Simulation in training: one-year experience using an efficiency index to assess interventional radiology fellow training status

PURPOSE: To compare objective fellow and expert efficiency indices for an interventional radiology renal artery stenosis skill set with the use of a high-fidelity simulator. MATERIALS AND METHODS: The Mentice VIST simulator was used for three different renal artery stenosis simulations of varying difficulty, which were used to grade performance. Fellows' indices at three intervals throughout 1 year were compared to expert baseline performance. Seventy-four simulated procedures were performed, 63 of which were captured as audiovisual recordings. Three levels of fellow experience were analyzed: 1, 6, and 12 months of dedicated interventional radiology fellowship. The recordings were compiled on a computer workstation and analyzed. Distinct measurable events in the procedures were identified with task analysis, and data regarding efficiency were extracted. Total scores were calculated as the product of procedure time, fluoroscopy time, tools, and contrast agent volume. The lowest scores, which reflected efficient use of tools, radiation, and time, were considered to indicate proficiency. Subjective analysis of participants' procedural errors was not included in this analysis. RESULTS: Fellows' mean scores diminished from 1 month to 12 months (42,960 at 1 month, 18,726 at 6 months, and 9,636 at 12 months). The experts' mean score was 4,660. In addition, the range of variance in score diminished with increasing experience (from a range of 5,940-120,156 at 1 month to 2,436-85,272 at 6 months and 2,160-32,400 at 12 months). Expert scores ranged from 1,450 to 10,800. CONCLUSIONS: Objective efficiency indices for simulated procedures can demonstrate scores directly comparable to the level of clinical experience.

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.

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.

International standards for programmes of training in intensive care medicine in Europe.

PURPOSE To develop internationally harmonised standards for programmes of training in intensive care medicine (ICM). METHODS Standards were developed by using consensus techniques. A nine-member nominal group of European intensive care experts developed a preliminary set of standards. These were revised and refined through a modified Delphi process involving 28 European national coordinators representing national training organisations using a combination of moderated discussion meetings, email, and a Web-based tool for determining the level of agreement with each proposed standard, and whether the standard could be achieved in the respondent's country. RESULTS The nominal group developed an initial set of 52 possible standards which underwent four iterations to achieve maximal consensus. All national coordinators approved a final set of 29 standards in four domains: training centres, training programmes, selection of trainees, and trainers' profiles. Only three standards were considered immediately achievable by all countries, demonstrating a willingness to aspire to quality rather than merely setting a minimum level. Nine proposed standards which did not achieve full consensus were identified as potential candidates for future review. CONCLUSIONS This preliminary set of clearly defined and agreed standards provides a transparent framework for assuring the quality of training programmes, and a foundation for international harmonisation and quality improvement of training in ICM.

Evaluation of Medical Students’ Attitudes and Performance of Basic Surgery Skills in a Training Program Using Fresh Human skin, Excised During Body Contouring Surgeries

BACKGROUND: Learning surgical skills in the operating room may be a challenge for medical students. Therefore, more approaches using simulation to enable students to develop their practical skills are required. OBJECTIVES: We hypothesized that (1) there would be a need for additional surgical training for medical students in the pre-final year, and (2) our basic surgery skills training program using fresh human skin would improve medical students' surgical skills. DESIGN: We conducted a preliminary survey of medical students to clarify the need for further training in basic surgery procedures. A new approach using simulation to teach surgical skills on human skin was set up. The procedural skills of 15 randomly selected students were assessed in the operating room before and after participation in the simulation, using Objective Structured Assessment of Technical Skills. Furthermore, subjective assessment was performed based on students' self-evaluation. The data were analyzed using SPSS, version 21 (SPSS, Inc., Chicago, IL). SETTING: The study took place at the Inselspital, Bern University Hospital. PARTICIPANTS: A total of 186 pre-final-year medical students were enrolled into the preliminary survey; 15 randomly selected medical students participated in the basic surgical skills training course on the fresh human skin operating room. RESULTS: The preliminary survey revealed the need for a surgical skills curriculum. The simulation approach we developed showed significant (p < 0.001) improvement for all 12 surgical skills, with mean cumulative precourse and postcourse values of 31.25 ± 5.013 and 45.38 ± 3.557, respectively. The self-evaluation contained positive feedback as well. CONCLUSION: Simulation of surgery using human tissue samples could help medical students become more proficient in handling surgical instruments before stepping into a real surgical situation. We suggest further studies evaluating our proposed teaching method and the possibility of integrating this simulation approach into the medical school curriculum.

How specific is apprenticeship training? Evidence from inter-firm and occupational mobility after graduation

Do apprenticeships convey mainly general or also firm- and occupation-specific human capital? Specific human capital may allow for specialization gains, but may also lead to allocative inefficiency due to mobility barriers. We analyse the case of Switzerland, which combines a comprehensive, high-quality apprenticeship system with a lightly regulated labour market. To assess human capital transferability after standardized firm-based apprenticeship training, we analyse inter-firm and occupational mobility and their effects on post-training wages. Using a longitudinal data set based on the PISA 2000 survey, we find high inter-firm and low occupational mobility within one year after graduation. Accounting for endogenous changes, we find a negative effect of occupation changes on wages, but no significant wage effect for firm changes. This indicates that occupation-specific human capital is an important component of apprenticeship training and that skills are highly transferable within an occupational field.

Level Set Segmentation with Shape and Appearance Models Using Affine Moment Descriptors

We propose a level set based variational approach that incorporates shape priors into edge-based and region-based models. The evolution of the active contour depends on local and global information. It has been implemented using an efficient narrow band technique. For each boundary pixel we calculate its dynamic according to its gray level, the neighborhood and geometric properties established by training shapes. We also propose a criterion for shape aligning based on affine transformation using an image normalization procedure. Finally, we illustrate the benefits of the our approach on the liver segmentation from CT images.

Influence of the training system on the agronomic behavior and grape composition of Albariño in Rías Baixas apellation

The aim of this study was to evaluate if early defoliation can be an alternative to bunch thinning in limiting yield and improving quality in grapes of the white cultivar Loureiro (Vitis vinifera L.), grafted onto 1103P. The field trial had been set up in a commercial vineyard in Vinhos Verdes Region (Northwest of Portugal, 41º 48? 53? N, 8º 24? 42? W). Treatments studied, performed five days before full bloom were: LR5 ? Leaf removal of the first five basal leaves, performed manually, LR8 ? Leave removal of the first eight basal leaves, LRM ? mechanical leaf removal and C ? the control, without defoliation. This paper reports the results of four years (2010-2013). The results presented a significant removal of main leaf area after defoliation principally in the most intensive treatment (LR8) but at harvest, the total leaf area had been compensated by lateral regrowth and no statistical differences between the treatments and the control were found. Early defoliation caused a decrease in fruit set and also a significant reduction in the diameter of the berry within the more severe defoliation treatments (LR5 and LR8). Yield factors were also significantly affected by the defoliation, causing a reduction of bunch weight and in 2013 a yield reduction in LR8 and LRM, and in 2010 in LR8. Conversely, LR5 presented a yield always similar to the control C. The reduction of cluster compactness and the substantial improvement of the microclimate at the cluster level significantly reduced bunch rot incidence in the defoliated modalities compared to control. No carry-over effects, along the four years trial were observed Early defoliation proved to be a canopy management technique that can have a strong impact in the final quality of grapes, reducing the compactness and lower the incidence and intensity of bunch rot, even if the reduction of yield observed in other papers had not been observed in all modalities.

Continuous Off-the-Job Training in East Germany After Unification: Preliminary Results of an Evaluation of the Effects for Individual Workers, CES Germany & Europe Working Papers, No. 05.9, 19 July, 1995

Retraining the labor force to match the demands of a modem economy is seen as an important task during the transition process from a centrally-planned to a market economy. This need was particularly pressing in East Germany, because the transition process has proceeded much faster than in the rest of Eastern Europe. Therefore, substantial resources have been devoted to this purpose. This paper analyzes the impact of continuous off-the-job training in East Germany from the point of view of individuals who were part of the labor force before German unification in 1990. It tries to answer questions about the average gains from participating in a specific type of training. Typical outcomes considered to measure those gains are income, employment status, job security, and expected future changes in job position. The methodology used for the evaluation is the potential outcome approach to causality. This approach has received considerable attention in the statistical literature over the last fifteen years and it has recently been rediscovered by the econometric literature as well. It is adapted to allow for important permanent and transitory shocks, such as unemployment, which influence the decision to participate in the training as well as future labor market outcomes. The empirical part is based on the first four waves of the Socio-Economic Panel (GSOEP)-East (1990-1993). This panel data set has the advantage that the fourth wave contains a special survey on continuous training and that it allows keeping track of individual behavior on a monthly, respectively yearly, basis. The econometric analysis focuses on off-the-job training courses that began after unification and were completed not later than in early 1993. Although it is obviously too early to evaluate the long-term implications, the results suggest that there are no positive effects in the short run.

1980 Annual Status Report: Training and Education (Multiannual Programme of the Joint Research Centre 1980-1983). EUR 7261 EN, 1981

The Education and Training Programme has been set up in recognition of the growing importance of continuing education in modern technological society. It is designed to improve the dissemination of scientific and technical knowledge in subjects related to the research activities of the JRC, to the potential external users: industries, public bodies, research and educational organizations, etc. . . Moreover, owing to the number and the quality of specialists of the various fields covered by the courses who are brought to Ispra as lecturers or participants, this programme plays an important role in the integration of the research teams of the JRC with the European scientific world, and in. the development of contacts and ties between European scientists active in a given field.

Ed Frutig, UM Football 1937-1940, posed in Naval Air training plane at Corpus Christi, Texas, 1942

[International News Photos cutline: "Now he's going to make a pass at the Japs. Corpus Christi Texas. Ed Frutig, former University of Michigan star, is set for a "Bullet Pass" at the Japs. He is now a cadet at Corpus Christi. He was member of the 1940 All-American grid squad and played professionally with the Green Bay Packers During the 1941 season. His Home is River Rouge, Mich."]

Managing the six percent set-aside /

"December, 1983."

A guide to the analysis of UI recipients' unemployment spells using a supplemented CWBH data set.

"Prepared by Lois Blanchard ... and Walter Corson."

Principles of electricity applied to telephone and telegraph work; a training course text prepared for employees of the Long lines department, American telephone and telegraph company, November, 1938...

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Medical student radiology training: What are the objectives for contemporary medical practice?

Rationale and Objectives. The authors attempt to provide a set of objectives for medical student training in radiology for contemporary medical practice. Materials and Methods. A questionnaire containing a list of educational objectives was sent to 32 radiologists in charge of medical student training in radiology at accredited residency programs in Australia and New Zealand. The importance of including each preselected objective in the curriculum was measured by respondents' agreement or disagreement on a scale of 1-6. Opportunity also was given to respondents to suggest objectives other than those presented on the questionnaire. Results. Twenty of the 32 questionnaires were returned, and a set of educational objectives was established based on the responses. The objectives were ranked in importance according to the mean score assigned to each objective by the respondents. Conclusion. This new set of educational objectives for medical student radiology training reflects recent changes in radiologic and medical practice and points to potential future developments.