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Training Sites (training + site)
Selected AbstractsEvaluating surgeons' informed decision making skills: pilot test using a videoconferenced standardised patientMEDICAL EDUCATION, Issue 12 2003Sarah L Clever Background, Standardised patients (SPs) are effective in evaluating communication skills, but not every training site may have the resources to develop and maintain SP programmes. Objectives, To test whether videoconferencing technology (VT) could enable an interaction between an SP and an orthopaedic surgeon that would allow the SP to accurately evaluate the surgeon's informed decision making (IDM) skills. We also assessed whether this sort of interaction was acceptable to orthopaedic surgeons as a means of learning IDM skills. Methods, We trained an SP to represent a 75-year-old woman considering hip replacement surgery. Orthopaedic surgeons in Chicago individually consulted with the SP in Philadelphia; each participant could see and hear the other on large television screens. The SP evaluated the surgeons' advice using a 23-item checklist of IDM elements, and gave each surgeon verbal and written feedback on his IDM skills. The surgeons then gave their evaluations of the exercise. Results, Twenty-two surgeons completed the project. The SP was ,,80% accurate in classifying 20 of the 23 IDM skills when compared to a clinician rater. Although 12 (55%) of the orthopaedic surgeons felt that some aspects of the technology were distracting, most were pleased with it, and 19 of 22 (86%) would recommend the videoconferenced SP interaction to their colleagues as a means of learning IDM skills. Conclusions, These results suggest that VT allows accurate evaluation of IDM skills in a format that is acceptable to orthopaedic surgeons. Videoconferencing technology may be useful in long-distance SP communication assessment for a variety of learners. [source] Seasonal prevalence of mosquitoes collected from light traps in the Republic of Korea in 2003ENTOMOLOGICAL RESEARCH, Issue 3 2006Heung Chul KIM Abstract Surveillance of adult mosquitoes was conducted at 29 US military installations and training sites in six provinces in the Republic of Korea during 2003. Adult mosquitoes were collected in New Jersey light traps and dry ice-baited New Jersey light traps from 1 May to 15 October. Mosquito surveillance was conducted to determine threshold levels to initiate pesticide applications and identify malaria infection rates at selected army installations and training sites. A total of 42 024 adult mosquitoes (32 594 females [77.6%] and 9430 males [22. 4%]) comprising 14 species and Anopheles sinensis s.l. (a complex of five species), representing seven genera, were collected. The most common species were members of the Anopheles sinensis Wiedemann complex (54.9%), followed by Aedes vexans nipponii (Theobald) (19.0%), Culex pipiens Coquillett (14.3%) and Culex tritaeniorhynchus Giles (10.6%). Trap indices varied widely for species over their range, due in part to geographical distribution and degree of association with urban communities. [source] Selecting discriminant function models for predicting the expected richness of aquatic macroinvertebratesFRESHWATER BIOLOGY, Issue 2 2006JOHN VAN SICKLE Summary 1. The predictive modelling approach to bioassessment estimates the macroinvertebrate assemblage expected at a stream site if it were in a minimally disturbed reference condition. The difference between expected and observed assemblages then measures the departure of the site from reference condition. 2. Most predictive models employ site classification, followed by discriminant function (DF) modelling, to predict the expected assemblage from a suite of environmental variables. Stepwise DF analysis is normally used to choose a single subset of DF predictor variables with a high accuracy for classifying sites. An alternative is to screen all possible combinations of predictor variables, in order to identify several ,best' subsets that yield good overall performance of the predictive model. 3. We applied best-subsets DF analysis to assemblage and environmental data from 199 reference sites in Oregon, U.S.A. Two sets of 66 best DF models containing between one and 14 predictor variables (that is, having model orders from one to 14) were developed, for five-group and 11-group site classifications. 4. Resubstitution classification accuracy of the DF models increased consistently with model order, but cross-validated classification accuracy did not improve beyond seventh or eighth-order models, suggesting that the larger models were overfitted. 5. Overall predictive model performance at model training sites, measured by the root-mean-squared error of the observed/expected species richness ratio, also improved steadily with DF model order. But high-order DF models usually performed poorly at an independent set of validation sites, another sign of model overfitting. 6. Models selected by stepwise DF analysis showed evidence of overfitting and were outperformed by several of the best-subsets models. 7. The group separation strength of a DF model, as measured by Wilks',, was more strongly correlated with overall predictive model performance at training sites than was DF classification accuracy. 8. Our results suggest improved strategies for developing reliable, parsimonious predictive models. We emphasise the value of independent validation data for obtaining a realistic picture of model performance. We also recommend assessing not just one or two, but several, candidate models based on their overall performance as well as the performance of their DF component. 9. We provide links to our free software for stepwise and best-subsets DF analysis. [source] Spatial prediction of nitrate pollution in groundwaters using neural networks and GIS: an application to South Rhodope aquifer (Thrace, Greece)HYDROLOGICAL PROCESSES, Issue 3 2009Dr A. Gemitzi Abstract Neural network techniques combined with Geographical Information Systems (GIS), are used in the spatial prediction of nitrate pollution in groundwaters. Initially, the most important parameters controlling groundwater pollution by nitrates are determined. These include hydraulic conductivity of the aquifer, depth to the aquifer, land uses, soil permeability, and fine to coarse grain ratio in the unsaturated zone. All these parameters were quantified in a GIS environment, and were standardized in a common scale. Subsequently, a neural network classification was applied, using a multi-layer perceptron classifier with the back propagation (BP) algorithm, in order to categorize the examined area into categories of groundwater nitrate pollution potential. The methodology was applied to South Rhodope aquifer (Thrace, Greece). The calculation was based on information from 214 training sites, which correspond to monitored nitrate concentrations in groundwaters in the area. The predictive accuracy of the model developed reached 86% in the training samples, 74% in the overall sample and 71% in the test samples. This indicates that this methodology is promising to describe the spatial pattern of nitrate pollution. Copyright © 2008 John Wiley & Sons, Ltd. [source] Review of an instructor computation model for Navy learning centers and a Navy instructor workweek analysis for facilitated self-paced instructionPERFORMANCE IMPROVEMENT, Issue 3 2008Monica Huff CPT The purpose of the performance study was to review a proposed U.S. Navy Learning Center instructor computation (ICOMP) model for calculating the number of instructors required for teaching courses at Navy training sites. Based on recommendations from the initial analysis, a workweek breakdown was conducted for facilitated self-paced instructors. Findings improved the application of an ICOMP for the U.S. Navy and advanced the understanding of instructors' workweek requirements and duties. [source] Quality assurance in medical and public health genetics services: A systematic review,AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 3 2009Ann F. Chou Abstract As genetic services grow in scope, issues of quality assessment in genetic services are emerging. These efforts are well developed for molecular and cytogenetic testing and laboratories, and newborn screening programs, but assessing quality in clinical services has lagged, perhaps owing to the small work force and the recent evolution from a few large training programs to multiple training sites. We surveyed the English language, peer-reviewed literature to summarize the knowledge-base of quality assessment of genetics services, organized into the tripartite categories of the Donabedian model of "structure," "process," and "outcome." MEDLINE searches from 1990 to July 2008, yielded 2,143 articles that addressed both "medical/genetic screening and counseling" and "quality indicators, control, and assurance." Of the 2,143 titles, 131 articles were extracted for in-depth analysis, and 55 were included in this review. Twenty-nine articles focused on structure, 19 on process, and seven on outcomes. Our review underscored the urgent need for a coherent model that will provide health care organizations with tools to assess, report, monitor, and improve quality. The structure, process, and outcomes domains that make up the quality framework provide a comprehensive lens through which to examine quality in medical genetics. © 2009 Wiley-Liss, Inc. [source] Gaps in Procedural Experience and Competency in Medical School GraduatesACADEMIC EMERGENCY MEDICINE, Issue 2009Susan B. Promes MD Abstract Objectives:, The goal of undergraduate medical education is to prepare medical students for residency training. Active learning approaches remain important elements of the curriculum. Active learning of technical procedures in medical schools is particularly important, because residency training time is increasingly at a premium because of changes in the Accreditation Council for Graduate Medical Education duty hour rules. Better preparation in medical school could result in higher levels of confidence in conducting procedures earlier in graduate medical education training. The hypothesis of this study was that more procedural training opportunities in medical school are associated with higher first-year resident self-reported competency with common medical procedures at the beginning of residency training. Methods:, A survey was developed to assess self-reported experience and competency with common medical procedures. The survey was administered to incoming first-year residents at three U.S. training sites. Data regarding experience, competency, and methods of medical school procedure training were collected. Overall satisfaction and confidence with procedural education were also assessed. Results:, There were 256 respondents to the procedures survey. Forty-four percent self-reported that they were marginally or not adequately prepared to perform common procedures. Incoming first-year residents reported the most procedural experience with suturing, Foley catheter placement, venipuncture, and vaginal delivery. The least experience was reported with thoracentesis, central venous access, and splinting. Most first-year residents had not provided basic life support, and more than one-third had not performed cardiopulmonary resuscitation (CPR). Participation in a targeted procedures course during medical school and increasing the number of procedures performed as a medical student were significantly associated with self-assessed competency at the beginning of residency training. Conclusions:, Recent medical school graduates report lack of self-confidence in their ability to perform common procedures upon entering residency training. Implementation of a medical school procedure course to increase exposure to procedures may address this challenge. [source] Conference Attendance Does Not Correlate With Emergency Medicine Residency In-Training Examination ScoresACADEMIC EMERGENCY MEDICINE, Issue 2009H. Gene Hern Jr MD Abstract Objectives:, The residency review committee for emergency medicine (EM) requires residents to have greater than 70% attendance of educational conferences during residency training, but it is unknown whether attendance improves clinical competence or scores on the American Board of Emergency Medicine (ABEM) in-training examination (ITE). This study examined the relationship between conference attendance and ITE scores. The hypothesis was that greater attendance would correlate to a higher examination score. Methods:, This was a multi-center retrospective cohort study using conference attendance data and examination results from residents in four large county EM residency training programs. Longitudinal multi-level models, adjusting for training site, U.S. Medical Licensing Examination (USMLE) Step 1 score, and sex were used to explore the relationship between conference attendance and in-training examination scores according to year of training. Each year of training was studied, as well as the overall effect of mean attendance as it related to examination score. Results:, Four training sites reported data on 405 residents during 2002 to 2008; 386 residents had sufficient data to analyze. In the multi-level longitudinal models, attendance at conference was not a significant predictor of in-training percentile score (coefficient = 0.005, 95% confidence interval [CI] = ,0.053 to 0.063, p = 0.87). Score on the USMLE Step 1 examination was a strong predictor of ITE score (coefficient = 0.186, 95% CI = 0.155 to 0.217; p < 0.001), as was female sex (coefficient = 2.117, 95% CI = 0.987 to 3.25; p < 0.001). Conclusions:, Greater conference attendance does not correlate with performance on an individual's ITE scores. Conference attendance may represent an important part of EM residency training but perhaps not of ITE performance. [source] China,Australia,Hong Kong tripartite community mental health training programASIA-PACIFIC PSYCHIATRY, Issue 2 2009Chee Hong Ng MBBS MD FRANZCP Abstract The present paper describes the unique mental health training cooperation between two countries involving three training sites to facilitate the improvement of mental health care and service delivery in China. The priority is to build workforce capacity to deliver appropriate mental health care and rehabilitation in the community. In response to this challenge, a training program was collaboratively planned between partners in both countries to provide a comprehensive training program for multiskilled case workers for mainland China. The development and key activities of the training and exchange program correspond to a diverse range of training programs across multiple levels of staff and sectors. The tripartite training program represents a unique, large scale training program that has contributed significantly to developing one of the largest global national mental health program of reform and building a national community mental health service system for China. Over their many years of cooperation, the Australian and Chinese partners have developed a model for successful collaboration, one based on mutual respect, exchange of expertise and a deep appreciation of cultural difference and its influences on broad aspects of health system development. [source] | |||||||||||||