Year-long Training Program Research Articles

Cosmetic Surgery: A Subspecialty That Needs Specialized Training and Recognition

Introduction: This study was performed to provide a comprehensive review of the breadth and depth of fellowship training provided by the American Academy of Cosmetic Surgery (AACS), with direct comparison with other current aesthetic surgery training programs available in the United States. We hypothesized that this subspecialty training provides essential experience and confidence to perform aesthetic procedures, which are likely not adequately imparted during traditional residency training. We also address the notion that Cosmetic Surgery is not under the sole ownership of one specialty, but rather a subspecialty that flourishes by collaboration between multidisciplinary surgical backgrounds. Materials and Methods: We performed a cross-sectional study of survey data from 2 distinct groups—current fellows in a 1-year AACS program and surgeons who completed an AACS fellowship between July 2008 and June 2017, who have been in active cosmetic surgery practice ranging from 6 months to over 6 years. A survey was administered via email and distributed by the AACS central office. The responses were compared with data published in the Annals of Plastic Surgery concerning Recent Trends in Resident Career Choices after Plastic Surgery Training. Results: The Accreditation Council for Graduate Medical Education (ACGME) requirements for aesthetic surgical cases in a 6-year Plastic Surgery program are 150 cases, but 50% of graduating seniors feel inadequately prepared to transition straight into aesthetic surgery practice, whereas among AACS graduating fellows, 100% feel very prepared to go on the aesthetic surgery practice, having completed an average of 687 cases within the yearlong training program. We note that the survey response rate was 81% among current fellows versus 35% among practicing surgeons. Discussion: We believe that focused subspecialty training in cosmetic surgery after completion of a primary surgical residency in a form of a structured fellowship through AACS, American Society of Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, Commission on Dental Accreditation, and American Society of Ophthalmic Plastic and Reconstructive Surgery (Oculoplastic) is the ideal preparation for the future. As we learn from each other through fellowship training, academic conferences, and research, this will further advance the subspecialty and ultimately improve patient care and outcomes. There is no evidence that these training programs provide less adequate preparation, although they are not accredited by the ACGME. To the contrary, the additional experience and knowledge gained during these fellowship training programs result in better outcomes and more competent practitioners. Conclusions: The development of subspecialty training and board certification for surgeons committed to cosmetic surgery yields the highest level of qualified providers. The diverse backgrounds of these providers continue to allow us to expand and innovate in this field. This study is aimed at moving this conversation forward in a positive direction.

Applying Experiential Action Learning Pedagogy to an Intensive Course to Enhance Capacity to Conduct Community-Based Participatory Research.

Community-based participatory research (CBPR) is widely recognized as an effective approach to understand and address health inequities. Opportunities for public health practitioners and researchers to engage jointly with community partners in intensive colearning processes can build capacity for CBPR. Using active learning approaches that engage diverse partners can enhance partnership development, competence, and equity. Examination of such pedagogical approaches can strengthen understanding of their contributions to the effectiveness of CBPR capacity-building programs. This article describes a weeklong intensive course carried out by the Detroit Urban Research Center as the foundation for a yearlong training program to build the capacity of community-academic partnership teams to engage in CBPR in their own communities. The in-person CBPR course was developed and implemented by expert academic and community instructors and used an experiential action learning model that integrated CBPR principles and processes. We describe the course content and application of our collaborative, experiential action learning model to course design; present results from participant evaluation of course effectiveness, CBPR competence, and equitable partnership development; and examine the contributions of the pedagogical approach to outcomes central to successful CBPR. The participatory, formative course evaluation used multiple methods that included closed- and open-ended questionnaires to assess instructional effectiveness, participant competence on 12 core components of CBPR, and course impact on partner relationships. Evaluation findings suggest that an experiential action learning approach with attention to colearning, collaboration among diverse instructors and participants, and an environment that fosters and models equitable and trusting relationships can be effective in building CBPR capacity.

The effect of power-specific weight training on the muscle function for the athletes in Korean national freestyle wrestling team

Purpose The purpose of this study was to identify the effect of a power-specific weight training program in order to improve the muscle strength of Korean national team’s freestyle wrestlers. Methods Participants were 13 male athletes in the national freestyle wrestling team. The period of the program was 6 weeks. Muscle strength, muscular endurance, muscle power, flexibility, agility, cardiorespiratory endurance, anaerobic power and isokinetic muscle function were measured. Data were analyzed using IBM SPSS Statistics ver. 23.0 (IBM Co., Armonk, NY, USA). Paired t-test was conducted for comparison between pre-test and post-test score. Results There were significant difference and tendency in the leg isokinetic power and trunk isokinetic flexion strength. However, there was no significant difference in muscle strength, muscular endurance, muscle power, flexibility, agility and cardiorespiratory endurance. Conclusion The 6-week program focusing on the power-specific weight training indicated a significant difference not in every variable but in isokinetic muscle power, speed power and core strength. It is suggested that the training program was applied to the athletes less continuously and not in the long term because of frequent international games abroad and the need for losing weight. Consequently, a year-long training program with personalized methods should be developed to bring about more significant outcomes.

Community-Focused Health Care For The Seriously Ill.

Experts offer a prescription for a health system that is centered on the community rather than traditional health care institutions.

Protocol for evaluating the effects of a foot-ankle therapeutic exercise program on daily activity, foot-ankle functionality, and biomechanics in people with diabetic polyneuropathy: a randomized controlled trial

BackgroundDiabetic polyneuropathy (DPN) negatively affects foot and ankle function (strength and flexibility), which itself affects the daily physical activity and quality of life of patients. A physical therapy protocol aiming to strengthen the intrinsic and extrinsic foot muscles and increase flexibility may be a promising approach to improve lower-extremity function, prevent further complications, and improve autonomy for daily living activities in these patients. Thus, the inclusion of a specific foot-related exercises focused on the main musculoskeletal impairments may have additional effects to the conventional interventions in the diabetic foot.Methods/DesignA prospective, parallel-group, outcome-assessor blinded, randomized controlled trial (RCT) will be conducted in 77 patients with DPN who will be randomly allocated to usual care (control arm) or usual care with supervised foot-ankle exercises aiming to increase strengh and flexibility twice a week for 12 weeks and remotely supervised foot-ankle exercises for a year through a web software. Patients will be evaluated 5 times in a 1 year period regarding daily physical activity level, self-selected and fast gait speeds (primary outcomes), foot ulcer incidence, ulcer risk classification, neuropathy testing, passive ankle range of motion, quality of life, foot health and functionality, foot muscle strength, plantar pressure, and foot-ankle kinematics and kinetics during gait.DiscussionThis study aims to assess the effect of a foot-ankle strength and flexibility program on a wide range of musculoskeletal, activity-related, biomechanical, and clinical outcomes in DPN patients. We intend to demonstrate evidence that the year-long training program is effective in increasing gait speed and daily physical activity level and in improving quality of life; foot strength, functionality, and mobility; and biomechanics while walking. The results will be published as soon as they are available.Trial registrationThis study has been registered at ClinicalTrials.gov as NCT02790931 (June 6, 2016) under the name “Effects of foot muscle strengthening in daily activity in diabetic neuropathic patients”.

A Primary Care Ultrasound Fellowship: Training for Clinical Practice and Future Educators.

As ultrasound devices become smaller, more portable, and more user friendly, there is now widespread use of this technology by physicians of all specialties, yet there are currently few structured opportunities for ultrasound education outside of emergency and critical care medicine. Anticipating the rising educational demand in the primary care specialties, the University of South Carolina School of Medicine created a primary care ultrasound fellowship in 2011, the first yearlong training program in point-of-care ultrasonography for graduates of internal medicine, medicine-pediatrics, pediatrics, and family medicine residencies. This paper reviews the history of point-of-care ultrasonography fellowships and then provides an overview of the primary care ultrasound fellowship.

Integration and expansion of palliative care work force.

126 Background: The specialty of Hospice and Palliative Medicine has grown out of the need for care of patients who are living longer with cancer and other serious illness and struggle with symptoms, decisions and care. Cancer patients and others often do not have access to Palliative Care services due to availability or accessibility of PC services. Since 2012, fellowship training is required for board eligibility but available programs do not meet the workforce need. As described by Weissman and Meier, viewing Palliative care services in the context of a primary, secondary or tertiary focus , allows for the expansion of these services outside of the traditional fellowship training. With additional intensive training, it is possible that experienced physicians can fill workforce gaps by providing primary palliative care in the providers practice area such as a clinic. Methods: The faculty member who will participate in a yearlong training program based in the Palliative Care Clinic is the Director of the Outpatient Clinic. This clinic is the center of the Duke resident ambulatory experience for the duration of their training. The complexity of these patients is high and often the DOC is the only place that these patients receive care. The Palliative Care training program will provide the faculty member the opportunity to see patients in the cancer center with board certified palliative care physicians. There will be 3 areas of focus for the trainee: clinical experience, didactic information and mentorship from a board certified palliative care provider around faculty identified cases from her own practice. Results: We have developed a yearlong intensive training program for experienced faculty to gain skills in Palliative Care. Conclusions: 1. It is hoped that this will allow for integration of primary palliative care into patient care areas where there is no formal palliative care program. 2. Integration of Palliative Care principles in the clinic to address symptoms of chronic severe illness as well as difficult conversations with more confidence and skill. 3. Earlier palliative care management–develop a systematic approach to assessing needs in high risk populations ie. Hospital Discharge reviews, now commonly done at the clinic.

The development, delivery and evaluation of a year-long skills and formulation training programme in a community residential rehabilitation setting

The psychologist’s role in rehabilitation settings includes supporting both team formulation and training (e.g. New Ways of Working, 2007). This article summarises our attempts to embed formulation within a year-long training programme in a community rehabilitation setting.

Monitoring Of A Yearlong Training Program On Performance Markers In Division-1 Male College Soccer Players

Monitoring Of A Yearlong Training Program On Performance Markers In Division-1 Male College Soccer Players

Library Instruction – Not Just for our Users: Skills Upgrading for Librarians as a Way of Increasing Self-Confidence

This article examines how librarians can improve their skills through a systematic skills upgrading programme, and how this can help improve their confidence in their own expertise. Two identical questionnaires have been issued to the same group of librarians engaged in research support services. In the time period between the two surveys, a skills upgrading programme was carried out. The aim of the second survey is to examine if the librarians’ confidence has increased after the yearlong training programme. Even though one of librarians’ main tasks is searching, research is becoming increasingly interdisciplinary and thusly setting new expectations for librarians.

A training programme to build cancer research capacity in low- and middle-income countries: findings from Guatemala

Guatemala is experiencing an increasing burden of cancer but lacks capacity for cancer prevention, control and research. In partnership with a medical school in the United States of America, a multidisciplinary Cancer Control Research Training Institute was developed at the Instituto de Cancerología (INCAN) in Guatemala City. This institute provided a year-long training programme for clinicians that focused on research methods in population health and sociocultural anthropology. The programme included didactic experiences in Guatemala and the United States as well as applied training in which participants developed research protocols responsive to Guatemala's cancer needs. Although INCAN is the point of referral and service for Guatemala's cancer patients, the institute's administration is also interested in increasing cancer research - with a focus on population health. INCAN is thus a resource for capacity building within the context of cancer prevention and control. Trainees increased their self-efficacy for the design and conduct of research. Value-added benefits included establishment of an annual cancer seminar and workshops in cancer pathology and qualitative analysis. INCAN has recently incorporated some of the programme's components into its residency training and established a research department. A training programme for clinicians can build cancer research capacity in low- and middle-income countries. Training in population-based research methods will enable countries such as Guatemala to gather country-specific data. Once collected, such data can be used to assess the burden of cancer-related disease, guide policy for reducing it and identify priority areas for cancer prevention and treatment.

A comprehensive disaster training program to improve emergency physicians’ preparedness: A 1-year pilot study

The main objective of this pilot study was to measure the effectiveness of a 1-year comprehensive training program on the long-term cognitive competence in disaster preparedness among attending emergency physicians (EPs). Ten attending EPs participated in a year-long training program in disaster preparedness and management. A baseline pretraining test and self-evaluation questionnaire were administered to the participants. Post-training written test and self-evaluation questionnaire were repeated at 12 months after the completion of the program. The study took place at an urban tertiary care medical center from July 2007 to June 2008. The training program was divided into three main categories: didactic core topics, formally recognized courses, and a practicum (drill). Pretraining and posttraining test scores in addition to pretraining and posttraining self-assessments were compared for disaster preparedness in various areas. There was a statistically significant increase in the overall post-test versus pretest scores on the written examination for the entire group (44.4 vs. 29.8, p < 0.005). In addition, statistically significant increases in each area of disaster preparedness were noted for the self-assessments (2.7 +/- 0.82 vs. 3.9 +/- 0.56, p = 0.01), where 1 means not prepared at all and 5 means extremely well prepared. Disaster preparedness is an essential area of clinical competence for EPs. Participation in a yearlong pilot training program demonstrated a statistically significant increase in cognitive competence among a pilot sample of EPs. More research is needed to validate the content of the training program and its instruments of evaluation.

The Cost-Benefit Transfer Model: An Adaptation from Medicine

How does transfer work? When is transfer likely to come about, and when is it likely to fail? Several theorists view transfer as a complex process involving the interaction of multiple variables. The cost-benefit transfer model which we introduce in this article is in keeping with the trend to consider transfer a complex process accounting for a performer's perceptions. The model considers a performer's perception of need, sensibility, and effort to determine the likelihood of putting to use an idea learned in training. In contrast to existing models, the cost-benefit transfer model focuses on the perception of the performer and broadens the definition of the notion of use. The model predicts use through an elegant mathematical formula—specifically, the product of need and sensibility divided by effort. In support of this model, we cite case evidence of academic physicians who used what they learned from a yearlong training program.

Periodization Essentials and Innovations in Resistance Training Protocols

summary The following article deals with the important topic of periodization from a theory of fractal similarity. It attempts to establish a link between different cycles during a year-long training program, which may assist the reader in designing and writing a more comprehensive resistance prescription.

THE MAGEC FELLOWSHIP EXPERIENCE: A MODEL FOR PERSONALIZED ADULT EDUCATION IN AGING

Faculty teaching in aging‐related areas in a variety of disciplines participated in a yearlong training program designed to improve their knowledge and skills in topics related to aging and to increase their appreciation for how other disciplines address these topics. The disciplines involved included medicine, dentistry, nursing, social work, pharmacy, public health, psychology, sociology, physical therapy, occupational therapy, and public policy. The training, which covered 2 days each month, included didactic sessions and problem‐oriented exercises. Participants were expected to function as teachers as well as learners. In addition, each trainee completed an educational or research project. The evaluations of the program were based on questionnaires completed after the end of each program year. There were good results for passive cognitive learning, slightly less good results for active cognitive learning, and mixed results for affective learning. Other indications of the program's success were seen in the establishment of four regional Geriatric Education Centers, the nucleus of each of which was the former fellows in the area, and the number of new projects and collaborations stimulated by the training experience.

Facilitating play skills: Efficacy of a staff development program

Staff members of a day care center took part in a year-long training program designed to help them facilitate a child's ability to learn through play. This paper briefly describes the training objectives and methods used in the first two workshops of this program. An evaluation of the effectiveness of those methods is presented, based on pre-training and post-training observation of interactions between caregivers and children in the day care center. Results indicate that the training was very effective in increasing caregiver verbal involvement with children during play, but was less effective in reducing the number of verbal directives delivered by caregivers in interacting with the children. A negative relationship was found between caregiver's level of education and amount of verbally directive behavior after training, but not before training.

Strength and Anthropometric Characteristics of Selected Offensive and Defensive University-Level Football Players

Prediction of football-playing ability from several tests of power and anthropometric measures and a prediction of body fat from several skinfold sites was determined among university-level football players. Success in football ability, determined from the coach's rating, correlated highly with skinfolds, % body fat, and a few power measures. Skinfold estimates of body fat can be accurately assessed ( r = .92) from two sites, iliac crest and cheek. Football teams would benefit from periodic “in-season” and “offseason” checks on body fat to ensure compliance to a year-long training program.

Masters Power Weight Training.

At the age of 50 the author, a former competitive weight lifter, undertook a year-long training program to see how much of his former strength could be regained.