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The Journal of Thoracic and... Oct 2013A dramatic transformation of cardiothoracic surgical education has evolved over the past few decades. (Review)
Review
BACKGROUND
A dramatic transformation of cardiothoracic surgical education has evolved over the past few decades.
METHODS
We begin by presenting recognized catalysts of this change, organized by whom they primarily affect: the trainees, the trainers, and the profession as a whole. Our trainees' prior training is different, and their current demographics and priorities have changed. There is less incentive to teach, with time-honored traditions of education inadequate to meet the needs of trainees. Concurrently, our profession has to adjust to new regulations, increasing financial constraints, and an expanding body of knowledge and technology. To address these issues requires developing new models of education and assessment that can thrive in today's environment. We discuss efforts in the United States and abroad, including new training paradigms ranging from restructuring existing models to novel approaches (eg, competency-based training). Training tools are being developed, such as online instruction, simulation-based learning, and regular student-centered assessments. Finally, models that recognize and reward teaching as a scholarly activity are being implemented.
CONCLUSIONS
Like the radical advances we have witnessed in surgical therapy, surgical education requires creative and perhaps disruptive changes if we are to continue to produce well-trained additions to our professional ranks.
Topics: Attitude of Health Personnel; Cardiac Surgical Procedures; Curriculum; Diffusion of Innovation; Education, Medical, Graduate; Faculty, Medical; Forecasting; History, 20th Century; History, 21st Century; Humans; Internship and Residency; Models, Educational; Motivation; Teaching; Thoracic Surgical Procedures
PubMed: 23870155
DOI: 10.1016/j.jtcvs.2013.06.004 -
Academic Emergency Medicine : Official... Feb 2018Immersive learning environments that use virtual simulation (VS) technology are increasingly relevant as medical learners train in an environment of restricted clinical...
Immersive learning environments that use virtual simulation (VS) technology are increasingly relevant as medical learners train in an environment of restricted clinical training hours and a heightened focus on patient safety. We conducted a consensus process with a breakout group of the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change Through Health Care Simulation: Systems, Competency, and Outcomes." This group examined the current uses of VS in training and assessment, including limitations and challenges in implementing VS into medical education curricula. We discuss the role of virtual environments in formative and summative assessment. Finally, we offer recommended areas of focus for future research examining VS technology for assessment, including high-stakes assessment in medical education. Specifically, we discuss needs for determination of areas of focus for VS training and assessment, development and exploration of virtual platforms, automated feedback within such platforms, and evaluation of effectiveness and validity of VS education.
Topics: Clinical Competence; Curriculum; Emergency Medicine; Humans; Simulation Training; Virtual Reality
PubMed: 28888070
DOI: 10.1111/acem.13308 -
The Ulster Medical Journal Sep 2012High profile error cases and reduced work hours have forced medicine to consider new approaches to training. Simulation-based learning for the acquisition and... (Review)
Review
High profile error cases and reduced work hours have forced medicine to consider new approaches to training. Simulation-based learning for the acquisition and maintenance of skills has a growing role to play. Considerable advances have been made during the last 20 years on how simulation should be used optimally. Simulation is also more than a technology learning experience for supplanting the traditional approach of repeated practice. Research has shown that simulation works best when it is integrated into a curriculum. Learning is optimal when trainees receive metric-based feedback on their performance. Metrics should unambiguously characterize important aspects of procedure or skill performance. They are developed from a task analysis of the procedure or skills to be learned. The outcome of the task analysis should also shape how the simulation looks and behaves. Metric-based performance characterization can be used to establish a benchmark (i.e., a level of proficiency) which trainees must demonstrate before training progression. This approach ensures a more homogeneous skill-set in graduating trainees and can be applied to any level of training. Prospective, randomized and blinded clinical studies have shown that trainees who acquired their skills to a level of proficiency on a simulator in the skills laboratory perform significantly better in vivo in comparison to their traditionally trained colleagues. The Food and Drug Administration in the USA and the Department of Health in the UK have candidly indicated that they see an emergent and fundamental role for simulation-based training. Although a simulation-based approach to medical education and training may be conceptually and intellectually appealing it represents a paradigm shift in how doctors are educated and trained.
Topics: Clinical Competence; Computer Simulation; Curriculum; Education, Medical; General Surgery; Humans
PubMed: 23620606
DOI: No ID Found -
Scandinavian Journal of Work,... May 2012Training is regarded as an important component of occupational health and safety (OHS) programs. This paper primarily addresses whether OHS training has a beneficial... (Review)
Review
OBJECTIVES
Training is regarded as an important component of occupational health and safety (OHS) programs. This paper primarily addresses whether OHS training has a beneficial effect on workers. The paper also examines whether higher engagement OHS training has a greater effect than lower engagement training.
METHODS
Ten bibliographic databases were searched for pre-post randomized trial studies published in journals between 1996 and November 2007. Training interventions were included if they were delivered to workers and were concerned with primary prevention of occupational illness or injury. The methodological quality of each relevant study was assessed and data was extracted. The impacts of OHS training in each study were summarized by calculating the standardized mean differences. The strength of the evidence on training's effectiveness was assessed for (i) knowledge, (ii) attitudes and beliefs, (iIi) behaviors, and (iv) health using the US Centers for Disease Control and Prevention's Guide to Community Preventive Services, a qualitative evidence synthesis method.
RESULTS
Twenty-two studies met the relevance criteria of the review. They involved a variety of study populations, occupational hazards, and types of training. Strong evidence was found for the effectiveness of training on worker OHS behaviors, but insufficient evidence was found of its effectiveness on health (ie, symptoms, injuries, illnesses).
CONCLUSIONS
The review team recommends that workplaces continue to deliver OHS training to employees because training positively affects worker practices. However, large impacts of training on health cannot be expected, based on research evidence.
Topics: Algorithms; Databases, Bibliographic; Education, Continuing; Educational Status; Health Knowledge, Attitudes, Practice; Humans; Occupational Health; Primary Prevention; Teaching; Workplace
PubMed: 22045515
DOI: 10.5271/sjweh.3259 -
Journal of Visceral Surgery Jun 2020The main objectives of the reform of the 3rd cycle of medical studies in France that was instituted in 2017 after eight years of preparation, are to train future... (Review)
Review
The main objectives of the reform of the 3rd cycle of medical studies in France that was instituted in 2017 after eight years of preparation, are to train future specialists in a consistent and equitable fashion and to replace the previous time-based qualification by training based on the progressive acquisition of skills. This reform was an opportunity for the 13 different French surgical specialty Colleges involved to share reflections on what a surgeon actually was and to define training in surgical sub-specialties. The current reform is well adapted to these specifications and has fostered training models that are consistent with each other. This article discusses the historical construction of this reform, what will change in the training of future surgeons, as well as some points that warrant caution. The third cycle reform has also triggered a reform of the second cycle, which is expected to come into force for the 2020 academic year. Its objective will be to eliminate the guillotine effect created by the National Classifying Examinations and to allow students to better understand and test their desire and skills for a given specialty. It will be up to these same surgical Colleges to determine how to do this for the sub-specialties of the "surgery" discipline.
Topics: Clinical Competence; Curriculum; Education, Medical; France; General Surgery; Humans; Specialties, Surgical
PubMed: 32331850
DOI: 10.1016/j.jviscsurg.2020.02.007 -
GMS Zeitschrift Fur Medizinische... 2013Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians' everyday clinical... (Review)
Review
BACKGROUND
Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians' everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable.
OBJECTIVE
The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development.
METHOD
The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for training of leadership skills in medicine in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects.
RESULTS
Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined.
CONCLUSIONS
More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education.
Topics: Cooperative Behavior; Curriculum; Education, Medical; Germany; Humans; Interdisciplinary Communication; Leadership
PubMed: 24282452
DOI: No ID Found -
TheScientificWorldJournal Mar 2006Widespread acceptance of laparoscopic urology techniques has posed many challenges to training urology residents and allowing postgraduate urologists to acquire often... (Review)
Review
Widespread acceptance of laparoscopic urology techniques has posed many challenges to training urology residents and allowing postgraduate urologists to acquire often difficult new surgical skills. Several factors in surgical training programs are limiting the ability to train residents in the operating room, including limited-hours work weeks, increasing demand for operating room productivity, and general public awareness of medical errors. As such, surgical simulation may provide an opportunity to enhance residency experience and training, and optimize post-graduate acquisition of new skills and maintenance of competency. This review article explains and defines the various levels of validity as it pertains to surgical simulators. The most recently and comprehensively validity tested simulators are outlined and summarized. The potential role of surgical simulation in the formative and summative assessment of surgical trainees, as well as, the certification and recertification process of postgraduate surgeons will be delineated. Surgical simulation will be an important adjunct to the traditional methods of surgical skills training and will allow surgeons to maintain their proficiency in the technically challenging aspects of minimally invasive urologic surgery.
Topics: Certification; Clinical Competence; Computer Simulation; Curriculum; Education, Medical, Graduate; Educational Technology; Humans; Internship and Residency; Laparoscopy; Mentors; Schools, Medical; Teaching; Urologic Surgical Procedures; Urology
PubMed: 17619704
DOI: 10.1100/tsw.2006.368 -
Anales de Pediatria Feb 2022The resuscitation of the newborn in the delivery room requires high capacities and occurs frequently in an unexpected way. Many professionals trained in pediatrics as... (Observational Study)
Observational Study
INTRODUCTION
The resuscitation of the newborn in the delivery room requires high capacities and occurs frequently in an unexpected way. Many professionals trained in pediatrics as pediatric residents will work posteriorly in pediatric units with delivery rooms and will perform neonatal resuscitation only occasionally. Skills acquired in practice or resuscitation courses deteriorate over time.
MATERIAL AND METHODS
Descriptive observational study through a survey to pediatricians trained in neonatology at a tertiary hospital in Madrid, and who completed their residency period between 2009 and 2016. Questions about their training in resuscitation and their usual work in the delivery room.
RESULTS
Out of 179 surveys sent, 140 pediatricians (78,2%) answered it. 73.6% took a training course in neonatal resuscitation during the residency. There was a progressive increase in the number of residents who did the course during the study period. 74.3% have worked after residency in assistance at birth. 40.7% have taken a refresher course in neonatal resuscitation.
CONCLUSIONS
Training in neonatal resuscitation has increased and been consolidated during the training process for pediatric residents. A high percentage of pediatricians work after residency in pediatric units with delivery rooms, less than half of these professionals having been recycled in neonatal resuscitation. Recycling and periodic training seem interesting options to improve the performance of these professionals in the delivery room.
Topics: Cardiopulmonary Resuscitation; Child; Clinical Competence; Humans; Infant, Newborn; Internship and Residency; Neonatology; Pediatricians
PubMed: 35125326
DOI: 10.1016/j.anpede.2020.11.014 -
Advances in Nutrition (Bethesda, Md.) Mar 2019There is a well-documented pandemic of malnutrition. It has numerous sequelae, including physical and psychological ill health, early death, and socioeconomic burden.... (Review)
Review
There is a well-documented pandemic of malnutrition. It has numerous sequelae, including physical and psychological ill health, early death, and socioeconomic burden. The nutrition landscape and dynamics of the nutrition transition are extremely complex, but one significant factor in both is the role of medical management. Doctors have a unique position in society from which to influence this scenario at global, public, and personal levels, but we are failing to do so. There are several reasons for this, including inadequate time; historical educational bias towards disease and therapeutic intervention-rather than diet, lifestyle, and prevention; actual or perceived incompetency in the field of nutrition; confusion or deflection within medicine about whose role(s) it is on a medical team to address nutrition; and public confusion about whom to turn to for advice. But the most fundamental reason is that current doctors (and thus the trainers of medical students) have not received-and future doctors are thus still not receiving-adequate training to render them confident or competent to take on the role. A small number of important educational approaches exist aimed at practicing doctors and medical students, but the most effective methods of teaching are still being evaluated. Without properly trained trainers, we have no one to train the doctors of tomorrow. This is a "catch 22." To break this deadlock, there is an urgent need to make appropriate nutrition training available, internationally, and at all levels of medical education (medical students, doctors-in-training, and practicing doctors). Until this is achieved, the current pandemic of nutrition-related disease will continue to grow. Using important illustrative examples of existing successful nutrition education approaches, we suggest potential approaches to breaking this deadlock.
Topics: Clinical Competence; Curriculum; Education, Medical; Humans; Nutritional Sciences
PubMed: 30624632
DOI: 10.1093/advances/nmy082 -
Health Literacy Research and Practice Apr 2022Effective provider communication skills are important for patient decision-making and understanding, particularly for those with low health literacy. A gap exists in...
BACKGROUND
Effective provider communication skills are important for patient decision-making and understanding, particularly for those with low health literacy. A gap exists in training methods and curriculum for community health workers (CHWs). Brief description of activity: Through a clinical and academic partnership, pilot training curriculum focused on patient communication skills was developed to align with CHW scope of work.
IMPLEMENTATION
The curriculum was implemented in three 2-hour training sessions over WebEx with seven state-certified CHWs. The goal was for CHWs to understand the key elements and application of active listening, Teach Back, and action planning in a clinical setting. The sessions included didactic and skills practice modules for each skill.
RESULTS
A survey was distributed to CHWs to evaluate knowledge, skills, and attitudes and reactions to training methods, instructors, and relevance using the Kirkpatrick's evaluation model (Reaction and Learning). Although CHWs agreed that they had actively participated in the training and that the instructors were well-prepared, there was less agreement that the course was relevant. CHWs reported an increase in understanding of active listening and action planning, capability of using Teach Back and providing social support, and ability to teach, whereas a decrease was reported in the capability to use action planning. When probed about training relevance, CHWs felt action listening and Teach Back were relevant, but that action planning was not relevant to their responsibilities. This gap in responsibilities was also acknowledged by the clinical leadership.
LESSONS LEARNED
The training allowed the CHWs to build on subsequent skills from previous sessions and to discuss struggles. A need for tools for integrating the skills in the clinical workflow were requested by CHWs and clinical leadership. These tools offer the opportunity to tailor future trainings on communication skills or patient scenarios. Future trainings should include CHWs to provide insight into scope of work. [] Plain Language Summary: It is important for community health workers to communicate with patients so that patients can understand information and make their own decisions. There is not enough known about the best way to train CHWs in patient communication. This training was created to help CHWs use three patient communication skills in their clinic.
Topics: Communication; Community Health Workers; Curriculum; Health Literacy; Humans; Social Support
PubMed: 35680123
DOI: 10.3928/24748307-20220518-02