Comparing pharmacy practice in health facilities with and without pharmaceutically trained dispensers: a post intervention study in Tanzania.

Background: The critical shortage of comprehensively trained healthcare staff in Tanzania affects the capacity to deliver essential health services, attain universal health coverage and compromises health outcomes. There is a specific lack of suitably trained pharmaceutical professionals, thus, an increase in the use of unqualified or poorly trained staff. Following the introduction of a one-year pharmacy dispenser course intervention, this study explored the impact that the new cadre of graduates had on pharmacy practice compared to healthcare facilities with non-pharmacy trained dispensers (NPTDs). Methods: A post intervention assessment was conducted in 2021 using questionnaires formulated to measure indicators of Good Pharmacy Practice, comparing 29 public health facilities employing pharmacy-trained dispensers (PTD) with 32 public health facilities with NPTDs in Dodoma, Shinyanga and Morogoro regions of Tanzania. Data were collected by experienced pharmacists or pharmaceutical technicians and subsequently aggregated and statistically analysed. Results: The dispensing times for medicines were found to be the same for PTDs and the NPTDs (2 min). There were no statistically significant differences in the adequacy of labelling elements between PTDs and NPTDs. Patients' level of knowledge of the medicines dispensed to them, from both PTDs and NPTDs, showed no difference. Moreover, no differences were observed in storage practice and documentation performance, records of dispensed medicines, handling of medicines and the dispensing area cleanliness between both groups. Overall, facilities with PTDs averaged a higher availability of tracer medicines (77%) than those with NPTDs (70%), however, availability of health commodities in all health facilities in the three regions was low and there was no statistically significant difference between both groups. Conclusion: The study showed no significant difference in performance of pharmacy practice between PTDs and NPTDs despite the former undertaking a one-year training course intended to improve knowledge and skills. Practice application not only depends on effective training but on the working environment. Clear job descriptions, appropriate tools and references to guide, Standard Operating Procedures, acceptance by management of the training undertaken to actively encourage recruits to apply these new skills could improve PTDs performance. Training and knowledge alone do not seem to lead to better practice and performance.

Avaliação de treinamento em entrevistas investigativas com crianças vítimas de violência sexual / Evaluation of training in investigative interviews with child victims of sexual violence / Evaluación de entrenamiento en entrevistas de investigación con niños víctimas de violencia

Este estudo teve como objetivo avaliar o impacto de um programa de treinamento para o uso do protocolo do National Institute of Child Health and Human Development (NICHD). O treinamento foi composto por 20h de atividades presenciais teórico-práticas. Participaram do estudo 55 profissionais com idade média de 38,4 anos. Inicialmente, foram mensurados os níveis de impacto do treinamento, engajamento no trabalho, autoeficácia ocupacional e características laborais. Em seguida, foram conduzidas entrevistas com seis participantes que, após o treinamento, adotaram a utilização do Protocolo NICHD ou optaram por não adotar a técnica. Os resultados apontam que os profissionais que participaram do treinamento o avaliaram de forma positiva e perceberam o impacto na sua prática profissional. Foi possível identificar que os níveis de engajamento no trabalho predizem a reação ao treinamento e antecedem a transferência de aprendizagem e o impacto do treinamento (i.e., transferência de treinamento).

This study aimed to evaluate the impact of a training program for the use of the National Institute of Child Health and Human Development (NICHD) protocol. The training consisted of 20 hours of classroom activities. The study included 55 professionals with an average age of 38.4 years. Initially, the levels of training impact, work engagement, occupational self-efficacy and job characteristics were measured. Then, interviews were conducted with six participants who, after training, either adopted the use of the NICHD protocol, or did not adopt it. The results show that the levels of work engagement predict the satisfaction with the training. When analysed together, these two factors precede the transfer of learningand the impact of training.

Este estudio tuvo como objetivo evaluar el impacto de un programa de entrenamiento para el uso del protocolo del National Institute of Child Health and Human Development (NICHD).El entrenamiento consistió en 20 horas de actividades teórico-práctcas en el aula. Participaron del estudio 55 profesionales, con edad promedio de 38,4 años. Inicialmente, fueron medidos los niveles del impacto del entrenamiento, el compromiso laboral, la autoeficacia ocupacional y las características laborales. Luego, fueron realizadas entrevistas con seis participantes que, después del entrenamiento, adoptaron el uso del Protocolo NICHD o decidieron no adoptar la técnica. Los resultados muestran que los profesionales que participaron del entrenamiento lo evaluaron de forma positiva y percibieron el impacto em su practaica professional. Fue posible identificar que los niveles de compromisso laboral predicen la reacción al entrenamiento y anticipam la transferencia de aprendizaje y el impacto del entrenamiento (i.e, transferencia del entrenamiento).

Improved attitudes of interns versus undergraduate medical students towards patients with mental illness in Saudi Arabia.

BACKGROUND: The attitudes of medical students towards mental illness are important since these students will be providing care to this group in the future. AIMS: To assess the beliefs and attitudes of undergraduate medical students regarding mental illness and to compare students at different levels. METHODS: This descriptive, cross-sectional study was conducted among undergraduate medical students in the College of Medicine, Majmaah University, Saudi Arabia, during the 2018-2019 academic years. Male students were included from Years 3-5 (25 from each year) and 25 male interns using the proportionate stratified random sampling method. The participants responded to the Beliefs about Mental Illness (BMI) Scale and the Attitudes towards Mental Illness Questionnaire (AMIQ). RESULTS: Bonferroni post hoc tests were used to conduct between-group comparisons of the year 3 group, who were at the beginning of their psychiatric training, with the other groups with more training. This revealed significant differences in scores for 11 of 21 items on the BMI Scale (P < 0.05). All questions regarding the 4 vignettes of the AMIQ (substance abuse, depression, psychosis, and obsessive compulsive disorders) showed a significant difference between students in year 3 and those in the other groups who had more psychiatric training (P < 0.05). CONCLUSIONS: The current medical psychiatric training positively improved the beliefs and attitudes of medical students towards patients with mental illnesses.

Unilateral and bilateral patellofemoral pain in young female dancers: Associated factors.

Aiming to evaluate the prevalence of unilateral/bilateral patellofemoral pain (PFP) among young dancers, and to investigate whether different factors are associated with PFP in young dancers, 132 dancers aged 12-14 years were assessed for PFP. Anthropometric parameters, proprioception ability, dynamic postural balance (DPB), and muscle strength were measured. PFP was found in 64.1% of the dancers. No significant differences in the prevalence of dancers with no, unilateral, or bilateral PFP at different ages were found. Significant age effects were found for anthropometric and developmental measurements, and for intensity of training. PFP effect was found for DPB asymmetry, ankle proprioception, and leg-length %height. A higher hip abductor/adductor ratio was associated with PFP in 14-year-old dancers. Binomial logistic regression showed that increased number of hours per day (h/day) and decreased number of hours per week (h/week), low proprioception scores, greater leg length as %height, and more anterior DPB asymmetry were significant predictors of PFP. In conclusion: unilateral/bilateral PFP is common among young dancers. Body morphology, reduced ankle proprioception ability, DPB asymmetry, and increased h/day of practice are associated with PFP. Dance teachers should start monitoring the impact of training and implement injury modification/prevention strategies when their students are at a young age.

What works and how: Adult learner perspectives on an autism intervention training program in India.

A significant treatment gap exists in low and middle income countries such as India for children with autism spectrum disorder. The Autism Intervention Training Program, a comprehensive 6-month program for training professionals in transdisciplinary evidence-based practices to address concerns associated with autism spectrum disorder, was piloted in India to address this gap. This study attempted to capture the perspectives of trainees on the effectiveness of andragogical approaches adopted in the Autism Intervention Training Program and the impact of this training on their work. An exploratory qualitative study was conceptualized, and in-depth interviews were conducted with 11 Autism Intervention Training Program trainees. Trainees highlighted the benefits of a blended training format, peer learning, and a responsive, reflective, experiential, and respectful approach to teaching and supervision. The impact of the program was perceived through an increase in trainees' knowledge and skills, impact on their organizations, and positive outcomes for children with autism spectrum disorder and their families. There is a need to develop and document comprehensive, contextualized, and evidence-based training programs for autism spectrum disorder professionals in low and middle income countries. Focusing on andragogical frameworks while conceptualizing and delivering these training programs is underscored, as approaches that promote self-efficacy in learners and enable transformative learning can lead to a cascading impact in resource-constrained settings.

The economic impact of educational training assessed by the Handling Questionnaire with three inhalation devices in asthma and Chronic Obstructive Pulmonary Disease patients.

BACKGROUND: The usability of inhalation devices depends on several factors, eg, the drug to inhale, device handling, and patients' training. Usability is then presumed to have economic consequences. AIM: To assess and compare the cost of patients' training for proper usability of Breezhaler and Genuair (both dry powder inhalers) and Respimat (a soft mist inhaler) in asthma and chronic obstructive pulmonary disease (COPD) outpatients. METHODS: The acceptance and handling of the three devices were investigated by means of the Handling Questionnaire. The time spent in specific training for ensuring a proper actuation and the corresponding costs were also calculated. Linear and logistic regressions were used in order to investigate the factors influencing proper handling of the devices. A significance level of P<0.05 was accepted. RESULTS: According to both the patients' and the nurse's judgments, Genuair and Respimat were perceived as the easiest devices to use, while Breezhaler required the highest number of attempts for achieving the first proper actuation (2.6 vs 1.6; P<0.0001). The total training cost per patient (including the nurse's time for demonstration and that for attending the patients' maneuvers) was €1.38±€1.21. Breezhaler was found to be the most expensive as the cost per patient was €2.35±€1.26, which was three to four times higher than that of Genuair and Respimat (both devices involved a cost of <€1 per patient, with negligible differences between each other). Asthma and COPD patients showed a similar trend, with better outcomes reported for asthma patients probably due to lower age. CONCLUSION: Substantial differences were found to exist in patients' acceptability and handling of the three devices. The economic impact of specific training was also different and strictly related to the comprehension of the procedure for actuation of each device. Respimat as a soft mist inhaler and Genuair as an metered-dose inhaler proved to be the most convenient in economic terms also.

A expectativa em relação ao treinamento influencia o impacto das ações de capacitação? / Expectation on the training influences the impact of these actions? Expectations and impact of training activities

O aumento da importância da área de treinamento e desenvolvimento para as organizações vem alimentando o interesse em investigar o impacto das ações de capacitação. Este estudo teve como principal objetivo identificar se características individuais influenciam o desempenho no trabalho das tarefas treinadas. A pesquisa, de natureza quantitativa, foi realizada em uma autarquia federal, com aplicação de questionários com escalas previamente validadas, em três momentos: antes do evento de capacitação (medição das expectativas em relação ao treinamento - 472 questionários); imediatamente após o curso (avaliação da reação - 485 questionários); e quatro meses após o término do curso (avaliação do impacto do treinamento - 296 questionários). Os principais resultados apontam índices elevados para as expectativas em relação ao treinamento, sendo mais altos entre mulheres, pessoas com escolaridade mais baixa e ocupantes do cargo de assistente. Também foi alta a percepção do impacto do treinamento no trabalho, sobretudo entre os treinandos com escolaridade mais baixa, aqueles que participaram de treinamentos de natureza cognitiva, aqueles que tinham expectativas de melhoria além da performance e reações mais positivas. São discutidas implicações teóricas e práticas dos resultados encontrados e é apresentada sugestão de agenda de pesquisa.

The importance of the development and training practices to the organizations is fuelling the interest in investigating the impact training actions. The main objective of this study is to identify if individual characteristics influence the performance of trained tasks at work. The research, of quantitative nature, was held in a federal autarchy with questionnaires application, with scales previously validated and in three phases: before the beginning of the training event (measure of expectancies related to the training - 472 questionnaires); immediately after the course (evaluation of the reaction - 485 questionnaires); and four months after the end of the course (evaluation of the impact of training - 296 questionnaires). The main results point to high ratings of expectations related to training, being higher among women, people with lower education and people who occupy assistant positions. The perception of impact of training at work was also high, in particular, among the trainees with lower education, who participated in training with cognitive nature, those who had improvement over performance expectancy and more positive reaction. The practical implications of the results are discussed and it is presented a suggested agenda to future researches.

Impactos individual e organizacional de treinamento: uma análise com base num modelo de avaliação institucional e na teoria multinível / Organizational and individual impacts of training: an analysis based on an institutional evaluation model and on the multilevel theory

O desafio deste estudo foi criar uma metodologia para verificar impactos de treinamentos nos comportamentos de indivíduos e de organizações, visando melhorar processos de planejamento, monitoramento e avaliação (PMeA) e compará-los com uma estratégia mais complexa, que incluía esses treinamentos e também outras atividades de desenvolvimento institucional. Utilizando um modelo de avaliação institucional, em que o componente "desempenho" seria uma função indireta dos componentes "ambiente", "capacidade" e "motivação", foram construídos e aplicados questionários em três amostras de respondentes: participantes e seus supervisores e colegas. Os impactos nos comportamentos dos indivíduos foram sistematicamente maiores que os organizacionais e ocorreram na seguinte ordem decrescente: motivação, capacidade, desempenho e ambiente. Treinamentos combinados com atividades de desenvolvimento institucional mostraram-se bastante mais efetivos do que treinamentos isolados. Os resultados encontrados são analisados à luz de modelos tradicionais de avaliação de treinamento, do modelo de avaliação institucional adotado e "da teoria multinível em organizações.

This study's challenge was to create a methodology to evaluate the impacts of trainings on individual and organizational behaviors, in order to improve the processes of planning, monitoring and evaluation (PM&E). It also aimed at comparing them with a more complex strategy, which included those trainings and also included other institutional development activities. Using a institutional evaluation model that included variables of environment, capacity, motivation and performance, the latter being an indirect function of the three former, questionnaires were developed and mailed to training participants, their supervisors and their colleagues. The individual impacts were systematically larger than the organizational ones. ln both cases, impacts occurred in the decreasing order of motivation, capacity, performance and environment. The combination of training with institutional development activities revealed to be much more effective than isolated training. Frameworks from traditional training evaluation models, from an institutional evaluation modei and from the multilevel theory are used for interpreting the findings.