Survey of non-tunneled temporary hemodialysis catheter clinical practice and training

2018 ◽  
Vol 20 (5) ◽  
pp. 507-515 ◽  
Author(s):  
Christina M Yuan ◽  
James D Oliver ◽  
Dustin J Little ◽  
Rajeev Narayan ◽  
Lisa K Prince ◽  
...  

Background:Nephrologists are placing fewer non-tunneled temporary hemodialysis catheters. Requiring competence for nephrology fellow graduation is controversial.Methods:Anonymous, online survey of all graduates from a single, military nephrology training program (n = 81; 1985–2017) and all US Nephrology program directors (n = 150).Results:Graduate response and completion rates were 59% and 100%, respectively; 93% agreed they had been adequately trained; 58% (26/45) place non-tunneled temporary hemodialysis catheters, independent of academic practice or time in practice, but 12/26 did ⩽5/year and 23/26 referred some or all. The most common reason for continuing non-tunneled temporary hemodialysis catheter placement was that it is an essential emergency procedure (92%). The single most significant barrier was time to do the procedure (49%). Program director response and completion rates were 50% and 79%, respectively. The single most important barrier to fellow competence was busyness of the service (36%), followed by disinterest (21%); 55% believed that non-tunneled temporary hemodialysis catheter insertion competence should be required, with 81% indicating it was an essential emergency procedure. The majority of graduates and program directors agreed that simulation training was valuable; 76% of programs employ simulation. Graduates who had simulation training and program directors with ⩽20 years of practice were significantly more likely to agree that simulation training was necessary.Conclusion:Of the graduate respondents from a single training program, 58% continue to place non-tunneled temporary hemodialysis catheters; 55% of program directors believe non-tunneled temporary hemodialysis catheter procedural competence should be required. Graduates who had non-tunneled temporary hemodialysis catheter simulation training and younger program directors consider simulation training necessary. These findings should be considered in the discussion of non-tunneled temporary hemodialysis catheter curriculum requirements.

2018 ◽  
Vol 13 (5) ◽  
pp. 718-725 ◽  
Author(s):  
Christina M. Yuan ◽  
Robert Nee ◽  
Dustin J. Little ◽  
Rajeev Narayan ◽  
John M. Childs ◽  
...  

Background and ObjectivesPracticing clinical nephrologists are performing fewer diagnostic kidney biopsies. Requiring biopsy procedural competence for graduating nephrology fellows is controversial.Design, Setting, Participants, & MeasurementsAn anonymous, on-line survey of all Walter Reed training program graduates (n=82; 1985–2017) and all United States nephrology program directors (n=149; August to October of 2017), regarding kidney biopsy practice and training, was undertaken.ResultsWalter Reed graduates’ response and completion rates were 71% and 98%, respectively. The majority felt adequately trained in native kidney biopsy (83%), transplant biopsy (82%), and tissue interpretation (78%), with no difference for ≤10 versus >10 practice years. Thirty-five percent continued to perform biopsies (13% did ≥10 native biopsies/year); 93% referred at least some biopsies. The most common barriers to performing biopsy were logistics (81%) and time (74%). Program director response and completion rates were 60% and 77%. Seventy-two percent cited ≥1 barrier to fellow competence. The most common barriers were logistics (45%), time (45%), and likelihood that biopsy would not be performed postgraduation (41%). Fifty-one percent indicated that fellows should not be required to demonstrate minimal procedural competence in biopsy, although 97% agreed that fellows should demonstrate competence in knowing/managing indications, contraindications, and complications. Program directors citing ≥1 barrier or whose fellows did <50 native biopsies/year in total were more likely to think that procedural competence should not be required versus those citing no barriers (P=0.02), or whose fellows performed ≥50 biopsies (P<0.01).ConclusionsAlmost two-thirds of graduate respondents from a single military training program no longer perform biopsy, and 51% of responding nephrology program directors indicated that biopsy procedural competence should not be required. These findings should inform discussion of kidney biopsy curriculum requirements.


Author(s):  
Suzette Nynas ◽  
Carrie Myers

The roles and responsibilities for program directors of professional educational programs are numerous. The purpose of this study was to investigate how multiplicity of roles and responsibilities influence occupational stress. Role theory was the theoretical framework to organize the research and to investigate the influence of multiple roles and responsibilities on occupational stress of Athletic Training Program Directors (ATPDs). This mixed methods study investigated which occupational roles and responsibilities contributed to the greatest amount of occupational stress for ATPDs. All ATPDs from the Commission on Accreditation for Athletic Training Education (CAATE) accredited programs were invited to participate in an online survey to investigate personal and program characteristics and to determine which occupational roles and responsibilities produce the most occupational stress. Eighty-three ATPDs participated in this study, and the stress levels in the various occupational roles and responsibilities were measured, summed, and averaged. The results indicated that accreditation was the most stressful occupational role and responsibility category whereas service was the least stressful occupational role and responsibility category. This study presents information which heightens awareness of occupational stress experienced by ATPDs and contributes to the understanding of the multifaceted ATPD position.


2012 ◽  
Vol 59 (1) ◽  
pp. 3-11 ◽  
Author(s):  
C. Gray Hicks ◽  
James E. Jones ◽  
Mark A. Saxen ◽  
Gerardo Maupome ◽  
Brian J. Sanders ◽  
...  

This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.


2015 ◽  
Vol 10 (3) ◽  
pp. 205-211
Author(s):  
Thomas G. Bowman ◽  
Thomas M. Dodge ◽  
Stephanie M. Mazerolle

Context Many professional master's athletic training program directors believe retention is a problem facing athletic training education. However, it remains unknown what steps, if any, are taken to improve retention. Objective To inquire with program directors about their respective methods and interventions aimed at increasing retention rates. Design Qualitative study. Setting Professional master's athletic training programs. Patients or Other Participants Fifteen program directors out of 25 responded to an online survey invitation for a response rate of 60%. We also completed follow-up telephone interviews with 8 randomly selected program directors to gather greater insight into the ways they improve retention. Main Outcome Measure(s) We asked directors of all 25 professional master's athletic training programs in the United States to complete an online survey. We also asked 8 program directors from those who responded to complete telephone interviews. Grounded theory guided data analysis and we secured credibility through the use of multiple-analyst triangulation, member checks, and peer review. Results We identified 3 themes of ways program directors help improve student retention rates. Our participants described adequately screening admissions packets, providing financial support to defray the cost of pursuing a degree in athletic training at the professional master's level, and various student initiatives. Conclusions Based on our findings, we recommend a thorough application process that screens prospective students and identifies those who can complete the program. Program directors should also find ways to help defray the costs of earning a master's degree to allow students to become integrated into the program intellectually, socially, and clinically without increasing stress levels. Finally, providing students with opportunities for early socialization and mentoring should be aimed at explaining program expectations while preparing the students for professional practice.


2021 ◽  
Vol 13 (01) ◽  
pp. e88-e94
Author(s):  
Alyssa M. Kretz ◽  
Jennifer E. deSante-Bertkau ◽  
Michael V. Boland ◽  
Xinxing Guo ◽  
Megan E. Collins

Abstract Background While ethics and professionalism are important components of graduate medical education, there is limited data about how ethics and professionalism curricula are taught or assessed in ophthalmology residency programs. Objective This study aimed to determine how U.S. ophthalmology residency programs teach and assess ethics and professionalism and explore trainee preparedness in these areas. Methods Directors from accredited U.S. ophthalmology residency programs completed an online survey about components of programs' ethics and professionalism teaching curricula, strategies for assessing competence, and trainee preparedness in these areas. Results Directors from 55 of 116 programs (46%) responded. The most common ethics and professionalism topics taught were informed consent (38/49, 78%) and risk management and litigation (38/49, 78%), respectively; most programs assessed trainee competence via 360-degree global evaluation (36/48, 75%). While most (46/48, 95%) respondents reported that their trainees were well or very well prepared at the time of graduation, 15 of 48 (31%) had prohibited a trainee from graduating or required remediation prior to graduation due to unethical or unprofessional conduct. Nearly every program (37/48, 98%) thought that it was very important to dedicate curricular time to teaching ethics and professionalism. Overall, 16 of 48 respondents (33%) felt that the time spent teaching these topics was too little. Conclusion Ophthalmology residency program directors recognized the importance of an ethics and professionalism curriculum. However, there was marked variation in teaching and assessment methods. Additional work is necessary to identify optimal strategies for teaching and assessing competence in these areas. In addition, a substantial number of trainees were prohibited from graduating or required remediation due to ethics and professionalism issues, suggesting an impact of unethical and unprofessional behavior on resident attrition.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039939
Author(s):  
Sahdia Parveen ◽  
Sarah Jane Smith ◽  
Cara Sass ◽  
Jan R Oyebode ◽  
Andrea Capstick ◽  
...  

ObjectivesThe aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also aimed to identify the most effective features (content and pedagogical) of dementia education and training.DesignCross-sectional survey study. Data collection occurred in 2017.SettingsHealth and social care staff in the UK including acute care, mental health community care trusts, primary care and care homes.ParticipantsAll health and social care staff who had completed dementia education and training meeting the minimal standards as set by Health Education England, within the past 5 years were invited to participate in an online survey. A total of 668 health and social care staff provided informed consent and completed an online survey, and responses from 553 participants were included in this study. The majority of the respondents were of white British ethnicity (94.4%) and identified as women (88.4%).OutcomesKnowledge, attitude and confidence of health and social care staff.ResultsHierarchical multiple regression analysis was conducted. Staff characteristics, education and training content variables and pedagogical factors were found to account for 29% of variance in staff confidence (F=4.13, p<0.001), 22% of variance in attitude (knowledge) (F=3.80, p<001), 18% of the variance in staff knowledge (F=2.77, p<0.01) and 14% of variance in staff comfort (attitude) (F=2.11, p<0.01).ConclusionThe results suggest that dementia education and training has limited impact on health and social care staff learning outcomes. While training content variables were important when attempting to improve staff knowledge, more consideration should be given to pedagogical factors when training is aiming to improve staff attitude and confidence.


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