Ageing of people with an intellectual disability: Effective training for frontline workers

While the attainment of late life represents a significant achievement for people with an intellectual disability, increased life expectancy has resulted in growing concerns about the extent to which disability service providers are ready to meet the changing needs of increasing numbers of older people and facilitate their ongoing social inclusion. Training of frontline disability staff is widely accepted as an effective strategy for increasing organisational capacity to contribute to improved quality of life for people with an intellectual disability. The study identifies training needs analyses and 'ready-to-deliver' training programs for frontline disability services staff working with adults with an intellectual disability who are ageing, assesses whether the training programs contribute to improved quality of life outcomes for service users, and makes recommendations for future research and development of training for disability services staff who work with older people with intellectual disability.

Is simulation training effective in increasing podiatrists' confidence in foot ulcer management?

Background: Foot ulcers are a frequent reason for diabetes-related hospitalisation. Clinical training is known to have a beneficial impact on foot ulcer outcomes. Clinical training using simulation techniques has rarely been used in the management of diabetes-related foot complications or chronic wounds. Simulation can be defined as a device or environment that attempts to replicate the real world. The few non-web-based foot-related simulation courses have focused solely on training for a single skill or “part task” (for example, practicing ingrown toenail procedures on models). This pilot study aimed to primarily investigate the effect of a training program using multiple methods of simulation on participants’ clinical confidence in the management of foot ulcers. Methods: Sixteen podiatrists participated in a two-day Foot Ulcer Simulation Training (FUST) course. The course included pre-requisite web-based learning modules, practicing individual foot ulcer management part tasks (for example, debriding a model foot ulcer), and participating in replicated clinical consultation scenarios (for example, treating a standardised patient (actor) with a model foot ulcer). The primary outcome measure of the course was participants’ pre- and post completion of confidence surveys, using a five-point Likert scale (1 = Unacceptable-5 = Proficient). Participants’ knowledge, satisfaction and their perception of the relevance and fidelity (realism) of a range of course elements were also investigated. Parametric statistics were used to analyse the data. Pearson’s r was used for correlation, ANOVA for testing the differences between groups, and a paired-sample t-test to determine the significance between pre- and post-workshop scores. A minimum significance level of p < 0.05 was used. Results: An overall 42% improvement in clinical confidence was observed following completion of FUST (mean scores 3.10 compared to 4.40, p < 0.05). The lack of an overall significant change in knowledge scores reflected the participant populations’ high baseline knowledge and pre-requisite completion of web-based modules. Satisfaction, relevance and fidelity of all course elements were rated highly. Conclusions: This pilot study suggests simulation training programs can improve participants’ clinical confidence in the management of foot ulcers. The approach has the potential to enhance clinical training in diabetes-related foot complications and chronic wounds in general.

Development and interrater reliability testing of a telephone interview training programme for Australian nurse interviewers

Summary Background The final phase of a three phase study analysing the implementation and impact of the nurse practitioner role in Australia (the Australian Nurse Practitioner Project or AUSPRAC) was undertaken in 2009, requiring nurse telephone interviewers to gather information about health outcomes directly from patients and their treating nurse practitioners. A team of several registered nurses was recruited and trained as telephone interviewers. The aim of this paper is to report on development and evaluation of the training process for telephone interviewers. Methods The training process involved planning the content and methods to be used in the training session; delivering the session; testing skills and understanding of interviewers post-training; collecting and analysing data to determine the degree to which the training process was successful in meeting objectives and post-training follow-up. All aspects of the training process were informed by established educational principles. Results Interrater reliability between interviewers was high for well-validated sections of the survey instrument resulting in 100% agreement between interviewers. Other sections with unvalidated questions showed lower agreement (between 75% and 90%). Overall the agreement between interviewers was 92%. Each interviewer was also measured against a specifically developed master script or gold standard and for this each interviewer achieved a percentage of correct answers of 94.7% or better. This equated to a Kappa value of 0.92 or better. Conclusion The telephone interviewer training process was very effective and achieved high interrater reliability. We argue that the high reliability was due to the use of well validated instruments and the carefully planned programme based on established educational principles. There is limited published literature on how to successfully operationalise educational principles and tailor them for specific research studies; this report addresses this knowledge gap.

Influence of high-intensity interval training on adaptations in well-trained cyclists

The purpose of the present study was to examine the influence of 3 different high-intensity interval training regimens on the first and second ventilatory thresholds (VT1 and VT2), anaerobic capacity (ANC), and plasma volume (PV) in well-trained endurance cyclists. Before and after 2 and 4 weeks of training, 38 well-trained cyclists (VO2peak = 64.5 +/- 5.2 ml[middle dot]kg-1[middle dot]min-1) performed (a) a progressive cycle test to measure VO2peak, peak power output (PPO), VT1, and VT2; (b) a time to exhaustion test (Tmax) at their VO2peak power output (Pmax); and (c) a 40-km time-trial (TT40). Subjects were assigned to 1 of 4 training groups (group 1: n = 8, 8 3 60% Tmax at Pmax, 1:2 work-recovery ratio; group 2: n = 9, 8 x 60% Tmax at Pmax, recovery at 65% maximum heart rate; group 3: n = 10, 12 x 30 seconds at 175% PPO, 4.5-minute recovery; control group: n = 11). The TT40 performance, VO2peak, VT1,VT2, and ANC were all significantly increased in groups 1, 2, and 3 (p < 0.05) but not in the control group. However, PV did not change in response to the 4-week training program. Changes in TT40 performance were modestly related to the changes in VO2peak, VT1, VT2, and ANC (r = 0.41, 0.34, 0.42, and 0.40, respectively; all p < 0.05). In conclusion, the improvements in TT40 performance were related to significant increases in VO2peak, VT1,VT2, and ANC but were not accompanied by significant changes in PV. Thus, peripheral adaptations rather than central adaptations are likely responsible for the improved performances witnessed in well-trained endurance athletes following various forms of high-intensity interval training programs.

Development and formative evaluation of a motorcycle rider training intervention to address risk taking

The need to address on-road motorcycle safety in Australia is important due to the disproportionately high percentage of riders and pillions killed and injured each year. One approach to preventing motorcycle-related injury is through training and education. However, motorcycle rider training lacks empirical support as an effective road safety countermeasure to reduce crash involvement. Previous reviews have highlighted that risk-taking is a contributing factor in many motorcycle crashes, rather than merely a lack of vehicle-control skills (Haworth & Mulvihill, 2005; Jonah, Dawson & Bragg, 1982; Watson et al, 1996). Hence, though the basic vehicle-handling skills and knowledge of road rules that are taught in most traditional motorcycle licence training programs may be seen as an essential condition of safe riding, they do not appear to be sufficient in terms of crash reduction. With this in mind there is considerable scope for the improvement of program focus and content for rider training and education. This program of research examined an existing traditional pre-licence motorcycle rider training program and formatively evaluated the addition of a new classroom-based module to address risky riding; the Three Steps to Safer Riding program. The pilot program was delivered in the real world context of the Q-Ride motorcycle licensing system in the state of Queensland, Australia. Three studies were conducted as part of the program of research: Study 1, a qualitative investigation of delivery practices and student learning needs in an existing rider training course; Study 2, an investigation of the extent to which an existing motorcycle rider training course addressed risky riding attitudes and motives; and Study 3, a formative evaluation of the new program. A literature review as well as the investigation of learning needs for motorcyclists in Study 1 aimed to inform the initial planning and development of the Three Steps to Safer Riding program. Findings from Study 1 suggested that the training delivery protocols used by the industry partner training organisation were consistent with a learner-centred approach and largely met the learning needs of trainee riders. However, it also found that information from the course needs to be reinforced by on-road experiences for some riders once licensed and that personal meaning for training information was not fully gained until some riding experience had been obtained. While this research informed the planning and development of the new program, a project team of academics and industry experts were responsible for the formulation of the final program. Study 2 and Study 3 were conducted for the purpose of formative evaluation and program refinement. Study 2 served primarily as a trial to test research protocols and data collection methods with the industry partner organisation and, importantly, also served to gather comparison data for the pilot program which was implemented with the same rider training organisation. Findings from Study 2 suggested that the existing training program of the partner organisation generally had a positive (albeit small) effect on safety in terms of influencing attitudes to risk taking, the propensity for thrill seeking, and intentions to engage in future risky riding. However, maintenance of these effects over time and the effects on riding behaviour remain unclear due to a low response rate upon follow-up 24 months after licensing. Study 3 was a formative evaluation of the new pilot program to establish program effects and possible areas for improvement. Study 3a examined the short term effects of the intervention pilot on psychosocial factors underpinning risky riding compared to the effects of the standard traditional training program (examined in Study 2). It showed that the course which included the Three Steps to Safer Riding program elicited significantly greater positive attitude change towards road safety than the existing standard licensing course. This effect was found immediately following training, and mean scores for attitudes towards safety were also maintained at the 12 month follow-up. The pilot program also had an immediate effect on other key variables such as risky riding intentions and the propensity for thrill seeking, although not significantly greater than the traditional standard training. A low response rate at the 12 month follow-up unfortunately prevented any firm conclusions being drawn regarding the impact of the pilot program on self-reported risky riding once licensed. Study 3a further showed that the use of intermediate outcomes such as self-reported attitudes and intentions for evaluation purposes provides insights into the mechanisms underpinning risky riding that can be changed by education and training. A multifaceted process evaluation conducted in Study 3b confirmed that the intervention pilot was largely delivered as designed, with course participants also rating most aspects of training delivery highly. The complete program of research contributed to the overall body of knowledge relating to motorcycle rider training, with some potential implications for policy in the area of motorcycle rider licensing. A key finding of the research was that psychosocial influences on risky riding can be shaped by structured education that focuses on awareness raising at a personal level and provides strategies to manage future riding situations. However, the formative evaluation was mainly designed to identify areas of improvement for the Three Steps to Safer Riding program and found several areas of potential refinement to improve future efficacy of the program. This included aspects of program content, program delivery, resource development, and measurement tools. The planned future follow-up of program participants' official crash and traffic offence records over time may lend further support for the application of the program within licensing systems. The findings reported in this thesis offer an initial indication that the Three Steps to Safer Riding is a useful resource to accompany skills-based training programs.

Comparison of moped, scooter and motorcycle crashes : implications for rider training and education

Scooter and moped sales have increased at a faster rate than motorcycle sales over the last decade in countries such as Australia, Canada and the United States. This may be particularly evident in jurisdictions where moped riding is permitted for car license holders and a motorcycle license is not required, such as in Queensland, Australia. Having historically comprised only a small proportion of powered two-wheelers (PTWs) outside of Europe and Asia, the safety of scooters and mopeds has received relatively little focused research attention. However, the recent trends in sales and crash involvement have stimulated greater interest in these PTW types. The current paper examines differences and similarities between scooters (over 50cc), mopeds (up to 50cc) and motorcycles in crash involvement and crash characteristics through analyses of crash and registration data from Queensland, Australia. The main findings include that moped and scooter riders are similar in terms of usage patterns, but the evidence suggests superior skills, greater experience and safer behaviour among scooter riders than moped riders. The requirement in Queensland for scooter riders but not moped riders to hold a motorcycle license, usually obtained through competency-based training and assessment, may help to explain some of this difference. Findings also suggest that scooter riders are safer than motorcycle riders in some respects, despite both being subject to the same licensing requirements which encourage participation in rider training. Safer attitudes and motivations rather than superior skills and knowledge may therefore underlie the differences between scooter and motorcycle riders. In summary, riders of larger scooters exhibit a combination of skills and behavior suggestive of safer riding than both their moped and motorcycle riding counterparts. It is reasonable to expect that mopeds and scooters will remain popular and that their usage may increase further, along with that of motorcycles. This research therefore has important practical implications regarding pathways to improved PTW safety. Future policy and planning should consider options for encouraging moped riders to acquire better riding skills and greater safety awareness, as apparent among scooter riders, including rider training, education and licensing. As is noted in recent literature and reflected in some contemporary rider training programs, motorcycle safety may be improved by addressing rider attitudes more comprehensively in addition to developing skills and knowledge.

Innovations in dietetic training in foodservice management : can early exposure to practice enhance final year competency development?

Student engagement in the delivery of theoretical course materials is a current challenge in the tertiary sector including for dietetic training. In 2011 with the creation of a new nutritionist position for Queensland Meals on Wheels (QMOW), a service learning approach to support this organisation was used with third year dietetic students undertaking two days of structured activities at various QMOW sites in South East Queensland, aligned with coursework in Foodservice Management (FSM). This cohort of students was then followed in their final year post successful completion of five weeks professional practice in FSM to see if this experience supported readiness for placement and competency development. Evaluation was undertaken of eligible students (n = 50) via paper based survey (response rate 94%) with all participating in targeted focus groups. Findings showed that students acknowledged the QMOW experience (on reflection 14 months later) providing opportunity for participation and/or observation in 5 of 12 FSM areas taught in third year, including food safety, meal production, assembly, delivery and dishwashing. Over half the students identified good exposure to FSM competency areas during the QMOW experience, with 83% satisfied with their competency exposure and subsequent practice during final year placements. A consistent theme emerged from focus groups supporting inclusion of practical opportunities with the theoretical component of the FSM subject to highlight relevance to learning. These findings highlight the importance of such teaching initiatives to met student learning preferences, linking theory with practice and supporting competency development in the final year of training programs.

Pushing cultural competence boundaries in nutrition and dietetics training

A health workforce ready for safe practice is a government priority, and particularly critical to support indigenous communities closing ‘the gap’. Increased pressure exists on dietetic training programs for quality placements, with fewer opportunities for immersion in Aboriginal and Torres Strait Islander communities to demonstrate cultural competence. In 2012, Queensland University of Technology established a partnership with Apunipima Cape York Health Council with 56 weeks of dietetic placement for 8 students provided to achieve these aims. Clinical practice in Community Public Health Nutrition (CPHN) was structured in a standard 6 week placement, with Individual Case Management (ICM) and Foodservice Management (FSM) integrated across 8 weeks (4 each), with an additional 2 weeks ICM prior in a metropolitan indigenous health service. Students transitioned from urban to rural then remote sites, with new web-based technologies used for support. Strong learning opportunities were provided, with CPHN projects in antenatal and child health, FSM on standardisation of procedures in a 22 bed health facility, and ICM exposing students to a variety of cases via hospital in/outpatients, general clinics and remote community outreach. Supervisor focus group evaluation was positive, with CPHN and FSM enhancing capacity of service. Student focus group evaluation revealed placements exceeded expectations, with rating high, and strong confidence in cultural competence described. Students debriefed final and third year cohorts on their experiences, with increased awareness and enthusiasm for work with indigenous communities indicated by groups. With the success of this partnership, placements are continuing 2013, and new boundaries in dietetic training established.

Doctoral research training : encouraging timely completion – case study reflections of one university on how it supports a vibrant research training culture

This is a case study of a young university striving to generate and sustain a vibrant Research Training culture. The university’s research training framework is informed by a belief in a project management approach to achieving successful research candidature. This has led to the definition and reporting of key milestones during candidature. In turn, these milestones have generated a range of training programs to support Higher Degree Research (HDR) students to meet these milestones in a timely fashion. Each milestone focuses on a specific set of skills blended with supporting the development of different parts of the doctoral thesis. Data on student progress and completion has provided evidence in highlighting the role that the milestones and training are playing in supporting timely completion. A university-wide reporting cycle generated data on the range of workshops and training provided to Higher Degree Research students and supervisors. The report provided details of thesis topic and format, as well as participation in research training events and participant evaluation of those events. Analysis of the data led to recommendations and comments on the strengths and weaknesses of the current research training program. Discussion considered strategies and drivers for enhancements into the future. In particular, the paper reflects on the significant potential role of centrally curated knowledge systems to support HDR student and supervisor access, and engagement and success. The research training program was developed using blended learning as a model. It covered face-to-face workshops as well as online modules. These were supplemented by web portals that offered a range of services to inform and educate students and supervisors and included opportunities for students to interact with each other. Topics ranged from the research life cycle, writing and publication, ethics, managing research data, managing copyright, and project management to use of software and the University’s Code of Conduct for Research. The challenges discussed included: How to reach off campus students and those studying in external modes? How best to promote events to potential participants? How long and what format is best for face-to-face sessions? What online resources best supplement face-to-face offerings? Is there a place for peer-based learning and what form should this take? These questions are raised by a relatively young university seeking to build and sustain a vibrant research culture. The rapid growth in enrolments in recent years has challenged previous one-to-one models of support. This review of research training is timely in seeking strategies to address changing research training support capacity and student needs. Part of the discussion will focus on supervisory training, noting that good supervision is the one remaining place where one-to-one support is provided. Ensuring that supervisors are appropriately equipped to address student expectations is considered in the context of the research training provisions. The paper concludes with reflection on the challenges faced, and recommended ways forward as the number of research students grows into the future.

Fuzzy logic to evaluate driving maneuvers: An integrated approach to improve training

Driver training is one of the interventions aimed at mitigating the number of crashes that involve novice drivers. Our failure to understand what is really important for learners, in terms of risky driving, is one of the many drawbacks restraining us to build better training programs. Currently, there is a need to develop and evaluate Advanced Driving Assistance Systems that could comprehensively assess driving competencies. The aim of this paper is to present a novel Intelligent Driver Training System (IDTS) that analyses crash risks for a given driving situation, providing avenues for improvement and personalisation of driver training programs. The analysis takes into account numerous variables acquired synchronously from the Driver, the Vehicle and the Environment (DVE). The system then segments out the manoeuvres within a drive. This paper further presents the usage of fuzzy set theory to develop the safety inference rules for each manoeuvre executed during the drive. This paper presents a framework and its associated prototype that can be used to comprehensively view and assess complex driving manoeuvres and then provide a comprehensive analysis of the drive used to give feedback to novice drivers.

Gain's in knowledge, attitude and skills of counselors across three trainings programs

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) sponsored by the G20 nations has helped fund the development of training programs for HIV/AIDS counselors in India. To date no study has examined the effectiveness of these training programs. This study, therefore, aimed to examine the impact of a 12 training program in improving the knowledge of new HIV/AIDS counselors in West Bengal and compare benefits of three training programs. Pre and post measures were taken from 87 counsellors attending three training programs organized by the GFATM-7 team of the Department of Applied Psychology, University of Calcutta. Overall pre and post training scores of three training programs together show significant improvements in knowledge. The findings from this study provide confidence that the 12 day training program can be effectively implemented among West Bengal HIV/AIDS counsellors.

The protective mechanisms of first aid training within a school-based program for early adolescents

This thesis was concerned with the protective mechanisms of first aid training in the context of peer support. Using a randomised control trial design the current program of research explores first aid training in the school setting and identifies the key components of effective school-based first aid training programs. In particular, examining whether first aid training and associated knowledge could be protective for early adolescents. This broader framing considered whether first aid impacted on increasing behaviour and attitudes towards helping an injured friend, and reducing personal risk taking and related injury.

SOTrain: A new program for training supervisors and operators in Australian sugar factories

The provision of effective training of supervisors and operators is essential if sugar factories are to operate profitably and in an environmentally sustainable and safe manner. The benefits of having supervisor and operator staff with a high level of operational skills are reduced stoppages, increased recovery, improved sugar quality, reduced damage to equipment, and reduced OH&S and environmental impacts. Training of new operators and supervisors in factories has traditionally relied on on-the-job training of the new or inexperienced staff by experienced supervisors and operators, supplemented by courses conducted by contractors such as Sugar Research Institute (SRI). However there is clearly a need for staff to be able to undertake training at any time, drawing on the content of online courses as required. An improved methodology for the training of factory supervisors and operators has been developed by QUT on behalf of a syndicate of mills. The new methodology provides ‘at factory’ learning via self-paced modules. Importantly, the training resources for each module are designed to support the training programs within sugar factories, thereby establishing a benchmark for training across the sugar industry. The modules include notes, training guides and session plans, guidelines for walkthrough tours of the stations, learning activities, resources such as videos, animations, job aids and competency assessments. The materials are available on the web for registered users in Australian Mills and many activities are best undertaken online. Apart from a few interactive online resources, the materials for each module can also be downloaded. The acronym SOTrain (Supervisor and Operator Training) has been applied to the new training program.

Somatisation in primary care: experiences of primary care physicians involved in a training program and in a randomised controlled trial

Background: A new intervention aimed at managing patients with medically unexplained symptoms (MUS) based on a specific set of communication techniques was developed, and tested in a cluster randomised clinical trial. Due to the modest results obtained and in order to improve our intervention we need to know the GPs' attitudes towards patients with MUS, their experience, expectations and the utility of the communication techniques we proposed and the feasibility of implementing them. Physicians who took part in 2 different training programs and in a randomised controlled trial (RCT) for patients with MUS were questioned to ascertain the reasons for the doctors' participation in the trial and the attitudes, experiences and expectations of GPs about the intervention. Methods: A qualitative study based on four focus groups with GPs who took part in a RCT. A content analysis was carried out. Results: Following the RCT patients are perceived as true suffering persons, and the relationship with them has improved in GPs of both groups. GPs mostly valued the fact that it is highly structured, that it made possible a more comfortable relationship and that it could be applied to a broad spectrum of patients with psychosocial problems. Nevertheless, all participants consider that change in patients is necessary; GPs in the intervention group remarked that that is extremely difficult to achieve. Conclusion: GPs positively evaluate the communication techniques and the interventions that help in understanding patient suffering, and express the enormous difficulties in handling change in patients. These findings provide information on the direction in which efforts for improving intervention should be directed.

Safety Training and Oceanic Fishing

This paper reports on the cultural adaptation of Atlantic commercial fishermen to the danger of their occupation and efforts to ameliorate that danger through safety training programs. The research is directed towards measuring fishermen's patterns of subjective perceived danger and assessing the impact of safety training on these patterns of thinking. Safety training for commercial fishermen has unique problems owing to a culture that relies heavily on the trivialization or denial of the dangers associated with the work (Binkley, 1995; Poggie et al., 1995, 1996; Pollnac et al., 1995). Hence, understanding the efficacy of various approaches to safety training is important in promoting greater safety at sea, for this understanding will help create the most effective programs.