Evaluating 10 years of state-funded GP training in GP offices in Switzerland.

BACKGROUND: Switzerland lacks future general practitioners (GPs). Residents who wished to specialize as general practitioners were formerly trained solely in hospital settings. To better prepare and also attract more young doctors to become GPs, the canton of Bern (equivalent to a state) has implemented a partly state-funded vocational training program in GP practices. Our study examines the efficacy of this 10-year program, identifies factors that positively influence residents in their decision to become a GP and the distribution of new GPs in the canton of Bern, who had taken part in the traineeship. METHODS: This cross-sectional survey among all residents, who participated in a traineeship in general practice from 2008 to 2017 in the canton of Bern asked if residents had taken a subsequent career choice as a GP and if so in which region. Residents scored the importance of their traineeship and their mentor's influence on becoming a GP. By using zip codes of work area of respondents already working as GPs and matching it with population census data, we could obtain the distribution of GPs on a per capita basis. RESULTS: Out of 165 residents who participated in a traineeship, 151 (92%) completed our survey. 81% had chosen a career as a GP or were on track to become a GP. Almost half of the participants became GPs in the offices of their mentors or in the area. Our respondents emphasized the importance of their mentors' influence as well as the training program in their decision-making to become a GP. Most mentioned benefits of being a GP were broad field of medical care (37%) and a fulfilling doctor-patient relationship (34%). We could show an increase in GP practices in the canton of Bern, not only in urban but also accordingly in rural areas. CONCLUSIONS: Most residents continued subsequent careers as general practitioners after having completed a GP traineeship, with almost half of them in the region of their training. A vocational training program helped motivating young doctors to become GPs and underserved regions of the canton of Bern to gain new GPs.

[An assessment of the role of the Social Insurance Institution in the occupational activation of people with health problems, conducted by issuing decisions on the appropriateness of vocational retraining]. / Ocena roli Zakladu Ubezpieczen Spolecznych w aktywizacji zawodowej osób z problemami zdrowotnymi, realizowanej poprzez wydawanie orzeczen o celowosci przekwalifikowania zawodowego.

BACKGROUND: The new training allowance policy has been put in the Social Insurance Institution to bring back to employment workers with health problems unfit for their previous occupation. These people, following specific vocational training, may acquire new skills and competencies to stay on the labor market. The aim of this study was to assess the role of the Social Insurance Institution in the activation of persons with health problems, which was carried out by issuing opinions about the appropriateness of vocational retraining. MATERIAL AND METHODS: The analysis included 460 cases in which decisions on the appropriateness of vocational retraining, due to the inability to work in the current profession, were issued in 2009. RESULTS: It was found that 40.9% of the analyzed cases were not in accordance with the principles of adjudicating on the incapacity for work and applicable law. The majority of the study group (72.4%) were people with basic vocational education. No significant changes were found as regards gender, age and the place of residence between the retrained (N = 89) and not retrained subjects (N = 252). In the retrained group including 89 persons, 13 subjects started to collect pension again within 6 months; and 1 person collected pension while working. In addition, 51 (57.3%) retrained subjects were unemployed. After 12 months, the number of unemployed subjects decreased to 31. CONCLUSIONS: The effectiveness of the training allowance as a tool for the activation of people with health problems, expressed as the number of retrained people who returned to the labor market, is low. More than 80% of the people fail to get retrained and some of them again submit pension applications. A large number of incorrect vocational retraining opinions, as well as the lack of cooperation between institutions conducting retraining (the Social Insurance Institution and labor offices) resulted in a limited effectiveness of the training allowance. In order to enhance the effectiveness of the training allowance, it is necessary to carry out organizational and legislative changes, with particular emphasis on expanding the knowledge of medical examiners representing the Social Insurance Institution and occupational health physicians, as well as to improve cooperation between all institutions involved in the occupational activation of people with health problems. Med Pr. 2020;71(3):309-23.

The Ohio State University Early Psychosis Intervention Center (EPICENTER) step-based care programme for individuals at clinical high risk for psychosis: study protocol for an observational study.

INTRODUCTION: In October 2018, the Substance Abuse and Mental Health Services Administration funded 21 sites throughout the USA to develop, implement and evaluate specialised care programmes for individuals at clinical high risk for developing a psychotic disorder (CHR-P). Per the funding requirements, such programmes were required to provide 'step-based care'-a model in which individuals are initially provided with low-intensity, non-psychosis-specific and more benign (ie, least side effects) interventions and only progress onto higher-intensity, psychosis-specific interventions with a greater risk of more severe side effects should they not meet a priori criteria for clinical response to such lower-intensity interventions. Here, we outline the evaluation component of the step-based care programme for individuals at CHR-P at The Ohio State University Early Psychosis Intervention Center (EPICENTER). METHODS AND ANALYSES: The EPICENTER CHR-P programme provides a step-based care model comprising psychotherapy, medication management, family support/education, peer support and vocational/educational support. All participants who opt to receive care at the EPICENTER will complete a standardised assessment battery as part of usual care. This battery will be administered on enrolment and will be re-administered at 6-month intervals throughout individuals' participation in EPICENTER clinical services. Participants will have the opportunity to allow for data from these usual care assessments to be used as part of an evaluation project for this new clinical service. The primary outcome for this evaluation project is time to remission of symptomatic and functional deficits commonly experienced by individuals at CHR-P. Participants will also have the opportunity to participate in a supplemental research project designed to further evaluate treatment outcomes and patient characteristics among individuals participating in EPICENTER clinical services. ETHICS AND DISSEMINATION: This project was approved by The Ohio State University Institutional Review Board. Results from this project will be disseminated through publications and presentations. TRIAL REGISTRATION NUMBER: NCT03970005; Pre-results.

Differences in subjective quality of life of people with a schizophrenia diagnosis between participants in Occupational Therapy Workshops and those working in a Sheltered Employment Establishment. / Róznice w subiektywnej jakosci zycia osób z diagnoza schizofrenii pomiedzy uczestnikami Warsztatów Terapii Zajeciowej a osobami pracujacymi w Zakladzie Pracy Chronionej.

OBJECTIVES: The research objective was to compare the course of illness among patients with schizophrenia undergoing rehabilitation in Occupational Therapy Workshops (OTW) or employed in the Vocational Development Center "Pensjonat u Pana Cogito" (VDC), with particular focus on quality of life (QoL), and to analyse the relations between QoL and general, social, and cognitive functioning, psychopathological condition and insight in the two groups. METHODS: The sample comprised 52 subjects (VDC = 25 and OT = 27). The following tools were used: the LQoLP (for quality of life assessment) by Oliver, the PANSS, GAF, and SOFAS scales, the MoCA, RAVLT and RHLB cognitive tests, and the insight questionnaire "My thoughts and feelings". RESULTS: Differences were found between the groups, to the VDC group's advantage, in such areas of subjective QoL as: family relationships (p . 0.05), somatic health (p . 0.05) and selfesteem (p . 0.05). In the VDC group, QoL correlated negatively with symptoms of distress and positively with overall insight into symptoms, while in the OTW group it correlated negatively with cognitive function and positively with insight as a reaction to information from others. CONCLUSIONS: For people with schizophrenia obtaining and retaining employment in a VDC translates into better outcomes in important areas of quality of life such as family relationships, overall health, and self-esteem. Poorer QoL was associated with the severity of symptoms, in particular depressive symptoms. People employed in the VDC benefited to a greater extent from autonomous control of symptoms, while among the OTW group an important role was played by others.

Essential Elements for Effective Safety and Health Education in Postsecondary Construction Career Technical Education.

Because Career Technical Education (CTE) programs at the community/technical college level are among the few places new construction workers receive training or preparation, they are an important vehicle for educating new and young workers about occupational health and safety (OSH). We developed recommendations for (1) OSH "core competencies" that all postsecondary construction students should achieve and (2) "essential elements" for OSH education in construction training programs. Based on a review of the literature, subject matter expert focus groups, and iterative engagement with an expert advisory group, we identified fourteen core competencies and a list of essential supporting elements at the school, program, and instructor levels. Knowledge and recognition of the importance of effective safety and health management systems served as the foundation for elements and competencies. Findings provide an important starting point for systematically improving the preparation of construction CTE students that can help keep them safe on the job.

Can the unemployed be trained to care for the elderly? The effects of subsidized training in elderly care.

Demographic change has increased the need for elderly care. Training unemployed workers might be one way to increase the supply of elderly care nurses. This study analyzes the effectiveness of subsidized training for unemployed individuals in the elderly care professions in Germany over 11.5 years. We find that short further training and long retraining courses significantly increase workers' long-term employment. As approximately 25% to 50% of trained nurses have permanent jobs in the care sector, we estimate that approximately 5% of all employed nurses are formerly trained unemployed workers.

Effectiveness of the settings-based intervention Shaping the Social on preventing dropout from vocational education: a Danish non-randomized controlled trial.

BACKGROUND: Lack of formal education is an important social determinant of health inequality and represents a public health problem. School dropout is particularly common in vocational education; however few prevention programs targeting dropout in the vocational school setting have been evaluated. The purpose of the present study was to test the effect on school dropout of a settings-based intervention program (named Shaping the Social) that targeted the school organization in order to create social and supportive learning environments. METHODS: A non-randomized controlled design including four large intervention schools and six matched-control schools was used. The target population was students in technical and agricultural vocational education, which is provided to students from age 16. Students were enrolled at school start. Register-based data (n = 10,190) was used to assess the effect on school dropout during a 2-year period. Odds ratios (OR) and 95% confidence intervals (CI) were calculated in logistic regression models, adjusting for age, sex, ethnicity, parental income, prior school dropout and type of basic course. Student survey (n = 2396) at 10-week follow-up was used to examine wellbeing at school (four subscales: school connectedness, student support, teacher relatedness, and valuing the profession) which was the hypothesized proximal intervention effect. As a secondary aim, we examined how the student wellbeing factors were associated with school dropout, independently of the intervention, and we explored whether the student wellbeing factors were potential mediators. RESULTS: The present study showed an intervention effect on school dropout with dropout rates lower in intervention schools (36%) than control schools (40%) (OR = 0.86, 95% CI: 0.74, 0.99). We had no attrition on the dropout outcome. School connectedness mediated the intervention effect; no significant mediation effects were found for student support, teacher relatedness, and valuing the profession. Independently of the intervention, each student wellbeing factor prevented dropout. CONCLUSIONS: Findings from this study suggest that a comprehensive, multicomponent school-based intervention could prevent dropout from vocational education by promoting school connectedness; nevertheless, the dropout rate remained high. Our results point to the need to explore how to further improve the wellbeing at school among young people in vocational education. TRIALS REGISTRATION: ISRCTN, ISRCTN57822968 . Registered 16 January 2013 (retrospective registered).

VOCATIONAL TRAINING AND ACTIVITY OF PHARMACISTS IN GEORGIA.

Aim of the research was to study features of pharmacists' job satisfaction in Georgia. The study was quantitative investigation by using survey (Questionnaire). Surveys were for pharmacists, 810 pharmacists were interviewed in Georgia. We used methods of systematic, sociological (surveying, questioning), comparative, segmentation, mathematical-statistical, graphical analysis. The data was processed and analyzed with the SPSS program. On the basis of performed of sociological study of pharmacist specialists have been founded that the government should organize preparation and implementation of the registration-certification regulations for the pharmacists' staff.

Midwifery in Iceland: From vocational training to university education.

Midwifery education is a foundation for health professionals' competence in providing quality healthcare for the benefit of women, their families and society. This paper describes midwifery and the development of midwifery education in Iceland. It examines policy and extensive reforms, from hospital-based vocational training in midwifery to an academic university education, and the impact on the scope of midwifery practice in Iceland. The university-based programme, with its emphasis on autonomy of the midwife, seems to have affected the context of home birth and strengthened midwives' role in primary healthcare. Education reform with a focus on evidence-based practice and midwife-led continuity of care has had limited influence within the hospital system, where the structure of care is fragmented and childbirth is under threat of increasing interventions. Research is needed on the role of education in supporting evidence-based practice, normal childbirth and reproductive health in the Icelandic context.

A comparative study of vocational education and occupational safety and health training in China and the UK.

In order to enhance Chinese workers' occupational safety awareness, it is essential to learn from developed countries' experiences. This article investigates thoroughly occupational safety and health (OSH) in China and the UK; moreover, the article performs a comparison of Chinese and British OSH training-related laws, regulations and education system. The following conclusions are drawn: China's work safety continues to improve, but there is still a large gap compared with the UK. In China a relatively complete vocational education and training (VET) system has been established. However, there exist some defects in OSH. In the UK, the employer will not only pay attention to employees' physiological health, but also to their mental health. The UK's VET is characterized by classification and grading management, which helps integrate OSH into the whole education system. China can learn from the UK in the development of policies, VET and OSH training.

An evaluation of a two-site pilot model for dental foundation training.

Objectives To evaluate the feasibility, strengths, weaknesses, and challenges of a two-site model of dental foundation training.Methods A mixed methods approach was used to evaluate the two-site pilot. Qualitative interviews and focus groups were employed to gain an in-depth understanding of the expectations, experiences and concerns of the stakeholders. Additionally, purposefully designed questionnaires were used to rate different elements of the training.Results Participants included 12 foundation dentists, 15 educational supervisors and seven assistant educational supervisors. An increased breadth of clinical experience, a more variable case-mix, feedback from two teams of supervisors, and the experience of working within two different practices with two different teams and cultures were perceived to be the main strengths. The key challenges reported by the trainers were increased workload, a perceived disruption to the continuity of patient-care and perceived difficulties in establishing professional relationships.Conclusions This paper reports on the evaluation of a new model of dental foundation training in London. It highlights potential advantages and drawbacks of providing dental foundation training in two dental practices. Given the limitations of the of evaluation reported in this paper, additional work is required to establish the feasibility and effectiveness of the two-site training model.

Occupational Health and Safety in a Vocational Training Program: How Gender Impacts Teachers' Strategies and Power Relationships: Santé et sécurité des stagiaires dans un programme de formation professionnelle: Impact du genre sur les stratégies et rapports de pouvoir.

In Quebec (Canada), the Work-Oriented Training Path, a work-study program, prepares students who are having difficulty at school for the job market. Occupational health and safety is an important part of their training. This article aims to analyze the impact of gender on the interpersonal dynamics among teachers, trainees, and key actors from the businesses involved. This article also looks at the influence of gender on teachers' strategies and capacity to act regarding occupational health and safety. Using a work activity analysis lens, a multiple case-study analysis of teachers' work activity was carried out. The findings show that gendered social relationships create a specific supervisory context that influences occupational health and safety training. Solutions aimed at reducing the negative impact of gender-associated prejudice on work injury prevention include training for teachers, attention to work organization at the schools, and the creation of cohesive teachers' work teams. Résumé Au Québec, le Parcours de formation axée sur l'emploi (WOTP), un programme en alternance, offre une préparation au marché du travail aux élèves en difficultés scolaires. La santé et la sécurité du travail (SST) est un enjeu important de la formation. L'article vise à analyser l'impact du genre dans la dynamique relationnelle entre les enseignant.es, leurs élèves et les interlocuteurs clés des entreprises impliquées, et son influence sur les stratégies et la capacité d'agir des enseignant.es en matière de SST. Une analyse de cas multiples basée sur l'analyse ergonomique de l'activité des enseignants a été menée. Les résultats montrent que les relations sociales de genre déterminent un contexte spécifique de supervision qui influence la formation à la SST. La formation des enseignant.es, l'organisation scolaire et la création de collectifs enseignants cohésifs sont des pistes de solution pour réduire l'effet négatif des préjugés liés au genre influençant la prévention des lésions professionnelles.

Medical Advice for Sick-reported Students (MASS) in intermediate vocational education schools: design of a controlled before-and-after study.

BACKGROUND: School absenteeism, including medical absenteeism, is associated with early school dropout and may result in physical, mental, social and work-related problems in later life. Especially at intermediate vocational education schools, high rates of medical absenteeism are found. In 2012 the Dutch intervention 'Medical Advice for Sick-reported Students' (MASS), previously developed for pre-vocational secondary education, was adjusted for intermediate vocational education schools. The aim of the study outlined in this paper is to evaluate the effectiveness of the MASS intervention at intermediate vocational education schools in terms of reducing students' medical absenteeism and early dropping out of school. Additionally, the extent to which biopsychosocial and other factors moderate the effectiveness of the intervention will be assessed. METHODS: A controlled before-and-after study will be conducted within Intermediate Vocational Education schools. Schools are allocated to be an intervention or control school based on whether the schools have implemented the MASS intervention (intervention schools) or not (control schools). Intervention schools apply the MASS intervention consisting of active support for students with medical absenteeism provided by the school including a consultation with the Youth Health Care (YHC) professional if needed. Control schools provide care as usual. Data will be collected by questionnaires among students in both groups meeting the criteria for extensive medical absenteeism (i.e. 'reported sick four times in 12 school weeks or for more than six consecutive school days' at baseline and at 6 months follow-up). Additionally, in the intervention group a questionnaire is completed after each consultation with a YHC professional, by both the student and the YHC professional. Primary outcome measures are duration and cumulative incidence of absenteeism and academic performances. Secondary outcome measures are biopsychosocial outcomes of the students. DISCUSSION: It is hypothesized that implementing the MASS intervention including a referral to a YHC professional on indication, will result in a lower level of medical absenteeism and a lower level of school drop outs among intermediate vocational education students compared to students receiving usual care. The study will provide insight in the effectiveness of the intervention as well as in factors moderating the intervention's effectiveness. TRIAL REGISTRATION: Nederlands Trial Register NTR5556. Date of clinical trial registration: 29-Oct-2015.

The effect of an organizational level participatory intervention in secondary vocational education on work-related health outcomes: results of a controlled trial.

BACKGROUND: Work-related stress is highly prevalent in the educational sector. The aim of the current study was to evaluate the effectiveness of an organizational level, participatory intervention on need for recovery and vitality in educational workers. It was hypothesized that the intervention would decrease need for recovery and increase vitality. METHODS: A quasi-experiment was conducted at two secondary Vocational Education and Training schools (N = 356) with 12- and 24-months follow-up measurements. The intervention consisted of 1) a needs assessment phase, wherein staff and teachers developed actions for happy and healthy working under supervision of a facilitator, and 2) an implementation phase, wherein these actions were implemented by the management teams. Mixed model analysis was applied in order to assess the differences between the intervention and control group on average over time. All analyses were corrected for baseline values and several covariates. RESULTS: No effects of the intervention were found on need for recovery, vitality and most of the secondary outcomes. Two small, statistically significant effects were in unfavorable direction: the intervention group scored on average over time significantly lower on absorption (i.e. a subscale of work engagement) and organizational efficacy than the control group. CONCLUSIONS: Since no beneficial effects of this intervention were found on the primary and most of the secondary outcomes, further implementation of the intervention in its current form is not eligible. We recommend that future organizational level interventions for occupational health 1) incorporate an elaborate implementation strategy, 2) are more specific in relating actions to stressors in the context, and 3) are integrated with secondary preventive, individual focused stress management interventions. TRIAL REGISTRATION: Netherlands Trial Register NTR3284 (date registered: February 14 2012).

[Medical Studies + Internship + Vocational Training = A Complete Ophthalmic Surgeon? A Theoretical Analysis of the Ophthalmic Surgery Training from the Perspective of Medical and Educational Sciences]. / Medizinstudium + Praktika + Weiterbildung = fertiger Ophthalmochirurg? Eine theoretische Analyse der ophthalmochirurgischen Ausbildungssituation aus medizinischer und bildungswissenschaftlicher Perspektive.

"Let's have the courage to train young doctors to conduct ophthalmic surgery!" - This is the final plea of this theoretical article, which appeals for greater collaboration between medical and educational sciences in the training of ophthalmic surgeons. It will be discussed whether surgery-based training is adequate, from the point of view of both medical knowledge and learning theory. Standard requirements for the specialist qualification in ophthalmic surgery are presented for Bavaria, Austria and Switzerland; these are then compared and contrasted with the experience-based practice of vocational training. Assuming that vocational training can be understood as providing the context for action-oriented learning, the relevance of procedural knowledge will be discussed for the development of practical surgical skills. A model for expertise in ophthalmic surgery will be outlined. Instructors' didactic skills and expertise will be discussed in relation to the requirements and guidelines for receiving the license to train assistants. In general, the article highlights the relevance of performance in learning surgery, and calls for the provision of sufficient possibilities to learn surgery in the course of assistant doctors' vocational training. This article addresses those who are involved in ophthalmologists' and ophthalmic surgeons' vocational training (e.g. medical instructors, medical associations, assistant doctors) and who welcome thought-provoking impulses from unfamiliar academic disciplines on key questions and concerns in practical vocational training.

Work activity in the process of recovery - an interpretive phenomenological analysis of the experiences of people with a schizophrenia spectrum diagnosis. / Aktywnosc zawodowa w procesie zdrowienia ­ interpretacyjna analiza fenomenologiczna doswiadczen pacjentów ze spektrum schizofrenii.

OBJECTIVES: Having the opportunity to work has been found meaningful for individuals suffering from severe mental illness, in order to boost their self-esteem, provide a sense of control over their lives and of belonging to a community. There are no studies in Polish literature on the process of recovery from schizophrenia with reference to work activity. The objective of this research was to explore personal experiences of people employed in Vocational Development Centers. METHODS: Eight semi-structured interviews were conducted with adult patients. Their transcripts were subject to interpretative phenomenological analysis (IPA). RESULTS: Having the opportunity to work was significant for participants because it mobilized them and encouraged self-care. G oing to work helped them overcome social isolation by meeting people with similar difficulties and those who did not suffer from mental illness. Financial gratification enables a sense of independence and the ability to develop skills to plan and control their budget. CONCLUSIONS: This study finds that patients who lost their jobs due to mental illness should be encouraged to utilize rehabilitation institutions to help them undertake work activity and use previously acquired qualifications or develop new skills. Access to appropriate psychological support should be provided during vocation reorientation and adaptation into new work environments. This helps patients regain a sense of control and purpose, and cope with losing valued social roles. We also highlight the need for further studies into challenges in the workplace and the strategies patients use to cope with them.

Effects of a settings-based intervention to promote student wellbeing and reduce smoking in vocational schools: A non-randomized controlled study.

RATIONALE: School dropout and health risk behavior such as cigarette smoking represent major problems among students attending upper secondary vocational education. Modifications to the social environment may promote educational attainment as well as health and wellbeing of young people. However, there is a need for more evidence-based intervention programs. OBJECTIVE: The aim of this study was to assess the effectiveness of an intervention targeting the socio-environmental setting at vocational schools on student wellbeing and smoking. METHODS: We conducted a non-randomized controlled trial of 5794 students (mean age 21 years; 81% male) in 10 (four intervention and six comparison) large vocational schools in Denmark. The intervention involved changes in everyday school practices focusing on four themes: (i) introduction activities, (ii) daily class meetings, (iii) scheduled breaks and (iv) pleasant non-smoking environment. Outcomes were student wellbeing (four subscales: school connectedness, student support, teacher relatedness, positive valuing of the profession) and daily smoking measured at 10-week follow-up. RESULTS: We found statistically significant between-group difference in school connectedness, but not in student support, teacher relatedness and valuing the profession. The intervention had no effect on daily smoking. However, we found a statistically significant interaction between baseline smoking status and condition. This interaction suggested that baseline occasional smokers in the intervention group had significantly reduced odds ratio (OR) of becoming a daily smoker compared to baseline occasional smokers in the control group (8% versus 16%; OR = 0.44). CONCLUSION: The positive effects on school connectedness and in preventing occasional smokers becoming daily smokers indicate that it is possible to tackle school-related wellbeing and smoking in a high risk population through settings-based interventions.

A lack of anaesthetic clinical attachments for emergency medicine advanced trainees in New Zealand: perceptions of directors of emergency medicine training.

AIMS: Anaesthetic skills are a core competency for emergency physicians. Anecdotally, there are limited anaesthetic attachments specifically available for Emergency Medicine Advanced Trainees (ATs). This study had several aims: Firstly, to quantify anaesthetic terms set aside for ATs; secondly, to gauge the opinions of Directors of Emergency Medicine Training (DEMTs) regarding the importance and difficulty in securing and maintaining anaesthetic training terms for ATs in their institutions; thirdly, to outline strategies that DEMTs used to get or maintain these posts and their opinions about what institutions should do to provide anaesthetic training for ATs. METHODS: An online qualitative survey was emailed to all DEMTs of hospitals accredited for vocational ED training within New Zealand. Registered Medical Officer (RMO) units at accredited hospitals were asked to provide numbers of anaesthetic places available specifically for ATs. RESULTS: Annually there are 15 anaesthetic training posts set aside for 145 ATs. Most DEMTs thought that an anaesthetic term was important for progression of vocational training, and a majority thought that term availability was a significant barrier to progression of training. A number of DEMTs felt that procuring and maintaining anaesthetic posts was difficult, some citing a lack of collegiality from anaesthetic departments. Some DEMTs and ATs used novel approaches to procure anaesthetic attachments. CONCLUSIONS: Anaesthetic skills are an essential component of emergency medicine vocational training. It is in the best interests of hospitals to provide anaesthetic training positions for ATs. There are few training positions currently available.

Bridging the gap between high school and University studies for student with disability.

The choice of the university program represents an important and difficult step for a large part of high school students, especially for those who have to change city and lifestyle to follow their ambitions. In particular, for students with disabilities this choice is even more complicated due to their specific needs concerning both their educational and everyday life. In order to bridge the gap between high school and the University of Pisa, supporting the students during the selection of the program and their stay in Pisa, this paper presents a new model for matching the needs of the students and the existing services in Pisa, with particular attention to those with disabilities. It is based on questionnaires to assess the needs of the students and an accessible website to make available information about places and services offered in Pisa and its surrounding.

How can we strengthen students' social relations in order to reduce school dropout? An intervention development study within four Danish vocational schools.

BACKGROUND: This article describes the rationale and contents of an intervention program aimed at strengthening students' social relations in order to reduce dropout from vocational schools in Denmark. Taking its theoretical cue from the concept of 'social participation', a qualitative study was performed to investigate the specific relationships between the social environment within the schools and the institutional structures in order to analyse reasons for school dropout and their relation to well-being, cigarette smoking and substance use. METHODS: The development study was based on ethnographic methods, including 22 qualitative interviews with students 17-19 years old and fieldwork with participant observations at four vocational schools over 40 days, including informal interviews and discussion meetings with managers, teachers, counselors and students. As part of the fieldwork, four additional qualitative interviews and four group interviews were conducted with students 16-25 years old. RESULTS: The qualitative data collection resulted in seven major themes to be addressed in the intervention: social relations, sole focus on professional skills, institutionalized individualization, importance of the introduction period, physical surroundings and schedules, tobacco and cannabis use and communication about drug use. The program addressing these themes incorporates suggestions that are meant to improve how teachers welcome new students, to enable greater integration of social and educational activities and to enhance the capacity of teachers and counselors to deal with drug use problems among students. CONCLUSION: The development of new intervention programs might benefit from adopting a theoretical and methodological perspective that enables a closer exploration of the everyday social practices in which interventions are embedded. Thus, we aimed to create a comprehensive intervention that worked through organizational changes in everyday school practices. Intervention programs must be planned in dialogue and collaboration with practitioners in the field to ensure the pertinence and usability of the program.