Examining the Feasibility, Acceptability, and Effectiveness of Remote Training on Community-Based Participatory Research: Single-Arm Pre-Post Pilot Study

BACKGROUND

Over the past decade, a growing body of scientific evidence has demonstrated that community engagement in research leads to more relevant research, enhances the uptake of research findings, and improves clinical outcomes. Despite the increasing need for the integration of community engagement methodologies into the scientific inquiry, doctoral and master's level competencies in the field of psychiatry often lack dedicated training or coursework on community engagement methodologies.

OBJECTIVE

A total of 13 service users, peer support specialists, caregivers of people with mental health challenges, and scientists (with specialties ranging from basic science to implementation science) aged 18 and older participated in remote training on community-based participatory research. Data were collected at baseline, 2 days, and 3 months.

METHODS

A total of 13 service users, peer support specialists, caregivers of people with mental health challenges, and scientists (with specialties ranging from basic science to implementation science) aged 18 and older participated in remote training on community-based participatory research. Data were collected at baseline, 2 days, and 3 months.

RESULTS

The pilot study demonstrated that a 3-month remote training on community-based participatory research ("Partnership Academy") was deemed feasible and acceptable by service users, peer support specialists, caregivers of people with mental health challenges, and scientists. Improvements were found in research engagement and the quality of partnership. A marked increase in distrust in the medical system was also found. Groups submitted 4 grant applications and published 1 peer-reviewed journal at a 3-month follow-up.

CONCLUSIONS

This pre- and postpilot study demonstrated it is possible to train groups of service users, peer support specialists, caregivers of people with mental health challenges, and scientists in community-based participatory research. These findings provide preliminary evidence that a 3-month remote training on community-based participatory research ("Partnership Academy") is feasible, acceptable, and potentially associated with improvements in research engagement as well as the quality of partnership and output, such as manuscripts and grant applications.

Evaluation of an adapted virtual training for master trainers of the WHO Caregiver Skills Training Program during the COVID-19 pandemic

LAY ABSTRACT

The COVID-19 pandemic interrupted in-person professional activities. We developed and evaluated a remote training approach for master trainers of the Caregiver Skills Training Program. Master trainers support community practitioners, who in turn deliver the Caregiver Skills Training Program to caregivers of children with developmental delays or disabilities. The Caregiver Skills Training Program teaches caregivers how to use strategies to enhance learning and interactions during everyday play and home activities and routines with their child. The aim of this study was to evaluate the remote training of master trainers on Caregiver Skills Training Program. Twelve out of the 19 practitioners who enrolled in the training completed the study. The training consisted of a 5-day in-person session completed prior to the pandemic, followed by supporting participants' ability to identify Caregiver Skills Training Program strategies through coding of video recordings over 7 weekly meetings and group discussions and ended with participants independently coding a set of 10 videos for Caregiver Skills Training Program strategies. We found all but one participant was able to reliably identify Caregiver Skills Training Program strategies from video recordings despite a lack of ability to practice the Caregiver Skills Training Program strategies with children due to the pandemic. Taken together, our findings illustrate the feasibility and value of remote training approaches in implementing interventions.

An Educational Program for Remote Training and Supervision of Home-Based Transcranial Electrical Stimulation: Feasibility and Preliminary Effectiveness

OBJECTIVES

There has been recent interest in the administration of transcranial electrical stimulation (tES) by a caregiver, family member, or patient themselves while in their own homes (HB-tES). The need to properly train individuals in the administration of HB-tES is essential, and the lack of a uniform training approach across studies has come to light. The primary aim of this paper is to present the HB-tES training and supervision program, a tele-supervised, instructional, and evaluation program to teach laypersons how to administer HB-tES to a participant and to provide a standardized framework for remote monitoring of participants by teaching staff. The secondary aim is to present early pilot data on the feasibility and effectiveness of the training portion of the program based on its implementation in 379 sessions between two pilot clinical trials.

MATERIALS AND METHODS

The program includes instructional materials, standardized tele-supervised hands-on practice sessions, and a system for remote supervision of participants by teaching staff. Nine laypersons completed the training program. Data on the feasibility and effectiveness of the program were collected.

RESULTS

No adverse events were reported during the training or any of the HB-tES sessions after the training. All laypersons successfully completed the training. The nine laypersons reported being satisfied with the training program and confident in their tES administration capabilities. This was consistent with laypersons requiring technical assistance from teaching staff very infrequently during the 379 completed sessions. The average adherence rate between all administrators was >98%, with seven of nine administrators having 100% adherence to the scheduled sessions.

CONCLUSIONS

These findings indicate that the HB-tES program is effective and is associated with participant satisfaction.

SIGNIFICANCE

We hope that the remote nature of this training program will facilitate increased accessibility to HB-tES research for participants of different demographics and locations. This program, designed for easy adaptation to different HB-tES research applications and devices, also is accessible online. The adoption of this program is expected to facilitate uniformity of study methods among future HB-tES studies and thereby accelerate the pace of tES intervention discovery.

Capacity Building in Remote Facilitation of Newborn Resuscitation

The past decade has been notable for widespread dissemination of newborn resuscitation training in low-resource settings through simplified training programs including Helping Babies Breathe. Since 2020, implementation efforts have been impacted by restrictions on travel and in-person gatherings with the SARS-CoV-2 pandemic, prompting the development of alternative methods of training. While previous studies have demonstrated feasibility of remote neonatal resuscitation training, this perspective paper covers common barriers identified and key lessons learned developing a cadre of remote facilitators. Challenges of remote facilitation include mastering videoconferencing platforms, establishing personal connections, and providing effective oversight of skills practice. Training sessions can be used to support facilitators in acquiring comfort and competency in harnessing videoconferencing platforms for effective facilitation. Optimization of approaches and investment in capacity building of remote facilitators are imperative for effective implementation of remote neonatal resuscitation training.

Evaluation of a Telehealth Training Package to Remotely Teach Caregivers to Conduct Discrete-Trial Instruction

The present study evaluated the effectiveness of using telehealth technologies to remotely train caregivers of children with ASD to conduct discrete-trial instruction (DTI). We used a multiple-baseline-across-participants design to evaluate caregiver correct implementation of the DTI procedures and child emission of independent correct tacts as dependent measures. We observed robust and immediate improvements for all three caregivers and two of three children. Treatment effects were maintained during follow-up and generalization probes. We discuss the benefits of telehealth technologies and other remote treatment applications.

Developing and Delivering Behavioral Interventions Through Telehealth

This special issue on telehealth in Behavior Modification features 10 studies related to developing and delivering behavioral interventions through telehealth. The studies in this issue cover a variety of topics including using telehealth to train caregivers, training clinicians to use telehealth, and directly implementing interventions or assessments through telehealth. The special issue concludes with a comprehensive literature review examining variables that impact the effectiveness of telehealth as a service-delivery tool.

Watching me … watching you: Training and assessment in a virtual world

Virtual education isn't new. Teaching has been delivered remotely for many years, although it came to prominence with the enforced move to online learning during the COVID-19 pandemic. Technologies provide tools that are integral to our everyday lives, and training and assessment are no different. Stepping back from the obligatory remote delivery of practical skills training, now we have the opportunity to review and evaluate our own learning (as educators) about the value of resources for training delivery. Combining sound educational principles with the available technologies, we can use remotely delivered learning to enhance our teaching and to increase access to learning, without hindrance because of distance or the type of facility. Remote connections allow expertise and best practice to become suddenly available to a wider cohort of researchers, rapidly spreading new ideas about refinement of in vivo procedures and supporting colleagues to learn and develop. We currently use only a few of the technological tools available, and there is much to learn from other disciplines where virtual and augmented reality are assisting surgeons, aircraft pilots and others daily. By harnessing remote and assisted technologies in teaching, we can also develop the mindset and ability of the biomedical community to use them to augment, or even to replace, animal studies in future and to democratise training globally.

Athlete level, sport-type, and gender influences on training, mental health, and sleep during the early COVID-19 lockdown in Malaysia

Purpose: We evaluated the extent of changes in training practices, recovery, mental health, and sleep patterns of athletes during the early COVID-19 lockdown in a single country-cohort. Methods: A total of 686 athletes (59% male, 41% female; 9% World Class, 28% International, 29% National, 26% State, 8% Recreational) from 50 sports (45% individual, 55% team) in Malaysia completed an online, survey-based questionnaire study. The questions were related to training practices (including recovery and injury), mental health, and sleep patterns. Results: Relative to pre-lockdown, training intensity (-34%), frequency (-20%, except World-Class), and duration (-24%-59%, especially International/World-Class) were compromised, by the mandated lockdown. During the lockdown, more space/access (69%) and equipment (69%) were available for cardiorespiratory training, than technical and strength; and these resources favoured World-Class athletes. Most athletes trained for general strength/health (88%) and muscular endurance (71%); and some used innovative/digital training tools (World-Class 48% vs. lower classification-levels ≤34%). More World-Class, International, and National athletes performed strength training, plyometrics, and sport-specific technical skills with proper equipment, than State/Recreational athletes. More females (42%) sourced training materials from social media than males (29%). Some athletes (38%) performed injury prevention exercises; 18% had mild injuries (knees 29%, ankles 26%), and 18% received a medical diagnosis (International 31%). Lower-level athletes (e.g., State 44%) disclosed that they were mentally more vulnerable; and felt more anxious (36% vs. higher-levels 14%-21%). Sleep quality and quantity were "normal" (49% for both), "improved" (35% and 27%), and only 16% and 14% (respectively) stated "worsened" sleep. Conclusion: Lockdown compromised training-related practices, especially in lower-level athletes. Athletes are in need of assistance with training, and tools to cope with anxiety that should be tailored to individual country requirements during lockdown situations. In particular, goal-driven (even if it is at home) fitness training, psychological, financial, and lifestyle support can be provided to reduce the difficulties associated with lockdowns. Policies and guidelines that facilitate athletes (of all levels) to train regularly during the lockdown should be developed.

Training Practices of Football Players During the Early COVID-19 Lockdown Worldwide

The COVID-19 lockdown challenged the training options of athletes worldwide, including players from the most popular sport globally, football/soccer.

PURPOSE

The authors explored the training practices of football players worldwide during the COVID-19 lockdown.

METHODS

Football players (N = 2482, 30% professional, 22% semipro, and 48% amateur) completed an online survey (May-July 2020) on their training practices before versus during lockdown (March-June 2020). Questions were related to training frequency and session duration, as well as training knowledge and attitudes.

RESULTS

Before lockdown, more professional (87%) than semipro (67%) and amateur (65%) players trained ≥5 sessions/wk, but this proportion decreased during the lockdown to 55%, 35%, and 42%, respectively. Players (80%-87%) trained ≥60 minutes before lockdown, but this proportion decreased to 45% in professionals, 43% in amateurs, and 36% in semipros during lockdown. At home, more than two-thirds of players had training space (73%) and equipment (66%) for cardiorespiratory training, while availability of equipment for technical and strength training was <50% during lockdown. Interactions between coach/trainer and player were more frequent (ie, daily) among professional (27%) than amateur (11%) and semipro (17%) players. Training load monitoring, albeit limited, was mostly performed by fitness coaches, more so with professionals (35%) than amateurs (13%) and semipros (17%). The players' training knowledge and attitudes/beliefs toward training were relatively modest (50%-59%).

CONCLUSION

COVID-19 lockdown negatively affected training practices of football players worldwide, especially amateurs and semipros, for example, in training frequency, duration, intensity, technical, recovery, and other fitness training and coaching-related aspects. During lockdown-like situations, players should be monitored closely and provided appropriate support to facilitate their training.

Training Infrastructure as a Service

BACKGROUND

Hands-on training, whether in bioinformatics or other domains, often requires significant technical resources and knowledge to set up and run. Instructors must have access to powerful compute infrastructure that can support resource-intensive jobs running efficiently. Often this is achieved using a private server where there is no contention for the queue. However, this places a significant prerequisite knowledge or labor barrier for instructors, who must spend time coordinating deployment and management of compute resources. Furthermore, with the increase of virtual and hybrid teaching, where learners are located in separate physical locations, it is difficult to track student progress as efficiently as during in-person courses.

FINDINGS

Originally developed by Galaxy Europe and the Gallantries project, together with the Galaxy community, we have created Training Infrastructure-as-a-Service (TIaaS), aimed at providing user-friendly training infrastructure to the global training community. TIaaS provides dedicated training resources for Galaxy-based courses and events. Event organizers register their course, after which trainees are transparently placed in a private queue on the compute infrastructure, which ensures jobs complete quickly, even when the main queue is experiencing high wait times. A built-in dashboard allows instructors to monitor student progress.

CONCLUSIONS

TIaaS provides a significant improvement for instructors and learners, as well as infrastructure administrators. The instructor dashboard makes remote events not only possible but also easy. Students experience continuity of learning, as all training happens on Galaxy, which they can continue to use after the event. In the past 60 months, 504 training events with over 24,000 learners have used this infrastructure for Galaxy training.

Effect of an Online Mindfulness Course for Hospital Doctors During COVID-19 Pandemic on Resilience and Coping

INTRODUCTION

Physicians' wellbeing is a priority to prevent increasing rates of poor mental health and burnout, exacerbated by caregiving during the COVID-19 pandemic. Structured mindfulness courses have been shown to be beneficial, but face-to-face delivery is not always feasible in the context of busy health services. Remotely delivered structured mindfulness courses could enable wider participation, particularly at time when social distancing to prevent infection transmission is necessary. Our objective was to test the feasibility of a remotely delivered structured mindfulness course for hospital doctors during the COVID-19 pandemic.

METHODS

This was a feasibility study run at one English hospital between January and March 2021, when COVID-19 admissions were at a high. Interested doctors participated in a 6-session remotely delivered mindfulness course. Sessions lasted 90 min and could be attended on-line or the recording watched at later time. Main outcome measures were data on interest, course attendance and engagement, together with validated psychological outcome measures at baseline and follow-up after course completion.

RESULTS

20 doctors expressed interest to participate and 16 started the course. Of these, 12 completed at least 3 sessions (median = 4); difficulty attending resulted from conflicting clinical commitments and rosters. Twelve participants completed the follow-up survey. They rated the course highly and all perceived it to have been useful, with statistically significant (P < .01) improvements in wellbeing and mindfulness scores. They all stated that they would recommend this course to their colleagues and most (10/12) were interested in follow-up mindfulness sessions.

CONCLUSION

Remotely delivered structured mindfulness training for hospital doctors was feasible, but there is a need to address the difficulties that affected attendance in order to optimize accessibility and completion of such programs.

COVID-19 Lockdown: A Global Study Investigating the Effect of Athletes' Sport Classification and Sex on Training Practices

PURPOSE

To investigate differences in athletes' knowledge, beliefs, and training practices during COVID-19 lockdowns with reference to sport classification and sex. This work extends an initial descriptive evaluation focusing on athlete classification.

METHODS

Athletes (12,526; 66% male; 142 countries) completed an online survey (May-July 2020) assessing knowledge, beliefs, and practices toward training. Sports were classified as team sports (45%), endurance (20%), power/technical (10%), combat (9%), aquatic (6%), recreational (4%), racquet (3%), precision (2%), parasports (1%), and others (1%). Further analysis by sex was performed.

RESULTS

During lockdown, athletes practiced body-weight-based exercises routinely (67% females and 64% males), ranging from 50% (precision) to 78% (parasports). More sport-specific technical skills were performed in combat, parasports, and precision (∼50%) than other sports (∼35%). Most athletes (range: 50% [parasports] to 75% [endurance]) performed cardiorespiratory training (trivial sex differences). Compared to prelockdown, perceived training intensity was reduced by 29% to 41%, depending on sport (largest decline: ∼38% in team sports, unaffected by sex). Some athletes (range: 7%-49%) maintained their training intensity for strength, endurance, speed, plyometric, change-of-direction, and technical training. Athletes who previously trained ≥5 sessions per week reduced their volume (range: 18%-28%) during lockdown. The proportion of athletes (81%) training ≥60 min/session reduced by 31% to 43% during lockdown. Males and females had comparable moderate levels of training knowledge (56% vs 58%) and beliefs/attitudes (54% vs 56%).

CONCLUSIONS

Changes in athletes' training practices were sport-specific, with few or no sex differences. Team-based sports were generally more susceptible to changes than individual sports. Policy makers should provide athletes with specific training arrangements and educational resources to facilitate remote and/or home-based training during lockdown-type events.

[Development of Clinical Practice in Adult Nursing (Chronic Care) During the COVID-19 Pandemic - Building and Implementing an Online Training Program]

The Department of Nursing, School of Health Sciences, University of Occupational and Environmental Health provides the specialized course "Clinical Practice in Adult Nursing (Chronic Care)" as a compulsory subject for third- and fourth-year students to acquire the basic skills required in nursing practice for adult patients with chronic diseases. Students are trained in hospital wards and in outpatient medical departments/admission support units for a total of 3 weeks to communicate directly with patients with chronic diseases, and to deepen their learning about the specialty of chronic nursing care. The COVID-19 pandemic forced the Department of Nursing to hold prompt discussions and determine an appropriate method to provide clinical training under this situation. It decided to cancel the conventional face-to-face training program, which was scheduled to start in May 2020, and to implement an online training program instead. Remote training was provided using the online conferencing system Zoom. The online training program was designed to realize simultaneous bidirectional training. To prepare for the training, simulated cases and simulated medical records were created. Faculty members played the roles of "simulated patients", "clinical supervisors", and "faculty members", while adopting elaborate approaches to help students develop nursing practice in real time. As a result, students were able to participate in training with a real feeling, even in an online environment, as they communicated with simulated patients daily, similarly to the case of clinical training. They also realized the limitations of learning without using the five physial senses and providing patient support with appropriate timing, revealing challenges specific to online training.

Creating a Proficiency-based Remote Laparoscopic Skills Curriculum for the COVID-19 Era

OBJECTIVE

Social distancing restrictions due to COVID-19 challenged our ability to educate incoming surgery interns who depend on early simulation training for basic skill acquisition. This study aimed to create a proficiency-based laparoscopic skills curriculum using remote learning.

DESIGN

Content experts designed 5 surgical tasks to address hand-eye coordination, depth perception, and precision cutting. A scoring formula was used to measure performance: cutoff time - completion time - (K × errors) = score; the constant K was determined for each task. As a benchmark for proficiency, a fellowship-trained laparoscopic surgeon performed 3 consecutive repetitions of each task; proficiency was defined as the surgeon's mean score minus 2 standard deviations. To train remotely, PGY1 surgery residents (n = 29) were each issued a donated portable laparoscopic training box, task explanations, and score sheets. Remote training included submitting a pre-test video, self-training to proficiency, and submitting a post-test video. Construct validity (expert vs. trainee pre-tests) and skill acquisition (trainee pre-tests vs. post-tests) were compared using a Wilcoxon test (median [IQR] reported).

SETTING

The University of Texas Southwestern Medical Center in Dallas, Texas PARTICIPANTS: Surgery interns RESULTS: Expert and trainee pre-test performance was significantly different for all tasks, supporting construct validity. One trainee was proficient at pre-test. After 1 month of self-training, 7 additional residents achieved proficiency on all 5 tasks after 2-18 repetitions; trainee post-test scores were significantly improved versus pre-test on all tasks (p = 0.01).

CONCLUSIONS

This proficiency-based curriculum demonstrated construct validity, was feasible as a remote teaching option, and resulted in significant skill acquisition. The remote format, including video-based performance assessment, facilitates effective at-home learning and may allow additional innovations such as video-based coaching for more advanced curricula.

Remote training as a common tool for the different professionals involved in the acute phase after terror attacks across Europe: Perspectives from an expert panel

The acute response after a terror attack may have a crucial impact on the physical and psychological wellbeing of the victims. Preparedness of the professionals involved in the acute response is a key element to ensure effective interventions, and can be improved through trainings. Today in Europe there is a recognized lack of inter-professional and international trainings, which are important, among others, to respond to the needs and the rights of victims affected by a terrorist attack in another country than their home country. In this paper we report the perspectives of an expert panel composed by different categories of professionals on the possible role of interprofessional trainings provided remotely. The experts discussed the pertinence of remote trainings for professionals involved in the acute response of a terror attack, and highlighted their Strengths, Weaknesses, Opportunities and Threats (SWOT analysis). We concluded that, while remote trainings cannot replace in-person trainings, they may be useful to share knowledge about the role and the organization of the different categories of professionals, thus potentially improving response coordination, and to easily share good practices across professionals and countries.

Training behavior analysts to conduct functional analyses using a remote group behavioral skills training package

Behavioral skills training (BST) is a well-established procedure used to train individuals how to perform a variety of complex skills. Previous research has used BST to train parents, teachers, and clinicians how to conduct a variety of clinical procedures, including functional analysis of problem behavior. Although this procedure has been demonstrated to be very effective, it can be time consuming and resource intensive. In the present study, 13 behavior analysts were trained to conduct functional analyses of problem behavior. All participants were employees of a multistate early intervention clinic. This staff training was conducted fully remotely, and trainers acted as child role-play partners. Participants experienced baseline, an instruction/discussion component, a post-instruction probe, group BST, and a post-BST probe. For 5 participants, in-situ probes were also conducted. All participants achieved mastery and in-situ errors were low.

Remote Relaxation and Acceptance Training for the Management of Stress in Cancer Patients: A Study Protocol

Background: Cancer patients are now facing a double distinctive challenge of survival against both the disease and fear of contracting COVID-19. This challenge has resulted in the forced adoption of social distancing measures and reorganization of the delivery of medical and psychological treatments. The perceived loneliness and uncertainty increased distress and symptoms burden. In the current period, eHealth interventions might provide valuable benefits in the field of cancer care. Objective: The overall goal of the study protocol will be to provide an innovative intervention for cancer patients based on an online platform, to help them manage and prevent psychological problems related to social isolation. Specifically, the efficacy of two web-based interventions aimed at lowering stress in cancer patients will be tested and compared. Methods: One hundred and fifty participants (75 per group) will be enrolled in a two-group randomized trial. The two interventions will be composed either by exercises on relaxation and meditation practices, presented in both automated online content and interactive group sessions or by fixed psychoeducational online content. Stress, anxiety, and depressive symptoms, distress, resilience, and perceived social isolation will be measured before the start of the interventions (T0), 2 weeks (T1), 4 weeks (T2), and 2 months (T3) after the beginning of the interventions in both groups. A repeated measures ANOVA will be performed to test differences in the questionnaires' scores between groups across the four-time points. Expected Results: We hypothesized greater improvement in the specific domain of stress symptoms (IES-R) assessed in the group receiving the interactive intervention, compared to the group which will receive only fully automated psychoeducational content. Secondarily, we expect the same trend of improvement across all the psychological variables in the blended intervention group. Conclusions: Implementing these practices on people who are forced into mandatory social isolation may help them become more aware of their mind-body condition and reduce negative effects. Moreover, relaxation techniques help individuals in achieving a greater state of well-being, increasing the ability to cope with stressful situations (resilience), and strengthening the immune system.

Emergency Remote Training in Psychoanalysis and Psychotherapy: An Initial Assessment from Columbia

The Covid-19 pandemic and the social distancing required to combat it have set in motion an experiment in psychoanalytic education of unprecedented scope. Following an abrupt shift from in-person study to remote classes, supervision, clinical work, and training analyses, the Columbia University Center for Psychoanalytic Training and Research polled its psychotherapy and psychoanalysis trainees to assess their initial experience of remote training. Most candidates found the technical aspects of online learning easy and were satisfied with remote training overall. Across all programs, most trainees considered class length and reading load about right and felt their class participation was unaffected, though they found it harder to concentrate. Most found it no harder to start a training case, felt the shift to remote supervision had no negative effect, and were satisfied with seeing their training analyst remotely. Most trainees preferred in-person classes, clinical work, and training analyses to those offered remotely, yet in light of the health risks they said they were less likely to continue training in fall 2020 if in-person work resumed. Trainees suggested several modifications of teaching techniques to improve their participation and concentration in class. These findings' implications for the debate regarding remote training in psychoanalysis are explored.

Effective remote staff training of objective session notes

Session notes are a required component of documenting behavior analytic sessions. The direct training of writing objective session notes is important to the success of direct line staff completing adequate documentation and meeting requirements set forth by agencies, certification boards, and insurance funders. However, in-person training is not always immediately available due to contextual restrictions. This study evaluated the effectiveness of implementing the teaching interaction procedure when training staff remotely to objectively document client progress within session notes. Three Registered Behavior Technicians™ (RBT®s) were trained via telehealth to complete session notes objectively. Results showed that all 3 participants met the mastery criterion during probes measuring the objective documentation of home-based behavior analytic sessions. These findings suggest that a training package, such as the teaching interaction procedure, can be effectively implemented remotely when conducting staff training.

Use of technology in facilitating remote caregiver training for token systems

The prevalence of autism continues to rise, yet the ability to receive treatment or caregiver training through traditional in-person methods continues to be a precluding factor for many families. Studies have shown that parent training provides benefits to caregivers and children through increased success of interventions, implementation, and generalization of skills. This study evaluated the effect of using technology for remote caregiver training of a token economy for use during routine non-preferred activities. A multiple-baseline design was implemented across two participants, through three phases. Additional surveys and interviews were conducted to evaluate social validity. Results revealed that caregivers acquired necessary skills to implement the fixed interval schedule of reinforcement with token system and participants reported experiencing greater positive interactions with the children. Limitations of this study included no data were collected on the children's behavior, nor were they trained on token economy use. Extraneous variables may have affected the results, such as unplanned household events. Results suggest that remote caregiver training can increase desirable interactions between caregiver and child, improve socially significant behaviors, and extend resources not typically available to all families.

Remote onboarding and training of new program coordinators into the medical education office during Covid-19 social distance quarantine: process and recommendations

Background

The Medical Education Office at Rochester Regional Health was required to remotely onboard and train its new program coordinators using telework during the Covid-19 quarantine restrictions mandating all non-clinical administrative staff work from home.

Objective

To implement a remote onboarding and training process for new program coordinators that would introduce solutions for learning new tasks, maintain business operations effectively, and prevent employee feelings of isolation.

Method

The System Director of Medical Education implemented eight actionable items to remotely train the new program coordinators, consisting of creating a virtual workday, planning for purposeful learning, developing spreadsheets for process flow, engaging other staff for mini-tutorials, scheduling remote meet and greets, assigning supplemental self-learning modules, establishing standard virtual meeting formats, and conducting regular one to one check-ins.

Results

Recommendations for successful results during training are to be specific in communication, think a step ahead and reassure the employee.

Conclusion

The Medical Education Office successfully used the eight actions as a remote onboarding and training platform for new hires.

Remote skin self-examination training of melanoma survivors and their skin check partners: A randomized trial and comparison with in-person training

Background

Compared with other cancers, melanoma has the longest delays measured as the median time to patient presentation for care from symptom onset. Time to presentation for care is a key determinant of outcomes, including disease stage, prognosis, and treatment.

Methods

Melanoma survivors with localized disease and their skin check partners enrolled in two sequential randomized control trials of skin self‐examination (SSE) training. In Phase 1, the pair read a workbook in the office and had quarterly total body skin examinations with a study dermatologist. In Phase 2, materials were mailed to pairs, whose surveillance was with a community physician. SSE knowledge, performance (frequency and extent), and identification of concerning moles were compared between phases.

Results

Among 341 patients, 197 received the workbook and the others were controls. Knowledge in performing SSE was higher for the workbook relative to controls in both phases. The SSE frequency ranged from 2.38 to 5.97 times in 9 months. Patients randomized to the workbook in both phases performed significantly more SSE than controls at 9 months (P < .05). In both phases, trained survivors performed significantly more SSEs on the scalp than controls at 9 and 18 months (P < .05). Phase 1 survivors performed significantly more SSEs on the abdomen, buttocks, and soles of the feet than controls, but this did not occur in Phase 2. Finally, in both phases, survivors trained with the workbook resulted in greater detection of suspicious lesions and melanomas.

Conclusions

These findings justify the benefits of remote SSE training for patients as an adjunct to provider‐administered screening.

Attention Deficit Hyperactivity Disorder Outcomes Following Remotely Administered Self-Help Training for Parents

BACKGROUND: Attention deficit hyperactivity disorders (ADHD) is a neurodevelopmental disorder that affects up to 7% of children, with consequences lasting into adulthood for an indeterminate number of people. Children with ADHD need special interventions that start with effective parenting. Yet parent-education programs are often inappropriate for low-income or single-parent families who lack transportation, availability, or resources to attend. AIMS: We evaluated a remotely administered, 6-week, Six-step Parenting Program (SsPP) at two community health centers in Trenton, New Jersey. METHODS: Eight low-income, single-parent families were selected for participation. The parent/teacher rating scale of ADHD symptoms (SNAP-IV [Swanson, Nolan, and Pelham-IV questionnaire]) was administered pre- and post-application. RESULTS: Six out of 8 (75%) participating parents/guardians perceived improvements in children's symptoms. Completion of SsPP resulted in reduced SNAP-IV values by an average of 12.4% (n = 8), with improvements in 16 of 18 variables. CONCLUSIONS: The remotely administered SsPP may hold promise for parents unable to attend training and deserves further consideration and evaluation.

Using Remote Communication Technology in Insulin Pump Training: A Feasibility Study

PURPOSE

This feasibility study was designed to examine if remote communication technology can be used in the technical training of an insulin pump in adults with diabetes who were familiar with insulin pump therapy.

METHODS

Surveys were emailed to 69 individuals who purchased an insulin pump and had been trained by the manufacturer's diabetes educators. In consultation with providers, participants were given the choice of receiving training in a face-to-face meeting or via remote communication technology. The survey consisted of 27 questions asking participants' characteristics, device proficiency, confidence, and their satisfaction with the insulin pump and the training method. Differences between the 2 groups were examined using bivariate analyses.

RESULTS

There were 17 participants in the remote group and 20 participants in the face-to-face group. Participants had a mean age of 40.9 ± 14.3 years, had diabetes for 24.3 ± 13.8 years, and used an insulin pump for 9.8 ± 4.9 years. The participants in both groups were not statistically different in age, diabetes history, years on insulin pump, device proficiency, confidence, or satisfaction with the training method. The remote group reported less graduate-level education (P < .05) and higher satisfaction scores with the insulin pump training (P < .05).

CONCLUSION

Although this study has limitations associated with the small sample size and self-selection bias, the results suggest that remote communication technology may be an effective tool to provide technical training to adults who are familiar with insulin pump therapy. Additional research is required to determine the effectiveness of the remote insulin pump training.