Retrospective adjustment of self-assessed medical competencies - noteworthy in the evaluation of postgraduate practical training courses

The efficacy of postgraduate practical training courses is frequently evaluated by self-assessment instruments. The present study analyses the effect of a basic course in laparoscopic surgery on self-assessed medical competencies.

Maintenance of skills, competencies, and performance in allergy and clinical immunology: time to lay the foundation for a universal approach

Allergist/clinical immunologist maintenance of certification and training program reaccreditation are mandatory in some countries. The World Allergy Organization conducted surveys in 2009 and 2011 to assess where such programs were available and to promote the establishment of such programs on a global level. This was done with the presumption that after such an "inventory," World Allergy Organization could offer guidance to its Member Societies on the promotion of such programs to assure the highest standards of practice in the field of allergy and clinical immunology. This review draws on the experience of countries where successful programs are in place and makes recommendations for those wishing to implement such programs for the specialty.

Competencies in arts therapies: A rating of importance, training and performance by practitioners and referring professionals in Switzerland

This survey was conducted in developing a final specialized examination for all arts therapists in Switzerland by the Council of Swiss Arts Therapy Associations (CSATA). Forty-eight generic key competencies (GKC) were sent to all 1235 arts therapists in five different disciplines in Switzerland (response 47.5%) and to 384 referring professionals and employers (RPE) listed by therapists (response 42%). The mean importance of GKC was rated high (4 points of 5) by practitioners and RPE. Different opinions on importance of GKC in disciplines included artistic ability and psychotherapeutic relative to medical orientation. The training of competencies was rated lower by practitioners (3.48 points) and different in the eight competence categories and five disciplines. Areas of weak training were identified. The performance of GKC was rated by referring professionals equally to its importance (mean +0.3 points) and showed a good understanding of competencies by RPE. Judging of performance was difficult for RPE in more than 20% of items. The results provide criteria for detailed outcome assessments and the advancement of a final examination for arts therapists in Switzerland.

An outline of competencies and the appropriate postgraduate educational pathways in implant dentistry

The use of dental implants has become a widely accepted and well-documented treatment option offering to both patients and dentists an alternative to traditional treatment modalities and at the same time opening a brand new area in dental postgraduate education. As such, it is necessary to define the competencies that the graduate student/dentist will need at the different levels of clinical practice in Implant Dentistry and the educational pathways that are required to convey those competencies in a structured manner. The present position paper provides an initial suggestion for the knowledge, skills and behaviour necessary for a graduate student to practice implant dentistry at the different levels of clinical complexity. An outline of the necessary competencies and structure of various levels of postgraduate university courses is provided together with different educational approaches to support them. The present paper should be evaluated as a platform for discussion for future development of postgraduate curricula in implant dentistry rather than a manual on how to design and operate such curricula.

The relationship between competencies acquired through Swiss academic sports science courses and the job requirements

In view of the changes in and growing variety of sports-related occupations, it is highly relevant for educational institutions 10 to know how well the educational contents of their sport science courses meet the professional requirements. This study analyses the relationship between the competencies acquired through academic sports science courses and the requirements of the relevant jobs in Switzerland. The data for this empirical analysis were drawn from a sample of n = 1054 graduates of different academic sport science programmes at all eight Swiss universities. The results show that academic sport science courses primarily communicate sports-specific expertise and practical sports skills. On the other hand, most graduates consider that the acquisition of interdisciplinary competencies plays a comparatively minor role in sport science education, even though these competencies are felt to be an important requirement in a variety of work-related environments and challenges.

"It was hard to come to mutual understanding..." - Multidimensionality of social learning processes in natural resource use in India, Africa and Latin America

Sustainable natural resource use requires that multiple actors reassess their situation in a systemic perspective. This can be conceptualised as a social learning process between actors from rural communities and the experts from outside organisations. A specifically designed workshop oriented towards a systemic view of natural resource use and the enhancement of mutual learning between local and external actors, provided the background for evaluating the potentials and constraints of intensified social learning processes. Case studies in rural communities in India, Bolivia, Peru and Mali showed that changes in the narratives of the participants of the workshop followed a similar temporal sequence relatively independently from their specific contexts. Social learning processes were found to be more likely to be successful if they 1) opened new space for communicative action, allowing for an intersubjective re-definition of the present situation, 2) contributed to rebalance the relationships between social capital and social, emotional and cognitive competencies within and between local and external actors.

Postgraduate training program

BACKGROUND: Faculties face the permanent challenge to design training programs with well-balanced educational outcomes, and to offer various organised and individual learning opportunities. AIM: To apply our original model to a postgraduate training program in rheumatology in general, and to various learning experiences in particular, in order to analyse the balance between different educational objectives. METHODS: Learning times of various educational activities were reported by the junior staff as targeted learners. The suitability of different learning experiences to achieve cognitive, affective and psychomotor learning objectives was estimated. Learning points with respect to efficacy were calculated by multiplication of the estimated learning times by the perceived appropriateness of the educational strategies. RESULTS: Out of 780 hours of professional learning per year (17.7 hours/week), 37.7% of the time was spent under individual supervision of senior staff, 24.4% in organised structured learning, 22.6% in self-studies, and 15.3% in organised patient-oriented learning. The balance between the different types of learning objectives was appropriate for the overall program, but not for each particular learning experience. Acquisition of factual knowledge and problem solving was readily aimed for during organised teaching sessions of different formats, and by personal targeted reading. Attitudes, skills and competencies, as well as behavioural and performance changes were mostly learned during caring for patients under interactive supervision by experts. CONCLUSION: We encourage other faculties to apply this approach to any other curriculum of undergraduate education, postgraduate training or continuous professional development in order to foster the development of well-balanced learning experiences.

[Active and healthy living in old age--results from a representative survey of community-dwelling senior citizens in Hamburg]

BACKGROUND: The majority of community-dwelling people 60 years and older are independent and live actively. However, there is little information about elderly persons' views on aging, health and health promotion. METHODS: Therefore, an anonymous, written questionnaire survey was performed in a representative sample of inhabitants from a section of the city of Hamburg, 60 years and older; 5 year intervals, 14 subsamples according to 7 age groups of females and males. RESULTS: Questionnaires from 950 participants (29% response) could be evaluated: mean age 71.5 years, 58% women, 34% living alone, 5% with professional healthcare needs as indicated by status according to German nursing care insurance. Senior citizens' positive attitudes towards aging and health were predominant: 69% of respondents felt young, 85% worried about loss of autonomy in old age. CONCLUSIONS: The results provide evidence indicating potential for improving health-promoting lifestyles in parts of the older population by evaluating and strengthening older persons' competencies and by considering their concerns seriously. These results provide valuable information for future plans in the public-health sector in the city of Hamburg where particular health-promoting actions for elderly persons will be considered.

Teaching and assessment of implant dentistry in undergraduate and postgraduate education: a European consensus

This paper constitutes a summary of the consensus documents agreed at the First European Workshop on Implant Dentistry University Education held in Prague on 19-22 June 2008. Implant dentistry is becoming increasingly important treatment alternative for the restoration of missing teeth, as patients expectations and demands increase. Furthermore, implant related complications such as peri-implantitis are presenting more frequently in the dental surgery. This consensus paper recommends that implant dentistry should be an integral part of the undergraduate curriculum. Whilst few schools will achieve student competence in the surgical placement of implants this should not preclude the inclusion of the fundamental principles of implant dentistry in the undergraduate curriculum such as the evidence base for their use, indications and contraindications and treatment of the complications that may arise. The consensus paper sets out the rationale for the introduction of implant dentistry in the dental curriculum and the knowledge base for an undergraduate programme in the subject. It lists the competencies that might be sought without expectations of surgical placement of implants at this stage and the assessment methods that might be employed. The paper also addresses the competencies and educational pathways for postgraduate education in implant dentistry.

European veterinary public health specialization: post-graduate training and expectations of potential employers

Residents of the European College of Veterinary Public Health (ECVPH) carried out a survey to explore the expectations and needs of potential employers of ECVPH diplomates and to assess the extent to which the ECVPH post-graduate training program meets those requirements. An online questionnaire was sent to 707 individuals working for universities, government organizations, and private companies active in the field of public health in 16 countries. Details on the structure and activities of the participants' organizations, their current knowledge of the ECVPH, and potential interest in employing veterinary public health (VPH) experts or hosting internships were collected. Participants were requested to rate 22 relevant competencies according to their importance for VPH professionals exiting the ECVPH training. A total of 138 completed questionnaires were included in the analysis. While generic skills such as "problem solving" and "broad horizon and inter-/multidisciplinary thinking" were consistently given high grades by all participants, the importance ascribed to more specialized skills was less homogeneous. The current ECVPH training more closely complies with the profile sought in academia, which may partly explain the lower employment rate of residents and diplomates within government and industry sectors. The study revealed a lack of awareness of the ECVPH among public health institutions and demonstrated the need for greater promotion of this veterinary specialization within Europe, both in terms of its training capacity and the professional skill-set of its diplomates. This study provides input for a critical revision of the ECVPH curriculum and the design of post-graduate training programs in VPH.

Shying away: An observer-based microprocess analysis of experiential avoidance and resource activation in outpatients with generalized anxiety spectrum disorder

Despite long-standing calls for patient-focused research on individuals with generalized anxiety spectrum disorder there is little systematized knowledge about the in-session behaviors of these patients. The primary objective of this study was to describe of in-session trajectories of the patients' level of explication (as an indicator of an elaborated exposure of negative emotionality) and the patients' focus on their own resources and how these trajectories are associated with post-treatment outcome. In respect to GAD patients, a high level of explication might be seen as an indicator of successful exposure of avoided negative emotionality during therapy sessions. Observers made minute-by-minute ratings of 1100 minutes of video of 20 patients-therapists dyads. The results indicated that a higher level of explication generally observed at a later stage during the therapy sessions and the patients' focus on competencies at an early stage was highly associated with positive therapy outcome at assessment at post treatment, independent of pretreatment distress, rapid response of well-being and symptom reduction, as well as the therapists' professional experience and therapy lengths. These results will be discussed under the perspective of emotion regulation of patients and therapist's counterregulation. It is assumed that GAD-Patients are especially skilled in masking difficult emotions. Explication level and emotion regulation are important variables for this patient group but there's relation to outcome is different.

Lerntagebücher im Praktikum von Lehramtsstudierenden

Im vorgestellten Projekt ging es darum, Lernprozesse und -inhalte im Praktikum anhand von Tagebüchern sichtbar zu machen. Im Rahmen einer größeren Befragung zum Thema "Lernen im Praktikum" führten 46 Studierende ein Lerntagebuch und berichteten insgesamt 620 Lernsituationen, welche mittels qualitativer Inhaltsanalyse ausgewertet wurden. Die Ergebnisse weisen auf eine Schwerpunktsetzung hinsichtlich des Erwerbs didaktischer Kompetenzen hin. Sowohl Praxislehrpersonen als auch Schüler gaben wesentliche Impulse für die Lernprozesse der Studierenden. Zentrale Einzelthemen bezogen sich auf die Einschätzung des Schwierigkeitsgrads, des Anspruchsniveaus von Anforderungen und Aufgaben und auf den Umgang mit Unterrichtsstörungen.

Models for intensive care training. A European perspective.

The diversity of European culture is reflected in its healthcare training programs. In intensive care medicine (ICM), the differences in national training programs were so marked that it was unlikely that they could produce specialists of equivalent skills. The Competency-Based Training in Intensive Care Medicine in Europe (CoBaTrICE) program was established in 2003 as a Europe-based worldwide collaboration of national training organizations to create core competencies for ICM using consensus methodologies to establish common ground. The group's professional and research ethos created a social identity that facilitated change. The program was easily adaptable to different training structures and incorporated the voice of patients and relatives. The CoBaTrICE program has now been adopted by 15 European countries, with another 12 countries planning to adopt the training program, and is currently available in nine languages, including English. ICM is now recognized as a primary specialty in Spain, Switzerland, and the UK. There are still wide variations in structures and processes of training in ICM across Europe, although there has been agreement on a set of common program standards. The combination of a common "product specification" for an intensivist, combined with persisting variation in the educational context in which competencies are delivered, provides a rich source of research inquiry. Pedagogic research in ICM could usefully focus on the interplay between educational interventions, healthcare systems and delivery, and patient outcomes, such as including whether competency-based program are associated with lower error rates, whether communication skills training is associated with greater patient and family satisfaction, how multisource feedback might best be used to improve reflective learning and teamworking, or whether increasing the proportion of specialists trained in acute care in the hospital at weekends results in better patient outcomes.

Development of meta-representations: Procedural metacognition and the relationship to Theory of Mind

In several studies it was shown that metacognitive ability is crucial for children and their success in school. Much less is known about the emergence of that ability and its relationship to other meta-representations like Theory of Mind competencies. In the past years, a growing literature has suggested that metacognition and Theory of Mind could theoretically be assumed to belong to the same developmental concept. Since then only a few studies showed empirically evidence that metacognition and Theory of Mind are related. But these studies focused on declarative metacognitive knowledge rather than on procedural metacognitive monitoring like in the present study: N = 159 children were first tested shortly before making the transition to school (aged between 5 1/2 and 7 1/2 years) and one year later at the end of their first grade. Analyses suggest that there is in fact a significant relation between early metacognitive monitoring skills (procedural metacognition) and later Theory of Mind competencies. Notably, language seems to play a crucial role in this relationship. Thus our results bring new insights in the research field of the development of meta-representation and support the view that metacognition and Theory of Mind are indeed interrelated, but the precise mechanisms yet remain unclear.