Training evaluation: a case study of training Iranian health managers

Pediatric emergency care (PEC) training for health care workers (HCWs) is commonly offered in the form of short courses. This study gathers the perspectives of HCWs from eight African countries on how to best deliver and implement short training courses in PEC. This is a qualitative study using semi-structured key informant (KI) interviews. Utilizing the African Federation for Emergency Medicine (AFEM) member list serve, we identified African HCWs who had previous experience participating in and/or delivering short training courses in PEC. From this cohort, four interviewers were selected. These interviewers all received training in qualitative interviewing and then each recruited five KIs in their respective settings using convenience sampling. All interviews were recorded, transcribed, translated as necessary, and coded using thematic analysis. A total of 20 interviews were completed. Most KIs (75%) were physicians. Several themes on short training courses in PEC emerged: there was strong motivation to participate in PEC trainings, interactive sessions were preferred over didactic sessions, the recommended course structure was a half-day format with longitudinal follow-up, and the ideal for course instructors was a mix of local trainers and visiting trainers. KIs reported several potential negative consequences of short training courses in PEC, including clinical staffing gaps during courses and PEC content taught that was incongruous with local protocols. Future curricular development and implementation of short training courses in PEC should incorporate the preferences and best practices identified by African HCWs, namely interactive sessions with longitudinal follow-up given by a mix of local and visiting trainers. Our study limitations include the number of participants and potential for selection bias.

Introduction:Since the invention of laparoscopic cholecystectomy, there have been tremendous developments in minimal access surgery and an increasing need for well-structured laparoscopic training courses. There is a need to analyse the real benefit of short training courses. The study was conducted to find whether a focused 3-day structured laparoscopy training course conducted by the Indian Association of Gastrointestinal Endo Surgeons (IAGES) could improve the cognitive and technical skills of surgeons in essential laparoscopic surgery.Materials and Methods:The Indian Association of Gastrointestinal Endo Surgeons conducted this prospective study during 2023–2024. Five hundred and fifty one candidates under the examination category in 14 consecutive courses were considered as the study groups to compare their pre- and post-test multiple-choice question (MCQ) scores to find the improvement in their knowledge base. A survey of candidates using Google Forms was also done at 6 months to find out the impact of the course. The following outcome measures were analysed:Improvement in the mean score in post-test MCQ when compared to pre-test MCQWe compared the pre- and post-test scores after categorising the candidates into three grades according to the marks scored by them.Grade A: Above 75% marksGrade B: 50%–75% marksGrade C: <50% marks.Quality of laparoscopy training modules including hands-on suture training module and live demonstration of laparoscopic proceduresThe volume of laparoscopic procedures done before and after the course.Statistical Analysis Used:The paired t-test.Results:There were 551 examination category candidates for FIAGES during this study period with pre- and post-test scores (grades) available for evaluation. Four hundred and fourteen candidates submitted the 15-question Google Forms which were also taken for further analysis of the impact of the training course. After the FIAGES course, it was evident that most of the participants obtained Grade A in the post-test as compared to the pre-test (5.4% vs. 41.4%), and only very few participants obtained Grade C (0.9%). It was also evident that the candidates started performing more basic laparoscopic cases after the FIAGES score (P < 0.001).Conclusions:The FIAGES course has established itself as a famous well-structured laparoscopic training course. It improved the knowledge base of the registrants and also helped with their career progress. Efforts are on the way to make FIAGES with a more elaborate course curriculum to enable accreditation by statutory bodies.

Smartphone-based first responder alert systems are akey component of the chain of survival in out-of-hospital cardiac arrest. In Germany, there are considerable regional differences in terms of qualification requirements and registration and approval processes. The impact of these barriers to access on the number of registered first responders has not yet been systematically investigated. Aretrospective secondary data analysis was performed based on freely available data. Ninety-nine regions with complete information on registration procedures, qualification requirements, and the number of registered first responders were included. In addition, the effect of voluntary 2 h short training courses on chest compressions on the subjective confidence of participants was examined in the Rheinisch-Bergisch district using asurvey. At the time of data collection, asmartphone-based first responder alert system had been implemented in 45% of emergency medical service areas. The average registration rate was 0.246% of the population. Regions with self-registration procedures had significantly higher registration rates than regions with formal registration (0.267% vs. 0.152%; p < 0.001). In two regions with self-declaration only and no verification of proof, rates of up to 0.489% were achieved. In the local case study, 2217 first responders were registered, 40% of whom had first aid qualifications only. The short training course was associated with asignificant increase in subjective safety. Low-threshold registration procedures are associated with higher registration rates in smartphone-based first responder alert systems. Accompanying short training courses can apparently increase the subjective confidence of first responders. Reducing formal barriers to access could help improve the availability of volunteer first responders. However, the effects of lower barriers to access on the psychological stress of first responders and on patient outcomes are unclear.

The aim was to determine the scope and quality of published health services research concerned with medical practice in the United Kingdom. Scope of health services research was reviewed in articles published in 41 medical and public health journals in 1985. In random sample of 60 papers stratified by study design, 18 key research parameters were assessed for the quality of reporting and application in the studies. Over 80% of the research described in 246 articles was carried out by clinicians, mostly without acknowledged epidemiological or statistical assistance. More than half the studies were descriptive and only 17% were trials. In studies of hospital services, 4% covered long term care, in contrast to 67% concerned with inpatient care. One third of studies were conducted in general practice but only 10% of these included an assessment of clinical outcome. Important research parameters were often not reported; for example, response rates were missing in 52% of the studies, and comparability of cases and controls was not stated in 42% of relevant studies. Major inadequacies were found in the conduct of research, particularly in the selection of controls, allowance for confounding factors, objectivity of measurements, application of statistical tests, and conclusions reached. Published health services research concerned with medical practice in the United Kingdom is often conducted by clinicians without expert assistance. The quality of reporting and methods employed are deficient in many respects. Short training courses and other initiatives are required to enhance the quality of health services research in medical practice.

Background: Prescription writing is a skill that almost every doctor will use several times a day. But are medical students effectively taught how to write a complete and accurate prescription? Most commonly the answer is no. There is increasing need for the rational of medicines and the clearly appropriate prescribing is a key to achieve this. Objectives: To find out whether a short training course of problem teaching, improves the competence of rational prescribing among medical students. Methods: All 6 th year medical students (Batch 13), Omdurman Islamic university were randomly separated into intervention and control group. Students of intervention group were taught to choose P how to apply this choice to specific patient problem, using the WHO Results: The competence of intervention group is significantly better than the control group p =0.011. The mean results of post test for intervention group was [3.4 ± 4.5] and fo Conclusion: Teaching medical students all basic knowledge about drugs does not guarantee rational prescribing. Additional short course of problem-based pharmacotherapy could be effective in improving prescribing skills Sudanese medical students. Background Prescribing of drugs in current practice is often inappropriate and irrational. There is a great need to ensure that drugs are prescribed and used rationally 1 . Irrational drug prescribing includes practices such as polypharmacy, wrong medication for the diagnosis, use of expensive drugs when less expensive alternatives are available, use of wrong dose (both over and under-dose), and prescribing when medications are not necessary 2 . The rationality of the scripts prescribed by physician is of critical i since bad prescribing habits lead to ineffective and unsafe treatment, causing exacerbation or prolongation of disease and distress or harm to the patient, which add extra burden to the health budgets 3 .

Non-Invasive Central Venous Pressure Measurement by Compression Ultrasound—A Step Into Real Life

BackgroundDelirium, a common problem among hospitalized elderly patients, is not usually diagnosed by doctors for various reasons. The primary aim of this study was to evaluate the effect of a short training course on the identification of delirium and the diagnostic rate of delirium among hospitalized patients aged ≥65 years. The secondary aim was to identify the risk factors for delirium.MethodsA prospective study was conducted in an acute-care hospital in Moscow, Russia. Six doctors underwent a short training course on delirium. Data collected included assessment by the confusion assessment method for the intensive care units, sociodemographic data, functional state before hospitalization, comorbidity, and hospitalization indices (indication for hospitalization, stay in intensive care unit, results of laboratory tests, length of hospitalization, and in-hospital mortality).ResultsDelirium was diagnosed in 13 of 181 patients (7.2%) who underwent assessment. Cognitive impairment was diagnosed more among patients with delirium (30.0% vs 6.1%, P=0.029); Charlson comorbidity index was higher (3.6±2.4 vs 2.3±1.8, P=0.013); and Barthel index was lower (43.5±34.5 vs 94.1±17.0, P=0.000). The length of hospitalization was longer for patients with delirium at 13.9±7.3 vs 8.8±4.6 days (P=0.0001), and two of the 13 patients with delirium died during hospitalization compared with none of the 168 patients without delirium (P=0.0001).ConclusionAlthough the rate of delirium was relatively low compared with studies from the West, this study proves that an educational intervention among doctors can bring about a significant change in the diagnosis of the condition.

PurposeTo investigate the effectiveness of one‐off short continuing adult education courses for expanding the penetration of sustainable development education beyond current tertiary students.Design/methodology/approachPre‐ and post‐course questionnaires are used to evaluate the effectiveness of a series of short training courses on environment and sustainability issues conducted by the Centre for Environmental Strategy for a UK government department.FindingsThese short continuing education courses were effective at meeting their specific aims of increasing awareness and understanding of sustainability issues, with longer courses being more beneficial and providing qualitatively different experiences. Learning on sustainable development was maximised by overtly drawing on the collective past learning experiences and knowledge of participants though carefully facilitated discussion that encourages the sharing of and building upon this knowledge base.Practical implicationsIf the training effectiveness of short continuing education courses in sustainable development is to be effective then such courses need to exploit existing knowledge bases so that limited time resources are used for maximum benefit through teaching methodologies that promote a constructivist learning environment.Originality/valueThis paper examines a significant means for maximising the effectiveness short continuing education courses in sustainability. Ensuring the effectiveness of such courses is critical to increasing the penetration of sustainable development education in higher education.

Evaluating workforce development for public health is a high priority for federal funders, public health agencies, trainees, trainers, and academic researchers. But each of these stakeholders has a different set of interests. Thus, the evolving science of training evaluation in the public health sector is being pulled simultaneously in a number of different directions, each emphasizing different methods, indicators, data-collection instruments, and reporting priorities. We pilot-tested the evaluation of a 30-hour, competency-based training course in a large urban health department. The evaluation processes included strategic, baseline assessment of organizational capacity by the agency; demographic data on trainees as required by the funder; a pre- and posttraining inventory of beliefs and attitudes followed by a posttraining trainee satisfaction survey as required by the trainers and the agency; and a 9-month posttraining follow-up survey and discussion of learning usefulness and organizational impact as desired by the academic researchers and the trainers. Routinely requiring all of these processes in training programs would be overly burdensome, time-consuming, and expensive. This pilot experience offers some important practical lessons for training evaluations in the future.

Impact of a short course in pharmacotherapy for undergraduate medical students: an international randomised controlled study.

Evaluation of the efficacy of a short course of technical clinical skills to change performance in general practice. Subjects were self-selected general practitioners (n=59) who were unaware of the study design. They were assigned to the intervention group (n=31) or control group (n=28) according to their preference for course date. The course covered four different technical clinical skills (shoulder injection technique, PAP-smear, laboratory examination of vaginal discharge, ophthalmoscopic control in diabetes mellitus). Main outcome measures used were pre- and post-training scores on a knowledge test of skills (60 multiple choice items), and pre- and post-training performance of procedures in practice using a log-diary covering 20 days. University of Maastricht, The Netherlands. Self-selected general practitioners. Competence, as measured by the knowledge test of skills, improved significantly as a result of the training and skills test scores were satisfactory after training. A significant effect on performance in practice was found for PAP-smear and shoulder injection technique, whereas no effect could be demonstrated for examination of vaginal discharge and ophthalmoscopic control in diabetes mellitus. A good degree of competence is a necessary but not always sufficient condition for a physician to change his performance in practice. While some skills training seems adequate to bring about desired changes, for other skills more complex interventions are probably needed.

Investments in gender training for agricultural researchers have not attained expected outcomes, bringing into question the efficacy of training approaches used. New approaches for transformative gender training need to draw on lessons learned from previous courses. This chapter analyses short gender training courses identified using a scoping methodology. Selected courses offered between 2005 and 2015 for scientists in Eastern Africa were critiqued against a theoretical framework for transformative gender training. Also shared is a training model (Gender Responsive Researchers Equipped for Agricultural Transformation course) that addresses gaps in previous courses. The chapter identifies critical lessons for facilitating transformative gender training for non-gender research practitioners which include the need for inter-disciplinary grounding in the disciplines of gender and agriculture, having a phased course delivery and the value of continuous technical support during and after training. Gender training models should also allow for the deepening of gender awareness and consciousness by providing safe spaces for personal reflections on the root causes of gender inequalities and for the questioning of the internalized norms and biases.

BackgroundRobust health systems are required for the promotion of child and adolescent mental health (CAMH). In low and middle income countries such as Uganda neuropsychiatric illness in childhood and adolescence represent 15–30 % of all loss in disability-adjusted life years. In spite of this burden, service systems in these countries are weak. The objective of our assessment was to explore strengths and weaknesses of CAMH systems at national and district level in Uganda from a management perspective.MethodsSeven key informant interviews were conducted during July to October 2014 in Kampala and Mbale district, Eastern Uganda representing the national and district level, respectively. The key informants selected were all public officials responsible for supervision of CAMH services at the two levels. The interview guide included the following CAMH domains based on the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS): policy and legislation, financing, service delivery, health workforce, medicines and health information management. Inductive thematic analysis was applied in which the text in data transcripts was reduced to thematic codes. Patterns were then identified in the relations among the codes.ResultsEleven themes emerged from the six domains of enquiry in the WHO-AIMS. A CAMH policy has been drafted to complement the national mental health policy, however district managers did not know about it. All managers at the district level cited inadequate national mental health policies. The existing laws were considered sufficient for the promotion of CAMH, however CAMH financing and services were noted by all as inadequate. CAMH services were noted to be absent at lower health centers and lacked integration with other health sector services. Insufficient CAMH workforce was widely reported, and was noted to affect medicines availability. Lastly, unlike national level managers, lower level managers considered the health management information system as being insufficient for service planning.ConclusionManagers at national and district level agree that most components of the CAMH system in Uganda are weak; but perceptions about CAMH policy and health information systems were divergent.

ProblemPeople living with a human immunodeficiency virus (HIV) infection have a high risk of tuberculosis and should undergo regular screening. However, they can be difficult to reach because they are stigmatized and discriminated against.ApproachIn Nepal, the nongovernmental organization Naya Goreto implemented a peer-led tuberculosis screening project in which people living with HIV volunteered to contact others in this high-risk population. Volunteers took part in a short training course, after which they attempted to contact people living with HIV through existing networks and self-help groups. Tuberculosis screening and testing were carried out in accordance with national guidelines.Local settingIn Nepal, the prevalence of HIV infection is 0.3% in the general population but is much higher, at 6%, in people in Kathmandu who inject drugs. To date, the health system has not been able to implement systematic tuberculosis screening in people living with HIV.Relevant changesBetween May 2014 and mid-September 2015, 30 volunteers screened 6642 people in 10 districts, 5430 (82%) of whom were living with HIV. Of the 6642, 6046 (91%) were tested for tuberculosis and 287 (4.3%) were diagnosed with the disease, 240 of whom were HIV-positive. Of those with tuberculosis, 270 (94%) initiated treatment.Lessons learntUsing peers to contact people living with HIV for tuberculosis screening resulted in a high participation rate and the identification of a considerable number of HIV-positive tuberculosis patients. Follow-up during treatment was difficult in this highly mobile group and needs more attention in future interventions.

Improving undergraduate clinical supervision in a South African context. E Archer and M van Heusden The context and setting The Faculty of Health Sciences, Stellenbosch University has undergraduate programmes for several disciplines. All these programmes; MBChB, Physiotherapy, Speech, Language and Hearing therapy, Dietetics and Occupational therapy need clinical supervisors to teach their undergraduate students in the clinical settings. Apart from having theoretical knowledge the students need to demonstrate clinical competence. They are supervised by qualified health professionals in the clinical areas. The faculty does not have the resources to present different clinical supervision courses for each discipline, hence the development of an interdisciplinary short course. Why the idea was necessary The health professionals acting as supervisors may be the experts in their fields, however, they do not always have the necessary teaching skills. This short course endeavored to increase the standard of clinical supervision in order to improve the knowledge, skills and attitudes of the undergraduate students. Ultimately this short course can attempt to raise the standard of health care in both private and public sectors. What was done? The Centre for Health Sciences Education (CHSE) at the faculty developed a generic short course in undergraduate clinical supervision to address the above issues. This course, coordinated by a professional nurse, was designed by representatives from each of the disciplines listed above. The content of the course covers topics such as the different roles of the supervisor, adults learning; learning in a clinical environment; techniques of facilitating learning; assessment and feedback.. The course consists of one interdisciplinary contact session where a study guide is provided for self study. Within six weeks of attending the initial contact session students have to submit an assignment reflecting on their own clinical supervision skills. Continuous professional development points are awarded on completion of the course. A qualitative study was done to determine the strengths and weaknesses of the course in order to re-curriculate as deemed necessary. Semi-structured individual interviews were held with 10 (n=18) course participants as well as the tutors involved in the development of the course. Ethical approval was obtained. Participation was voluntary and anonymity was guaranteed. The recorded and transcribed data was analyzed. The evaluation of the results or impact The data was used to inform restructuring of the short course e.g. the contact session was increased from 5 to 8 hours. The impact of this short course on clinical supervisors was that their interaction with students in the clinical setting improved. Another impact was that the short course provided the clinical supervisors with skills to use new teaching strategies and to apply adult education principles. There was unanimous support for extending the short course to all clinical supervisors. If this is not done supervisors have the inclination to apply the same teaching methods used when they were undergraduate students. The lecturers involved in developing the course were positive about the interdisciplinary cooperation amongst colleagues and students. They emphasized that the university s an obligation to provide opportunities for clinical supervisors to improve their skills to supervise students and to have a better understanding of adult learning.