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Training Experience (training + experience)
Selected AbstractsDuty Hours in Emergency Medicine: Balancing Patient Safety, Resident Wellness, and the Resident Training Experience: A Consensus Response to the 2008 Institute of Medicine Resident Duty Hours RecommendationsACADEMIC EMERGENCY MEDICINE, Issue 9 2010Mary Jo Wagner MD Abstract Representatives of emergency medicine (EM) were asked to develop a consensus report that provided a review of the past and potential future effects of duty hour requirements for EM residency training. In addition to the restrictions made in 2003 by the Accreditation Council for Graduate Medical Education (ACGME), the potential effects of the 2008 Institute of Medicine (IOM) report on resident duty hours were postulated. The elements highlighted include patient safety, resident wellness, and the resident training experience. Many of the changes and recommendations did not affect EM as significantly as other specialties. Current training standards in EM have already emphasized patient safety by requiring continuous on-site supervision of residents. Resident fatigue has been addressed with restrictions of shift lengths and limitation of consecutive days worked. One recommendation from the IOM was a required 5-hour rest period for residents on call. Emergency department (ED) patient safety becomes an important concern with the decrease in the availability and in the patient load of a resident consultant that may result from this recommendation. Of greater concern is the already observed slower throughput time for admitted patients waiting for resident care, which will increase ED crowding and decrease patient safety in academic institutions. A balance between being overly prescriptive with duty hour restrictions and trying to improve resident wellness was recommended. Discussion is included regarding the appropriate length of EM training programs if clinical experiences were limited by new duty hour regulations. Finally, this report presents a review of the financing issues associated with any changes. ACADEMIC EMERGENCY MEDICINE 2010; 17:1004,1011 © 2010 by the Society for Academic Emergency Medicine [source] Hippocampal participation in navigational map learning in young homing pigeons is dependent on training experienceEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 2 2000Paolo Ioalè Abstract The homing pigeon navigational map is perhaps one of the most striking examples of a naturally occurring spatial representation of the environment used to guide navigation. In a previous study, it was found that hippocampal lesions thoroughly disrupt the ability of young homing pigeons held in an outdoor aviary to learn a navigational map. However, since that study an accumulation of anecdotal data has hinted that hippocampal-lesioned young pigeons allowed to fly during their first summer could learn a navigational map. In the present study, young control and hippocampal-lesioned homing pigeons were either held in an outdoor aviary or allowed to fly during the time of navigational map learning. At the end of their first summer, the birds were experimentally released to test for navigational map learning. Independent of training experience, control pigeons oriented homeward during the experimental releases demonstrating that they learned a navigational map. Surprisingly, while the aviary-held hippocampal-lesioned pigeons failed to learn a navigational map as reported previously, hippocampal-lesioned birds allowed flight experience learned a navigational map indistinguishable from the two control groups. A subsequent experiment revealed that the navigational map learned by the three groups was based on atmospheric odours. The results demonstrate that hippocampal participation in navigational map learning depends on the type of experience a young bird pigeon has, and presumably, the type of navigational map learned. [source] Improving international nurse training: an American,Italian case studyINTERNATIONAL NURSING REVIEW, Issue 2 2006H. F. W. Dubois msc Background:, Institutionalized international nurse training organized by national educational institutions is a relatively new phenomenon. This, descriptive case study examines an early example of an American,Italian initiative of such training, in order to stimulate future international education of nurses. Aim:, To find out what factors have to be taken into account to improve training and what its potential effects are in exchange and also in the context of nurse migration. Method:, A questionnaire was sent to the 85 nurses who all participated in this particular international programme (response rate: 30.6%). Findings:, The collected data indicate that personalized and well-aimed training, preparatory language courses, predeparture exposure of nurses to the culture of the host country and well-prepared welcomes are among the most important ways to improve this programme. Implications for practice:, While the specific circumstances and cultures involved in this particular case study should not be ignored, these factors might also be applied to maximize the positive effects of nurse-migration. Two-way learning is among the positive effects of such an international training experience. Motivational and team-building effects can result in enhanced quality of care and a more efficient allocation of resources. However, the mind-opening effect seems to be the most important learning experience. Therefore, regardless of whether one system is considered better or worse than another, experiencing a different way of nursing/education is considered the most important, enriching element of an international learning experience. The effects of this experience could include avoiding cultural imposition in the increased cultural diversity of nursing in the country of origin. [source] A Multidisciplinary Program for Delivering Primary Care to the Underserved Urban Homebound: Looking Back, Moving ForwardJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2006Kristofer L. Smith BA The coming decades will see a dramatic rise in the number of homebound adults. These individuals will have multiple medical conditions requiring a team of caregivers to provide adequate care. Home-based primary care (HBPC) programs can coordinate and provide such multidisciplinary care. Traditionally, though, HBPC programs have been small because there has been little institutional support for growth. Three residents developed the Mount Sinai Visiting Doctors (MSVD) program in 1995 to provide multidisciplinary care to homebound patients in East Harlem, New York. Over the past 10 years, the program has grown substantially to 12 primary care providers serving more than 1,000 patients per year. The program has met many of its original goals, such as helping patients to live and die at home, decreasing caregiver burden, creating a home-based primary care training experience, and becoming a research leader. These successes and growth have been the result of careful attention to providing high-quality care, obtaining hospital support through the demonstration of an overall positive cost,benefit profile, and securing departmental and medical school support by shouldering significant teaching responsibilities. The following article will detail the development of the program and the current provision of services. The MSVD experience offers a model of growth for faculty and institutions interested in starting or expanding a HBPC program. [source] Duty Hours in Emergency Medicine: Balancing Patient Safety, Resident Wellness, and the Resident Training Experience: A Consensus Response to the 2008 Institute of Medicine Resident Duty Hours RecommendationsACADEMIC EMERGENCY MEDICINE, Issue 9 2010Mary Jo Wagner MD Abstract Representatives of emergency medicine (EM) were asked to develop a consensus report that provided a review of the past and potential future effects of duty hour requirements for EM residency training. In addition to the restrictions made in 2003 by the Accreditation Council for Graduate Medical Education (ACGME), the potential effects of the 2008 Institute of Medicine (IOM) report on resident duty hours were postulated. The elements highlighted include patient safety, resident wellness, and the resident training experience. Many of the changes and recommendations did not affect EM as significantly as other specialties. Current training standards in EM have already emphasized patient safety by requiring continuous on-site supervision of residents. Resident fatigue has been addressed with restrictions of shift lengths and limitation of consecutive days worked. One recommendation from the IOM was a required 5-hour rest period for residents on call. Emergency department (ED) patient safety becomes an important concern with the decrease in the availability and in the patient load of a resident consultant that may result from this recommendation. Of greater concern is the already observed slower throughput time for admitted patients waiting for resident care, which will increase ED crowding and decrease patient safety in academic institutions. A balance between being overly prescriptive with duty hour restrictions and trying to improve resident wellness was recommended. Discussion is included regarding the appropriate length of EM training programs if clinical experiences were limited by new duty hour regulations. Finally, this report presents a review of the financing issues associated with any changes. ACADEMIC EMERGENCY MEDICINE 2010; 17:1004,1011 © 2010 by the Society for Academic Emergency Medicine [source] Keeping the spirit high: why trauma team training is (sometimes) implementedACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2008T. WISBORG Background: Systematic and multiprofessional trauma team training using simulation was introduced in Norway in 1997. The concept was developed out of necessity in two district general hospitals and one university hospital but gradually spread to 45 of Norway's 50 acute-care hospitals over the next decade. Implementation in the hospitals has varied from being a single training experience to becoming a regular training and part of quality improvement. The aim of this study was to better understand why only some hospitals achieved implementation of regular trauma team training, despite the intentions of all hospitals to do so. Methods: Focus group interviews were conducted with multiprofessional respondents in seven hospitals, including small and large hospitals and hospitals with and without regular team training. Interviews were transcribed and analyzed using a Grounded Theory approach. Results: ,Keeping the spirit high' appeared to be the way to achieve implementation. This was achieved through ,enthusiasm,',strategies and alliances,' and ,using spin-offs.' It seems that the combination of enthusiasts, managerial support, and strategic planning are key factors for professionals trying to implement new activities. Conclusions: Committed health professionals planning to implement new methods for training and preparedness in hospitals should have one or more enthusiasts, secure support at the administrative level, and plan the implementation taking all stakeholders into consideration. [source] A comparison study of career satisfaction and emotional states between primary care and speciality residentsMEDICAL EDUCATION, Issue 1 2006Donald E Girard Objective, To evaluate career satisfaction, emotional states and positive and negative experiences among residents in primary care and speciality programmes in 1 academic medical centre prior to the implementation of the Accreditation Council for Graduate Medical Education's (ACGME) duty hour requirements. Design, Cross-sectional survey. Measurements, All 581 residents in the academic health centre were asked to participate voluntarily in a confidential survey; 327(56%) completed the survey. Results, Compared to their primary care colleagues, speciality residents had higher levels of satisfaction with career choice, feelings of competence and excitement, lower levels of inferiority and fatigue and different perceptions of positive and negative training experiences. However, 77% of all respondents were consistently or generally pleased with their career choices. The most positive residents' experiences related to interpersonal relationships and their educational value; the most negative experiences related to interpersonal relationships and issues perceived to be outside of residents' control. Age and training level, but not gender also influenced career satisfaction, emotional states and positive and negative opinions about residency. Conclusions, Less satisfaction with career choice and more negative emotional states for primary care residents compared to speciality residents probably relate to the training experience and may influence medical students' selections of careers. The primary care residents, compared to speciality residents, appear to have difficulty in fulfilling their ideals of professionalism in an environment where they have no control. These data provide baseline information with which to compare these same factors after the implementation of the ACGME duty hours' and competency requirements. [source] Training program and learning curve in experimental microsurgery during the residency in plastic surgeryMICROSURGERY, Issue 4 2007Ioan Lascar M.D., Ph.D. This article presents a comparison of microsurgical training of groups with different background. A protocol based on the rat femoral arterial anastomoses was used to provide an objective representation of the microsurgical skills progress. The performance is assessed by consistent (×4) patency of a standardized anastomosis. Three groups of beginner residents with progressive microsurgical experience and one group of experienced surgeons were observed. The patency curve of the beginner-groups was as an abrupt learning curve, and then a plateau was reached. There was no statistically significant difference in the patency rate between the beginner-groups after their first 32 anastomoses. No statistically significant difference was noted when the patency of the advanced group was compared with beginner-groups after different numbers of anastomoses (inverse proportional with their training experience). A slight or a plateau learning curve was found among the experienced group. The learning curve is a useful adjunct in the assessment of training. © 2007 Wiley-Liss, Inc. Microsurgery 2007. [source] THE RETURNS TO EDUCATION AND TRAINING: EVIDENCE FROM THE MALAYSIAN FAMILY LIFE SURVEYSPACIFIC ECONOMIC REVIEW, Issue 2 2004Tsung-Ping Chung I estimate a Mincer type earnings function, augmented by information on the women's training experience. The results indicate that there are positive and economically significant returns to education and training. I also investigate the determinants of training and find that training participation is positively related to educational attainment, while if women are credit-constrained they are significantly less likely to undertake training. [source] The relationship between organisational context and novice workers' learningINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 4 2002Erica Smith This article reports on findings from a longitudinal study, carried out during 1998,9, of the learning and training experiences of 11 Australian teenagers in their first year of fulltime work. Interviews with the young people over the course of the year were supplemented by interviews with parents, employers, and college teachers where appropriate. The working and training environments, and the learning experiences of the young people are described. The relationship between performance and learning is discussed. The article provides an insight into the lived experiences of young people attempting to learn about work within an organisational context. [source] A comparison study of career satisfaction and emotional states between primary care and speciality residentsMEDICAL EDUCATION, Issue 1 2006Donald E Girard Objective, To evaluate career satisfaction, emotional states and positive and negative experiences among residents in primary care and speciality programmes in 1 academic medical centre prior to the implementation of the Accreditation Council for Graduate Medical Education's (ACGME) duty hour requirements. Design, Cross-sectional survey. Measurements, All 581 residents in the academic health centre were asked to participate voluntarily in a confidential survey; 327(56%) completed the survey. Results, Compared to their primary care colleagues, speciality residents had higher levels of satisfaction with career choice, feelings of competence and excitement, lower levels of inferiority and fatigue and different perceptions of positive and negative training experiences. However, 77% of all respondents were consistently or generally pleased with their career choices. The most positive residents' experiences related to interpersonal relationships and their educational value; the most negative experiences related to interpersonal relationships and issues perceived to be outside of residents' control. Age and training level, but not gender also influenced career satisfaction, emotional states and positive and negative opinions about residency. Conclusions, Less satisfaction with career choice and more negative emotional states for primary care residents compared to speciality residents probably relate to the training experience and may influence medical students' selections of careers. The primary care residents, compared to speciality residents, appear to have difficulty in fulfilling their ideals of professionalism in an environment where they have no control. These data provide baseline information with which to compare these same factors after the implementation of the ACGME duty hours' and competency requirements. [source] A national medical education needs' assessment of interns and the development of an intern education and training programmeMEDICAL EDUCATION, Issue 4 2000Frances B Hannon A needs' assessment of interns was undertaken using a self-completion questionnaire and a semistructured interview. The questionnaire explored to what degree graduates had been helped to acquire a range of competencies and professional characteristics. In the interviews graduates discussed their self-perceived learning needs, their educational and training experiences and made suggestions. A 25% random sample of 1996 graduate doctors was selected from the five medical schools in Ireland (n=95). The overall response rate was 88% (n=84). The software package SPSS was utilized to carry out descriptive statistics on the questionnaire data while the interview data were analysed qualitatively. Of the responders, 91% reported that they were not prepared for all the skills needed as an intern. History taking and clinical examination were considered well covered at the undergraduate level but little training was received in a range of professional competencies and personal characteristics. Formal education and training during the intern year was found to be poor. However, some skills and characteristics improved during the year as a result of work experience. In the interviews the graduates explored educational issues. They considered an improved clinical experience throughout the undergraduate years to be at the heart of curriculum development but stressed that, in order to succeed, it would have to be accompanied by leadership within the healthcare system and efforts to improve the learning environment. [source] | |||||||||||||