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Ulasi IB, Ezeme C, Irabor DO. Surgical Residency Training in Nigeria: An Audit Through the Lenses of the Trainee and Trainer. J Surg Res 2024; 299:56-67. [PMID: 38703745 DOI: 10.1016/j.jss.2024.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/13/2024] [Accepted: 03/11/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Resident doctors constitute an important workforce of the Nigerian healthcare system wherein they undergo structured training to become competent specialists in different fields of medicine. The aim of this survey was to audit the surgical residency training process, incorporating both the trainer's and the trainee's perspectives, with a view to improving both residency training and overall patient care. METHODS This was a multicenter descriptive cross-sectional study involving consultant surgeons and surgical trainees in selected tertiary healthcare institutions in Nigeria. A link to an online semi-structured and pretested questionnaire was sent to study participants whose agreement to fill out the questionnaire was taken as implied consent for the study. The perception of respondents on key areas of surgical residency training like the quality of training, skill acquisition, mentorship, supervision, operative exposures, research, funding, didactic sessions, and work schedule was assessed using a Likert scale. Their perceived challenges to training and measures to improve the quality of training were recorded. Data were analysed using version 23 of the SPSS. RESULTS A total of 127 participants (25 trainers and 102 trainees) were recruited with a mean age of 34.8 ± 3.5 y for the trainees and 47.5 ± 6.9 y for the trainers. The majority of both the trainers and trainees (72%, n = 18 and 93%, n = 96, respectively) were dissatisfied with the quality of surgical residency training in Nigeria with the trainers (88%, n = 22) and trainees (97.1%, n = 99) mostly agreeing that surgical training should be standardized across training centres in Nigeria. The trainees and trainers rated mentorship, research, funding, and overall quality of surgical residency training as inadequate, while most of the trainees and trainers rated supervision of trainees as adequate. The trainees predominantly identified poor training facilities as the most important challenge to surgical residency, followed by high clinical workload, while the majority of the trainers identified workplace bullying and high clinical workload as being the predominant factors. The nine-pronged recommendations by both the trainers and trainees to improve surgical training in Nigeria include mentorship program for trainees, funding of surgical residency training, provision of facilities and equipment for training, adequate supervision of trainees by trainers, job description and defined work schedule for trainees, health insurance of patients, overseas training of trainees during the residency program, improved remuneration of trainees, and adequate motivation of trainers. CONCLUSIONS The quality of surgical residency training in Nigeria is perceived as suboptimal by trainees and trainers. Perceived common challenges to surgical residency training include poor training facilities, workplace bullying, and high clinical workload. Adequate funding of surgical residency program, standardized mentorship, and training of trainees with improved remuneration of trainees and motivation of their trainers would enhance the overall quality of surgical residency training in Nigeria.
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Affiliation(s)
| | - Constantine Ezeme
- Department of Surgery, University College Hospital, Ibadan, Nigeria; Sheffield Teaching Hospitals NHS Foundation Trust, South Yorkshire, United Kingdom
| | - David O Irabor
- Department of Surgery, University College Hospital, Ibadan, Nigeria; Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
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An K, Zhang R, Zhu B, Liu L, Tang J, Ma Y, Wu Z, Zhang L, She Y, Luo D, Li C, Li H, Ma Y, Shi W, Su Q, Li S. Familiarity of teaching skills among general practitioners transfer training trainers in China: a cross-sectional survey. BMC Med Educ 2023; 23:949. [PMID: 38087271 PMCID: PMC10717701 DOI: 10.1186/s12909-023-04945-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND The insufficient number of general practitioners (GPs) is a major challenge facing China's healthcare system. The purpose of the GP transfer training programme was to provide training for experienced doctors to transition to general practice. However, research on the competencies of GP transfer training trainers in teaching skills in China is limited. This cross-sectional study aimed to examine the baseline familiarity with teaching skills among Chinese GP transfer training trainers. METHODS An online survey was conducted among trainers who participated in the 2021 Sichuan Province General Practice Training Trainer Program. The survey collected data on participants' characteristics and familiarity with 20 skills in three essential teaching knowledge areas: the core functions of primary care (five questions), preparation for lesson plan (four questions), and teaching methods (11 questions). RESULTS In total, 305 participants completed the survey. Familiarity rates were generally low across all three essential teaching knowledge areas. No significant differences were observed in familiarity rates between the tertiary and secondary hospitals. CONCLUSION This study revealed gaps in the teaching skills of GP transfer training trainers in China. These results suggest the necessity for targeted training programs to enhance the teaching skills and competencies of trainers.
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Affiliation(s)
- Kang An
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruohan Zhang
- West China School of Public Health, Sichuan University/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Binlu Zhu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liyun Liu
- General Practitioners' Training Center of Sichuan Province, Chengdu, Sichuan, China
| | - Jiayu Tang
- Nanchang University Queen Mary School, Nanchang, Jiangxi, China
| | - Yiru Ma
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- University of Copenhagen, Copenhagen, Denmark
| | - Zengxiang Wu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi She
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Fang-cao Community Health Service Center, Chengdu, Sichuan, China
| | - Dan Luo
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Caizheng Li
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Heting Li
- West China School of Public Health, Sichuan University/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuehua Ma
- Jin-cheng Community Health Service Center, Chengdu, Sichuan, China
| | - Weichang Shi
- Jin-cheng Community Health Service Center, Chengdu, Sichuan, China
| | - Qiaoli Su
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Shuangqing Li
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Fang-cao Community Health Service Center, Chengdu, Sichuan, China.
- Jin-cheng Community Health Service Center, Chengdu, Sichuan, China.
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Galvin D, O'Reilly B, Greene R, O'Donoghue K, O'Sullivan O. A national survey of surgical training in gynaecology: 2014-2021. Eur J Obstet Gynecol Reprod Biol 2023; 288:135-141. [PMID: 37517105 DOI: 10.1016/j.ejogrb.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES Over the last decade barriers to surgical training have been identified, including reducing access to theatre lists, reducing numbers of major surgical procedures being performed, increasing numbers of trainees and reduction in working hours since the introduction of the European Work Time Directive (EWTD). We aimed to assess the impact of these challenges on training in gynaecology over time. STUDY DESIGN We designed a study which aimed to assess both trainers and trainees perception of gynaecological surgical training in Ireland. The purpose of this was to identify confidence levels and challenges and to highlight potential areas for future improvement of surgical training in gynaecology. A a cross-sectional survey was distributed to all trainees and trainers registered with the Royal College of Physicians of Ireland Obstetrics and Gynaecology higher specialist training programme in 2014, 2017 and again in 2021. RESULTS During the study period trainees' confidence that the training programme prepared them to perform gynaecological surgery fell significantly. This fall in confidence was most evident for trainees' ability to perform abdominal hysterectomy (40.9% vs 15.2%, χ2 = 4.61, p =.03) and vaginal hysterectomy (31.8% vs 12.1%, χ2 = 4.58, p =.03) when comparing 2014 with 2021. All trainees reporteded that gynaecology was not given adequate time in the training programme to prepare them to practice independently as consultants. Themes identified by participants to improve training included dedicated access to theatre time with a named trainer, increased simulation training and subspecialisation at later stages of training. CONCLUSION Our findings show an overall decrease in trainees' and trainers' confidence in the surgical training available in gynaecology over an eight-year period.. This is particularly true for major gynaecology procedures. Efforts must be made to ensure trainees have improved access to surgical training in gynaecology. Potential solutions include improving access to simulation and incorporation of subspecialist training into later stages of training.
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Affiliation(s)
- Daniel Galvin
- Department of Obstetrics and Gynaecology, College of Medicine and Health, University College Cork, Ireland.
| | - Barry O'Reilly
- Department of Obstetrics and Gynaecology, College of Medicine and Health, University College Cork, Ireland
| | - Richard Greene
- Department of Obstetrics and Gynaecology, College of Medicine and Health, University College Cork, Ireland
| | - Keelin O'Donoghue
- Department of Obstetrics and Gynaecology, College of Medicine and Health, University College Cork, Ireland; INFANT Research Centre, University College Cork, Cork, Ireland
| | - Orfhlaith O'Sullivan
- Department of Obstetrics and Gynaecology, College of Medicine and Health, University College Cork, Ireland
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Bocanegra JO, Gallup J, Hou M, Gubi AA, Fan CH, Yang NJ, Perihan C. COVID-19, Mental Health, Technology Use, and Job Satisfaction Among School Psychology Trainers. Contemp Sch Psychol 2023:1-12. [PMID: 36747888 PMCID: PMC9893972 DOI: 10.1007/s40688-023-00449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic threatens to exacerbate the school psychology personnel crisis. There is a dearth of knowledge regarding how the pandemic has impacted school psychology trainers and course delivery. In this national study, 92 school psychology trainers completed an online questionnaire regarding technological instructional changes, job satisfaction, and their own mental health well-being during the pandemic. Findings suggest that during the portion of the pandemic assessed most trainers reported that they: (a) switched from in-person instruction to primarily online instruction, (b) were mostly satisfied with their jobs, and (c) generally experienced a positive sense of well-being. Furthermore, a sizable portion of those that switched to a mixture of hybrid and online instruction during the pandemic endorsed that they are likely to continue to use these modalities after the pandemic subsides. Unfortunately, although school psychology trainers presented as generally resilient workforce during the pandemic, almost 20% participants screened positive for possible depression.
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Affiliation(s)
- Joel O. Bocanegra
- Department of School Psychology and Educational Leadership, Idaho State University, 921 S 8Th Ave, Stop 8059,
, Pocatello, ID USA
| | - Jennifer Gallup
- Teaching and Educational Studies, Idaho State University, Pocatello, USA
| | - Minghui Hou
- Educational Foundations and Leadership, Old Dominion University, Norfolk, USA
| | - Aaron A. Gubi
- Advanced Studies in Psychology, Kean University, Union and Hillside, USA
| | - Chung-Hau Fan
- Department of School Psychology and Educational Leadership, Idaho State University, 921 S 8Th Ave, Stop 8059,
, Pocatello, ID USA
| | - Nai-Jiin Yang
- Department of Psychology, Utah State University, Logan, USA
| | - Celal Perihan
- Teaching and Educational Studies, Idaho State University, Pocatello, USA
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Jiang S, Ning CF. Interactive communication in the process of physical education: are social media contributing to the improvement of physical training performance. Univers Access Inf Soc 2022; 22:1-10. [PMID: 36091494 PMCID: PMC9443638 DOI: 10.1007/s10209-022-00911-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
The development of modern technologies and the use of social networks create an environment for the exchange of information, interactive communication, learning, and optimization of various processes. The study describes the results of the effectiveness of using various social media tools to increase the level of physical activity in people of different ages (12-35 years old). Effective tools for increasing the level of physical activity that can be used on social media have been considered. A survey created in Google forms was conducted to select research participants and group them; the pedagogical experiment is the introduction of social media tools to encourage users to do sports. The experiment involved 148 people of different age groups: adolescents, students, adults. After the experiment with the experimental group, there were 59.20% of participants with an average level of physical activity and 22.37% of participants with a high level of physical activity; in the control group, 31.58% of participants had a low level of physical activity, 48.70%-average, 10.53%-high. Most participants of all ages (88.16%) refrained from posting videos of their achievements on social media, while nine participants (5 pupils and 4 students) posted their achievements in the form of short video exercises or screenshots, and reports of exercises in mobile applications in their groups. The research results are applicable to various social groups and can be used to create private groups on social media to encourage physical activity. The data obtained can be used for further development of specialized training programs using digital technology and social networks.
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Affiliation(s)
- Suyi Jiang
- Department of Physical Education, Hohai University, Nanjing, China
| | - Chang Feng Ning
- Institute of Physical Education, Yancheng Institute of Technology, Yancheng, China
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Abstract
Aims Simultaneous bilateral total knee arthroplasty (TKA) has been used due to its financial advantages, overall resource usage, and convenience for the patient. The training model where a trainee performs the first TKA, followed by the trainer surgeon performing the second TKA, is a unique model to our institution. This study aims to analyze the functional and clinical outcomes of bilateral simultaneous TKA when performed by a trainee or a supervising surgeon, and also to assess these outcomes based on which side was done by the trainee or by the surgeon. Methods This was a retrospective cohort study of all simultaneous bilateral TKAs performed by a single surgeon in an academic institution between May 2003 and November 2017. Exclusion criteria were the use of partial knee arthroplasty procedures, staged bilateral procedures, and procedures not performed by the senior author on one side and the trainee on another. Primary clinical outcomes of interest included revision and re-revision. Primary functional outcomes included the Oxford Knee Score (OKS) and patient satisfaction scores. Results In total, 315 patients (630 knees) were included for analysis. Of these, functional scores were available for 189 patients (378 knees). There was a 1.9% (n = 12) all-cause revision rate for all knees. Overall, 12 knees in ten patients were revised, and both right and left knees were revised in two patients. The OKS and patient satisfaction scores were comparable for trainees and supervising surgeons. A majority of patients (88%, n = 166) were either highly likely (67%, n = 127) or likely (21%, n = 39) to recommend bilateral TKAs to a friend. Conclusion Simultaneous bilateral TKA can be used as an effective teaching model for trainees without any significant impact on patient clinical or functional outcomes. Excellent functional and clinical outcomes in both knees, regardless of whether the performing surgeon is a trainee or supervising surgeon, can be achieved with simultaneous bilateral TKA. Cite this article: Bone Jt Open 2022;3(1):29–34.
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Affiliation(s)
- Gerard A Sheridan
- Division of Lower Limb Reconstruction and Oncology, The University of British Columbia, Vancouver, Canada
| | - Rotem Moshkovitz
- Division of Lower Limb Reconstruction and Oncology, The University of British Columbia, Vancouver, Canada
| | - Bassam A Masri
- Division of Lower Limb Reconstruction and Oncology, The University of British Columbia, Vancouver, Canada
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Vignesh S, Butt AS, Alboraie M, Martins BC, Piscoya A, Tran QT, Yew DTM, Ghazanfar S, Alavinejad P, Kamau E, Verma AM, Mendelsohn RB, Khor C, Moss A, Liao DWC, Huang CS, Tsai FC. Impact of COVID-19 on Endoscopy Training: Perspectives from a Global Survey of Program Directors and Endoscopy Trainers. Clin Endosc 2021; 54:678-687. [PMID: 34619833 PMCID: PMC8505182 DOI: 10.5946/ce.2021.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/25/2021] [Indexed: 12/26/2022] Open
Abstract
Background/Aims The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education.
Methods Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on.
Results The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching.
Conclusions This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.
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Affiliation(s)
- Shivakumar Vignesh
- Division of Gastroenterology and Hepatology, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Amna Subhan Butt
- Section of Gastroenterology, Aga Khan University Hospital, Karachi, Pakistan
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Bruno Costa Martins
- University of Sao Paulo Institute of Cancer of Sao Paulo State, Sao Paulo, Brazil
| | | | - Quang Trung Tran
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Damien Tan Meng Yew
- Department of Gastroenterology, Duke, NUS Medical School, Singapore General Hospital, Singapore, Singapore
| | - Shahriyar Ghazanfar
- Department of Surgery, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, Pakistan
| | - Pezhman Alavinejad
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Edna Kamau
- Department of Clinical medicine and Therapeutics University of Nairobi, Nairobi, Kenya
| | - Ajay M Verma
- Consultant Gastroenterologist & Physician Kettering General Hospital NHS, Kettering, UK
| | - Robin B Mendelsohn
- Gastroenterology, Hepatology and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Christopher Khor
- Department of Gastroenterology & Hepatology, Singapore General Hospital , Duke-NUS Medical School, Singapore, Singapore
| | - Alan Moss
- Western Health and University of Melbourne, Melbourne, Australia
| | - David Wei Chih Liao
- Department of Internal Medicine National Taiwan University Hospital, Taipei, Taiwan
| | - Christopher S Huang
- Section of Gastroenterology, Boston University School of Medicine, Boston, USA
| | - Franklin C Tsai
- Division of Gastroenterology, Scripps Clinic - Scripps Green Hospital, Scripps Green Hospital, San Diego, USA
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Dennis AA, Foy MJ, Monrouxe LV, Rees CE. Exploring trainer and trainee emotional talk in narratives about workplace-based feedback processes. Adv Health Sci Educ Theory Pract 2018; 23:75-93. [PMID: 28456856 PMCID: PMC5801389 DOI: 10.1007/s10459-017-9775-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/17/2017] [Indexed: 06/01/2023]
Abstract
Emotion characterises learners' feedback experiences. While the failure-to-fail literature suggests that emotion may be important, little is known about the role of emotion for educators. Secondary analyses were therefore conducted on data exploring 110 trainers' and trainees' feedback experiences. Group and individual narrative interviews were conducted across three UK sites. We analysed 333 narratives for emotional talk using textual analysis: Linguistic Inquiry and Word Count. Furthermore, thematic framework analysis was conducted on the trainer narratives to explore aspects of feedback processes that are emotional. An additional in-depth little 'd' discourse analysis was conducted on selected trainer narratives to enable us to explore the complex relationship between the whats (reported events) and the hows (emotional talk). Trainer narratives did not differ significantly in positive or negative emotional talk from trainee narratives. By exploring the interplay of the whats and the hows, several aspects of feedback processes were identified as potentially emotional for trainers including trainers being concerned about upsetting learners and worried about patient safety. This was illustrated through numerous linguistic devices to establish emotional tone such as metaphoric talk and laughter. These findings suggest that feedback processes can be emotional for trainers. It highlights the need to better understand the 'filter' of emotion for trainers but also to better understand how emotion plays a role in feedback as a complex social process.
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Affiliation(s)
- A A Dennis
- Centre for Medical Education, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, Scotland, UK.
| | - M J Foy
- Centre for Medical Education, School of Medicine, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, Scotland, UK
| | - L V Monrouxe
- Chang Gung Medical Education Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - C E Rees
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Abstract
The predominant approach to training dogs and modifying their behavior has been steeped in antiquated theories of dominance and pack leadership that are not based in scientific evidence. Animals learn best through associative and consequential interactions. Using the most current evidence-based techniques, while acknowledging that each pet is an individual, results in more effective behavior modification.
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Doctor M, Katz A, McNamara SO, Leifer JH, Bambrick-Santoyo G, Saul T, Rose KM. A novel method for creating custom shaped ballistic gelatin trainers using plaster molds. J Ultrasound 2018; 21:61-64. [PMID: 29374397 DOI: 10.1007/s40477-017-0274-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 10/28/2017] [Indexed: 11/30/2022] Open
Abstract
Simulation based procedural training is an effective and frequently used method for teaching vascular access techniques which often require commercial trainers. These can be prohibitively expensive, which allows for homemade trainers made of gelatin to be a more cost-effective and attractive option. Previously described trainers are often rectangular with a flat surface that is dissimilar to human anatomy. We describe a novel method to create a more anatomically realistic trainer using ballistic gelatin, household items, and supplies commonly found in an emergency department such as the plaster wrap typically used to make splints.
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Affiliation(s)
- Michael Doctor
- Mount Sinai St. Luke's Mount Sinai West Hospitals, New York, NY, USA.
| | - Anne Katz
- Mount Sinai St. Luke's Mount Sinai West Hospitals, New York, NY, USA
| | | | - Jessica H Leifer
- Mount Sinai St. Luke's Mount Sinai West Hospitals, New York, NY, USA
| | | | - Turandot Saul
- Mount Sinai St. Luke's Mount Sinai West Hospitals, New York, NY, USA
| | - Keith M Rose
- Mount Sinai St. Luke's Mount Sinai West Hospitals, New York, NY, USA
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Druker I, Gesser-Edelsburg A. Identifying and assessing views among physically-active adult gym members in Israel on dietary supplements. J Int Soc Sports Nutr 2017; 14:37. [PMID: 28947895 PMCID: PMC5609049 DOI: 10.1186/s12970-017-0194-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sports dietary supplements are available for sale in public places including sports clubs. Although there is uncertainty regarding their safety, many gym members who regularly work out consume them. The present study aimed to identify the approaches and perspectives of the public who work out in gyms and take dietary supplements. It examined how professionals view sports dietary supplement consumption, and how they communicate this issue to gym members. The literature discusses the prevalence of SDS use among athletes, but rarely discusses or compares between the risk perceptions of gym members, trainers, and dietitians, who represent the physically-active general public, regarding SDS. METHODS We conducted constructivist qualitative research in semi-structured one-on-one interviews (n = 34). We held in-depth interviews (n = 20) with a heterogeneous population of adult gym members who take dietary supplements, and (n = 14) with dietitians and fitness trainers. RESULTS The main finding was a gap in risk perception of dietary supplement use between dietitians, gym members and fitness trainers. There was low risk perception among dietary supplements consumers. Trainers believed that benefits of supplement consumption exceeded risk, and therefore they did not convey a message to their clients about risk. In contrast, dietitians interviewed for this study renounced general use of sports dietary supplements and doubted whether trainers had proper nutritional knowledge to support it. CONCLUSION Lack of awareness of risks suggests that there is a need for communication on this issue. We recommend that professionals (physicians and dietitians) be present in sports clubs that sell such products in an uncontrolled way.
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Affiliation(s)
- Inbal Druker
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838 Haifa, Israel.,The Zinman College of Physical Education and Sport Sciences, Wingate Institute, 42902 Netanya, Israel
| | - Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838 Haifa, Israel.,Health Promotion Program, School of Public Health, Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838 Haifa, Israel
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Kelly GA, Rowan FE, Hurson C. Factors influencing radiation exposure during internal fixation of hip fractures. Eur J Orthop Surg Traumatol 2017; 27:637-41. [PMID: 28396949 DOI: 10.1007/s00590-017-1951-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
The use of fluoroscopy is of great importance for operative fixation of fractures. Previous studies have shown an increased fluoroscopy time for intramedullary nails and with junior surgeons in comparison with more experienced surgeons. We examined the impact of operation length on fluoroscopy dose, cumulative fluoroscopy time between consultant and registrar surgeons and cumulative fluoroscopy time between dynamic hip screw and intramedullary nailing. We performed a retrospective cohort study of all patients admitted to our centre over the period of 1 year. Patients who underwent dynamic hip screw (DHS) or intramedullary (IM) nailing were identified from our in-hospital hip fracture database. Intraoperative fluoroscopy images were then accessed through our hospital's medical imaging software. A total of 137 patients were identified. Fluoroscopy reports were not available for 49 patients, resulting in a final total of 88 patients. Patients whose operation lasted longer than 1 h received a statistically significant higher dose of radiation (183.83 cGYM2 vs. 368.22 cGYM2; p value 0.0002). Operations performed by a consultant resulted in less cumulative fluoroscopy time in comparison with those performed by a registrar or specialist registrar although this was not statistically significant (00:00:53 vs. 00:00:45; p vaue 0.38). Cumulative fluoroscopy time was less in dynamic hip screw compared to long intramedullary nails (00:00:39 vs. 00:01:29; p value <0.001) and short intramedullary nails (00:00:39 vs. 00:01:52; p value 0.387). Studies, which had a cumulative fluoroscopy time exceeding 50 secs, delivered a higher radiation dose (434.34cGYM2 vs. 150.51cGYM2; p value <0.001). We concluded that there is no significant impact in cumulative fluoroscopy time in operations performed by either a registrar or consultant. Dynamic hip screws have a lower fluoroscopy time in comparison with long intramedullary nails.
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Abstract
BACKGROUND Opportunities for surgical skills practice using high-fidelity simulation in the workplace are limited due to cost, time and geographical constraints, and accessibility to junior trainees. An alternative is needed to practise laparoscopic skills at home. Our objective was to undertake a systematic review of low-cost laparoscopic simulators. METHOD A systematic review was undertaken according to PRISMA guidelines. MEDLINE/EMBASE was searched for articles between 1990 and 2014. We included articles describing portable and low-cost laparoscopic simulators that were ready-made or suitable for assembly; articles not in English, with inadequate descriptions of the simulator, and costs >£1500 were excluded. Validation, equipment needed, cost, and ease of assembly were examined. RESULTS Seventy-three unique simulators were identified (60 non-commercial, 13 commercial); 55 % (33) of non-commercial trainers were subject to at least one type of validation compared with 92 % (12) of commercial trainers. Commercial simulators had better face validation compared with non-commercial. The cost ranged from £3 to £216 for non-commercial and £60 to £1007 for commercial simulators. Key components of simulator construction were identified as abdominal cavity and wall, port site, light source, visualisation, and camera monitor. Laptop computers were prerequisite where direct vision was not used. Non-commercial models commonly utilised retail off-the-shelf components, which allowed reduction in costs and greater ease of construction. CONCLUSION The models described provide simple and affordable options for self-assembly, although a significant proportion have not been subject to any validation. Portable simulators may be the most equitable solution to allow regular basic skills practice (e.g. suturing, knot-tying) for junior surgical trainees.
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Affiliation(s)
- Mimi M Li
- Faculty of Medicine, Imperial College London, London, UK.
| | - Joseph George
- Department of Cardiothoracic Surgery, Morriston Hospital, Swansea, UK
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Mbanjumucyo G, DeVos E, Pulfrey S, Epino HM. State of emergency medicine in Rwanda 2015: an innovative trainee and trainer model. Int J Emerg Med 2015; 8:20. [PMID: 26101554 PMCID: PMC4471068 DOI: 10.1186/s12245-015-0067-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/28/2015] [Indexed: 11/18/2022] Open
Abstract
The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country’s economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countries in the world, Rwanda has made remarkable gains in health, social, and economic development over the last 20 years, but modern emergency care has been slow to progress. Rwanda has recently established the Human Resources for Health program to rapidly build capacity in multiple sectors of its healthcare delivery system, including emergency medicine. This project involves multiple medical and surgical residencies, nursing programs, allied health professional trainings, and hospital administrative support. A real strength of the program is that trainers work with international faculty at Rwanda’s referral hospital, but also as emergency medicine specialty trainers when returning to their respective district hospitals. Rwanda’s first emergency medicine trainees are playing a unique and important role in the implementation of emergency care systems and education in the country’s district hospitals. While there has been early vital progress in building emergency medicine’s foundations in Rwanda, there remains much work to be done. This will be accomplished with careful planning and strong commitment from the country’s healthcare and emergency medicine leaders.
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Affiliation(s)
- Gabin Mbanjumucyo
- Department of Emergency Medicine, Masaka District Hospital, P.O. Box 3472, Kigali, Rwanda ; University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Elizabeth DeVos
- University Teaching Hospital of Kigali, Kigali, Rwanda ; Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, 655 West 8th Street, Jacksonville, FL USA
| | - Simon Pulfrey
- University Teaching Hospital of Kigali, Kigali, Rwanda ; Department of Emergency Medicine, University of British Columbia, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC Canada
| | - Henry M Epino
- Department of Emergency Medicine, Massachusetts General Hospital, Zero Emerson Place, Boston, MA USA
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