An End-of-Life Care Educational Series to Improve Staff Knowledge and Comfort Levels.

Nursing staff play a key role in enhancing a patient's quality of life during end of life; however, they perceive lack of knowledge to be the largest barrier in providing quality end-of-life (EOL) care. Literature suggests that implementation of palliative and EOL care education can improve nursing EOL care practices. In order to address the gap in nursing knowledge and comfort, a quasi-experimental study was conducted; this study included the implementation of a multimodal EOL care educational series on an inpatient pediatric hematology oncology floor over 6 months. Prior to implementation, nursing staff completed a survey to measure perceived knowledge and comfort level regarding EOL care. The series included didactic sessions, in-services, case studies, practice exercises, and interactive discussions led by an interprofessional team of nurses, child-life specialists, and social workers. Educational topics included EOL symptom management, child-life services, supportive care resources, COMFORT communication, and an End-of-Life Nursing Education Consortium course. Following the educational series, the survey was repeated. Results of the survey demonstrated an increase in nursing knowledge and comfort levels. Significant improvements were observed across several items including medication management of dyspnea (χ1,83 =5.1, P = .023), comfort with implementing interventions (χ1,93 = 3.9, P = .049), and knowledge of hospital resources (χ1,93 = 6.1, P = .014). These results suggest that while EOL education strategies can vary, a combination of learner engagement tactics can increase knowledge and comfort regarding EOL concepts and potentially positively impact nursing practice.

Integrating the multiple breath washout test into international multicentre trials.

BACKGROUND: The lung clearance index (LCI), derived from the Multiple Breath Washout (MBW) test, is sensitive to treatment effects and compared with spirometry has higher feasibility in younger children and requires smaller sample sizes. As a result, the LCI has been endorsed by the European CF Society Clinical Trials Network for use as a primary outcome measure in CF clinical trials. METHODS: Here we describe the implementation of standardised protocols for MBW test performance, data collection and quality control to successfully incorporate LCI as a novel outcome measure in a large multicentre phase III clinical trial. RESULTS: Three regional (North America (NA), Europe (EU), Australia (AUS)) central over-reading centres (CORC) were established to provide a collaborative platform for MBW training, certification and quality control of data. One hundred and thirty-two naïve operators from 53 sites across NA, EU and AUS were successfully trained and certified to perform MBW testing.  Incorporation of a re-screening opportunity in the study protocol resulted a final screening feasibility rate of 93%, success remained high throughout the study resulting in an overall feasibility of MBW study data of 88.1% (1107/1257). MBW test acceptability was similar between geographical regions: NA (88%), EU (89%) and AUS (89%). CONCLUSION: With this approach we achieved high MBW test feasibility and sustained collection of good quality data, demonstrating the utility of LCI as an effective primary endpoint in the first international phase III clinical trial to report LCI as the primary outcome.

Examining Associations Between Physician Data Utilization for Practice Improvement and Lifelong Learning.

INTRODUCTION: Practice data can inform the selection of educational strategies; however, it is not widely used, even when available. This study's purpose was to determine factors that influence physician engagement with practice data to advance competence and drive practice change. METHODS: A practice-based, pan-Canadian survey was administered to three physician subspecialties: psychiatrists (Psy), radiation oncologists (RO), and general surgeons (GS). The survey was distributed through national specialty society membership lists. The survey assessed factors that influence the use of data for practice improvement and orientation to lifelong learning, using the Jefferson Scale of Physician Lifelong Learning (JeffSPLL). Linear regression was used to model the relationship between the outcome variable frequency of data use and independent predictors of continuous learning to improving practice. RESULTS: A total of 305 practicing physicians (Psy = 203, RO = 53, GS = 49) participated in this study. Most respondents used data for practice improvement (n = 177, 61.7%; Psy = 115, 40.1%; RO = 35; 12.2%; GS = 27, 9.4%) and had high orientation to lifelong learning (JeffSPLL mean scores: Psy = 47.4; RO = 43.5; GS = 45.1; Max = 56). Linear regression analysis identified significant predictors of data use in practice being: frequency of assessing learning needs, helpfulness of data to improve practice, and frequency to develop learning plans. Together, these predictors explained 42.9% of the variance in physicians' orientation toward integrating accessible data into practice (R = 0.426, P < .001). DISCUSSION: This study demonstrates an association between practice data use and perceived data utility, reflection on learning needs and learning plan development. Implications for this work include process development for data-informed action planning for practice improvement for physicians.

Work engagement among participants of residency and professional development programs in nursing / Engagement en el trabajo entre residentes y profesionales en perfeccionamiento de enfermería / Engagement no trabalho entre residentes e aprimorandos de enfermagem

ABSTRACT Objective: to assess the levels of engagement at work of nurses enrolled in multi-professional residency and professional development programs in health care of a Brazilian public institution. Method: a cross-sectional study with 36 professionals. The data were collected in September 2013, with use of the Utrecht Work Engagement Scale (UWES), composed of seventeen self-evaluation items with the dimensions vigor, dedication and absorption, as well as an overall score. Results: the levels of engagement ranged from 3.8 to 4.3, and the standard deviations, between 1.1 and 1.3. Nurses showed average levels on vigor (3.8) and absorption (3.9) dimensions, and high levels on dedication (4,3) and engagement (4.0). Conclusion: the professionals presented good levels of energy, resilience, enthusiasm and involvement with the work. They are satisfied with the activity and are dedicated to it, which promotes the acquisition of skills and competences along the in-service training, ensuring a future professional practice of quality.

RESUMEN Objetivo: evaluar los niveles de engagement en el trabajo de enfermeros matriculados en programas de residencia multiprofesional y perfeccionamiento profesional en salud de una institución pública brasileña. Método: estudio transversal con 36 profesionales. Los datos fueron recogidos en septiembre del 2013, mediante la Utrech Work Engagement Scale (UWES), compuesta por diecisiete ítems de autoevaluación con las dimensiones vigor, dedicación y absorción, además de una puntuación general. Resultados: los índices de engagement variaron de 3,8 a 4,3, y los desvíos estándar, entre 1,1 y 1,3. Los enfermeros presentaron niveles medios de vigor (3,8) y absorción (3,9), y niveles altos de dedicación (4,3) y engagement (4,0). Conclusión: los profesionales presentan buenos niveles de energía, resiliencia, entusiasmo e involucración con el trabajo. Se encuentran satisfechos con la actividad y se dedican a ella, lo que favorece a adquisición de habilidades y competencias a lo largo de la formación en servicio, lo que asegura una práctica profesional futura de calidad.

RESUMO Objetivo: Avaliar os níveis de engagement no trabalho de enfermeiros matriculados em programas de residência multiprofissional e aprimoramento profissional em saúde de uma instituição pública brasileira. Método: Estudo transversal com 36 profissionais. Os dados foram coletados em setembro de 2013, com o Utrech Work Engagement Scale (UWES), composto por dezessete itens de auto avaliação com as dimensões: vigor, dedicação e absorção, além de um escore geral. Resultados: os índices de engagement variaram de 3,8 a 4,3, e os desvios-padrão, entre 1,1 e 1,3. Os enfermeiros apresentaram níveis médios de vigor (3,8) e absorção (3,9), e níveis altos de dedicação (4,3) e engagement (4,0). Conclusão: Os profissionais apresentam bons níveis de energia, resiliência, entusiasmo e envolvimento com trabalho. Encontram-se satisfeitos e se identificam com o trabalho, o que favorece a aquisição de habilidades e competências ao longo da formação em serviço, assegurando uma prática profissional futura de qualidade.

Teaching Professional Development to Orthopaedic Residents.

BACKGROUND: The traditional focus of residency training programs has been on the development of clinical and surgical skills. The expectation has been that nonclinical skills, including professional development, will be learned in an informal manner rather than through formal teaching. METHODS: After recognizing the absence of formal teaching on professional development in the residency curriculum, we developed a symposium to specifically address this omission. Topics included applying for fellowships, military promotions, overseas assignments, moonlighting, board certification, time management, lifelong orthopaedic learning, and finding a job after the military. Residents were surveyed before and after the symposium to determine the overall usefulness and value of the individual topics. RESULTS: All participating residents reported that they would recommend the symposium to other residents. The course received a mean overall rating of 4.64 (range, 4-5) on a on a scale from 1 (poor) to 5 points (excellent). High ratings were received for course usefulness, content, and relevance to future practice. CONCLUSIONS: A formal professional development program to address topics that are relevant to practice and learning should be integrated into an orthopaedic surgery residency curriculum.

Política nacional de cuidado de enfermería: plan de implementación / National nursing care policy: implementation plan

El "Plan de Implementación de la Política Nacional de Cuidado de Enfermería" que se presenta en este documento, tiene el propósito de orientar al gremio de profesionales en esta disciplina, sobre las actividades precisas que se realizarán para el cumplimiento de la política que guiará el accionar hacia el cuidado de enfermería de calidad en El Salvador. Plan que contribuirá en el desarrollo de la política a lograr las competencias técnicas y mayor desarrollo profesional en el gremio para intervenir eficazmente en la gestión institucional y en la mejora de la calidad de los cuidados de enfermería. El Plan acorde a lo planteado en la política, describe los ocho ejes de actuación: administración del cuidado de enfermería, cuidado de enfermería humanizado y de calidad, docencia en enfermería, investigación en enfermería, promoción y educación para la salud, sistema de información en enfermería, condiciones de trabajo y de vida, e imagen de la profesión de enfermería. Para su elaboración requirió del esfuerzo colectivo, intersectorial e institucional de enfermería, realizando un ejercicio de reflexión sobre el ser y el hacer de la profesión, relacionada con la dinámica compleja del desarrollo social y económico, nacional e internacional. El documento integra objetivos, matrices con los ejes temáticos desarrollados, estrategias y líneas de acción; ampliando de éstas últimas y de una manera más específica las actividades, los indicadores que servirán para medir y evaluar los resultados obtenidos, los tiempos respectivos de cumplimiento, así como las entidades responsables de su ejecución. (AU)

Conhecimento, atitudes e práticas de manipuladores de alimentos em segurança dos alimentos: uma revisão sistemática / Knowledge, attitudes and practices of food handlers in food safety: a systematic review

A formação dos manipuladores de alimentos é uma das estratégias que pode garantir e/ou manter a segurança do alimento, oferecendo benefícios a longo prazo ao setor da alimentação e nutrição. Este artigo apresenta uma revisão sobre o papel da formação dos manipuladores de alimentos em segurança dos alimentos, identificando possíveis barreiras à formação e os modelos de avaliação. Foram utilizados na pesquisa, estudos observacionais, descritivos ou analíticos coletados em periódicos no período de 1986 a 2014, que permitiram a seguinte síntese: a formação baseada no modelo CAP (conhecimento, atitudes, práticas) tem se mostrado ineficiente na transferência do conhecimento em mudanças de atitudes e comportamentos em relação à segurança dos alimentos. Avaliar a competência dos manipuladores permite traçar estratégias para desenvolver modelos de treinamento que resultarão na mudança desejada do comportamento.

The training of food handlers is a strategy where food security can be implemented or maintained, offering long-term benefits to the food sector. This article presents an overview of the role of training of food handlers in food safety, identifying potential barriers to training and evaluation models. Observational, descriptive or analytical studies were used in these research being collected in the period 1989 to 2010, which allowed the following summary: a training model based on KAP model (knowledge, attitudes, practice) are inefficient in transferring knowledge into behavioral changes in regarding food safety. Several factors influence the effectiveness of training, emphasizing the training of managers and motivation of handlers. Evaluate the competence of handlers allows to devise strategies to develop training models that will result in the desired change of behavior.

Design and Outcome of a Certification Preparation Program for Outpatient Nurses.

This article presents the design, implementation, and outcomes of a certification preparation program for nurses working in an outpatient clinic. A nurse educator designed curriculum using the Certified Breast Care Nurse test blueprint. Nurse administrators provided the resources and the staff coverage to allow all staff members to attend the sessions without disruption to patient care. This outpatient center has achieved and sustained 100% certification among eligible nurses over the past 5 years.

Situación de los recursos humanos en El Salvador, 2013: bases para la Política Nacional de Desarrollo de Recursos Humanos en Salud / Situation of human resources in El Salvador, 2013: bases for the National Policy for the Development of Human Resources in Health

La Política de Salud 2009-2014 Construyendo La Esperanza es la definición política más importante del Gobierno de El Salvador que presidió Mauricio Funes para mejorar la salud de la población salvadoreña. Bajo la conducción de la Dra. María Isabel Rodríguez, Ministra de Salud, se plantearon seis líneas de política y 25 estrategias principales para avanzar en la transformación del sistema de salud vigente hasta el año 2009. Una de las líneas y tres de sus estrategias se refieren al desarrollo de los recursos humanos de salud, componente fundamental de cualquier sistema de salud. Allí se plantea la necesidad de definir y ejecutar una política nacional de desarrollo de los recursos humanos, la búsqueda de mecanismos efectivos de cooperación entre el sistema de salud y las instituciones formadoras de personal de salud y la necesidad de potenciar la práctica de los agentes comunitarios de salud como un componente importante del primer nivel de atención en el sistema de salud. Con dicha política el Gobierno del FMLN propone garantizar el derecho a la salud a toda la población salvadoreña a través de un Sistema Nacional Integrado de Salud que fortalezca sostenidamente lo público (incluyendo a la seguridad social) y regule efectivamente lo privado; que garantice el acceso a la promoción, prevención, atención y rehabilitación de la salud; a un ambiente sano y seguro. Se incluye el objetivo (pero no se limita a ello) de crear y mantener un sistema de atención a la salud eficiente, de alta resolutividad y acceso equitativo a servicios de calidad para todas las personas. Entre los principales problemas que debió enfrentar la gestión en Salud 2009-2014 se identificaba la "ausencia de una política de gestión y desarrollo de recursos humanos en salud; inadecuada distribución del personal, personal de salud insuficiente en toda la red pública de establecimientos de salud, combinado con una carencia de plazas para cubrir necesidades básicas. Personal de salud muy por debajo de los mínimos internacionales recomendados; la contratación de la mayor parte de los médicos especialistas con modalidades de menos de cuatro horas de trabajo diarias perjudica la atención al público y la gestión del hospital, así como la calidad del trabajo". La mayoría de esos problemas, identificados tempranamente en la gestión, son de índole estructural, largamente instalados en un sistema de salud segmentado y fragmentado, desfinanciado, carente de políticas y con baja capacidad de gestión efectiva y eficiente de sus principales componentes, entre ellos, de los recursos humanos de salud. La vigencia de esos problemas y el reconocimiento de otros identificados posteriormente, que impiden el avance de la transformación del sistema de salud, le colocan al Gobierno el imperativo de construir a la brevedad posible una política de desarrollo de recursos humanos teniendo en consideración los requerimientos de la Reforma de la Salud en el país. Así como los problemas de salud ­ enfermedad requieren que las políticas públicas que les respondan sean no sólo alineadas e integradas a una política de salud, sino que también sean integrales (que actúen sobre los determinantes sociales como empleo, ingreso, educación, ambiente, cultura, vivienda); de la misma manera se requiere que las políticas para reorientar los procesos de desarrollo de los recursos humanos en el sistema nacional de salud, sean también integrales e integradas, alineadas a la política nacional del salud. La razón de ello es que los problemas de los agentes esenciales de la atención y del cuidado de la salud de la población, que son los trabajadores de la salud, conocidos como recursos humanos, no son sólo problemas de dotación de medicinas, vacunas e instrumentos para atender el servicio. Es indispensable asegurar que los trabajadores de salud estén motivados y competentes técnicamente, y que trabajen en adecuadas condiciones, de manera efectiva y productiva en el lugar que se le necesita y en el momento en que se le requiere. En asegurar estas condiciones de manera sostenible consiste básicamente una política de recursos humanos de salud. El presente documento tiene como propósito servir de referencia y ampliación para el análisis de los recursos humanos, y es una ampliación del documento base para la Política Nacional de Recursos Humanos, elaborado por el Dr. Pedro Brito, Consultor de OPS/OMS, en el 2010; su objetivo es caracterizar la situación de los recursos humanos en El salvador, documento que ha sido validado por la Comisión Intersectorial de Recursos Humanos. (AU)

Challenges in transferring individual learning to organizational learning in the residential care of older people.

PURPOSE: The purpose of this paper is to evaluate the outcomes of a workplace learning intervention on organizational learning and to identify factors influencing the creation of organizational learning in residential care of older people. DESIGN/METHODOLOGY/APPROACH: The study consisted of a quasi-experimental intervention for outcome evaluation. In addition, a case study design was used to identify factors influencing organizational learning. Outcomes were evaluated using the validated Dimensions of the Learning Organization Questionnaire at three time points, and interviews were conducted with nursing staff and managers. FINDINGS: The intervention had some effects on the individual level, but no improvements in organizational learning were found. Hindering factors for creating organizational learning were poor initial learning climate, managers' uncertainty about their role, lack of ownership and responsibility among staff and managers, managers' views of personality being a more important component than staff development in older people's care, and a lack of systems for capturing acquired knowledge. ORIGINALITY/VALUE: The study offers suggestions for the transfer of individual-level learning to organizational learning in older people's care.

Pilot project and evaluation of delivering diabetes work-based education using video conferencing.

CONTEXT: Diabetes is a chronic long-term disease with an increasing incidence. There is a need to increase access to effective care and to ensure such care is delivered as locally as possible. The geographical spread of NHS Highland Scotland presents additional challenges to ensuring a skilled workforce given education is normally work-based tuition and assessment. The aim of this pilot project was to deliver teleconferenced diabetes training to healthcare and allied healthcare professionals who provide basic level care for, and management of, people with diabetes and to evaluate this training. ISSUE: Work-based diabetes education was designed to be delivered by a diabetes educator through videoconferencing or face to face (F2F) for healthcare professionals in peripheral settings in the Scottish Highlands region over two half-days. The education covered theoretical and practical training in diabetes. The evaluation of the project was through post-course questionnaires and assessment instruments to capture views of the content and delivery mode, as well as student performance. LESSONS LEARNED: Feedback from participants indicated that the educational content was relevant and that the use of videoconferencing (VC) could provide accessibility to training where distance, cost and other issues may make access difficult. Student performance on the assessment instruments did not differ between those who received the training through video conferencing and those who received the training through F2F delivery. Video conferencing can counteract the difficulties of accessing training for clinical peripherally based professionals. Training through VC did not compromise student acquisition of learning outcomes. Feedback indicates that VC can reduce the interactive nature of the learning and teaching experience.

Segunda medición a las metas regionales de recursos humanos en salud / Second measurement of the regional goals of human resources in health

El Llamado a la Acción de Toronto para una Década de Recursos Humanos en Salud (2006-2015), producto de la reunión regional de recursos humanos en salud realizada en el año 2005, presentó en la región de las américas cinco desafíos, considerados críticos, para el desarrollo de los recursos humanos en la década que iniciaba (Organización Panamericana de la Salud, 2005), como pilar fundamental para el logro de los Objetivos de Desarrollo del Milenio. (AU)

Informe final de la segunda medición de las metas regionales de los recursos humanos para la salud para Guatemala / Final report of the second measurement of the regional goals of human resources for health for Guatemala

INTRODUCCIÓN: El presente documento constituye el Informe Final de la Segunda Medición de las Metas Regionales de los Recursos Humanos para la Salud para Guatemala, el cual fue elaborado siguiendo la Metodología propuesta para dicha medición, por OPS/OMS. Se desarrolló una primera etapa de recolección de información en todas las instituciones relacionadas con la formación y contratación de los recursos humanos en salud, para luego tener una segunda etapa de análisis, discusión y conclusiones con la participación de todos los personajes clave de: Escuelas y Facultades de Medicina de las Universidades Pública y Privada, Escuelas de enfermería, Instituto Guatemalteco del Seguro Social, Organizaciones No Gubernamentales, Instituto Nacional de Estadística, Oficina Nacional de Servicio Civil, Sanidad Militar, Sector Privado de Salud, Ministerio de Salud Pública y Asistencia Social, OPS/OMS; y finalmente, una tercera etapa de elaboración del presente informe que recopila el trabajo intenso de muchas personas identificadas con el desarrollo de los Recursos Humanos en Salud del país. OBETIVO: evaluar nuevamente el avance de los recursos humanos para la salud en el país, tomando como base la línea basal establecida en 2011. MÉTODOS: La Segunda Medición de Metas Regionales de Recursos Humanos para la Salud se realizó en tres etapas que consistieron en: una primera etapa en la que se envió a todas las instituciones participantes del sector salud y educativo público, social y privado, toda la información y formatos específicos para dar respuesta a cada una de las veinte metas. Una vez recolectada la información se concentró para poder ser analizada por todas las instituciones en un taller. La segunda etapa fue el desarrollo del taller que se realizó el 19 de abril del presente año, donde asistieron más de 70 personas. La tercera etapa se trabajó con un grupo representativo de las instituciones para concentrar los resultados, realizar la priorización e metas a trabajar y elaborar compromisos que fueron presentados inicialmente ante la Comisión Interinstitucional de Acciones Conjuntas entre el Sector Salud y el Sector Educativo para su aprobación, luego se presentó ante el Señor Ministro de Salud y Asistencia Social para su aprobación definitiva. CONCLUSIÓN: De acuerdo a los resultados obtenidos en la Segunda Medición de Metas y su análisis, y comparación con la medición basal las presentes propuestas de vías de compromiso en materia de Recursos Humanos de Salud es el resultado del trabajo que se realizó dentro de la Comisión Interinstitucional de Acciones Conjuntas entre el Sector Académico y de Salud; mismo que fue consensado entre las autoridades de las Facultades y Escuelas de Ciencias de la Salud de todo el país: Medicina y Enfermería y las autoridades del Seguro Social y del Ministerio. Luego se revisó por la Dirección de Recursos Humanos y la Dirección del Centro Nacional de Ciencias de Salud del Ministerio, para proponerse como compromiso de país. Durante los próximos dos años se hará un seguimiento, medición y evaluación a cada uno de los compromisos que aquí se describen, y que para el efecto se han diseñado tablas de control de mando e indicadores que se anexan. Mismos que se estarán actualizando continuamente dentro del Observatorio de Recursos Humanos. (AU)

Palliative care in a community hospital: educating nurses to embrace this new initiative.

Palliative care, often mistaken for hospice care, improves patients' quality of life via symptom management of life-limiting illnesses. A community hospital began a palliative care team. Along with Nursing Education, this team educated a group of nurses to implement treatment modalities and offered ongoing education to prepare nurses to become certified in palliative and hospice nursing.

Career development resource: educational leadership in a department of surgery: vice chairs for education.

The growing appreciation of the need to adopt an evidence-based approach to teaching and assessment has led to a demand for faculty who are well versed in best practices in education. Surgeons with interest and expertise in instruction, curriculum development, educational research, and evaluation can have an important impact on the educational mission of a department of surgery. The increased fervor for accountability in education together with the challenges imposed by accreditation agencies and hospitals has made educational leadership responsibilities more time consuming and complex. In response to this, an increasing number of department chairs created Vice Chair for Education positions to support clerkship and program directors and ensure the department's education mission statement is fulfilled.

Barreras para la formación en docencia de los profesores de medicina: una aproximación cualitativa / Barriers for faculty development in medical education: a qualitative study

Background: Since 2000, the medical school of the Catholic University of Chile (EMUC) has offered courses for its faculty as part of a Diploma in Medical Education (DEM). However by 2009, 41% of faculty had never taken any courses. Aim: To explore the reasons why faculty choose not to participate in these courses. Material and Methods: Semi-structured interviews to seven faculty members, all of whom have an active role in teaching but who had not taken any DEM courses. The sampling was intentional and guided by theory. Based on Grounded theory, the data was analyzed using open, axial and selective coding. Results: Three categories emerged from the analysis. First, the characteristics of a "good teacher" and what it means to be a good teacher. Second, the current status of teaching. Third, the barriers to participate in courses of DEM. Non-attendance is multifactorial; teaching is seen as a natural skill that is difficult to be trained, teaching has a lower priority than other activities, and there are many barriers perceived for attendance. Conclusions: With these results we developed a model to explain the reasons why faculty choose not to participate in these courses. The lower value of teaching and the multiple roles that teachers have, are highlighted.

Developing and implementing an effective framework for collaboration: the experience of the CS2day collaborative.

Organizations from varied sectors have pursued collaboration to better fulfill their missions, facilitate decision making, solve more complex problems, and respond more rapidly to a changing environment. While these benefits are evident through the products and services provided, few organizations evaluate the factors that contribute to the success or failure of the collaboration itself. The CS2day Collaborative was formed by 9 separate organizations with a common goal of increasing smoking quit rates through health care professional education. To better understand the factors that influence successful collaboration, the authors applied criteria established by the Wilder Foundation to the functioning of this health care education collaborative. Factors analyzed include the influence of the environment, membership, process and structure, communication, purpose, and resources. Factors relevant to continuing medical education/continuing professional development (CME/CPD) including accreditation, conflict of interest resolution and management, guideline dissemination, continuous assessment and interprofessional education influenced the collaborative structure. Specific examples provided illustrate how diverse organizations can work together effectively to address a public health need. While the CS2day Collaborative was not formed with prior knowledge of these factors, they provide a useful framework for examining how this collaborative was developed and has operated.

Local technicians in long-term research projects: evaluation of 25 years experience in an active tropical research station

Most field ecology is conceived and financed by scientists from urban areas but is actually carried out in rural areas. Field staff can either be imported from urban areas or recruited from local residents. We evaluated the advantages and disadvantages of involving rural residents as local technicians over a 25- year period at active field research site in Costa Rica. We defined "local technicians" as local residents with no university education who acquired significant experience in field data collection, data management and/or laboratory work. We analyzed the experiences of incorporating these technicians into field research In developing countries from the points of view of scientist and of the local technicians themselves. Primary data were written responses from to a standardized survey of 19 senior scientists and Ph.D. students, and results from standardized personal interviews with 22 local technicians. Researchers highlighted the advantages of highly-skilled technicians with minimal staff turnover, as well as the technicians’ knowledge of local ecological conditions. Local technicians considered the primary advantages of their jobs to be opportunities for continuing education training in science as well as cultural enrichment through interactions with people of different cultures. The main challenges identified by researchers were the lack of long-term funding for projects and extended training required for local technicians. Local technicians can be of great benefit to research projects by providing high-quality data collection at reasonable costs with low staff turnover. Over the last 25 years the research model at the field station we studied has evolved to the point that most long-term projects now depend heavily on local technicians. This model of involving local technicians in long-term research has multiple benefits for the researchers, the technicians and the local community, and could be adapted to a variety of settings in rural areas of developing countries. Rev. Biol. Trop. 59 (4): 1455-1462. Epub 2011 December 01.