Developing Initial Competency-Based Outcomes for the Hospice and Palliative Medicine Subspecialist: Phase I of the Hospice and Palliative Medicine Competencies Project

2007 ◽  
Vol 10 (2) ◽  
pp. 313-330 ◽  
Author(s):  
Laura J. Morrison ◽  
Judy Opatik Scott ◽  
Susan D. Block ◽  
Keyword(s):  
Phase I ◽  
Palliative Medicine ◽  
Competency Based

Prevalence of palliative care consultations in phase I pediatric oncology trials.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 108-108
Author(s):  
Andrea Joan Cuviello ◽  
Andrea Beri ◽  
Renee D Boss ◽  
Nirali N. Shah ◽  
Brigitte C. Widemann ◽  
...  
Keyword(s):  
Palliative Care ◽  
Phase I ◽  
Pediatric Oncology ◽  
Advance Directive ◽  
Patient Population ◽  
Palliative Medicine ◽  
Pediatric Patients ◽  
Standards Of Care ◽  
Phase I Clinical Trials ◽  
Risk Of Death

108 Background: In 2015 the Psychosocial Standards of Care Project for Childhood Cancer published 15 evidence-based standards for pediatric psychosocial care for children with cancer and their families. One standard endorses incorporation of palliative care to “reduce suffering throughout the disease process, regardless of disease status”. Patients enrolling on phase I studies represent a unique cohort within pediatric oncology, as they generally represent a patient population that has not responded to standard therapies and a chance of cure is limited. Phase I trials, primarily designed to test safety and feasibility, offer a low chance of therapeutic benefit and high risk of death. This study aims to define the prevalence of palliative medicine consultation for phase I patients. Methods: A retrospective chart review of pediatric patients enrolled in a National Cancer Institute (NCI) Pediatric Oncology Branch Phase I clinical trial between 2015-present, using the NIH Biomedical Translational Research Information System (BTRIS). Palliative Care Consult Notes, Advance Directive information, diagnoses and medications were captured. Results: We reviewed the records of 126 phase I patients; 66% were male, 47% were >18 years, 67% had relapsed/refractory leukemia, and 46% are now recorded as deceased. Palliative medicine was consulted in <20% of patients; all consultations were for symptom management, primarily pain control (91%). Only 9% of patients had an advance directive prior to enrollment at the NCI. During therapy at the NCI, an additional 20% of patients completed an advance directive, just over a third (35%) of which were patients who received palliative medicine consultation. Conclusions: Palliative care was infrequently consulted in a highly vulnerable patient population where survival outcomes are poor and disease or therapy side effects are substantial. Efforts to increase the use of palliative care services in this population may improve the quality of life for children and families. Future directions include working to standardize the involvement of palliative medicine for pediatric patients enrolling onto phase I clinical trials.

scholarly journals Colonoscopy Trainers Experience Greater Stress During Insertion than Withdrawal: Implications for Endoscopic Curricula

2019 ◽  
Author(s):  
Madeline Lemke ◽  
Alison Banwell ◽  
Natalie Rubinger ◽  
Michelle Wiepjes ◽  
Mark Ropeleski ◽  
...  
Keyword(s):  
Phase I ◽  
Cognitive Load ◽  
Phase Ii ◽  
Simulation Training ◽  
Skills Training ◽  
Task Load ◽  
Simulated Environment ◽  
Competency Based ◽  
Insertion Techniques ◽  
Nasa Task Load Index

Abstract Background Optimal colonoscopy training curricula should minimize stress and cognitive load. This study aimed to determine whether withdrawal or insertion colonoscopy skills training is associated with less stress or cognitive load for trainees or trainers. Methods In Phase I, participants were randomized to train on either insertion or withdrawal in a simulated environment. In Phase II, participants were randomized to begin with either insertion or withdrawal in patient encounters. Salivary cortisol levels, heart rate, and State-Trait Anxiety Inventory (STAI) surveys were used to assess stress in trainees and trainers. NASA Task Load Index (TLX) survey was used to assess cognitive workload in trainees. Results In Phase I, trainee stress increased during the simulation training during both withdrawal and insertion compared to baseline, while trainer stress changed minimally. Cognitive load was higher for trainees during withdrawal (P = 0.005). In Phase II, trainers’ STAI scores were greater during insertion training (P = 0.013). Trainees’ stress was highest prior to beginning patient training and decreased during training, while trainer’s stress increased during training. Trainees reported insertion training being of greater value (70.0%), while trainers reported withdrawal was preferred (77.8%). Conclusion Trainees and trainers exhibit important differences in stress during colonoscopy skills training. Trainees reported more stress during simulation training and greatest cognitive load during simulation withdrawal, whereas trainers reported greatest stress during patient encounters, particularly training of insertion techniques. Attention to the effect of stress on trainees and trainers and the drivers of stress is warranted and could be incorporated in competency based medical education.

Educating Doctors in Palliative Medicine: Development of a Competency-Based Training Program

1998 ◽  
Vol 14 (3) ◽  
pp. 79-82 ◽  
Author(s):  
Kevin Yuen ◽  
Dianne Barrington ◽  
Neil Headford ◽  
Mary Mcnulty ◽  
Michael Smith
Keyword(s):  
Training Program ◽  
Palliative Medicine ◽  
Medicine Development ◽  
Competency Based

scholarly journals La influencia de las competencias genéricas en la empleabilidad laboral inicial. Caso de estudio en la UANL.

2017 ◽  
Vol 8 (16) ◽  
Author(s):  
Valeria Paola González Duéñez ◽  
Joel Mendoza Gómez
Keyword(s):  
Social Interaction ◽  
Phase I ◽  
Educational Program ◽  
Job Skills ◽  
Phase Iii ◽  
Study Phase ◽  
Generic Competencies ◽  
Aeronautical Industry ◽  
Competency Based ◽  
Teaching Learning

Abstract. Currently the aeronautical industry demand human resource that is highly competitive with excellent abilities, skills and job skills that allow the growth of this industry in Mexico. UANL offers the educational program in Aeronautical Engineering and because is a program designed under the new competency-based education model, it is necessary to measure the employability of students working under this new teaching-learning process,such as is achieved and even provide feedback to continually improve any area of opportunity in the transition of students during their training. This research presents a cause-effect model where independent variables are considered classified generic competencies: instrumentals, social interaction and integrative, and the dependent variable initial workforce readiness. Todefine the variables, objectives and hypotheses we did an analysis of competency-based international models. Variables were operationalized to design and determine the reliability of the measuring instrument performing the content validity with 12 experts on the competency model. To test the hypothesis of educational program were selected 103 students using Phase I, II and III as field study. Phase I is an assessment of students, Phase II is anevaluation with teachers and Phase III is the opinion of employers. Finally, we present the results of analysis of the direct influence of generic skills: instrumentals, social interaction and integrative and professional-labor performance work called initial workforce readiness.Keywords: employability, generic competencies, initial workforce readinessResumen. Actualmente la industria Aeronáutica demanda recurso humano que sea altamente competitivo con excelentes capacidades, destrezas y aptitudes laborales que permitan el crecimiento de esta industria en México. En la UANL se oferta el programa educativo de Ingeniero en Aeronáutica y por ser un programa diseñado bajo el nuevo modelo educativo basado en competencias, es necesario medir la empleabilidad de los estudiantes  que trabajan bajo este nuevo proceso de enseñanza-aprendizaje, de tal forma de que se logre mejorar continuamente e inclusive retroalimentar cualquier área de oportunidad en el tránsito de estudiantes durante su formación. En esta investigación se plantea un modelo causa-efecto en el que se consideran como variables independientes las competencias genéricas clasificadas en: instrumentales, de interacción social e integradoras; y la variable dependiente la empleabilidad laboral inicial. Se realizó un análisis de los modelos internacionales basados en competencias, definiéndose las variables, los objetivos y las hipótesis. Se operacionalizaron las variables para diseñar y determinar la confiabilidad del instrumento de medición realizándose la validez de contenido con 12 expertos sobre el modelo por competencias. Para probar las hipótesis se seleccionaron 103 estudiantes del PE aplicando Fase I, II y III como estudio de campo. La Fase I es una evaluación de estudiantes, la Fase II es evaluación con profesores y la Fase III es la opinión de los empleadores. Finalmente se presentan los resultados del análisis sobre la influencia directa entre las competencias genéricas: instrumentales, de interacción social e integradoras y el desempeño profesional-laboral llamado empleabilidad laboral inicial.Palabras clave: competencias genéricas, empleabilidad, empleabilidad laboral inicial

Training Aides to Screen Children for Speech and Language Problems

1976 ◽  
Vol 7 (4) ◽  
pp. 236-241 ◽  
Author(s):  
Marisue Pickering ◽  
William R. Dopheide
Keyword(s):  
Rural Areas ◽  
Large Scale ◽  
School Personnel ◽  
School Age Children ◽  
Speech And Language ◽  
Elementary School Age ◽  
Evaluation Procedures ◽  
Language Problems ◽  
Competency Based ◽  
Large Scale Screening

This report deals with an effort to begin the process of effectively identifying children in rural areas with speech and language problems using existing school personnel. A two-day competency-based workshop for the purpose of training aides to conduct a large-scale screening of speech and language problems in elementary-school-age children is described. Training strategies, implementation, and evaluation procedures are discussed.

A Phonomotor Approach to Apraxia of Speech Treatment

2020 ◽  
Vol 29 (4) ◽  
pp. 2109-2130
Author(s):  
Lauren Bislick
Keyword(s):  
Phase I ◽  
Treatment Effects ◽  
Single Case ◽  
Motor Planning ◽  
The Other ◽  
Multimodal Approach ◽  
Apraxia Of Speech ◽  
Duration Of Treatment ◽  
Treatment Gains ◽  
Future Work

Purpose This study continued Phase I investigation of a modified Phonomotor Treatment (PMT) Program on motor planning in two individuals with apraxia of speech (AOS) and aphasia and, with support from prior work, refined Phase I methodology for treatment intensity and duration, a measure of communicative participation, and the use of effect size benchmarks specific to AOS. Method A single-case experimental design with multiple baselines across behaviors and participants was used to examine acquisition, generalization, and maintenance of treatment effects 8–10 weeks posttreatment. Treatment was distributed 3 days a week, and duration of treatment was specific to each participant (criterion based). Experimental stimuli consisted of target sounds or clusters embedded nonwords and real words, specific to each participants' deficit. Results Findings show improved repetition accuracy for targets in trained nonwords, generalization to targets in untrained nonwords and real words, and maintenance of treatment effects at 10 weeks posttreatment for one participant and more variable outcomes for the other participant. Conclusions Results indicate that a modified version of PMT can promote generalization and maintenance of treatment gains for trained speech targets via a multimodal approach emphasizing repeated exposure and practice. While these results are promising, the frequent co-occurrence of AOS and aphasia warrants a treatment that addresses both motor planning and linguistic deficits. Thus, the application of traditional PMT with participant-specific modifications for AOS embedded into the treatment program may be a more effective approach. Future work will continue to examine and maximize improvements in motor planning, while also treating anomia in aphasia.

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