Training Supervision Research Articles

(185) Small Group Supervision in Psychiatric Residency Training: A National Survey to Determine Prevalence, Barriers and Feasibility

(185) Small Group Supervision in Psychiatric Residency Training: A National Survey to Determine Prevalence, Barriers and Feasibility

Occupational therapists' practice with complex trauma: A profile.

Many children in Aotearoa (New Zealand) and Australia experience complex trauma and its developmental impacts. Internationally, occupational therapists work with complex trauma and use sensory-based, integrative, and functional approaches. The practices of occupational therapists in Aotearoa and Australia with children experiencing complex trauma have not previously been described. This article reports the quantitative results of a mixed-methods study which profiled occupational therapists' practice in Aotearoa and Australia with children aged 0 to 12 years old who experienced complex trauma. Twenty-five participants completed the survey. The average age of participants was 43 years (SD = 10.65), all were female (n = 25), and most identified as New Zealand European (n = 11) or Australian European (n = 9). A survey was distributed via Occupational Therapy New Zealand - Whakaora Ngangahau Aotearoa and Occupational Therapy Australia. The majority of participants had a bachelor's degree (64%) and worked in community settings (76%). Fourteen participants (56%) used sensory approaches. The most common assessments used were those of sensory processing (n = 12, 48%) and observation (n = 12, 48%). The Sensory Profile was the most popular standardised assessment (n = 8, 32%). The most common interventions used with children experiencing complex trauma were sensory (n = 13, 52%) and play based (n = 13, 52%). Most participants reported not adapting their practices for Māori or Aboriginal children. Most participants felt somewhat prepared (n = 15) for working with complex trauma, with most reporting a lack of experience in this area (n = 10). Supervision was suggested by 92% (n = 23) of the participants. Sensory-based practices were most common among occupational therapists in Aotearoa and Australia who worked with children experiencing complex trauma. The participants suggested supervision, social support, and practical training when working with complex trauma. Advocacy and research are required within this subspecialty, and further professional engagement in the application of culturally safe practice.

Development of the standardized supervisee framework as a novel approach to supervision training.

Development of the standardized supervisee framework as a novel approach to supervision training.

Alpha-SGANet: A multi-attention-scale feature pyramid network combined with lightweight network based on Alpha-IoU loss.

The design of deep convolutional neural networks has resulted in significant advances and successes in the field of object detection. However, despite these achievements, the high computational and memory costs of such object detection networks on the edge or in mobile scenarios are one of the most significant barriers to their broad adoption. To solve this problem, this paper introduces an improved lightweight real-time convolutional neural network based on YOLOv5, called Alpha-SGANet: A multi-attention-scale feature pyramid network combined with a lightweight network based on Alpha-IoU loss. Firstly, we add one more prediction head to detect different-scale objects, design a lightweight and efficient feature extraction network using ShuffleNetV2 in the backbone, and reduce information loss using the SPP module with a smaller convolutional nucleus. Then, cleverly, employ GAFPN to improve feature transition processing in the neck region, including the usage of the Ghost module to construct efficient feature maps to help prediction. The CBAM module was further integrated to find areas of interest in the scene; finally, combined with Alpha-IOU loss for model supervision training, the biggest performance improvement was achieved. The experiment results show that, compared with YOLOv5s, our proposed method can achieve higher accuracy with fewer parameters and has real-time speed through verification on the PASCAL VOC dataset and MS COCO dataset.

Acceptance of using technologies in telesupervision during the pandemic: An international study

This study utilizes the Technology Acceptance Model by exploring the relationship between user acceptance attitude and actual usage behaviors of technological tools in telesupervision among supervisors in international societies. Specifically, the age of supervisors is examined to see whether it mediates the relationship between acceptance attitude and usage behavior. Survey data were collected from 194 supervisors in international societies using online Survey Monkey. The results indicated a significant relationship between user acceptance attitude and actual usage behaviors of technological tools in telesupervision. Implications of these findings for supervision training and further telesupervision development are discussed.

33.5 CBT Supervision in Child and Adolescent Fellowship Training: A Milestone-Based Competency Model

The Accreditation Council for Graduate Medical Education (ACGME) mandates CBT training during child and adolescent psychiatry fellowship. Despite the training requirement, there is a lack of universally accepted standard methods for CBT supervision and training of psychiatrists. The high variability of CBT supervision across programs poses a challenge in meeting the milestone competencies designated by the current accreditation system for child and adolescent fellowships. We will share the milestone competency-based model for CBT training developed using well-defined principles of adult learning.

Weakly supervised moment localization with natural language based on semantic reconstruction

The goal of cross-modal moment localization is to find the temporal moment in the untrimmed video that semantically corresponds to the natural language query. The majority of current approaches learn the cross-modal moment localization models from fine-grained temporal annotations in the video, which are extremely time-consuming and labor-intensive to obtain. In this paper, we offer a novel framework for weakly supervised cross-modal moment localization that incorporates a proposal generation module and a semantic reconstruction module. The proposal generation module uses a two-dimensional temporal feature map to model cross-modal video representations and can encode the moment-by-moment temporal relationships of moment candidates. The semantic reconstruction module, which is based on the generated proposals, assesses a proposal's capacity to restore the text query and provides weak supervision for network training. Besides, a punishment loss is also proposed to further eliminate the effect of the invalid area. Extensive experimental results show that the proposed method achieves state-of-the-art performance, demonstrating its effectiveness for weakly supervised moment localization with natural language. • A new framework is proposed for weakly supervised cross-modal moment localization. • A multi-task loss is designed for the weakly supervised optimizing of the network. • The proposal generation module could exploit moment-wise temporal relationships. • Extensive experimental results demonstrate the effectiveness of our method.

Supervision as a form of inclusive education retraining and school community professional advancement

Using the example of Kryvyi Rih, we present the supervision model used to promote the education reform in Ukraine and the retraining of the school's major players. Through a sociopolitical and educational description of the current situation in Kryvyi Rih, empirical study has introduced a model of retraining. Due to this, 124 key stakeholders from 20 inclusive schools underwent testing to help plan the implementation of the monitoring model (teachers, tutors, staff, psychologists and parents from 7 districts of Kryvyi Rih were invited to participate). In this study, we provide an alternative strategy for interagency supervisory groups and communication, with an emphasis on the model supervision retraining of inclusive education specialists. Four stages make up the supervision process: case report, exchange, conceptualization, and summary. In the paper, we suggest a modification of an unstructured interview by a specialist who specifies the context of training supervision in order to facilitate successful work. The psycho-educational support team in inclusive education was able to propose the supervision program thanks to the analysis of the organizational, methodological, and information retraining system and the execution of the pilot project of supervisory groups: I. Providing team members with the necessary training to work with the objectives of each child development plan; II. Using case preparation tools; III. Analyzing environmental elements; and IV. Managing team support.

Fully automated segmentation of prostatic urethra for MR-guided radiation therapy.

Accurate delineation of the urethra is a prerequisite for urethral dose reduction in prostate radiotherapy. However, even in magnetic resonance-guided radiation therapy (MRgRT), consistent delineation of the urethra is challenging, particularly in online adaptive radiotherapy. This paper presented a fully automatic MRgRT-based prostatic urethra segmentation framework. Twenty-eight prostate cancer patients were included in this study. In-house 3D half fourier single-shot turbo spin-echo (HASTE) and turbo spin echo (TSE) sequences were used to image the Foley-free urethra on a 0.35T MRgRT system. The segmentation pipeline uses 3D nnU-Net as the base and innovatively combines ground truth and its corresponding radial distance (RD) map during training supervision. Additionally, we evaluate the benefit of incorporating a convolutional long short term memory (LSTM-Conv) layer and spatial recurrent convolution layer (RCL) into nnU-Net. A novel slice-by-slice simple exponential smoothing (SEPS) method specifically for tubular structures was used to post-process the segmentation results. The experimental results show that nnU-Net trained using a combination of Dice, cross-entropy and RD achieved a Dice score of 77.1±2.3% in the testing dataset. With SEPS, Hausdorff distance (HD) and 95% HD were reduced to 2.95±0.17mm and 1.84±0.11mm, respectively. LSTM-Conv and RCL layers only minimally improved the segmentation precision. We present the first Foley-free MRgRT-based automated urethra segmentation study. Our method is built on a data-driven neural network with novel cost functions and a post-processing step designed for tubular structures. The performance is consistent with the need for online and offline urethra dose reduction in prostate radiotherapy.

Supervision of Surgical Trainees During Operative Procedures: Implementation of a Formal Preoperative Surgical Checklist.

Background Trainers in surgery have an educational obligation to train trainees in performing operative procedures. Objective We hypothesized that poor concordance manifests as discrepancies between the trainee and the trainer, with an associated reduction in satisfaction with the training experience, perception of training quality, and completion of workplace-based assessments (WBAs). This study also aimed to validate the novel Supervised Training Operative Procedure (STOP) online tool. Method We developed an online proforma (STOP online tool) and conducted a prospective, single-blinded study of 53 orthopedic operative procedures with 53 traineesbetween January 19, 2019, and August 27, 2019. Results Forty-four (82%) trainees were listed as the primary surgeon. The overall mean trainee satisfaction (on a 0-10 Likert scale) was 8.25 (range: 3-10), and the mean trainer satisfaction was 8.28 (range: 4-10). A preoperative discussion between the trainee and the trainer occurred in 96.2% of the cases. Forty-eight (91%) trainers preoperatively established trainees' objectives and 91% (n = 48) of the cases showed postoperative completion of objectives. Forty-four (83%) trainers anticipated workplace-based assessment(WBA) completion for trainees, and this translated into 41 (77%) completed WBAs. Overall, 47 (92.9%) trainees felt that the STOP tool would be useful as a surgical training checklist and in the completion of WBAs. Conclusion The STOP checklist is useful in understanding qualitative and quantitative measures of the overall trainee performance of an operative case. This holistic approach will enable us to establish a structured perioperative surgical training checklist, as trainee and trainer requirements are dependent on one another.

Remote supervision in psychiatry training: Unlocking capacity and technology.

This paper explores the literature regarding remote supervision in the context of training in psychiatry with contemporary pedagogic theory and practice and utilising telephonic and videoconference technologies to enhance education outcomes. Remote supervision may provide psychiatry trainees with a balance between autonomy and support, promote clinical and professional independence in addition to developing a specific subset of telehealth skills whilst unlocking supervisory capacity to grow the psychiatry workforce, particularly in rural and remote settings.

TRAINING OF GROUP MODEL CLINIC SUPERVISION IN DOCUMENTATION OF NURSING CARE AT SANSANI HOSPITAL, PEKANBARU

Documentation of nursing care is the responsibility of nurses in improving the quality of nursing services. Nursing documentation is an indicator of quality in assessing the quality of services provided by nurses. Good supervision can improve the competence and performance of nurses in the room. Supervision is a manager's professional support in providing assistance and direction to nursing staff to develop their abilities and competencies of nursing staff. Sansani Hospital in documenting care has made a policy that the application of nursing care documentation is according to standards, but the implementation is still not up to standard. The implementation of supervision in the documentation by the supervisor has not been optimal. Therefore, the IbM team will conduct clinical supervision training for the model group in documenting nursing care. IbM is carried out for 1 year, while the targets in this IbM are the head of the room and the team leader at Sansani Hospital. The solutions offered are socialization of clinical supervision and documentation of nursing care and simulation of the implementation of group model clinical supervision. IbM's output target is clinical supervision training on a group model in nursing care documentation developed in the form of modules and publications in online media. After the training, it was found that there was an increase in knowledge about the supervision of the model group in the documentation of nursing care.

Body activity grading strategy for cervical rehabilitation training

A body activity grading strategy is proposed for computer-assisted cervical rehabilitation training, which employs hidden Markov model to partition an exercise into independently assessable phases and a scoring reference to rate respective kinematic features. Samples of 34 cervical rehabilitation exercises are evaluated by both manual and the proposed approaches, where the average phase segmentation difference is 93 ms, the phase scoring difference is 0.045, and the grading difference for overall samples is 5.5% between the approaches. It indicates that the proposed method has similar accuracy as physical therapists and is thus capable of performing online supervision for cervical rehabilitation training.

AMM-FuseNet: Attention-Based Multi-Modal Image Fusion Network for Land Cover Mapping

Land cover mapping provides spatial information on the physical properties of the Earth’s surface for various classes of wetlands, artificial surface and constructions, vineyards, water bodies, etc. Having reliable information on land cover is crucial to developing solutions to a variety of environmental problems, such as the destruction of important wetlands/forests, and loss of fish and wildlife habitats. This has made land cover mapping become one of the most widespread applications in remote sensing computational imaging. However, due to the differences between modalities in terms of resolutions, content, and sensors, integrating complementary information that multi-modal remote sensing imagery exhibits into a robust and accurate system still remains challenging, and classical segmentation approaches generally do not give satisfactory results for land cover mapping. In this paper, we propose a novel dynamic deep network architecture, AMM-FuseNet that promotes the use of multi-modal remote sensing images for the purpose of land cover mapping. The proposed network exploits the hybrid approach of the channel attention mechanism and densely connected atrous spatial pyramid pooling (DenseASPP). In the experimental analysis, in order to verify the validity of the proposed method, we test AMM-FuseNet with three datasets whilst comparing it to the six state-of-the-art models of DeepLabV3+, PSPNet, UNet, SegNet, DenseASPP, and DANet. In addition, we demonstrate the capability of AMM-FuseNet under minimal training supervision (reduced number of training samples) compared to the state of the art, achieving less accuracy loss, even for the case with 1/20 of the training samples.

Imposter Syndrome Among Surgeons Is Associated With Intolerance of Uncertainty and Lower Confidence in Problem Solving.

Feelings of imposter syndrome (inadequacy or incompetence) are common among physicians and are associated with diminished joy in practice. Identification of modifiable factors associated with feelings of imposter syndrome might inform strategies to ameliorate them. To this point, though, no such factors have been identified. Are intolerance of uncertainty and confidence in problem-solving skills independently associated with feelings of imposter syndrome after accounting for other factors? This survey-based experiment measured the relationship between feelings of imposter syndrome, intolerance of uncertainty, and confidence in problem-solving skills among musculoskeletal specialist surgeons. Approximately 200 surgeons who actively participate in the Science of Variation Group, a collaboration of mainly orthopaedic surgeons specializing in upper extremity illnesses primarily across Europe and North America, were invited to this survey-based experiment. One hundred two surgeons completed questionnaires measuring feelings of imposter syndrome (an adaptation of the Clance Imposter Phenomenon Scale), tolerance of uncertainty (the Intolerance of Uncertainty Scale-12), and confidence in problem-solving skills (the Personal Optimism and Self-Efficacy Optimism questionnaire), as well as basic demographics. The participants were characteristic of other Science of Variation Group experiments: the mean age was 52 ± 5 years, with 89% (91 of 102) being men, most self-reported White race (81% [83 of 102]), largely subspecializing in hand and/or wrist surgery (73% [74 of 102]), and with just over half of the group (54% [55 of 102]) having greater than 11 years of experience. We sought to identify factors associated with greater feelings of imposter syndrome in a multivariable statistical model. Accounting for potential confounding factors such as years of experience or supervision of trainees in the multivariable linear regression analysis, greater feelings of imposter syndrome were modestly associated with higher intolerance of uncertainty (regression coefficient [β] 0.34 [95% confidence interval (CI) 0.16 to 0.51]; p < 0.01) and with lower confidence in problem-solving skills (β -0.70 [95% CI -1.0 to -0.35]; p < 0.01). The finding that feelings of imposter syndrome may be modestly to notably associated with modifiable factors, such as difficulty managing uncertainty and lack of confidence in problem-solving, spark coaching opportunities to support and sustain a surgeon's mindset, which may lead to increased comfort and joy at work. Beginning with premedical coursework and throughout medical training and continuing medical education, future studies can address the impact of learning and practicing tactics that increase comfort with uncertainty and greater confidence in problem solving on limiting feelings of imposter syndrome.

Do young adult males aiming to improve strength or develop muscle hypertrophy train according to the current strength and conditioning recommendations?

Objective: The present study aimed to verify if young adult males who aimed to improve their strength or attain muscle hypertrophy trained in agreement with the current strength and conditioning guidelines. Methods: Four hundred and fourteen subjects aged 18-25 with less than one year of strength training experience and whose training goal was to increase their strength or develop muscle hypertrophy were finally included in this research. They were surveyed through an 18-item self-administered questionnaire to verify whether their strength training practices met the current strength training guidelines. Results: Overall, more than 50% of the respondents did not follow the current strength and conditioning recommendations related to muscle action, number of sets, training structure, type of resistance, training to failure, and training supervision. Only slightly more than 50% of them did not train in agreement with the recommendations regarding exercise selection, number of repetitions, and weekly training frequency. The level of compliance with the training objectives of the respondents who followed the current strength and conditioning guidelines related to exercise selection, rest, speed, type of resistance, and training supervision was higher than specific cohorts who did not. Conclusion: Training in agreement with the current strength and conditioning guidelines would ensure that young adult males with less than one year of strength training experience attain their training objectives to a greater extend. Subjects who practice strength training should follow those strength and conditioning guidelines to avoid limiting future adaptations and increase the variability of their training programs, thus preventing workout plateau and fostering motivation.

Online knowledge distillation network for single image dehazing

Single image dehazing, as a key prerequisite of high-level computer vision tasks, catches more and more attentions. Traditional model-based methods recover haze-free images via atmospheric scattering model, which achieve favorable dehazing effect but endure artifacts, halos, and color distortion. By contrast, recent learning-based methods dehaze images by a model-free way, which achieve better color fidelity but tend to acquire under-dehazed results due to lacking of knowledge guiding. To combine these merits, we propose a novel online knowledge distillation network for single image dehazing named OKDNet. Specifically, the proposed OKDNet firstly preprocesses hazy images and acquires abundant shared features by a multiscale network constructed with attention guided residual dense blocks. After that, these features are sent to different branches to generate two preliminary dehazed images via supervision training: one branch acquires dehazed images via the atmospheric scattering model; another branch directly establishes the mapping relationship between hazy images and clear images, which dehazes images by a model-free way. To effectively fuse useful information from these two branches and acquire a better dehazed results, we propose an efficient feature aggregation block consisted of multiple parallel convolutions with different receptive. Moreover, we adopt a one-stage knowledge distillation strategy named online knowledge distillation to joint optimization of our OKDNet. The proposed OKDNet achieves superior performance compared with state-of-the-art methods on both synthetic and real-world images with fewer model parameters. Project website: https://github.com/lanyunwei/OKDNet.

Implementing routine outcome monitoring in a psychodynamic training clinic: it’s complicated

ABSTRACT The use of routine outcome monitoring (ROM) has been shown to improve treatment outcomes, reduce symptom deterioration and treatment dropout, and is especially relevant for training clinics. However, the use of ROM in a psychodynamic training clinic has remained relatively unexplored. We aimed to instigate an open dialogue about the use and usefulness of ROM within the context of contemporary psychodynamic clinical practice. As a graduate trainee and professor in a psychodynamic training program, we reflect on the seemingly irreconcilable differences between psychoanalytic thinking and ROM, the anxiety around being evaluated as a trainee, whom ROM is for, the pragmatic challenges when trying new tools and technology (especially when not chosen yourself), and the limitations of standardized self-report measures, such as the OQ. Overall, these complexities suggest that although ROM is likely worthwhile for patients, therapists, supervisors, and researchers, it will only come to its fruition if we integrate it into the tri-legged stool of evidence-based practice . We will need to engage in a genuine discussion about the use of ROM and consider the possibility that ROM might even improve our psychodynamic practices. Integrating ROM into psychodynamic didactic courses and supervision in graduate training could be a good starting point.

Group supervision is a distinct supervisor competency: empirical evidence and a brief scale for supervisory practice

ABSTRACT Objectives There is strong endorsement of competency-based frameworks for practitioner training and widespread use of group supervision in practitioner training. However, there has been little effort made to understand the components and anatomy of group supervision, or efforts made to evaluate its efficacy. The current study investigates the nature and extent to which abilities and skills within individual and group supervision are similar or distinct from each other. Method A total of 98 supervisees, across 21 groups, evaluated individual and group supervisor competence of their supervisors (N = 11) using the Supervision Evaluation and Supervisor Competence Scale. Results Hierarchical cluster analysis revealed that group supervision emerged as a distinct and independent cluster to individual supervision competencies. Additionally, supervisors were rated higher on individual than group supervision competencies. Conclusion Group supervision should be considered a distinct competency requiring specific skills and therefore would likely benefit from specialised training to deliver competent group supervision. These preliminary results have implications for supervisor training, as well as clinical training programs in Australia and abroad who use group supervision as a form of clinical training.

Career-long clinical supervision among counselors in Turkey: Current experiences, needs, and preferred practices

Career-long clinical supervision is still not common and is a relatively new study area in the counseling profession. Thus, this study aims to describe the current supervision experiences, needs, and preferred practices among counselors in Turkey, as well as the factors affecting their supervision experiences. For this purpose, cross-sectional survey design study was used and a total of 402 counselors participated in the study by using convenience sampling. The Supervision Experiences and Needs Online Survey Form developed by researchers was also used for data collection. The descriptive statistics and chi-square analyses conducted to analyze data. The results indicated that current supervision experiences are varied though very limited. Twenty-three percent (n=92) of the participants reported to receive supervision. They received mostly psychotherapy/counseling training supervision, and then work setting supervision and volunteer supervision respectively. The most common reasons for receiving supervision were developing interviewing/counseling skills (n=83); developing intervention skills for client’s needs and problems (n=83); and learning a therapy/counseling approach (n=81). Besides, age, educational degree, work setting, work experience, and the professional organization membership was found to be the factors of receiving supervision. The supervision needs, methods, techniques, and supervisor characteristics were varied with respect to current and preferred practices. Most participants (n=381) want to receive regular, monthly, and face-to-face supervision from supervisors as professionally trained and experienced counselors with supervisor training. Overall, this study highlights the necessity of developing accessible, affordable supervision opportunities as well as the development of a pool of trained supervisors.