European Training Research Articles

European Peer Counselor Training in Accessible Tourism – Peer Act” Innovation for Inclusion in Adult Training and Inclusive Tourism

European Peer Counselor Training in Accessible Tourism – Peer Act” Innovation for Inclusion in Adult Training and Inclusive Tourism

Exploring the potential for CAI implementation in interpreter training in Ukraine

The article purports to assess the potential of the current European training in computer-assisted interpreting and associated technological competence development for making the corresponding technological turn in Ukraine’s tertiary interpreter education based on a narrative review. Discussed are the issues of the technological turn in interpreting and its teaching, the corresponding awareness of educators and interpreters, the role of computer-assisted interpreting (CAI) tools in interpreting activities and training, the related challenges faced by interpreters and interpreters’ training, and how Ukraine compares in this with the developments in the EU. Some problems are dwelt upon of COVID-propelled interpreting digitalization. Conclusions imply that Ukraine must undertake quickly such a technological turn not to lag behind the ongoing process of changes in interpreting and interpreter training.

Consultation-liaison psychiatry training in Europe: where do we stand?

Consultation-liaison psychiatry is a subspecialty of psychiatry that focuses on the interface between mental health and general medical care. In Europe, consultation-liaison psychiatry has a long history and is an established field of practice. The primary goal of consultation-liaison psychiatry is to provide psychiatric assessment, diagnosis, and treatment to patients with medical or surgical conditions that impact their mental health. Consultation-liaison psychiatrists work collaboratively with medical teams to manage the psychological and emotional aspects of illness and its treatment. In addition to providing direct patient care, consultation-liaison psychiatrists also participate in research, teaching, and advocacy activities related to the interface between medicine and psychiatry.

New Methodological Approaches to Review Governance and Financing Arrangements in Vocational Education and Training (VET) and Skill Systems: A Data Collection Tool (DCT) 4.0 for Facilitating Self-Assessment Processes

The European Training Foundation (ETF) is more than aware that effective -good multilevel- governance arrangements in Vocational Education and Training (VET)-and Skill policies-is key for having sound skills in the labour market. The ETF developed new Data Collection tool 4.0 (DCT) to implement self-assessments working with partner countries (PCs) in governance and financing arrangements involving, at least, seven different categories of policy stakeholders (e.g. governmental actors-public servants-, social partners, private actors, key experts). This -innovative- tool contains 65 indicators for self-assessing seven governance- and financing- functions including institutional coordination mechanisms (e.g. strategic and legislative framework, management of public-private partnerships, VET providers network, evaluation, research and data analysis provision, councils/committee’s system etc.). The DCT 4.0 has been piloted in 5 ETF PCs (Albania, Jordan, Kazakhstan, Moldova and Uzbekistan). The results might inform further policy development driven by governance and financing arrangements/issues in ETF PCs (or perhaps, beyond). Further, this tool for policy analysis could inspire advisory processes focusing on how to support systemic reforms and/or carry out monitoring implementation-and/or policy review-, based on different types of governance and financing arrangements. The pilot experience developed in COVID 19 times, confirmed that online facilitation is a good way to get good results. However, the human touch factor is essential to facilitate such self-assessment in more impactful way as it could be embedded in real time into current policy dialogue strategies in the countries.

The European Training Network ETUDE (Encompassing Training in fUnctional Disorders across Europe): a new research and training program of the EURONET-SOMA network recruiting 15 early stage researchers

The European Training Network ETUDE (Encompassing Training in fUnctional Disorders across Europe): a new research and training program of the EURONET-SOMA network recruiting 15 early stage researchers

Subspecialty training in Europe: a report by the European Network of Young Gynaecological Oncologists

BackgroundESGO (European Society of Gynaecological Oncology) and partners are continually improving the developmental opportunities for gynaecological oncology fellows. The objectives of this survey were to evaluate the progress in the...

Building the technological European Community through education: European mobility and training programmes in the 1980s.

The Community Action Programme for Education and Training for Technology (COMETT) played a key role in paving the way for increased cooperation between the member states of the European Community (EC) in the field of education and in the promotion of intra-Europe mobility. In this article, COMETT is considered as a non-traditional education and training programme for solving economic challenges in the context of technological change that was focused on the training of a highly skilled workforce. The process of setting the agenda for COMETT is studied through an analysis of official EC policy documents and archival material from the EU's historical archives in Florence. Our analysis suggests that the challenge posed by new information technologies acted as a catalyst for a new approach to education governance that was based on closer cooperation between European universities and industry. Promoting intra-Europe mobility among highly skilled workers and students was a key part of the programme, which defined an economic and social strategy for Europe in response to technological change. Educational and social goals were secondary in the design and implementation of the COMETT programme, which, first and foremost, was motivated by the EC agenda to boost the competitiveness of European industry.

Western European influence on the development of Russian neurology and psychiatry, part 1: Western European tours of early Russian neurologists and psychiatrists

ABSTRACT Beginning in the 1860s, two major centers of neurology and psychiatry arose in Russia: Imperial Moscow University (IMU) and Imperial Medical and Surgical Academy in St. Petersburg (IMSA). Both centers were strongly influenced by Leading Western European schools and specialists, through the clinical and research training regimes of both Russian universities, strongly influenced these centers of learning. In this study, we elaborate the Western European training of the first Russian specialists in the fields of neurology and neuropsychiatry from IMU and IMSA during the period from the late 1850s to 1900. Although prior studies emphasized the influence of French mentors and institutions, the Western European tours of early Russian specialists often included multiple destinations in Germany, France, and Austria. The most commonly visited cities (in descending order) were Paris, Berlin, Leipsig, and Vienna. The most commonly visited training centers (in descending order) were Hoôpital Salpêtriêre (Paris), Friedrich-Wilhelms-Universität (Berlin), Charité (Berlin), Universität Leipzig, First Psychiatric Clinic (Vienna), and Hôpital Sainte-Anne (Paris). The most commonly visited mentors, in descending order, were Charcot (Paris), Flechsig (Leipzig), Westphal (Berlin), Meynert (Vienna), and Magnan (Paris). Training of Russian specialists in Western Europe facilitated the emergence and development of the neurological and psychiatric schools in Moscow and St. Petersburg.

Short-term clinical outcomes of a European training programme for robotic colorectal surgery

BackgroundDespite there being a considerable amount of published studies on robotic colorectal surgery (RCS) over the last few years, there is a lack of evidence regarding RCS training pathways. This study examines the short-term clinical outcomes of an international RCS training programme (the European Academy of Robotic Colorectal Surgery—EARCS).MethodsConsecutive cases from 26 European colorectal units who conducted RCS between 2014 and 2018 were included in this study. The baseline characteristics and short-term outcomes of cases performed by EARCS delegates during training were analysed and compared with cases performed by EARCS graduates and proctors.ResultsData from 1130 RCS procedures were collected and classified into three cohort groups (323 training, 626 graduates and 181 proctors). The training cases conversion rate was 2.2% and R1 resection rate was 1.5%. The three groups were similar in terms of baseline characteristics with the exception of malignant cases and rectal resections performed. With the exception of operative time, blood loss and hospital stay (training vs. graduate vs. proctor: operative time 302, 265, 255 min, p < 0.001; blood loss 50, 50, 30 ml, p < 0.001; hospital stay 7, 6, 6 days, p = 0.003), all remaining short-term outcomes (conversion, 30-day reoperation, 30-day readmission, 30-day mortality, clinical anastomotic leak, complications, R1 resection and lymph node yield) were comparable between the three groups.ConclusionsColorectal surgeons learning how to perform RCS under the EARCS-structured training pathway can safely achieve short-term clinical outcomes comparable to their trainers and overcome the learning process in a way that minimises patient harm.

Long-Term Effects of Mental Training on Manual and Cognitive Skills in Surgical Education – A Prospective Study

Limited training opportunities and expanding requirements are challenging surgical education, calling for alternative training methods like simulation or mental training. The aim of this study is to evaluate short- and long-term effects of a structured mental training on surgical performance. Medical students without laparoscopic experience were randomly assigned to 3 groups: (1) control (2) video training, and (3) video plus mental training performing 2 E-BLUS (European Training in Basic Laparoscopic Urological Skills) exercises, "peg transfer" (PT) and "cutting a circle" (CC). Group 3 performed a structured mental training course (identification of procedural key steps, relaxation, mental vocalization, and imaging). Longitudinal assessment including binominal checklists, global rating scales (GRS), procedural times, and Test of Performance Strategies (TOPS) were performed at baseline, day 2, 14, and after 16 months. Statistical analysis included ANOVA and general linear models with repeated measures. The study was conducted in "Olympus Training and Education Center Hamburg West" and "Endo Club Academy" at the University Medical Center Hamburg-Eppendorf. Participants were eligible if they were medical students with no experience in laparoscopy. 24 participants were recruited and finished the study. The mental training group maintained significantly better GRS scores at 16 months for PT (mean score 24.6 [95% CI: 21-28.25]) and CC (mean score 22.5 [18.4-26.6]) (both p < 0.01) and performed faster in the latter (261 seconds [Std. Dev 116] vs. 427 seconds [SD 132] vs. 368 seconds [SD 78]) compared to the other groups (p = 0.004). Longitudinally, mental training had a significant effect on TOPS scores and procedural times (p < 0.001 and p = 0.005, respectively). In addition to short time efficacy, our study is the first to ascertain a positive long-term effect of mental training on manual and cognitive skills and might be a useful and cost-effective tool in surgical education.

The European Union pilots training

The European Union pilots training

Validation of Lung EpiCheck, a novel methylation-based blood assay, for the detection of lung cancer in European and Chinese high-risk individuals.

AimLung cancer screening reduces mortality. We aim to validate the performance of Lung EpiCheck, a six-marker panel methylation-based plasma test, in the detection of lung cancer in European and Chinese samples.MethodsA case–control European training set (n=102 lung cancer cases, n=265 controls) was used to define the panel and algorithm. Two cut-offs were selected, low cut-off (LCO) for high sensitivity and high cut-off (HCO) for high specificity. The performance was validated in case–control European and Chinese validation sets (cases/controls 179/137 and 30/15, respectively).ResultsThe European and Chinese validation sets achieved AUCs of 0.882 and 0.899, respectively. The sensitivities/specificities with LCO were 87.2%/64.2% and 76.7%/93.3%, and with HCO they were 74.3%/90.5% and 56.7%/100.0%, respectively. Stage I nonsmall cell lung cancer (NSCLC) sensitivity in European and Chinese samples with LCO was 78.4% and 70.0% and with HCO was 62.2% and 30.0%, respectively. Small cell lung cancer (SCLC) was represented only in the European set and sensitivities with LCO and HCO were 100.0% and 93.3%, respectively. In multivariable analyses of the European validation set, the assay's ability to predict lung cancer was independent of established risk factors (age, smoking, COPD), and overall AUC was 0.942.ConclusionsLung EpiCheck demonstrated strong performance in lung cancer prediction in case–control European and Chinese samples, detecting high proportions of early-stage NSCLC and SCLC and significantly improving predictive accuracy when added to established risk factors. Prospective studies are required to confirm these findings. Utilising such a simple and inexpensive blood test has the potential to improve compliance and broaden access to screening for at-risk populations.

Evaluation of new motorized articulating laparoscopic instruments by laparoscopic novices using a standardized laparoscopic skills curriculum

BackgroundMotorized articulating laparoscopic instruments (ALI) offer more degrees of freedom than conventional laparoscopic instruments (CLI). However, a difficult learning curve and complex instrument handling are still a problem of ALI. We compared the performance of new prototypes of motorized ALI with CLI in a series of standardized laparoscopic tasks performed by laparoscopic novices. Further, usability of the new ALI was assessed.MethodsA randomized cross-over study with 50 laparoscopic novices who either started with CLI and then changed to ALI (CA) or vice versa (AC) was conducted. All participants performed the European training in basic laparoscopic urological skills (E-BLUS) with each instrument in given order. Time and errors were measured for each exercise. Instrument usability was assessed.ResultsOverall, using CLI was significantly faster (CLI 4:27 min vs. ALI 4:50 min; p-value 0.005) and associated with fewer exercise failures in needle guidance (CLI 0 vs. ALI 12; p-value 0.0005) than ALI. Median amount of errors was similar for both instruments. Instrument sequence did not matter, as CA and AC showed comparable completion times. Regarding the learning effect, participants were significantly faster in the second attempt of exercises than in the first. In the needle guidance task, participants using CLI last demonstrated a significant speed improvement, whereas ALI were significantly slower in the second run. Regarding usability, CLI were preferred over ALI due to lighter weight and easier handling. Nevertheless, participants valued ALI’s additional degrees of freedom.ConclusionUsing new motorized ALI in the E-BLUS examination by laparoscopic novices led to a worse performance compared to CLI. An explanation could be that participants felt overwhelmed by ALI and that ALI have an own distinct learning curve. As participants valued ALI’s additional degrees of freedom, however, a future application of ALI could be for training purposes, ideally in combination with CLI.

Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

This manuscript represents an official Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) aiming to guide general gastroenterologists to develop and maintain skills in optical diagnosis during endoscopy. In general, this requires additional training beyond the core curriculum currently provided in each country. In this context, ESGE have developed a European core curriculum for optical diagnosis practice across Europe for high quality optical diagnosis training. 1 ESGE suggests that every endoscopist should have achieved general competence in upper and/or lower gastrointestinal (UGI/LGI) endoscopy before commencing training in optical diagnosis of the UGI/LGI tract, meaning personal experience of at least 300 UGI and/or 300 LGI endoscopies and meeting the ESGE quality measures for UGI/LGI endoscopy. ESGE suggests that every endoscopist should be able and competent to perform UGI/LGI endoscopy with high definition white light combined with virtual and/or dye-based chromoendoscopy before commencing training in optical diagnosis. 2 ESGE suggests competency in optical diagnosis can be learned by attending a validated optical diagnosis training course based on a validated classification, and self-learning with a minimum number of lesions. If no validated training course is available, optical diagnosis can only be learned by attending a non-validated onsite training course and self-learning with a minimum number of lesions. 3 ESGE suggests endoscopists are competent in optical diagnosis after meeting the pre-adoption and learning criteria, and meeting competence thresholds by assessing a minimum number of lesions prospectively during real-time endoscopy. ESGE suggests ongoing in vivo practice by endoscopists to maintain competence in optical diagnosis. If a competent endoscopist does not perform in vivo optical diagnosis on a regular basis, ESGE suggests repeating the learning and competence phases to maintain competence. Key areas of interest were optical diagnosis training in Barrett’s esophagus, esophageal squamous cell carcinoma, early gastric cancer, diminutive colorectal lesions, early colorectal cancer, and neoplasia in inflammatory bowel disease. Condition-specific recommendations are provided in the main document.

UEMS Section and Board of Paediatric Surgery-A Historical Perspective.

The European Union of Medical Specialists (UEMS) Section and Board of Pediatric surgery was founded more than 40 years ago. Since then major activities have been related to the improvement of quality of care of pediatric surgery in Europe. Remarkable success was achieved in the development of pediatric surgery as an independent specialty all over Europe. Other major successful activities of the UEMS Section and Board of Pediatric Surgery consisted of the development of a high-quality European examination and delineating a minimal common standard in pediatric surgery training in the form of European training requirements. Recommendations drawn from examination experience support that candidates who achieve weaker passes in part 1 may wish to consider more practice before attempting part 2 due to the weak correlation between the two scores. It may be helpful for candidates to consider having some experience working in an English-speaking clinical setting, if not truly fluent in English, to improve their chances of being successful in the part 2 examination. Other achievements of the Section were accreditation of the training centers in Europe and European Census in pediatric surgery project. All the aforementioned activities led to standardization and harmonization of pediatric surgery, as well as contributed to increasing quality of pediatric surgical service throughout Europe.

Comparative Study of the Influence of Three-Dimensional Versus Two-Dimensional Urological Laparoscopy on Surgeons' Surgical Performance and Ergonomics: A Systematic Review and Meta-Analysis.

Objective: The objective of this study is to compare the use of three-dimensional (3D) vision systems with traditional two-dimensional systems in laparoscopic urological surgery, analyzing the benefits, limitations, and impact of introducing this medical technology with regard to surgical performance and the surgeon's ergonomics. Methods: A systematic review with a structured bibliographic search was conducted in the electronic libraries (PubMed and EMBASE) until August 2019 and with no language restrictions. Studies on 3D visualization technology in laparoscopic urologic surgery, randomized controlled trials, and observational comparative studies were included. Relevant data were extracted and analyzed. Results: A total of 25 articles were obtained, of which 4 were clinical studies with patients, 2 studies were carried out in experimental animal models, and the remaining 19 were conducted in simulated environments. Regarding the European training program in basic laparoscopic urological skills, the results showed no significant differences in execution time using either imaging system. Three-dimensional vision led to a significant reduction in surgery time in pyeloplasty and radical nephrectomy. In addition, there was a reported decrease in blood loss in adrenalectomy, nephron-sparing nephrectomy, radical nephrectomy, simple nephrectomy, and pyeloplasty using 3D vision. Regarding ergonomics, the studies generally described no differences in side effects (headache, nausea, eye strain) when comparing the two types of visualization systems. Surgeons reported reduced workloads and stress with 3D vision than with traditional laparoscopy. Conclusions: Three-dimensional laparoscopic systems essentially advance surgical performance in less-experienced laparoscopic surgeons. Three-dimensional laparoscopy leads to improvements in surgery time, which is important for specific surgical procedures involving intracorporeal ligatures and sutures. The results achieved on the surgeons' ergonomics showed better depth perception and decreased stress and workloads during 3D vision with no differences in potential side effects.

Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

This manuscript represents an official Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) aiming to guide general gastroenterologists to develop and maintain skills in optical diagnosis during endoscopy. In general, this requires additional training beyond the core curriculum currently provided in each country. In this context, ESGE have developed a European core curriculum for optical diagnosis practice across Europe for high quality optical diagnosis training. 1: ESGE suggests that every endoscopist should have achieved general competence in upper and/or lower gastrointestinal (UGI/LGI) endoscopy before commencing training in optical diagnosis of the UGI/LGI tract, meaning personal experience of at least 300 UGI and/or 300 LGI endoscopies and meeting the ESGE quality measures for UGI/LGI endoscopy. ESGE suggests that every endoscopist should be able and competent to perform UGI/LGI endoscopy with high definition white light combined with virtual and/or dye-based chromoendoscopy before commencing training in optical diagnosis. 2: ESGE suggests competency in optical diagnosis can be learned by attending a validated optical diagnosis training course based on a validated classification, and self-learning with a minimum number of lesions. If no validated training course is available, optical diagnosis can only be learned by attending a non-validated onsite training course and self-learning with a minimum number of lesions. 3: ESGE suggests endoscopists are competent in optical diagnosis after meeting the pre-adoption and learning criteria, and meeting competence thresholds by assessing a minimum number of lesions prospectively during real-time endoscopy. ESGE suggests ongoing in vivo practice by endoscopists to maintain competence in optical diagnosis. If a competent endoscopist does not perform in vivo optical diagnosis on a regular basis, ESGE suggests repeating the learning and competence phases to maintain competence.Key areas of interest were optical diagnosis training in Barrett's esophagus, esophageal squamous cell carcinoma, early gastric cancer, diminutive colorectal lesions, early colorectal cancer, and neoplasia in inflammatory bowel disease. Condition-specific recommendations are provided in the main document.

The scorching tropics: fevers and public health in Brazil during the Joanine period, 1808-1821.

Although fevers (with the exception of yellow fever) have not yet been fully explored by the historiography of Brazilian health, they were almost inevitable in nineteenth-century Brazilian society, affecting huge portions of the population. Their victims suffered from a wide variety of symptoms, and identification and treatment of these symptoms were the object of intense debates in medical circles. The Luso-Brazilian intelligentsia considered European medical debates as well as their own clinical experiences and attempted to provide answers in a flurry of publications. Even so, the manifestations of fever in the tropics presented a challenge that lay beyond their European training, forcing them to combine experiences acquired in different parts of the Empire to comprise specific knowledge on tropical fevers.

“INSPIRE”: A European training network in safety pharmacology creating opportunities for 15 PhD students

“INSPIRE”: A European training network in safety pharmacology creating opportunities for 15 PhD students

Impact of the COVID-19 pandemic on orthopaedic and trauma surgery training in Europe.

PurposeThis study aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on orthopaedic and trauma surgery training in Europe by conducting an online survey among orthopaedic trainees.MethodsThe survey was conducted among members of the Federation of Orthopaedic and Trauma Trainees in Europe (FORTE). It consisted of 24 questions (single-answer, multiple-answer, Likert scales). Orthopaedic trainees’ demographic data (six questions), clinical role changes (four questions), institutional changes due to the COVID-19 pandemic (nine questions), and personal considerations (five questions) were examined.ResultsThree hundred and twenty-seven trainees from 23 European countries completed the survey. Most trainees retained their customary clinical role (59.8%), but a significant number was redeployed to COVID-19 units (20.9%). A drastic workload decrease during the pandemic was reported at most institutions. Only essential activities were performed at 57.1% of institutions and drastic disruptions were reported at 36.0%. Of the respondents, 52.1% stated that faculty-led education was restricted and 46.3% pursued self-guided learning, while 58.6% stated that surgical training was significantly impaired. Concerns about the achievement of annual training goals were expressed by 58.2% of the participants, while 25.0% anticipated the need for an additional year of training.ConclusionsThe SARS-CoV-2 pandemic significantly affected orthopaedic and trauma training in Europe. Most trainees felt the decrease in clinical, surgical, and educational activities would have a detrimental effect on their training. Many of them consulted remote learning options to compensate training impairment, stating that after the COVID-19 pandemic electronic educational approaches may become more relevant in future.Electronic supplementary materialThe online version of this article (10.1007/s00264-020-04742-3) contains supplementary material, which is available to authorized users.