Comparison of the effects of apprenticeship training by sandwich feedback and traditional methods on final-semester operating room technology students' perioperative competence and performance: a randomized, controlled trial.

BACKGROUND: Effective feedback is fundamental in clinical education, as it allows trainers to constantly diagnose the trainees' condition, determine their weaknesses, and intervene at proper times. Recently, different feedback-based approaches have been introduced in clinical training; however, the effectiveness of such interventions still needs to be studied extensively, especially in the perioperative field. Therefore, this study sought to compare the effects of apprenticeship training using sandwich feedback and traditional methods on the perioperative competence and performance of Operating Room (OR) technology students. METHODS: Thirty final-semester undergraduate OR technology students taking the apprenticeship courses were randomly allocated into experimental (n = 15) and control (n = 15) groups through the stratified randomization approach. The students in the experimental group experienced Feedback-Based Learning (FBL) using a sandwich model, and the students in the control group participated in Traditional-Based Training (TBT) in six five-hour sessions weekly for three consecutive weeks. All students completed the Persian version of the Perceived Perioperative Competence Scale-Revised (PPCS-R) on the first and last days of interventions. Also, a blinded rater completed a checklist to evaluate all students' performance via Direct Observation of Procedural Skills (DOPS) on the last intervention day. Besides, the students in the FBL filled out a questionnaire regarding their attitude toward the implemented program. RESULTS: The mean total score of the PPCS-R was significantly higher in the FBL than in the TBT on the last intervention day (P < 0.001). Additionally, the increase in mean change of PPCS-R total score from the first to last days was significantly more in the FBL (P < 0.001). Likewise, the FBL students had higher DOPS scores than the TBT ones (P < 0.001). Most FBL students also had a good attitude toward the implemented program (n = 8; 53.3%). CONCLUSION: Apprenticeship training using a sandwich feedback-based approach was superior to the traditional method for enhancing perioperative competence and performance of final-semester OR technology students. Additional studies are required to identify the sustainability of the findings.

The effect of resistance exercise on p53, caspase-9, and caspase-3 in trained and untrained men.

Apoptosis is a programmed cell death that has been demonstrated in human and animal studies and plays an essential role to remove injured cells after acute strenuous exercise. Protein p53 plays important roles in regulating apoptosis via mitochondrial pathway. Therefore, the aims of this study were to determine the effects of acute resistance exercise (RE) on serum p53, caspase-9, and caspase-3, markers of apoptosis, and whether resistance training status influences the magnitude of the RE-induced apoptosis. Nine resistance-trained (RT) (age, 22.37 ± 1.99 years; height, 174 ± 5.04 cm; body weight, 71.32 ± 5.57 kg; and body mass index [BMI] 23.58 ± 2.05 kg·m(-2)) and 9 untrained (UT) college-age men (age, 22.25 ± 2.13 years; height, 171 ± 3.4 cm; body weight, 68.45 ± 3.23 kg; and BMI, 23.41 ± 1.08 kg·m(-2)) volunteered to participate in this study. Resistance-trained and UT men completed an RE bout consisting of 4 sets of 6 exercise at 80% of 1 repetition maximum until failure. Serum levels of p53, caspase-9, and caspase-3 were examined at preexercise (pre), immediately post (IP), 3 hours post (3 hours post), and 24 hours post RE (24 hours post). In UT, serum levels of p53, caspase-9, and caspase-3 were significantly increased at IP compared with RT. However, plasma insulin-like growth factor 1 level was higher for RT compared with UT at IP. Collectively, our data suggest the role of p53 in regulating apoptosis through mitochondrial pathway as measured by caspase-9 and caspase-3 after acute RE in UT. Our results also revealed that regular RT alters apoptosis biomarkers, especially the intrinsic pathway of apoptosis.