Webinar Training: an acceptable, feasible and effective approach for multi-site medical record abstraction: the BOWII experience

Background Abstractor training is a key element in creating valid and reliable data collection procedures. The choice between in-person vs. remote or simultaneous vs. sequential abstractor training has considerable consequences for time and resource utilization. We conducted a web-based (webinar) abstractor training session to standardize training across six individual Cancer Research Network (CRN) sites for a study of breast cancer treatment effects in older women (BOWII). The goals of this manuscript are to describe the training session, its participants and participants' evaluation of webinar technology for abstraction training. Findings A webinar was held for all six sites with the primary purpose of simultaneously training staff and ensuring consistent abstraction across sites. The training session involved sequential review of over 600 data elements outlined in the coding manual in conjunction with the display of data entry fields in the study's electronic data collection system. Post-training evaluation was conducted via Survey Monkey©. Inter-rater reliability measures for abstractors within each site were conducted three months after the commencement of data collection. Ten of the 16 people who participated in the training completed the online survey. Almost all (90%) of the 10 trainees had previous medical record abstraction experience and nearly two-thirds reported over 10 years of experience. Half of the respondents had previously participated in a webinar, among which three had participated in a webinar for training purposes. All rated the knowledge and information delivered through the webinar as useful and reported it adequately prepared them for data collection. Moreover, all participants would recommend this platform for multi-site abstraction training. Consistent with participant-reported training effectiveness, results of data collection inter-rater agreement within sites ranged from 89 to 98%, with a weighted average of 95% agreement across sites. Conclusions Conducting training via web-based technology was an acceptable and effective approach to standardizing medical record review across multiple sites for this group of experienced abstractors. Given the substantial time and cost savings achieved with the webinar, coupled with participants' positive evaluation of the training session, researchers should consider this instructional method as part of training efforts to ensure high quality data collection in multi-site studies.

Training-related modulations of the autonomic nervous system in endurance athletes: is female gender cardioprotective?

The risk of sudden death is increased in athletes with a male predominance. Regular physical activity increases vagal tone, and may protect against exercise-induced ventricular arrhythmias. We investigated training-related modulations of the autonomic nervous system in female and male endurance athletes. Runners of a 10-mile race were invited. Of 873 applicants, 68 female and 70 male athletes were randomly selected and stratified according to their average weekly training hours in a low (≤4 h) and high (>4 h) volume training group. Analysis of heart rate variability was performed over 24 h. Spectral components (high frequency [HF] and low frequency [LF] power in normalized units) were analyzed for hourly 5 min segments and averaged for day- and nighttime. One hundred and fourteen athletes (50 % female, mean age 42 ± 7 years) were included. No significant gender difference was observed for training volume and 10-mile race time. Over the 24-h period, female athletes exhibited a higher HF and lower LF power for each hourly time-point. Female gender and endurance training hours were independent predictors of a higher HF and lower LF power. In female athletes, higher training hours were associated with a higher HF and lower LF power during nighttime. In male athletes, the same was true during daytime. In conclusion, female and male athletes showed a different circadian pattern of the training-related increase in markers of vagal tone. For a comparable amount of training volume, female athletes maintained their higher markers of vagal tone, possibly indicating a superior protection against exercise-induced ventricular arrhythmias.

Endurance training modulates the muscular transcriptome response to acute exercise

We hypothesized that in untrained individuals (n=6) a single bout of ergometer endurance exercise provokes a concerted response of muscle transcripts towards a slow-oxidative muscle phenotype over a 24-h period. We further hypothesized this response during recovery to be attenuated after six weeks of endurance training. We monitored the expression profile of 220 selected transcripts in muscle biopsies before as well as 1, 8, and 24 h after a 30-min near-maximal bout of exercise. The generalized gene response of untrained vastus lateralis muscle peaked after 8 h of recovery (P=0.001). It involved multiple transcripts of oxidative metabolism and glycolysis. Angiogenic and cell regulatory transcripts were transiently reduced after 1 h independent of the training state. In the trained state, the induction of most transcripts 8 h after exercise was less pronounced despite a moderately higher relative exercise intensity, partially because of increased steady-state mRNA concentration, and the level of metabolic and extracellular RNAs was reduced during recovery from exercise. Our data suggest that the general response of the transcriptome for regulatory and metabolic processes is different in the trained state. Thus, the response is specifically modified with repeated bouts of endurance exercise during which muscle adjustments are established.

Effects of arm training with the robotic device ARMin I in chronic stroke: three single cases

BACKGROUND: Several clinical studies on chronic stroke conducted with end-effector-based robots showed improvement of the motor function in the affected arm. Compared to end-effector-based robots, exoskeleton robots provide improved guidance of the human limb and are better suited to train task-oriented movements with a large range of motions. OBJECTIVE: To test whether intensive arm training with the arm exoskeleton ARMin I is feasible with chronic-stroke patients and whether it improves motor function in the paretic arm. METHODS: Three single cases with chronic hemiparesis resulting from unilateral stroke (at least 14 months after stroke). A-B design with 2 weeks of multiple baseline measurements (A), 8 weeks of training (B) with repetitive measurements and a follow-up measurement 8 weeks after training. The training included shoulder and elbow movements with the robotic rehabilitation device ARMin I. Two subjects had three 1-hour sessions per week and 1 subject received five 1-hour sessions per week. The main outcome measurement was the upper-limb part of the Fugl-Meyer Assessment (FMA). RESULTS: The ARMin training was well tolerated by the patients, and the FMA showed moderate, but significant improvements for all 3 subjects (p < 0.05). Most improvements were maintained 8 weeks after discharge. CONCLUSIONS: This study indicates that intensive training with an arm exoskeleton is feasible with chronic-stroke patients. Moderate improvements were found in all 3 subjects, thus further clinical investigations are justified.

Expertise in Clinical Psychology. The Effects of University Training and Practical Experience on Expertise in Clinical Psychology

How do university training and subsequent practical experience affect expertise in clinical psychology? To answer this question we developed methods to assess psychological knowledge and the competence to diagnose, construct case conceptualizations, and plan psychotherapeutic treatment: a knowledge test and short case studies in a first study, and a complex, dynamically evolving case study in the second study. In our cross-sectional studies, psychology students, trainees in a certified postgraduate psychotherapist curriculum, and behavior therapists with more than 10 years of experience were tested (100 in total: 20 each of novice, intermediate, and advanced university students, postgraduate trainees, and therapists). Clinical knowledge and competence increased up to the level of trainees but unexpectedly decreased at the level of experienced therapists. We discuss the results against the background of expertise research and the training of clinical psychologists (in Germany). Important factors for the continuing professional development of psychotherapists are proposed.

The effects of resistance training on well-being and memory in eldery volunteers

Objective: to determine the short- and long-term effects of resistance training on muscle strength, psychological well-being, control-beliefs, cognitive speed and memory in normally active elderly people. Methods: 46 elderly people (mean age 73.2 years; 18 women and 28 men), were randomly assigned to training and control groups (n = 23 each). Pre- and post-tests were administered 1 week before and 1 week after the 8-week training intervention. The training sessions, performed once a week, consisted of a 10 min warm-up phase and eight resistance exercises on machines. Results: there was a significant increase in maximum dynamic strength in the training group. This training effect was associated with a significant decrease in self-attentiveness, which is known to enhance psychological well-being. No significant changes could be observed in control-beliefs. Modest effects on cognitive functioning occurred with the training procedure: although there were no changes in cognitive speed, significant pre/post-changes could be shown in free recall and recognition in the experimental group. A post-test comparison between the experimental group and control group showed a weak effect for recognition but no significant differences in free recall. Significant long-term effects were found in the training group for muscular strength and memory performance (free recall) 1 year later. Conclusion: an 8-week programme of resistance training lessens anxiety and self-attentiveness and improves muscle strength.

Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a study protocol

BACKGROUND The Cochrane risk of bias (RoB) tool has been widely embraced by the systematic review community, but several studies have reported that its reliability is low. We aim to investigate whether training of raters, including objective and standardized instructions on how to assess risk of bias, can improve the reliability of this tool. We describe the methods that will be used in this investigation and present an intensive standardized training package for risk of bias assessment that could be used by contributors to the Cochrane Collaboration and other reviewers. METHODS/DESIGN This is a pilot study. We will first perform a systematic literature review to identify randomized clinical trials (RCTs) that will be used for risk of bias assessment. Using the identified RCTs, we will then do a randomized experiment, where raters will be allocated to two different training schemes: minimal training and intensive standardized training. We will calculate the chance-corrected weighted Kappa with 95% confidence intervals to quantify within- and between-group Kappa agreement for each of the domains of the risk of bias tool. To calculate between-group Kappa agreement, we will use risk of bias assessments from pairs of raters after resolution of disagreements. Between-group Kappa agreement will quantify the agreement between the risk of bias assessment of raters in the training groups and the risk of bias assessment of experienced raters. To compare agreement of raters under different training conditions, we will calculate differences between Kappa values with 95% confidence intervals. DISCUSSION This study will investigate whether the reliability of the risk of bias tool can be improved by training raters using standardized instructions for risk of bias assessment. One group of inexperienced raters will receive intensive training on risk of bias assessment and the other will receive minimal training. By including a control group with minimal training, we will attempt to mimic what many review authors commonly have to do, that is-conduct risk of bias assessment in RCTs without much formal training or standardized instructions. If our results indicate that an intense standardized training does improve the reliability of the RoB tool, our study is likely to help improve the quality of risk of bias assessments, which is a central component of evidence synthesis.

Modular training in vascular and endovascular surgery exemplified by the Vascular International Foundation and School

The partial shift from patient to model is a reasonable and necessary paradigm shift in surgery in order to increase patient safety and to adapt to the reduced training time periods in hospitals and increased quality demands. Since 1991 the Vascular International Foundation and School has carried out many training courses with more than 2,500 participants. The modular build training system allows to teach many open vascular and endovascular surgical techniques on lifelike models with a pulsatile circulation. The simulation courses cannot replace training in operating rooms but are suitable for supporting the cognitive and associative stages for achieving motor skills. Scientific evaluation of the courses has continually shown that the training principle established since 1991 can lead to significant learning success. They are extremely useful not only for beginners but also for experienced vascular surgeons. They can help to shorten the learning curve, to learn new techniques or to refine previously used techniques in all stages of professional development. Keywords Advanced training · Advanced training regulations · Training model · Vascular International · Certification

Social Support at the Workplace, Motivation to Transfer, and Training Transfer: A Multi-Level Indirect Effects Model

Supervisor support, peer support and transfer motivation have been identified as important predictors for training transfer. Transfer motivation is supposed to mediate the support–training transfer relationship. Especially after team training interventions that include all team members (i.e., intact-team training), individual perception of these factors might be shared among team members. However, an integration of the team level in the training transfer process is rare, yet still needed. Analyzing 194 employees from 34 teams in the context of intact-team training interventions, we found similar relationships and processes at both levels of analysis: Social support enhances transfer motivation at the individual and team levels. Furthermore, motivation to transfer increases training transfer and serves as a connecting mechanism in the social support–training transfer link. The results underline the importance of (1) considering multiple levels in theories and research about the training transfer process and (2) ensuring the practice of individual-directed support and a shared, supportive climate within teams.

The application of biomechanics to penalty corner drag-flick training: a case of Study

The penalty corner is one of the most important game situations in field hockey with one third of all goals resulting from this tactical situation. The aim of this study was to develop and apply a training method, based on previous studies, to improve the drag- flick skill on a young top-class field hockey player. A young top-class player exercised three times per week using specific drills over a four week period. A VICON optoelectronic system (Oxford Metrics, Oxford, UK) was employed to capture twenty drag-flicks, with six cameras sampling at 250 Hz, prior and after the training period. In order to analyze pre- and post-test differences a dependent t-test was carried out. Angular velocities and the kinematic sequence were similar to previous studies. The player improved (albeit not significantly) the angular velocity of the stick. The player increased front foot to the ball at T1 (p < 0.01) and the drag-flick distances. The range of motion from the front leg decreased from T1 to T6 after the training period (p < 0.01). The specific training sessions conducted with the player improved some features of this particular skill. This article shows how technical knowledge can help with the design of training programs and whether some drills are more effective than others.

Hands-on training in Nonimaging Optics for SME's: the SMETHODS experience

A 5-day training in Nonimaging Optics for European SME’s employees was carried out in June 2012 in the framework of the FP7 funded Support Action "SMETHODS". The training combined theoretical introduction and hands-on practice. The experience was very positive, and the lessons learned will improve the next scheduled sessions. Introduction The FP7 funded Support Action "SMETHODS" [1] is an initiative of seven European academic institutions to strengthen Europe's optics and photonics industry, which has started on 1 September 2011. Participation in training sessions is free for participants, who are selected with priority will be given to employees of small and medium sized European enterprises (SMEs). The consortium in SMETHODS is formed by seven partners that are the most prominent academic institutions in optical design in their countries. Through fully integrated collaborative training sessions, the consortium provides professional assistance as well as hands-on training in a variety of design tasks in four domains: (1) imaging optics, (2) nonimaging optics, (3) wave optics, and (4) diffractive optics. For each of this domains domain, 5-day training sessions are scheduled to be hold in different locations throughout Europe, four times in two years, the teach four times in a 2.5 years period.

Design of a training tool for improving the use of hand-held detectors in humanitarian demining

Purpose – The purpose of this paper is to introduce the design of a training tool intended to improve deminers' technique during close-in detection tasks. Design/methodology/approach – Following an introduction that highlights the impact of mines and improvised explosive devices (IEDs), and the importance of training for enhancing the safety and the efficiency of the deminers, this paper considers the utilization of a sensory tracking system to study the skill of the hand-held detector expert operators. With the compiled information, some critical performance variables can be extracted, assessed, and quantified, so that they can be used afterwards as reference values for the training task. In a second stage, the sensory tracking system is used for analysing the trainee skills. The experimentation phase aims to test the effectiveness of the elements that compose the sensory system to track the hand-held detector during the training sessions. Findings – The proposed training tool will be able to evaluate the deminers' efficiency during the scanning tasks and will provide important information for improving their competences. Originality/value – This paper highlights the need of introducing emerging technologies for enhancing the current training techniques for deminers and proposes a sensory tracking system that can be successfully utilised for evaluating trainees' performance with hand-held detectors.

COST Action Urban Agriculture Europe Training School «Urban agriculture inside the city:alternatives for vacant lots and public space»

The third Training School of the Action took place in Vitoria-Gasteiz (Basque country, Spain) from 24th to 26th September 2014. Vitoria-Gateiz has experimented an important urban outgrowth in the last decade, mainly through the planning and development of two new neighborhoods, Zabalgana and Salburúa, situated at the eastern and western border of the city, by the Greenbelt. These new development are well-equipped and designed according to sustainability principles. Nevertheless, among the main problems they present is their over-dimensioned public space, which creates some areas lacking enough density and mix of uses. On the other hand it is very expensive for the municipality to maintain these public space with the high Vitorian urban standards for public space. The proposed solution for this problem is a strategy of "re-densification" through the insertion of new uses The debate has arisen about which are the most adequate uses to insert in order to get an increasing of urban vitality, specially considering that housing has reached its peak and that Vitoria-Gasteiz is well served with social and sport amenities. The main goal of the TS was to offer an opportunity for the reflection about how urban agriculture might be an optimal alternative for the re-qualifying of this over-dimensioned public space in the new neighbourhoods, especially considering it synergic potential as a tool for production, leisure and landscaping, including the possibility of energy crops within the limits of urban space. Continuity with rural and natural surrounding area through alternatives for urban fringe at the small scale is a relevant issue to be considered as well within the reflection. Taking Zabalgana neighbourhood as a practical field for experiment, the Training School is conceived as a practical and intensive design charrette to be held during a whole day after two days of local knowledge-deepening through field visits and presentations.

Face, content, and construct validity of the EndoViS training system for objective assessment of psychomotor skills of laparoscopic surgeons

Background The aim of this study is to present face, content, and constructs validity of the endoscopic orthogonal video system (EndoViS) training system and determines its efficiency as a training and objective assessment tool of the surgeons’ psychomotor skills. Methods Thirty-five surgeons and medical students participated in this study: 11 medical students, 19 residents, and 5 experts. All participants performed four basic skill tasks using conventional laparoscopic instruments and EndoViS training system. Subsequently, participants filled out a questionnaire regarding the design, realism, overall functionality, and its capabilities to train hand–eye coordination and depth perception, rated on a 5-point Likert scale. Motion data of the instruments were obtained by means of two webcams built into a laparoscopic physical trainer. To identify the surgical instruments in the images, colored markers were placed in each instrument. Thirteen motion-related metrics were used to assess laparoscopic performance of the participants. Statistical analysis of performance was made between novice, intermediate, and expert groups. Internal consistency of all metrics was analyzed with Cronbach’s α test. Results Overall scores about features of the EndoViS system were positives. Participants agreed with the usefulness of tasks and the training capacities of EndoViS system (score >4). Results presented significant differences in the execution of three skill tasks performed by participants. Seven metrics showed construct validity for assessment of performance with high consistency levels. Conclusions EndoViS training system has been successfully validated. Results showed that EndoViS was able to differentiate between participants of varying laparoscopic experience. This simulator is a useful and effective tool to objectively assess laparoscopic psychomotor skills of the surgeons.

The Knowledge of High-Performance Gymnastic Coaches : Competition and Training Considerations

The purpose of this study is to report the knowledge used in training and competition by 17 expert high-performance gymnastic coaches. A qualitative research methodology was used to collect and inductively analyze the data. The knowledge elicited for the competition component was categorized as competition site, competition floor, and trial competitions. These categories indicated that the coaches are minimally involved with the gymnasts in competition. The knowledge of the coaches elicited within the training component were categorized as coach involvement in training, intervention style, technical skills, mental skills, and simulation. Properties of these categories that were extensively discussed by the expert coaches, such as teaching progressions, being supportive, and helping athletes to deal with stress,are consistent with the literature on coaching and on sport psychology. Other aspects considered important in the sport psychology literature, such as developing concentration skills, were not discussed as thoroughly by the expert coaches.