, attitude and beliefs about the importance of function and the role of CRM in the care of patients with cancer. The study was conducted at a comprehensive cancer center in the United States. Descriptive survey study was administered to postgraduate oncology trainees who spent at least 1 day a week providing patient care. Participants' report of their knowledge, attitudes, and beliefs on the importance of function and CRM in the care of patients with cancer. The survey was sent to 197 oncology trainees with a response rate of 67% (n=132) and 126 were ultimately included. All participants believed that function is important in the care of patients with cancer. The majority believed that better function improves treatment tolerance (94%) and survival (84%). Most reported that having CRM physicians (80%) and an inpatient rehabilitation unit (88%) in the oncological setting is important; however, most participants reported that they refer fewer than 25% of their patients to CRM services. Participants with prior exposure to PM&R were significantly more likely to consult PM&R compared to those without exposure (p= .005). Most oncology trainees (81%) believed that education in CRM should be part of their oncology training. This study demonstrates that oncology trainees believe that function is important. They also believe that access to CRM would improve treatment tolerance and survival, but most report that they rarely refer patients to CRM services. Most trainees desire increased exposure to CRM during oncology training.

Knowledge, Attitudes, Practices and Mental Health Status of Trainees in Selected Health Institutes Regarding COVID-19 in Uttar Pradesh, India

On 11 March 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic. Knowledge about COVID-19 is an important determinant towards successful disease control. This study was designed to elucidate the knowledge, attitudes and practices (KAP) and mental health status regarding COVID-19 amongst trainees of two institutes in the state of Uttar Pradesh, India. The cross-sectional study was conducted from January to March 2021. A bilingual survey recorded the responses of 400 participants from the institutes. Variables, such as sex, age, marital status, occupation, level of education, number of family members and living place, were collected in a structured proforma. Unstandardised regression coefficients (95%) were used for evaluating the association among variables with KAP and mental health during COVID-19. The statistical significance level was determined at p&lt;0.05.The mean correct answer score regarding knowledge about COVID-19 was 23.5 (SD=2.1), indicating an overall 87% correct rate. The mean correct answer score regarding attitude towards COVID-19was 18.4 (SD=2.3), indicating an overall 87.2% correct rate. The mean correct answer score regarding practice towards COVID-19 was 35 (SD=3.4), indicating an overall 89.7% correct rate. The mean correct answer score regarding mental health status during COVID-19 was 24 (SD=4.7), indicating an overall 80% correct rate. Thus, the results showed that being female; belonging to a higher age group; having a healthcare related occupation; being married; and having a higher level of education were significantly associated with higher KAP test scores. Furthermore, belonging to a higher age group; having a healthcare related occupation; being married; and having a higher level of education were significantly associated with poor mental health.

Multidimensional Evaluation of Screening Brief Intervention and Referral to Treatment Training for Medical Students.

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based approach to identifying and addressing alcohol use in non-specialty settings. Many medical schools teach SBIRT, but most published evaluations of these efforts exclude rigorous skill assessments and teaching methods. During the 2017-2018 academic year, 146 third-year medical students received classroom-based learning on SBIRT and motivational interviewing (MI) and at least two SBIRT practices with feedback as part of a 4-week psychiatry clerkship. The objective of this curriculum was to improve SBIRT knowledge, attitudes, and confidence and enable learners to skillfully deliver SBIRT. Outcomes evaluated included satisfaction, knowledge, attitudes and confidence, and clinical skill in delivering SBIRT to a standardized patient (rated by the actor, as well as an expert). Results indicated acceptable satisfaction at post-curriculum and significant improvements in attitudes and knowledge from pre- to post-curriculum. On the clinical skills exam, all students were rated as having mastered at least 80% of SBIRT elements by standardized patients and 91.8% were rated at this level by a faculty expert. Student attitudes and knowledge were unrelated to expert ratings, and standardized patient ratings had limited associations with expert ratings. These results suggest curriculum objectives were achieved and provide unique contributions to the SBIRT curricular outcome research for healthcare trainees. Other findings included that trainee knowledge and confidence may not relate to skill, and standardized patient feedback provides different information on SBIRT and MI skill than expert ratings.

Implementation of Endurance Training Model Based on Basic Soccer Techniques to Soccer Coaches in Pariaman City

Soccer is a game sport that requires good endurance skills. Good endurance will help players to be able to play optimally during the game. The selection of the right training model will encourage the creation of a structured and directed training process. Based on the results of interviews and observations in the field, there are findings that trainers still use the old or conventional training model. Lack of knowledge of trainers about training models can ultimately lead to the inability of trainers to create varied training programs. To overcome these problems, football coaches need to be given various training models. The approach methods used in solving partner problems are 1) Workshops in order to improve the understanding of trainers in preparing training programs, 2) Field practice to understand more deeply how to implement Drill-Based Endurance training models and 3) Follow-up discussions in the context of monitoring and evaluation. The result of this activity is an increase in the trainer's understanding and ability in training to increase endurance abilities.

Virtual Outreach (VO) as an effort to increase VCT (Voluntary Counselling and Testing) coverage at PSP (Female Sex Workers) in Semarang Regency

The high number of HIV / AIDS cases in Indonesia requires the role of all parties to reduce the infection of the disease, one of the efforts to reduce the transmission of HIV / AIDS is to increase the coverage of VCT (Voluntary Counselling and Testing). The program aims to increase VCT coverage by using VO (virtual outreach). The method used in the activity uses the PRA (Parcipatory Rural Apraisal) model, namely by involving all field officers at the Sokoguru Foundation through providing education and training to increase capacity in conducting VO. As a result of this activity, there was a significant difference (p value 0.05) in terms of the knowledge of trainees before and after being given this education and training. In conclusion, the Sokoguru Foundation, which oversees field officers, can routinely increase the capacity of its field officers to conduct virtual outreaches as an alternative in conducting outreach to the Key population.

Three-Dimensional Photography and Computer Modeling as a Reconstructive Surgical Training Tool.

Reconstructive surgery operations are often complex, staged, and have a steep learning curve. As a vocational training requiring thorough three-dimensional (3D) understanding of reconstructive techniques, the use of 3D photography and computer modeling can accelerate this learning for surgical trainees. The authors illustrate the benefits of introducing a streamlined reconstructive pathway that integrates 3D photography and computer modeling, to create a learning database for use by trainees and patients alike, to improve learning and comprehension. A computer database of 3D photographs and associated computer models was developed for 35 patients undergoing reconstructive facial surgery at the Royal Free Hospital, London, UK. This was used as a training and teaching tool for 20 surgical trainees, with an MCQ questionnaire assessing knowledge and a Likert scale questionnaire assessing satisfaction with the understanding of core reconstructive techniques, given before and after teaching sessions. Data were analyzed using the Mann-Whitney U test for trainee knowledge and Wilcoxon rank sum test for trainee satisfaction. Trainee (n = 20) knowledge showed a statistically significant improvement, P < .01, as did trainee satisfaction, P < .05, after a teaching session using 3D photography and computer models for facial reconstruction. Three-dimensional photography and computer modeling are useful teaching and training tools for reconstructive facial surgery. The authors advocate the implementation of an integrated pathway for patients with facial defects to include 3D photography and computer modeling wherever possible, to develop internal databases for training trainees as well as patients. This algorithm can be extrapolated to other aspects of reconstructive surgery.

A study to assess the knowledge and attitude among teacher trainees about epilepsy in school children at selected teacher training institutes, at Bangalore, with a view to develop informational guide sheet

Background of the study: Epilepsy is a chronic condition characterized by uncertainty. It affects more than 50 million people worldwide and is an important public health problem (WHO, 2004). Some studies in developing countries suggest the prevalence of epilepsy to be more than 10 per 100 (WHO 2003) [2]. In India, there are 30 million people affected by epilepsy in 2004. According to Meadow and Smithells (2005) about 1 in 200 school children are affected with epilepsy about 1 person in 20 has a seizure of some type during life, and in the population at large about 1 in 200 has epilepsy. There are approximately 5 million people with epilepsy in India, and economic burden due to epilepsy to the nation is Rs. 13.500 million. According to this report there are only 400 Neurologists in India i.e., 1 Neurologist for 13.500 persons with epilepsy [8].Approach: The research approach adopted for this study was non-experimental descriptive survey approach.Design: The research design selected for this present study was descriptive research.Setting: The study was conducted at teacher training institutes at Bangalore, Karnataka.Participants: 60 teacher’s trainees were selected by purposive sampling technique, as non-probability sampling method.Methods: The data was generated by using the structured questionnaire. Purposive non-probability sampling techniques were adopted to select 60 subjects. The data was obtained from the study subjects were analyzed and interpreted in terms of the objectives and hypothesis of the study. Descriptive and inferential statistics were used for the data analysis and the level set at 0.05.Results: Data collected were analysed by using descriptive statistics. Results of the study revealed that, majority of the teacher trainees i.e. 76.67% had inadequate knowledge and 23.33% of teacher trainees had moderate knowledge. None of them had adequate knowledge. The Range knowledge of teacher trainees was 4-21. The Mean and Mean percentage of knowledge of teacher trainees was 14.44 and 48.13% respectively, with standard deviation 3.16. In the same way, majority of the teacher trainees i.e. 80% had unfavorable attitude. And 20% of teacher trainees had moderate attitude. None of them had Favorable attitude. The Range Attitude of teacher trainee’s was 40-92. The Mean and Mean percentage of attitude of teacher trainees was 77.5 and 51.67% respectively, with standard deviation 4.5. The correlation co-efficient value of knowledge and attitude of teacher trainees was + 0.19 that shows that there was positive correlation exists between knowledge and attitude of teacher trainees about epilepsy in school children. It indicates that this means more the knowledge better the attitude.Interpretation & Conclusion: On the basis of the study we can draw the following conclusions. The majority of the teacher trainees had inadequate knowledge and unfavorable attitude. The correlation co-efficient value of knowledge and attitude of teacher trainees was + 0.19 that shows that there was positive correlation exists between knowledge and attitude of teacher trainees about epilepsy in school children. It indicates that this means more the knowledge better the attitude.

Mainstreaming of genomics in oncology: a nationwide survey of the genomics training needs of UK oncologists

Genomics is rapidly changing treatment paradigms for cancers, obligating oncologists to have good genomics knowledge. Through this survey, we aimed to assess the current understanding of cancer genomics among UK oncologists. We conducted a web-based nation-wide self-assessment survey of the cancer genomics knowledge of UK clinical and medical oncology trainees and consultants. In total, 150 oncologists (81 consultants and 69 trainees) responded, representing 10% of UK oncologists.Formal training in genomics had not been received by 38.7% of oncologists and 92.7% identified a need for additional genomics training.In total, 71.3% self-reported to have good knowledge of defining somatic and germline mutations, falling to 35.3% for understanding principles of gene expression and regulation. Knowledge of cancer-predisposing syndromes was highest for Lynch syndrome (40.7% good knowledge) and lowest for multiple endocrine neoplasia (14.0% good knowledge).Overall, 49.0% of respondents had consented patients for germline testing, but 80.7% reported a lack of training in genetic counselling. Large knowledge gaps have been identified through this survey, highlighting the need for incorporation of improved formal training in cancer genomics for consultants and trainees, with an aim to equip oncologists for advances in clinical practice and to take up genetic mainstreaming confidently.

Effects of Experience-based Vocational Training that Used the Local Products to Acquire the Trainees Skills and Knowledge in Penal Institutions Examination through Qualitative Research

Effects of Experience-based Vocational Training that Used the Local Products to Acquire the Trainees Skills and Knowledge in Penal Institutions Examination through Qualitative Research

Effectiveness of a Formal Business of Ophthalmology Course for Trainees.

Objective In medical school and residency training, there is little emphasis on the administrative and business aspects of running a clinical practice as either an employee or a business owner. However, by the first day of practice, young ophthalmologists need to have a basic understanding of the business of medicine to be successful in clinical practice and to avoid common pitfalls. Areas such as risk management, negotiation, financial health, lawsuits, marketing, coding, and professionalism are particularly important for practicing ophthalmologists to grasp. We instituted a formal practice management course to increase the early exposure of our trainees to the business aspects of ophthalmology. Methods Ophthalmology trainees engaged in 11, 1-hour sessions over 3 weeks during a practice management course covering 10 of the most relevant business topics for early career ophthalmologists. A precourse needs assessment, and a postcourse satisfaction and outcomes survey were administered. Results Of the 24 trainees who completed the presurvey, 96% of respondents had no previous training in contract negotiation, 88% lacked training in lawsuits, and 88% had no training in liability insurance. 96% had no inpatient coding education, and 88% had no outpatient coding training. Seventeen trainees completed the postsurvey, and statistically significant improvements in confidence ratings were found in all domains including coding, malpractice claims, and building a practice. 88% of trainees reported that the course improved their ability to code, and 100% agreed that the course improved their understanding of lawsuits, ability to negotiate a contract, and their understanding of the business of ophthalmology. Conclusion A formal, targeted business of ophthalmology course improved the knowledge of trainees on essential business concepts. This course can serve as a model for other programs looking to meet this educational need.

How Training Needs are Assessed in Health Organizations? An Exploratory Study

Background and Aims: Health care organizations seek a qualified and competent workforce to achieve their goals. Imple¬menting effective training programs will improve or maintain desired outcomes. Training is valuable in fulfilling many goals in healthcare, with patient safety being a central purpose. Ideally, training serves relevant needs, and assessment to fetch such needs is a crucial initial step. Training need assessment (TNA) is a systematic process that utilizes data from different sources to develop and evaluate training activities related to skill and Knowledge, aiming to provide adequate training to target individuals with reasonable costs. Methods: This study aims to explore the status of TNA practice applied by trainers in health-related institutions in Saudi Arabia. The cross-sectional study was conducted in the training departments in Health institutions in Saudi Arabia. The sample size was (103 subjects). In addition, the research team developed an online survey as a data collection tool based on a literature review. Results: The result shows that most trainers have more than ten years of experience in training, and 52% of them (23 out of 44 expert trainers) apply scientific or professional TNA upon exploring the knowledge of trainers on TNA structure. The majority agrees with “TNA aligns training with” organizational goals (88%), organizational needs (87%), performance gaps (82%), and target population needs (82%). Conclusions: Follow-up studies are required with a larger heterogeneous study population and more detailed data acquisition tools. Also, we recommend establishing a healthcare training committee of expert trainers to create a harmonized framework for TNA tools development using the best available evidence and expert consensus. This should serve as a guide for healthcare trainers in Saudi Arabia and a ground for collaborative work with international committees.

Case logging habits of integrated vascular surgery residents

ObjectiveCurrent research suggests a significant discrepancy in integrated vascular resident (IVR) vs vascular fellow case numbers by the completion of training. Our objective was to understand how IVRs log cases over the course of their training. Additionally, we sought to assess whether IVRs receive any formal training on appropriate case logging techniques or their requirements for graduation. MethodsThis study was approved by the Association of Program Directors in Vascular Surgery; a survey was sent out to all current IVRs nationwide as well as to trainees who graduated in July of 2020. Demographic variables and training program data were collected in addition to assessing trainee knowledge of graduation requirements. Trainees where then given common case scenarios and asked how they would log the case. ResultsOf the 418 residents identified from the Association of Program Directors in Vascular Surgery program roster for the 2019-2020 and 2020-2021 academic years, 32% of individuals participated in the survey. Only one-quarter of the respondents logged all cases performed, with the major cited reason for not logging cases being the low level of involvement. Of the residents, 62% reported receiving formal instruction on how to log cases appropriately, with the majority of trainees logging cases either weekly (37%) or monthly (31%). Sixty-three percent of respondents knew that 250 major vascular cases were required to graduate; however, 71% of residents thought 250 major vascular cases were required to be completed during their chief year. Seventy-five percent of trainees incorrectly believed that only primary procedures logged count toward graduation requirements. Eighty-one percent of respondents were incorrect or unsure of how to log cases as a student in postgraduate year 4. Only 5% of respondents correctly answered all six case logging scenarios correctly based on the current/provided Accreditation Council for Graduate Medical Education guidelines, and only two trainees (1.5%) answered all graduation requirement questions correctly. No trainees answered all case logging scenarios and graduation requirement questions correctly. Having any type of instruction on how to log cases, whether from faculty or peers, did not affect ability to answer case logging scenarios or graduation requirement questions significantly. ConclusionsThere is significant variability when it comes to the case logging habits of IVRs. The majority of trainees do not receive formal instruction on how to log cases. The majority of trainees are also unaware of their graduation requirements as they pertain to the cases the are required to log.

Training design in mediating the relationship of participants’ motivation, work environment, and transfer of learning

PurposeThe purpose of this paper is to examine the relationship among training design, trainee motivation and work environment on the transfer of learning for teachers enrolled in a continuing professional education (CPE) training program and the confirmation of potential positive, predictive relationships of trainee motivation, work environment and training design to transfer of learning. This study investigated the contribution of training efficiency and relevance as measured by the training design; work environment as measured by work autonomy, work complexity and work variability; and trainee’s motivation of training (learning- and job-oriented) to the transfer of knowledge and skills from the training program to their workplace. Both direct and indirect effects of mentioned components on the learning transfer were explored.Design/methodology/approachThis study included 160 teachers working in high-needs schools with large numbers of English learners (ELs) Southwest USA. Teachers in this study primarily needed professional development to empower them and enhance their instructional capacity for ELs and economically challenged students. During the recruitment, participants completed a demographic information (e.g. gender, ethnicity, number of years teaching, age, educational background) survey.FindingsA mediation model with training design as the mediating factor was developed and analyzed. The results revealed that training design fully mediated the relationship between trainees’ work environments and the transfer of knowledge, skills and attitude acquired from the training to their workplace. Furthermore, it partially mediated the relationship between learning-oriented motivation and the transfer of learning. These findings further amplify the significance of CPE program training design and foster important considerations for future research regarding the isolation of specific training design aspects that significantly contribute to the mediation of these relationships.Research limitations/implicationsConsidering the significance of learning transfer in developing professional knowledge and skills for target employees and trainees, confirming the mediating effects of training design on training transfer holds critical implications for future research. Specific and purposeful attention needs to be given to the design of CPE training. Investigations into the effects of training design and successful elements such as the training platform (online, hybrid or in-person), sample size, group structure, facilitation and participant demographics are warranted.Practical implicationsThe finding of this research provides a preliminary guide for scholar-practitioners. Results of the study confirmed the role that learning-oriented motivation, job-oriented motivation, work variability or flexibility, work complexity and training design play in transfer of learning. In practice, training professionals will be more comfortable pinpointing the factors that lead to the transfer of learning or the lack of it.Originality/valueLearning transfer has been found to be imperative for target employees and trainees to develop professional knowledge, skills and attitudes. Results of this study reveal variables that promote the positive transfer of learning to the workplace.

Adapting Bruner’s 3-Tier Theory to Improve Teacher Trainees’ Conceptual Knowledge for Teaching Integers at the Basic School

&lt;p style="text-align: justify;"&gt;The focus of this action research was to adapt Bruner’s 3-tier theory to enhance conceptual knowledge of teacher trainees on integer operations. It looks into how learners' conceptual knowledge of integer operations changes over time, as well as their attitudes toward using the 3-tier model. Eighty-two (82) teacher trainees, who were in their first year semester one of the 2020/2021 academic year were purposely selected for the study. Data was collected using test and semi-structured interviews. The study found that using Bruner’s 3-tier theory contributed to substantial gains in conceptual knowledge on integers operations among learners. It was also found that learners proffered positive compliments about the Concrete-Iconic-Symbolic (C-I-S) construct of lesson presentation and how it built their understanding to apply knowledge on integers operations. Learners also largely proffered positive image about C-I-S construct as it aroused interest and activated unmotivated learners. On these bases, the study concludes that lessons presentations should mirror C-I-S construct in order to alleviate learning difficulties encountered on integer operations. To do this, the study suggests that workshops on lesson presentation using C-I-S construct be organized for both subject tutors, mentors and lead mentors to re-equip their knowledge and to buy-in the idea among others.&lt;/p&gt;

ПРИМЕНЕНИЕ ГРАФОВЫХ МОДЕЛЕЙ ПРИ РЕШЕНИИ ПРАКТИЧЕСКИХ ЗАДАЧ ОБРАЗОВАНИЯ И СПОРТА

The article is a generalization of some of the author's works, prepared by him both individuallyand in collaboration with colleagues. The article shows how graph theory can be applied, it wouldseem, in such diverse areas as education and sports. In the first case, the graph model is used to formulateand solve the problem of compiling optimal test tasks (tickets). It is formulated as a problem of cutting(partitioning) the graph G (N, R) into subgraphs. The original graph G(N, R) is divided into a givennumber K of subgraphs where the same topic. The peculiarities of the formulation of the given problemgive rise to many heuristic algorithms for its solution. The following heuristic is considered in the article:each test task is formed sequentially, and each next question is placed in the current test task if itsscore is the closest to the relative value of the difference between the average complexity of test tasksand the total complexity of those questions that are already included in this test task, to the amount ofquestions left to include in the task. Algorithms and results of their software implementations are presented,with the help of which studies were carried out on the optimal formation of test tasks designed tocontrol the knowledge of trainees. Various heuristics are analyzed that allow optimization of test tasks.In the second case, it is shown that tournament tables for sporting events can also be represented bygraph models. Formally, the task of drawing lots, as in the case of the formation of test tasks, is reducedto the task of splitting the graph into subgraphs, each of which will correspond to one of the groups inthe tournament table. In addition, each vertex of the graph corresponds to the rating of a certain participantin the tournament. The edges of the graph show the relationship between the participants – thepresence of an edge indicates that the corresponding participants are representatives of the same associationor club. Based on these models, descriptions of the developed algorithms and the results of theirsoftware implementations for the optimal formation of tournament tables used in competitions on theexample of table tennis are given. Heuristics are analyzed for one- and two-criteria optimization oftournament tables construction. The commonality and continuity in the algorithms for the formation oftournament tables and the sequential distribution of questions in test tasks is to use not only graph models,but also the same analytical relationships to formalize the heuristics used.

Education Research: High-Fidelity Simulation to Evaluate Diagnostic Reasoning Reveals Failure to Detect Viral Encephalitis in Medical Trainees

Background and Objectives Delays in treatment of both herpes simplex virus (HSV) encephalitis and seizures are associated with poor patient outcomes, but many physicians fail to recognize HSV despite classic presenting symptoms. Our goal was to assess trainee performance in a simulation-based case to recognize HSV encephalitis as the underlying etiology of refractory status epilepticus. Methods This is a prospective, observational, single-center simulation-based study of participants ranging from subinterns to attending physicians managing a patient with viral encephalitis complicated by nonconvulsive status epilepticus. Using a modified Delphi approach, we developed a list of critical actions. The primary outcome measure was critical action item sum score. We compared level of training and performance using analysis of variance as validity evidence to support our findings. Results Fifty-nine trainees completed the simulation. The mean sum of critical actions completed was 13.9/25 (56%). Eighty percent of trainees administered an appropriately dosed benzodiazepine, and 97% administered a second-line agent. Despite 88% of trainees obtaining a lumbar puncture, only 47% recognized viral encephalitis as the most likely diagnosis with 36% starting appropriate treatment. There was significant effect of training level on critical action sum score (level 1 mean score [SD] = 10.8 [1.5] vs level 2 mean score [SD] = 12.2 [2.5] vs level 3 mean score [SD] = 13.9 [3.0] vs level 4 mean score [SD] = 18.2 [3.2], p &lt; 0.001, R 2 = 0.38). Discussion Although initial seizure treatment was sufficient, failure to recognize HSV encephalitis was common with few trainees initiating appropriate treatment potentially leading to poor outcomes in real-life scenarios. High-fidelity simulation holds promise as an assessment tool in identifying trainee knowledge gaps and why classic clinical cases escape trainee diagnosis.

C-CASE 2022: Competence to Excellence01. The Queen Bee phenomenon in Canadian surgical subspecialties: an evaluation of gender biases in the resident training environment02. Barriers to surgical peer coaching — What have we learned, and where do we go from here?03. Shared decision-making and evidence-based medicine: Pivotal or trivial to patient care in orthopedic trauma?04. Immersive virtual reality and cadaveric bone

# 01. The Queen Bee phenomenon in Canadian surgical subspecialties: an evaluation of gender biases in the resident training environment {#article-title-2} The Queen Bee phenomenon describes the behavioural response that occurs when women achieve success in a male-dominated environment, and in this