Virtual Reality Simulation in Pediatric Resuscitation for Pre-hospital Providers.

This technical report explored the feasibility and utility of virtual reality (VR) pediatric resuscitation simulations for pre-hospital providers during their scheduled shifts. To our knowledge, neither the pediatric resuscitation VR simulation nor the feasibility of in situ, on-shift training with VR had been previously evaluated in pre-hospital providers. VR headset was available at an urban city fire station for 10 days where a total of 60 pre-hospital providers were scheduled to work. Providers were made aware of the VR module but no formal demonstration was done. There were no facilitators. Participants filled out an anonymous retrospective pre- and post-survey using a five-point Likert scale, rating their confidence from "not confident" to "very confident" in recognizing and managing pediatric emergencies. We found that VR simulation for pediatric resuscitation was a feasible training tool to use in situ as 63% of the providers were able to use it on shift. Furthermore, self-reported confidence increased after the training where responses of "very confident" increased from 20% to 30% for emergency medical technicians and 55% to 63% for paramedics.

Minimum wage standard adjustment and employment: Heterogeneity effects on the human capital investment.

Considerable debate has arisen around the potential effects of increasing the minimum wage on employment. This study aims to analyze the impact of changes in China's minimum wage standard on employment. The research utilises the canonical model method and constructs a regression model based on standard labor economics theory. The analysis is conducted using sample data from Chinese industrial enterprises between 2000 and 2007. Regression analysis is performed by categorizing enterprises based on their level of human capital investment. The findings indicate that minimum wage increases have a non-linear impact on employment, when seen from the standpoint of human capital investment. When the level of human capital investment is low, an increase in the minimum wage standard leads to a decrease in employment; when the level of human capital investment is high, an increase in the minimum wage standard leads to an increase in employment. According to the findings, the reason for this is that, investments in human capital can improve business profitability, increase worker marginal productivity, and increase labor demand. Similarly, the employment effect of a change in the minimum wage is positive in regions with high levels of human capital investment due to the externality effect of human capital. Adjustments to the minimum wage have a negative impact on employment in areas of the country with low levels of human capital investment. This demonstrates that changing the minimum wage does not result in a simple increase or decrease in total employment. The level of investment in human capital within the organization and the region is an important factor in determining the type and magnitude of the impact.

The Role of Continuing Professional Training or Development in Maintaining Current Employment: A Systematic Review.

The impact of continuing job education and professional development on early exit from the labor market is unclear. This systematic review examined how continuing job education or professional development influences the retention of current employment. We searched the PubMed and Embase databases from their start dates to January 2023. Two reviewers screened the full texts of relevant reports and assessed the methodological quality of the included studies using the adapted Effective Public Health Practice Project quality assessment. We qualitatively synthesized the results of the included studies. We screened 7338 publications and included 27 studies consisting of four cohort and 23 cross-sectional studies in the review. The participants of the selected studies were mostly from the health sector (24 studies). There were 19 studies on staying or leaving a current job, six on employee turnover intention, two on job change, one on return to work, one on early retirement, and one on employment. Continuing employee development or training opportunities were associated with increased intention to stay in a current job, decreased intention to leave a current job, decreased employee turnover intention, job change, or early retirement and with faster return to work. One of the two studies that examined the role of age showed that continuing employee development is a more important factor for retaining current employment among younger than older employees. A few studies found that job satisfaction and commitment fully mediated the relationship between employee development and employee intention to leave current employment. This study suggests that participating in professional training/development is related to a lower risk of leaving current employment.

The Impact of Modified Two-Surgeon Technique for Laparoscopic Liver Resection on the Training of Surgeons-in-Training.

Introduction Although laparoscopic liver resection (LLR) has gained widespread acceptance over the last decade, it is associated with a much steeper learning curve than other laparoscopic procedures. We currently perform a modified two-surgeon technique for LLR. We assessed the effect of our LLR technique on the surgical outcome and the learning curve of surgeons-in-training when pure non-anatomical LLR was performed. Methods Between 2017 and 2021, 118 LLRs were conducted at our institution, 42 of which were pure non-anatomical LLRs performed by five surgeons-in-training (with a career of 6-13 years). The perioperative outcomes of these cases were compared to those performed by the board-certified attending surgeon. Regarding the learning curve of surgeons-in-training, the duration of operation was used as an index of the proficiency level, and the number of surgical cases in which the surgeons reached the median duration of operation was examined. Results Mortality was zero, and neither postoperative bleeding nor bile leak was experienced in the whole cohort. There were no differences between surgeons-in-training and the board-certified surgeon in the duration of the operation, intraoperative blood loss, rate of postoperative complications, or length of postoperative stay (LOS). Among the operations performed by five surgeons-in-training, the rate of LLR with a difficulty score of 4 or higher was 52% (30%-75%). Concerning the learning curve, all five surgeons-in-training gradually shortened the duration of operation for each additional case and reached the median duration (218 minutes) by experiencing a median of five cases (3-8 cases). Conclusion A modified two-surgeon technique during LLR is feasible, with a relatively low number of cases (five cases) required to shorten the duration of operation in non-anatomical LLR. This technique is safe and beneficial to the education of surgeons-in-training.

Correlation Between Learning Motivation and Satisfaction in Synchronous On-the-Job Online Training in the Public Sector.

Non-governmental organizations often regard expanding revenue and reducing costs as standard procedures to achieve corporate sustainability, while at the same time considering human resources as important assets. Government agencies have greater flexibility in staffing, and their human resource strategies for employee education and training often use organizational learning to develop operational performance. Training is regarded as a panacea for corporate sustainability and channels have been established to support employees' learning. Curriculum development of synchronous online learning is an approach that requires further investigation. We distributed 360 questionnaires to supervisors and employees of the Taipei City Government, Taiwan. A total of 268 valid copies were retrieved, giving a response rate of 74%. The study results are expected to help public sector employers enhance employee cohesiveness and generate more operational team spirit.

Healthcare Providers' Experiences With a Clinical Mentorship Intervention to Improve Reproductive, Maternal and Newborn Care in Mwanza, Tanzania.

Introduction: There is increasing evidence suggesting that clinical mentorship (CM) involving on-the-job training is one of the critical resources-friendly entry points for strengthening the knowledge and skills of healthcare providers (HCPs), which in turn facilitate the delivery of effective reproductive, maternal, and newborn health (RMNH) care. The article explores the experiences of HCPs following participation in the CM program for RMNH in eight districts of Mwanza Region in Tanzania. Materials and Methods: A qualitative descriptive design employing data from midterm project review meetings and Key Informant Interviews (KIIs) with purposefully selected HCPs (mentors and mentees) and District Medical Officers (DMOs) during endline evaluation were employed. Interview data were managed using Nvivo Software and analyzed thematically. Results: A total of 42 clinical mentors and master mentors responded to a questionnaire during the midterm review meeting. Then, a total of 17 KIIs were conducted with Mentees (8), Mentors (5), and DMOs (4) during endline evaluation. Five key themes emerged from participants' accounts: (i) the topics covered during CM visits; (ii) the benefits of CM; (iii) the challenges of CM; (iv) the drivers of CM sustainability; and (iv) suggestions for CM improvement. The topics of CM covered during visits included antenatal care, neonatal resuscitation, pregnancy monitoring, management of delivery complications, and infection control and prevention. The benefits of CM included increased knowledge, skills, confidence, and change in HCP's attitude and increased client service uptake, quality, and efficiency. The challenges of CM included inadequate equipment for learning and practice, the limited financial incentive to mentees, shortage of staff and time constraints, and weaker support from management. The drivers of CM sustainability included the willingness of mentees to continue with clinical practice, ongoing peer-to-peer mentorship, and integration of the mentorship program into district health plans. Finally, the suggestions for CM improvement included refresher training for mentors, engagement of more senior mentors, and extending mentorship beyond IMPACT catchment facilities. Conclusion: CM program appears to be a promising entry point to improving competence among HCPs and the quality and efficiency of RMNH services potentially contributing to the reduction of maternal and neonatal deaths. Addressing the challenges cited by participants, particularly the equipment for peer learning and practice, may increase the success of the CM program.

Professional literacy that Taiwan's bag manufacturing industry talents should possess: Analyzing from a practical perspective.

Aim: This research aimed to explore the professional literacies that should be possessed by Taiwan's bag manufacturing industry talents. This understanding will also help the technical and vocational education system to cultivate talents in Taiwan's bag manufacturing industry. Methods: A qualitative research design was adopted. The outline of the interview on the professional literacy of Taiwan's bag manufacturing industry talents was compiled, and seven interviewees were selected by purposive sampling from those who had worked (including supervisors) in Taiwan's bag manufacturing industry for 21 to 42 years. One-on-one in-depth interviews with semi-structured interview questions were conducted. Using grounded theory, the content of the in-depth interviews was analyzed and discussed. Results and discussion: This study discusses what professional literacy of Taiwan's bag manufacturing industry talents should possess from the practical perspective of Taiwan's bag manufacturing industry leaders or senior managers. This study shows that bag manufacturing industry talents should possess knowledge, skills, and attitudes and values of common professional literacies. Moreover, bag designers, manufacturing technicians, patternmakers, hand stitchers, and production supervisors should acquire these professional literacies. The results of this study will help Taiwan's bag manufacturing industry leaders or senior managers to highlight the importance of professional literacy that Taiwan's bag manufacturing industry talents should possess. Conclusion: This study summarized the professional literacy of bag manufacturing industry talents into three major aspects: knowledge, skills, and attitudes and values. Based on this, suggestions are made as a reference for the implementation of curriculum development for talent cultivation in higher education institutions, and a reference for the learning and on-the-job training of bag manufacturing industry practitioners in the workplace.

Investigation and analysis of on-the-job training of health technicians in maternal and child care institutions / 中华医学教育探索杂志

Objective:To analyze the current situation and requirements of education for health technicians in maternal and child health care institutions, and put forward feasible strategies and measures to improve the comprehensive quality and professional level of the talent team of maternal and child health care institutions.Methods:Questionnaire survey was carried out on education needs of health technical staff of 11 maternal and child health care hospitals in 4 provinces (regions), and provincial, municipal and district-level medical institutions. The survey results were recorded by Epidata 3.1. SPSS 22.0 software was used for statistical analysis.Results:A total of 1 678 questionnaires were included in the analysis. A total of 1 313 people received training, accounting for 78.2%. The main reason for not receiving training was that the unit didn't arrange (180 people), accounting for 49.3%(180/365). There were 779 people who had more than 3 days of training, accounting for 59.3%. There were 384 people who were trained in superior general hospitals, accounting for 29.2%, and 268 people were trained in superior maternal and child health institutions, accounting for 20.4%. There were 837 people who learned the content of new professional progress, accounting for 50.8%(837/1 648). According to the interview, there were still some requirements for thematic training, further education, online learning, continuing education and standardized training.Conclusion:Maternal and child health care institutions have accelerated the construction of professional personnel, intensified training, and thoroughly implemented health personnel training programs, established a long-term mechanism, increased funding, improved training content, ensured the quality of training, and made a good job in hierarchical training to meet the learning needs of personnel at all levels. This is of great significance for strengthening the technical personnel of maternal and child health care institutions and improving their service capacity.

Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging.

BACKGROUND: Social Prescribing (SP) is an innovative strategy to respond to the non-clinical health needs of the population. A Social Prescribing Local System (SPLS) can be defined as a set of joined community, health, and social organizations to foster SP-oriented activities. This study aimed to develop and assess the feasibility of an SPLS implemented in a Mediterranean country, to promote health and wellbeing and contribute to active and healthy aging. METHODS: A mixed-methods approach was followed, including three sequential components: 1) Cross-sectional online survey targeting health professionals (HP) working in a primary health care cluster, Portugal's southern region; 2) Pilot study implementing an on-the-job training program for HP, designed to meet identified training needs in the survey; 3) Focus group (FG) with the HP who participated in the pilot study, two individual interviews, with an elderly patient and a community provider for assessing the satisfaction with the pilot test. RESULTS: Sixty-five HP completed the survey; of these, 13 completed the theoretical part of the on-the-job training program; and six (out of these 13) completed the full program. Five HP participated in the FG, one patient and one community provider were interviewed. The surveyed HP perceived as facilitators to implement SP: an automatic system of notifications to prompt the use of SP, contribute to patient satisfaction, human and community resources' stability. The survey also highlighted barriers to SP implementation: length of appointments, shortage of human resources, data records confidentiality, low patient adherence rates, bureaucratic issues, time constraints, and financial costs. Participants were satisfied with the training. Identified SPLS implementation benefits were grouped into four dimensions (from the qualitative approach): gains for patients' health and wellbeing, support for the health services, sustainability of the community resources, and HP' professional satisfaction. CONCLUSIONS: Our study took the first steps towards the implementation of an SPLS. Findings reinforce that training HP in SP and on-the-job training seems feasible. This approach was well received and appears to represent a suitable and sustainable strategy. It can promote professional satisfaction, support health services, contribute to the stability of community resources, improve health and promote active and healthy aging.

Covid-19: un reto para los estudiantes de Enfermería en la educación en el trabajo / COVID-19: a challenge for Nursing students in the on-the-job training

RESUMEN Introducción: en las prácticas docentes de Enfermería de la educación en el trabajo, que se realizan en centros hospitalarios, los estudiantes y enfermeros están expuestos al contagio por covid-19. De ahí que se haga necesaria la preparación de este personal para ejercer su labor de un modo exitoso en medio de un escenario complejo. Objetivo: evaluar el enfrentamiento a la covid-19 por parte de educandos y personal de enfermería en las prácticas de la educación en el trabajo. Materiales y métodos: se realizó una investigación de intervención y desarrollo en el Servicio de Neurocirugía del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, entre septiembre y octubre de 2020, período de rebrote de la covid. Para ello se trabajó con el universo constituido por 12 pacientes, 12 cuidadores y 6 educandos de 5to año de la carrera de Licenciatura en Enfermería. El estudio se dividió en tres etapas: diagnóstica, entrenamiento y evaluación. Se utilizó la entrevista. Resultados: predominó en los pacientes el grupo etario de 40 a 49 años, con 41,66 % del género masculino. En los cuidadores predominó el femenino, y la edad de 50 a 59 años. El entrenamiento resultó efectivo en un 58,33 %. Conclusiones: la prevención y el autocuidado fueron respuestas estratégicas positivas como formas de actuación en los educandos y el resto del personal que participó en la investigación. La labor asistencial educativa minimizó el riesgo epidemiológico en los pacientes y cuidadores, y logró un incremento en la percepción de riesgo de contraer la enfermedad (AU).

ABSTRACT Introduction: students and nurses are exposed to contagion by COVID-19 during the Nursing teaching practices of on-the-job training carried out in hospitals. Therefore, it is necessary train these staff to carry out their work successfully in the middle of a difficult scenario. Objective: to evaluate COVID-19 facing by students and nursing staff in the practices of on-the-job training. Materials and methods: an intervention and development research was conducted in the Neurosurgery Service of the University Hospital Comandante Faustino Pérez Hernández, of Matanzas, between September and October 2020, period of COVID-19 resurgence. For that we worked with a universe of 12 patients, 12 caregivers and 6 5th-year students of Nursing degree. The study was divided into three stages: diagnosis, training and evaluation. The interview was used. Results: the 40-49 age group predominated among patients, with 41.66 % of the male gender. Among caregivers, female gender predominated and 50-59 age group. The training was effective at 58.33 %. Conclusions: prevention and self-care were positive strategic answers as forms of action in students and the rest of the staff involved in the research. The educational aid work minimized the epidemiological risk in patients and caregivers, and achieved an increase in risk perception of contracting the disease (AU).

Assessing the Impact of Off-the-Job and On-the-Job Training on Employment Outcomes: A Counterfactual Evaluation of the PIPOL Program.

BACKGROUND: This article studies the effect of PIPOL, an integrated program of active labor policies launched by the Friuli Venezia Giulia, an Italian region, in 2014. OBJECTIVES: To understand the impact of training in a classroom setting (off-the-job) and work-related training (on-the-job) on employment integration of benefit recipients. RESEARCH DESIGN: We adopt a counterfactual approach by comparing a target group (treated) against a control group (19,899) extracted by means of propensity score matching and Mahalanobis distance matching among subjects who, while registered in the program over the years 2014-2016, had never benefited from it. The selection of about 7,175 recipients in the program and in each type of intervention was random. Subjects: About 30,000 job seekers made up of 3,911 interns, 2,945 trainees, and 319 recipients of training and internship within PIPOL. Target: Young people, Not in Education Employment or Trainings, and over 30s. MEASURES: We look at different outcomes: employment tout court and employment in open-ended contracts. RESULTS: The overall net impact of PIPOL was equal to +5 pp on average. Specifically, impact results were classroom training none, internship sizable (+14.1 pp), and training combined with an internship, quite sizable (+9.6 pp). Furthermore, training to gain a qualification was the most effective (+6.4 pp) among those receiving combined training and internship. Internship also increased the chance to find permanent employment (+3 pp). Among recipients, women, immigrants, and low-skilled recipients registered the most sizable impact on finding employment and training in manufacturing and construction was more effective than elsewhere. CONCLUSIONS: Italian young people have ever-increasing academic attainment but, due to the sequential nature of the education system, little work-related competences. This could explain the greater success of internships on classroom training.

Usability and Feasibility of an Innovative mLearning Approach for Nurses Providing Option B+ Services in Manica and Sofala Provinces, Mozambique

The scaling of Option B+ services, whereby all pregnant women who test HIV positive are started on lifelong antiretroviral therapy upon diagnosis regardless of CD4 T-cell count, is ongoing in many high HIV burden, low-resource countries. We developed and evaluated a tablet-based mobile learning (mLearning) training approach to build Option B+ competencies in frontline nurses in central Mozambique. Its acceptability and impact on clinical skills were assessed in maternal child health nurses and managers at 20 intervention and 10 control clinics. Results show that skill and knowledge of nurses at intervention clinics improved threefold compared with control clinics (p = .04), nurse managers at intervention clinics demonstrated a 9- to 10-fold improvement, and nurses reported strong acceptance of this approach. "mLearning" is one viable modality to enhance nurses' clinical competencies in areas with limited health workforce and training budgets. This study's findings may guide future scaling and investments in commercially viable mLearning solutions.

Gender, Nonformal Learning, and Earnings in South Korea.

Using data from the Programme for the International Assessment of Adult Competencies, this study examined gender differences in participation in various forms of nonformal learning-on-the-job training, distance learning, workshops, and private lessons-and their relationships with earnings in South Korea. We found significant gender differences in participation in on-the-job training, distance learning, and workshops favouring male workers, but the reverse gender gap in participation in private lessons favouring female workers. When it came to earnings, we found the positive relationships between participation in distance learning and earnings and between workshops and earnings for both males and females, even after controlling for other variables. However, the positive relationship between participation in on-the-job training and earnings was observed only for females. We highlight some unique aspects of Korea's organizational culture that may help explain the relationships among gender, on-the-job training, and earnings. Broader implications of the findings beyond South Korea are also discussed.

Lessons from a training needs assessment to strengthen the capacity of routine immunization service providers in Nigeria.

BACKGROUND: Health workers (HWs) providing routine immunization (RI) services play a crucial role in influencing vaccine uptake, a key determinant of improved immunization coverage. Over the years, Training Needs Assessments (TNAs) have not been routinely utilized in Nigeria to determine unmet needs of health workers offering immunization services and what approaches should be adopted to meet their training needs. The objective was to assess the level of Expanded Program on Immunization (EPI) knowledge among RI service providers and tutors in pre-service institutions in three Nigerian states, to identify unfulfilled training needs and their implications. It also sought HWs perception on a pilot training approach, where tutors will be used for in-service training. METHODS: TNA survey tools were designed to obtain knowledge-based information on the fundamental EPI concepts through key informant interviews and focus group discussions with 90 HWs and 27 pre-service tutors. Quantitative data was also obtained, hence utilizing a mixed method approach for the study. RESULTS: In spite of several previous trainings, HWs knowledge on basic immunization concepts including Reaching Every Ward (REW) strategy was varied and suboptimal. 83% of the HWs could not differentiate between the live attenuated and killed vaccines. In addition, pre-service tutors knowledge of fundamental EPI concepts, as well as HW perception of the new training approach also varied across the states. CONCLUSION: TNAs are valuable in determining specific training approaches to improve HWs skills needed to implement strategies required to increase vaccine uptake. However, EPI managers must be mindful of contextual factors beyond training needs such as finance and security, that can affect HW performance.

Satisfacción de estudiantes y docentes con la educación en el trabajo desde la Atención Primaria / Student and teacher satisfaction with on-the-job training in primary health care

Introducción: La formación del estudiante de Medicina se basa en los principios de la vinculación del estudio con el trabajo. La educación en el trabajo, como forma organizativa del proceso docente, lleva el protagonismo para cumplir con esta misión, por lo que los escenarios de la Atención Primaria de Salud deben ganar cada vez mayor espacio en la formación de estos profesionales. Objetivo: Valorar la satisfacción de estudiantes y profesores de la carrera de Medicina con la educación en el trabajo desde los escenarios de la Atención Primaria de Salud. Métodos: Se realizó un estudio descriptivo de corte longitudinal durante el curso 2016-2017 en Santo Domingo, provincia Villa Clara. La muestra estuvo constituida por 26 estudiantes de Medicina de tercer año del Policlínico Universitario "Manuel Piti Fajardo", 24 alumnos de sexto año que hicieron su rotación de Medicina General Integral en este municipio, y 20 profesores que participaron activamente en la formación de estos educandos. La información se obtuvo mediante revisión documental y encuestas realizadas a estudiantes y profesores. Resultados: Predominó el buen desempeño de los estudiantes, al adquirir sus habilidades en los dos años de la carrera, así como la promoción en la convocatoria ordinaria. Los profesores, en su mayoría, eran asistentes y estaban preparados metodológicamente para desarrollar la educación el trabajo. Conclusiones: La mayoría de los educandos y profesores del estudio se consideraron satisfechos con desarrollar la educación en el trabajo desde estos escenarios(AU)

Introduction: Medical education is based on the principles of on-the-job training. As a form of organization of the teaching process, on-the-job training plays a leading role in fulfilling such a mission. Primary health care settings should therefore permanently expand their involvement in the training of these professionals. Objective: Determine medical student and teacher satisfaction with on-the-job training in primary health care settings. Methods: A longitudinal descriptive study was conducted in Santo Domingo, Villa Clara province, during the school year 2016-2017. The sample was 26 third-year medical students from Manuel Piti Fajardo University Polyclinic, 24 sixth-year students rotating in Comprehensive General Medicine in this municipality, and 20 teachers actively involved in the training of these students. Data were obtained from document review and surveys applied to students and teachers. Results: Good performance prevailed. Students acquired their skills in the two years assigned to them, and all passed their end-of-term exams in the ordinary call. Most teachers were Assistant Professors methodologically trained to lead on-the-job training tasks. Conclusions: Most of the students and teachers in the study reported being satisfied with participating in on-the-job training activities in these environments(AU)

Momentos didácticos para el desarrollo de habilidades investigativas desde la educación en el trabajo / Didactic moments suitable for developing research skills via on-the-job training

Introducción: El proceso docente educativo que se desarrolla desde la educación en el trabajo debe sustentarse en una concepción didáctica de actualidad y pertinencia, en función de preparar a un individuo capaz de enfrentar nuevas situaciones y problemas mediante los métodos científicos. Objetivo: Caracterizar los dos momentos didácticos para el desarrollo de habilidades investigativas desde la educación en el trabajo. Métodos: Se realizó una investigación cualitativa en la carrera de Medicina en el ciclo clínico en la Filial de Ciencias Médicas "Lidia Doce Sánchez" de Sagua la Grande en el período 2014-2016. La población de estudio estuvo constituida por 160 estudiantes desde 3ro hasta 5to años de Medicina (ciclo clínico). La muestra fue seleccionada por un muestreo estratificado guiado por propósito y quedó finalmente constituida por 44 estudiantes. Además, participaron estudiantes de 6to año mediante un muestreo aleatorio simple, los profesores y tutores fueron seleccionados a través de un muestreo no probabilístico intencional, y los directivos y metodólogos de la carrera fueron seleccionados en su totalidad. La recogida de la información se realizó a través de diferentes técnicas: análisis de documento, encuesta a los profesores, encuesta a estudiantes, observación a las actividades de educación en el trabajo y entrevista a directivos y metodólogos. Resultados: El proceso docente educativo contribuyó al desarrollo de las habilidades investigativas de los estudiantes. Este debió ejecutarse en dos momentos didácticos fundamentales: la preparación de la ejecución y la ejecución del proceso, en los cuales se concibió la tarea investigativa y fueron diseñados teniendo en cuenta los problemas de salud que afectan al individuo, la familia, la comunidad y el medio ambiente. Conclusiones: Los dos momentos didácticos para la educación en el trabajo contribuyeron al desarrollo de las habilidades investigativas, al favorecer la adquisición de los modos de actuación profesional relacionados con los métodos clínico y epidemiológico(AU)

Introduction: The teaching-learning process carried out via on-the-job training should be based on current, relevant didactic principles, so that professionals are trained who can face up to new situations and problems applying scientific methods. Objective: Characterize the two didactic moments suitable for developing research skills via on-the-job training. Methods: A qualitative study was conducted of the Medicine major during its clinical cycle at Lidia Doce Sánchez Medical Sciences Branch School in Sagua la Grande in the period 2014-2016. The study population was 160 third-to-fifth-year medical students (clinical cycle). The sample was selected by purposive stratified sampling and was finally made up of 44 students. Additionally, sixth-year students were selected by simple random sampling. Teachers and tutors were chosen by purposive non-probability sampling. All faculty managers and methodologists went through the selection process. Data collection was based on document analysis, teacher surveys, student surveys, observation of on-the-job activities, and interviews with managers and methodologists. Results: The teaching-learning process conducted via on-the-job training in the major of Medicine in the various primary and secondary training environments, contributed to develop students' research skills. The process should be performed at two main didactic moments: preparation for conduct and process conduct. Research as the cornerstone of the teaching-learning process was conceived of as taking place at these two didactic moments, which were designed bearing in mind the health problems affecting the individual, the family, the community and the environment. Conclusions: The two didactic moments occurring during on-the-job training contributed to develop research skills, fostering the acquisition of professional behavior modes related to the clinical and epidemiological methods(AU)

The development and use of a pharmacist-specific Mini-CEX for postgraduate year trainees in Taiwan.

BACKGROUND: Clinical pharmacists must have a complex combination of academic knowledge and practical experience that integrates all aspects of practice. Taiwan's Ministry of Health and Welfare in 2007 launched the Postgraduate Year (PGY) training program to increase the standard of pharmaceutical care. This study aims to develop a pharmacist-specific Chinese-language Mini-Clinical Evaluation Exercise (Mini-CEX) to evaluate the professional development of postgraduate year trainees. METHOD: The specialized Mini-CEX was developed based on the core competencies of pharmacists, published literature, and expert opinion. A pilot test and evaluator workshop were held prior to the administration of the main test. Fifty-three samples were recruited. The main study was conducted at two regional teaching hospitals and a medical center teaching hospital in Taiwan between February and June 2012. The results were analyzed with the kappa statistic (inter-rater reliability) and descriptive statistics, while the Kruskal-Wallis test was used to examine the PGY trainees' Mini-CEX scores based on their performances. RESULTS: Trainees who had recently completed PGY programs (C-PGY) and 2nd year PGY trainees (PGY2) earned excellent scores, while the 1st year PGY trainees (PGY1) earned satisfactory scores in overall performance. C-PGY and PGY2 trainees also performed significantly better than PGY1 trainees in the organization and efficiency domain, and the communication skills domain. CONCLUSION: This study demonstrates the feasibility of using the newly developed pharmacist-specific Chinese-language version of the Mini-CEX instrument to evaluate the core competencies of PGY trainees in clinical settings.

Instructors for on-the-job training of advanced paramedics - definition of competencies and development of a quality management tool for a "High Responsibility Organization".

Objective: The psychological demands placed upon the emergency medical services, assures them of their place amongst High Responsibility Organizations. A high pressure to act and an irreversibility of situations are integral features of their workplaces. After the emergency services' job profiles were restructured in Germany, the practical stage of paramedic training is now undertaken in these conditions. That is, they are trained by a supervising instructor whilst caring for critically ill patients. This paper aims to describe the requisite skills for such an instructor, formulate the associated competences as learning objectives, and develop a quality-measuring instrument for the description of training situations. Methods: The compilation of a competence catalogue was done via a two-step process: following a Delphi survey with an expert panel of practical trainers and trainees, a large cohort of parameters were validated in terms of their relevance. Those factors that formed scales together were identified. Results: After validating the results of the Delphi analysis, six scales (composed of 25 items in toto) were defined. They included the areas of "Training during times of action", "Training during periods of calm", "Background and practical relevance", "Character and personality traits", "Pedagogical competencies" and "Organizational behaviour". Conclusion: For the first time, a competency catalogue has been developed for instructors working in the emergency medical services from German-speaking countries. The catalogue focuses upon clinical training during the acute care of critically ill patients. The scales and items can be used for training-the-trainers, and also quality monitoring. Further research needs to focus on the application of the catalogue in clinical practice and evaluate the need for situational customization.

Structured on-the-job training to improve retention of newborn resuscitation skills: a national cohort Helping Babies Breathe study in Tanzania.

BACKGROUND: Newborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania. METHODS: An initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site to others who were not trained. After a noted drop in skills, the program developed structured on-the-job training guidance and included this in the training. The approaches were implemented sequentially in 8 regions each with nurses/ midwives, other clinicians and medical attendants who had not received HBB training before. Newborn resuscitation skills were assessed immediately after training and 4-6 weeks after training using a validated objective structured clinical examination, and retention, measured through degree of skills drop, was compared between the two training approaches. RESULTS: Eight thousand, three hundred and ninety-one providers were trained and assessed: 3592 underwent the initial training approach and 4799 underwent the modified approach. Immediately post-training, average skills scores were similar between initial and modified training groups: 80.5 and 81.3%, respectively (p-value 0.07). Both groups experienced statistically significant drops in newborn resuscitation skills over time. However, the modified training approach was associated with significantly higher skills scores 4-6 weeks post training: 77.6% among the modified training approach versus 70.7% among the initial training approach (p-value < 0.0001). Medical attendant cadre showed the greatest skills retention. CONCLUSIONS: A modified training approach consisting of structured OJT, guidance and tools improved newborn resuscitation skills retention among health care providers. The study results give evidence for including on-site training as part of efforts to improve provider performance and strengthen quality of care.