Gastrointestinal endoscopy training in the United States: Program structure and competence assessment.

The general principles of gastrointestinal endoscopy training in the United States were formulated and summarized more than a decade ago and the principles have been consistent until now. To summarize, trainees should be prepared to (i) appropriately recommend endoscopic procedures as indicated by the findings of the consultative evaluation, with an explicit understanding of accepted specific indications, contraindications, and diagnostic/therapeutic alternatives, (ii) perform procedures safely, completely, and expeditiously, including possessing a thorough understanding of the principles of conscious sedation/analgesia techniques, the use of anesthesia-assisted sedation where appropriate, and pre-procedure clinical assessment and patient monitoring, (iii) correctly interpret endoscopic findings and integrate them into medical or endoscopic therapy, (iv) identify risk factors for each procedure, understand how to minimize each, and recognize and appropriately manage complications when they occur, (v) acknowledge the limitations of endoscopic procedures and personal skills and know when to request help, and (vi) understand the principles of quality measurement and improvement. This article provides an overview of the endoscopy training system and structure, evaluation scheme, and competence and credentialing process in the United States.

A novel optimized neural network model for cyber attack detection using enhanced whale optimization algorithm.

Cybersecurity is critical in today's digitally linked and networked society. There is no way to overestimate the importance of cyber security as technology develops and becomes more pervasive in our daily lives. Cybersecurity is essential to people's protection. One type of cyberattack known as "credential stuffing" involves using previously acquired usernames and passwords by attackers to access user accounts on several websites without authorization. This is feasible as a lot of people use the same passwords and usernames on several different websites. Maintaining the security of online accounts requires defence against credential-stuffing attacks. The problems of credential stuffing attacks, failure detection, and prediction can be handled by the suggested EWOA-ANN model. Here, a novel optimization approach known as Enhanced Whale Optimization Algorithm (EWOA) is put on to train the neural network. The effectiveness of the suggested attack identification model has been demonstrated, and an empirical comparison will be carried out with respect to specific security analysis.

Digital badges in academia: An educational tool for the clinical research coordinator.

Digital badges can provide condensed competency-based knowledge enabling individuals a chance to explore specialized careers in clinical research. A digital badge can be an efficient pathway to introduce clinical research job roles and educate a larger diverse workforce for clinical research coordinator positions at AMCs. The New Jersey Alliance for Clinical and Translational Science (NJ ACTS) developed a digital badge with potential to broaden exposure to training opportunities for CRCs and improve their prospects for a career at Rutgers. This paper describes the development of a digital badge introducing individuals to the clinical research profession, especially for those who aspire to become a CRC. The badge was designed to include five domains (Scientific Concepts and Research Design, Ethical and Participant Safety Considerations, Clinical Study Operations and Site Management, and Data Management and Informatics). Participants assessed the badge for accuracy and presentation level. The results demonstrated that the competencies were met, and content was appropriate for someone with limited knowledge of clinical research. Survey results along with the Difficulty Index and Discrimination Index calculated for quiz questions supported the badge rank as foundational. Research is ongoing to evaluate the value of the badge to job acquisition, performance, and career growth.

Evidence-based practice attitudes and nutrition support guideline knowledge between holders and nonholders of the Certified Nutrition Support Clinician credential.

BACKGROUND: Clinical practice frequently changes, and professionals should stay abreast of evidence-based practice (EBP) guidelines. Negative attitudes towards EBP are a barrier to guideline adoption. This study explored EBP attitudes and knowledge of a complex nutrition support clinical case scenario of individuals holding or not holding the Certified Nutrition Support Clinician (CNSC) credential. METHODS: This cross-sectional study used an online survey sent to American Society for Parenteral and Enteral Nutrition (ASPEN) members with and without the CNSC credential and all CNSC credential holders from the National Board of Nutrition Support Certification email list. The survey included the Evidence-Based Practice Attitude Scale Score (EBPAS-15) and eight knowledge questions using a nutrition support case scenario. An independent samples t test compared knowledge and EBPAS-15 total scores and subscores between CNSC holders and nonholders. Pearson correlation determined the correlation between knowledge and EBPAS-15 scores. RESULTS: The response rate was 7.8% (N = 706). CNSC holders (n = 536) had significantly higher mean knowledge scores (4.7 ± 1.6 out of 8) than nonholders (n = 159, 4.1 ± 1.7) (P < 0.001). Total EBPAS-15 scores were not significantly different between CNSC holders (n = 542, 2.9 ± 0.4 out of 4) and nonholders (n = 164, 2.8 ± 0.7) (P = 0.434), and knowledge scores and total EBPAS-15 scores (P = 0.639) or subscores were not significantly correlated. CONCLUSIONS: Regardless of holding the CNSC credential, EBPAS-15 scores indicated respondents had positive EBP attitudes. CNSC holders had significantly higher knowledge scores of recent nutrition support EBP guidelines compared with non-CNSC credential holders. Positive EBP attitudes are a precursor to clinical decision-making, but future research should determine the use of guidelines in clinical practice.

International stakeholder perspectives on One Health training and empowerment: a needs assessment for a One Health Workforce Academy.

BACKGROUND: One Health is defined as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems; this approach attracts stakeholders from multiple sectors, academic disciplines, and professional practices. The diversity of expertise and interest groups is frequently and simultaneously framed as (1) a strength of the One Health approach in the process of understanding and solving complex problems associated with health challenges such as pathogen spillovers and pandemics and (2) a challenge regarding consensus on essential functions of One Health and the sets of knowledge, skills, and perspectives unique to a workforce adopting this approach. Progress in developing competency-based training in One Health has revealed coverage of various topics across fundamental, technical, functional, and integrative domains. Ensuring that employers value the unique characteristics of personnel trained in One Health will likely require demonstration of its usefulness, accreditation, and continuing professional development. These needs led to the conceptual framework of a One Health Workforce Academy (OHWA) for use as a platform to deliver competency-based training and assessment for an accreditable credential in One Health and opportunities for continuing professional development. METHODS: To gather information about the desirability of an OHWA, we conducted a survey of One Health stakeholders. The IRB-approved research protocol used an online tool to collect individual responses to the survey questions. Potential respondents were recruited from partners of One Health University Networks in Africa and Southeast Asia and international respondents outside of these networks. Survey questions collected demographic information, measured existing or projected demand and the relative importance of One Health competencies, and determined the potential benefits and barriers of earning a credential. Respondents were not compensated for participation. RESULTS: Respondents (N = 231) from 24 countries reported differences in their perspectives on the relative importance of competency domains of the One Health approach. More than 90% of the respondents would seek to acquire a competency-based certificate in One Health, and 60% of respondents expected that earning such a credential would be rewarded by employers. Among potential barriers, time and funding were the most cited. CONCLUSION: This study showed strong support from potential stakeholders for a OHWA that hosts competency-based training with opportunities for certification and continuing professional development.

A Study on the Interoperability Technology of Digital Identification Based on WACI Protocol with Multiparty Distributed Signature.

In digital identity authentication, credentials are typically stored in a digital wallet and authenticated through a single key-based signature and public key verification. However, ensuring compatibility between systems and credentials can be challenging and the existing architecture can create a single point of failure, which can hinder system stability and prevent data interchange. To address this problem, we propose a multiparty distributed signature structure using FROST, a Schnorr signature-based threshold signature algorithm, applied to the WACI protocol framework for credential interaction. This approach eliminates a single point of failure and secures the signer's anonymity. Additionally, by following standard interoperability protocol procedures, we can ensure interoperability during the exchange of digital wallets and credentials. This paper presents a method that combines a multiparty distributed signature algorithm and an interoperability protocol, and discusses the implementation results.

Supporting clinical research professionals through educational innovations.

Clinical Research Professionals (CRPs) are essential members of the Clinical and Translational Research Workforce. Many academic medical institutions struggle to recruit and retain these vital team members. One strategy to increase job satisfaction and promote the retention of CRPs is through educational initiatives that provide training and professional development. The South Carolina Clinical and Translational Research (SCTR) Institute Workforce Development (WD) team at the Medical University of South Carolina (MUSC) developed several trainings as part of our larger educational portfolio for CRPs. In 2022 WD implemented a digital badge micro-credential for SCTR's Core Clinical Research Training (CCRT) course in collaboration with institution-wide education and technology offices. Beginning in January 2023, individuals were able to earn the CCRT Certified Digital Badge upon successful completion of the CCRT course.

An environmental scan of aging-related micro-credentials: implications for gerontology and gerontologists.

The purpose and rise of formal academic programs in gerontology at colleges and universities has been well documented over the last fifty years. What has been less well-documented is the rise of alternative pathways to gerontology training and gerontological competence, including micro-credentialing. Micro-credentials (MCs) are intended to provide quick-to-complete, competency-based education around specific topics to demonstrate relevant skills to employers. Little is known about the prevalence of micro-credentialing related to gerontology. To address this gap, we conducted an environmental scan of existing aging-related micro-credentialing opportunities. We identified 89 MCs with an explicit aging focus, applied strict inclusion criteria (narrowing the sample to 54 MCs included in the analysis), and examined the characteristics of the MCs' scope and nature. Most MCs focused on aging-related health/disease conditions, highlighting the decline mentality underlies such training. Future efforts should entail analysis of the competencies addressed by MCs as it is critical to ensure alignment between gerontological MCs and established gerontological competencies and standards and to differentiate MCs from formal academic programs.

Developing an Indigenous cultural safety micro-credential: initial findings from a training designed for public health professionals in southern Ontario.

Cultural safety training is a resource that healthcare institutions and staff can rely on to end anti-Indigenous racism in their organisations and to shift service providers' attitudes, beliefs, and knowledge of Indigenous people. The aim of this study was to understand the initial knowledge and interest about Indigenous Peoples that a southern Ontario public health unit's (PHU) staff hold. A cultural safety micro-credential project was developed in consultation with the PHU. An online survey was administered from January to March 2021 to those who were starting the micro-credential during this timeframe (n = 31). Thirty-one staff responded. A majority of the participants indicated that they had some knowledge of Indigenous Peoples and that this knowledge was relevant to their work. The number of interactions with Indigenous Peoples varied by role. Common themes for the open-ended responses included culture, relationships, and supports/services. Many of the open-ended responses highlighted feelings of not knowing enough and wanting to learn more about Indigenous Peoples. These results indicate a shift in attitudes, behaviours, and knowledge of Indigenous Peoples among the PHU staff. Cultural safety training can serve to address knowledge gaps and contribute to creating the systemic change needed to end anti-Indigenous racism in healthcare institutions.

Micro-credentials in leveraging emergency remote teaching: the relationship between novice users' insights and identity in Malaysia.

Micro-credentials have gained much popularity in recent years, and their popularity has skyrocketed due to emergency remote teaching instigated by the pandemic. It has been defined as a platform that provides credentials based on validated competencies. Nevertheless, in Malaysian HEI, such a concept is still novel and identifying insights on the benefits, challenges, and application are still scarce. Similarly, it was observed that there is a lack of observation on how students' digital learning identity and their perception of professional relevance are influenced by such platform. Henceforth, based on the adapted enriched virtual model approach, a micro-credentials course was implemented to complement the new "normal" classes for a pre-service teacher's instructional design course. A mixed-method triangulation design was used to explore the qualitative findings operationalized by open-ended questions (N = 74) with data obtained from the Digital Learning Identity Survey (DLIS) and Constructivist On-Line Learning Environment Survey (COLLES) (N = 72). The findings indicated that respondents had an overall positive perception of the use of micro-credentials to complement and overcome online learning challenges mainly due to substandard internet connectivity; nevertheless, they are unaware of the value of such credentials in their future profession. Conversely, their new identity as digital learners and experiences with a blended approach of online learning, especially with micro-credentials, was successful in shaping their identity as aspiring educators that embrace technology for teaching and learning.

A micro-credentialing methodology for improved recognition of HE employability skills.

Increasingly, among international organizations concerned with unemployment rates and industry demands, there is an emphasis on the need to improve graduates' employability skills and the transparency of mechanisms for their recognition. This research presents the Employability Skills Micro-credentialing (ESMC) methodology, designed under the EPICA Horizon 2020 (H2020) project and tested at three East African universities, and shows how it fosters pedagogical innovation and promotes employability skills integration and visibility. The methodology, supported by a competency-based ePortfolio and a digital micro-credentialing system, was evaluated using a mixed-method design, combining descriptive statistics and qualitative content analysis to capture complementary stakeholder perspectives. The study involved the participation of 13 lecturers, 169 students, and 24 employers. The results indicate that the ESMC methodology is a promising approach for supporting students in their transition from academia to the workplace. The implementation of the methodology and the involvement of employers entails rethinking educational practices and academic curricula to embed employability skills. It enables all actors to broaden their understanding of the relationship between higher education and the business sector and to sustain visibility, transparency, and reliability of the recognition process. These findings indicate that there are favourable conditions in the region for the adoption of the approach, which is a meaningful solution for the stakeholder community to address the skills gap.

The Learning Loop: Conceptualizing Just-in-Time Faculty Development.

BACKGROUND: As technology advances, the gap between learning and doing continues to close-especially for frontline academic faculty and clinician educators. For busy clinician faculty members, it can be difficult to find time to engage in skills and professional development. Competing interests between clinical care and various forms of academic work (e.g., research, administration, education) all create challenges for traditional group-based and/or didactic faculty development. METHODS: The authors engaged in a synthetic narrative review of literature from several unrelated fields: learning technologies, medical education/health professions education, general/higher education. The aim for this review was to synthesize this pre-existing literature to propose a new conceptual model. RESULTS: The authors propose a new conceptual model, the Just-In-Time Learning Loop, to guide the development of online faculty development for just-in-time delivery. CONCLUSIONS: The Just-In-Time Learning Loop is a new conceptual framework that may be of use to those engaging in online, digital learning design. Faculty developers, especially in emergency medicine, can integrate leading concepts from the technology-enhanced learning field (e.g., microlearning, micro-credentialing, badging) to create new types of learning experiences for their end-users.

Using Simulation-Based Methods to Support Demonstration of Competencies Required by Micro-Credential Courses.

The rise of the digital revolution has disrupted entire industries and job markets, leading individuals to either upgrade or transfer their skills in order to continue within their designated fields or transition to new workplace contexts. Employers expect their employees to apply their knowledge to real-world settings, analyze and solve problems, connect choices to actions, and innovate and create. Moreover, the COVID-19 pandemic has exacerbated changes to the educational landscape by forcing online and remote contexts; physical distancing and other preventive measures have necessitated a shift towards increasing the use of disruptive digital technologies- extended reality (e.g., virtual and augmented reality), gaming, and additive manufacturing-in simulation delivery. Yet Canada's economic and demographic data suggests that many new graduates struggle to transition from school to working life. The confluence of these factors has led to a need for both individuals and higher education institutions to upgrade and adapt to new digital techniques and modalities. As these needs grow, simulation-based education (SBE) techniques and technologies-already an integral part of training for some professions, including nursing, medicine, and various other health professions-are increasingly being used in digital contexts. In this editorial, we provide our perspective of the socio-technological movement associated with health-professions education (HPE) within the SBE context and examine the application and implementation of micro-credentialing within this field. We also discuss the various levels of expertise that learners may acquire. From this vantage point, we address how SBE can complement the assessment of competencies that learners must demonstrate to attain micro-credentials and explore micro-credentialing's advantages for, and use in, HPE.

Occupational Credentials and Job Qualities of Direct Care Workers: Implications for Labor Shortages.

Occupational training and credentialing requirements for direct care workers were in place for consumers' health and safety, but their effects on job qualities and labor shortages in the direct care industry have been controversial. Using a nationally representative sample of psychiatric, nursing, and home health aides, a series of Average Treatment Effect models were analyzed to examine the effects of occupational credentials on various measures of job qualities. The findings revealed that credential-holding was related to higher annual earnings and increased probability of working full-time, year-round, and having access to employer-provided health insurance and retirement savings plans. The positive effects, however, were modest in size and suggested that, given the current wage and benefit levels for direct care workers, training and credential requirements cannot be the key to resolving job quality and labor shortage issues in the direct care industry. Implications of these findings and alternative ways to address the issues were discussed.

Does the Type and Timing of Educational Attainment Influence Physical Health? A Novel Application of Sequence Analysis.

Nontraditional education trajectories are common, but their influence on physical health is understudied. We constructed year-by-year education trajectories for 7,501 National Longitudinal Survey of Youth 1979 participants aged 14 to 48 years (262,535 person-years of education data from 1979 to 2014). We characterized trajectory similarity using sequence analysis and used hierarchical clustering to group similar educational trajectories. Using linear regression, we predicted physical health summary scores of the participants at age 50 years from the 12-item Short-Form Survey, adjusting for available confounders, and evaluated effect modification by sex, race/ethnicity, and childhood socioeconomic status. We identified 24 unique educational sequence clusters on the basis of highest level of schooling and attendance timing. General education development credentials predicted poorer health than did high school diplomas (ß = -3.07, 95% confidence interval: -4.07, -2.07), and bachelor's degrees attained at earlier ages predicted better health than the same degree attained at later ages (ß = 1.66, 95% confidence interval: 0.05, 3.28). Structurally marginalized groups benefited more from some educational trajectories than did advantaged groups (e.g., Black vs. White Americans with some college; those of low vs. high childhood socioeconomic status who received an associate's or bachelor's degree). Both type and timing of educational credentials may influence physical health. Literature to date has likely underestimated the impact of educational trajectories on health.

Certified Hand Therapist Exam and Credential System of the United States:Introduction and Implication / 中国康复理论与实践

This study descriptively illustrated the definition of certified hand therapist, eligibility requirement and accreditation system based on the official guidelines from American Society of Hand Therapists (ASHT), Hand Therapy Certification Commission (HTCC) and Handbook of Certified Hand Therapy Examination. Besides, this exam was compared with National Physical Therapy Examination (NPTE) and Occupational Therapist Registered Examination (OTR Exam). The testing domains and contents may help the domestic teaching faculty to standardize the course syllabi, promote divided development of physical therapy and occupational therapy in a specialized manner, and ex-erted positive impact for promoting establishment of the hand specialists and accreditation system of China itself.

Associations of Educational Attainment With Disability and Life Expectancy by Race and Gender in the United States.

OBJECTIVE: This study provides estimates of associations of education with life expectancy and the percentage of remaining life from age 40 with disability. METHOD: We used the Panel Study of Income Dynamics, 1999-2011 ( n = 8,763; 94,246 person-years), measuring five education levels. We estimated probabilities of disability and death with multinomial logistic Markov models, and used microsimulations beginning at age 40, controlling for gender, race/ethnicity, age, and disability. RESULTS: With college education, African American and White women, and African American and White men, respectively, lived 46.6%, 44.0%, 55.2%, and 50.4% more years from age 40 than those educated at less than the ninth grade ( p < .001). Corresponding percentages of life with disability were lower with high education, by 37.9%, 38.9%, 41.0%, and 39.9% ( p < .001). There was little evidence of outcome differences between African Americans and Whites within education levels. DISCUSSION: Low education is associated with shorter lives with much more disability.

Preserving Smart Objects Privacy through Anonymous and Accountable Access Control for a M2M-Enabled Internet of Things.

As we get into the Internet of Things era, security and privacy concerns remain as the main obstacles in the development of innovative and valuable services to be exploited by society. Given the Machine-to-Machine (M2M) nature of these emerging scenarios, the application of current privacy-friendly technologies needs to be reconsidered and adapted to be deployed in such global ecosystem. This work proposes different privacy-preserving mechanisms through the application of anonymous credential systems and certificateless public key cryptography. The resulting alternatives are intended to enable an anonymous and accountable access control approach to be deployed on large-scale scenarios, such as Smart Cities. Furthermore, the proposed mechanisms have been deployed on constrained devices, in order to assess their suitability for a secure and privacy-preserving M2M-enabled Internet of Things.