The knowledge assessment and reducing the errors of medical certificate of cause of death with sensitization training of physicians: A quality improvement intervention study.

BACKGROUND: A Medical Certificate of Cause of Death (MCCD) is a vital document issued by a doctor and has a prescribed format published by the World Health Organization. It is an essential tool to obtain scientific and reliable information in terms of the cause of mortality. The aim of this study is to assess the knowledge about MCCD and to evaluate the impact of sensitization training on the MCCD among the physicians working in the trauma and emergency department in a Tertiary Care Centre. MATERIALS AND METHODS: A quasi-experimental quality improvement hospital-based study executed in Trauma and Emergency Department of Tertiary Care Hospital in Chhattisgarh State, India. The physicians posted in the Trauma and Emergency Department were participated in the study and attended the sensitization training session on MCCD. Statistical analysis used; the data were entered in Microsoft Excel and analyzed with SPSS version 20 statistical software. Mean scores and standard deviation (SD) were used for pre and posttest data while statistical significance was tested using the paired t-test. P < 0.05 was considered as significant. The technical and medical errors in MCCD forms were depicted in percentages. RESULTS: A total of 54 physicians completed the study, including 42 junior resident doctors, 6 senior resident doctors, and 6 faculties. There was a significant difference in the scores before (M = 4.39, SD = 1.571) and after (M = 7.5, SD = 0.885) the training (t = 17.6, P < 0.0001). The participants showed substantial improvement by reduction in technical errors from 28% to 14% while the medical error also slashed down from 42% to 16%. CONCLUSIONS: Sensitization and educational training should be carried out consistently on regular intervals to improve the knowledge of physicians regarding the appropriate filling of MCCD and minimize the errors in MCCD, ultimately this will enhance usability and comparability of mortality statistics generated from International Classification of Diseases data.

Effectiveness of training and educational programs for hospital managers: A systematic review.

BACKGROUND: Developing and strengthening the competencies and skills of health care managers is a key objective in many health systems. Selecting adequate training methods, content, and using appropriate criteria for assessing their impact is fundamental for improving their usefulness and effectiveness. Filling an important gap in knowledge, this review assesses the evidence on the effectiveness of different types of training and educational programmes delivered to hospital managers. METHODS: In this narrative systematic review, the following electronic databases were searched for literature published between January 1st, 1990 and January 31st, 2019. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the included studies. RESULTS: In total, 9 articles were included. Results showed that the main topics covered by training programs for hospital managers were: planning, organization and coordination, control and supervision of hospital staff, teamwork, communication, motivation and leadership, monitoring and evaluation, and quality improvement skills. Training in these skills was found to improve managers' strategic and operational planning abilities, change management and behavioural management methods, and leadership. CONCLUSIONS: The examined training programs had a relatively positive effect on the managerial skills, knowledge and competencies of hospital managers. In general, these capacity-building programs focused on developing three types of skills: technical, interpersonal and conceptual. Training programs focused on developing technical skills among managers were more effective than those focused on developing other types of skills. Increased investment and large-scale planning are needed to develop better the knowledge and competencies of hospital managers.

Effectiveness of training interventions to improve quality of medical certification of cause of death: systematic review and meta-analysis.

BACKGROUND: Valid cause of death data are essential for health policy formation. The quality of medical certification of cause of death (MCCOD) by physicians directly affects the utility of cause of death data for public policy and hospital management. Whilst training in correct certification has been provided for physicians and medical students, the impact of training is often unknown. This study was conducted to systematically review and meta-analyse the effectiveness of training interventions to improve the quality of MCCOD. METHODS: This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration ID: CRD42020172547) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. CENTRAL, Ovid MEDLINE and Ovid EMBASE databases were searched using pre-defined search strategies covering the eligibility criteria. Studies were selected using four screening questions using the Distiller-SR software. Risk of bias assessments were conducted with GRADE recommendations and ROBINS-I criteria for randomised and non-randomised interventions, respectively. Study selection, data extraction and bias assessments were performed independently by two reviewers with a third reviewer to resolve conflicts. Clinical, methodological and statistical heterogeneity assessments were conducted. Meta-analyses were performed with Review Manager 5.4 software using the 'generic inverse variance method' with risk difference as the pooled estimate. A 'summary of findings' table was prepared using the 'GRADEproGDT' online tool. Sensitivity analyses and narrative synthesis of the findings were also performed. RESULTS: After de-duplication, 616 articles were identified and 21 subsequently selected for synthesis of findings; four underwent meta-analysis. The meta-analyses indicated that selected training interventions significantly reduced error rates among participants, with pooled risk differences of 15-33%. Robustness was identified with the sensitivity analyses. The findings of the narrative synthesis were similarly suggestive of favourable outcomes for both physicians and medical trainees. CONCLUSIONS: Training physicians in correct certification improves the accuracy and policy utility of cause of death data. Investment in MCCOD training activities should be considered as a key component of strategies to improve vital registration systems given the potential of such training to substantially improve the quality of cause of death data.

Face-to-Face and Distance Education Modalities in the Training of Healthcare Professionals: A Quasi-Experimental Study.

This study evaluates the effectiveness of an 18-month-long course in Family Health. The course was offered in two modalities, distance education and face-to-face learning. Dependent variables were as follows: self-regulation of learning, procrastination, the perception of self-efficacy, and academic performance. The course was attended by 27 health professionals (i.e., physicians, nurses, and dentists) working in the Brazilian Unified Health System. The investigation followed a quasi-experimental design. Participants in the two modalities achieved similar academic performance; and globally no statistically significant differences were found regarding the study variables. Findings, notwithstanding their importance for professional training in health, are preliminary and further research is needed on the effectiveness of training modalities distance education and face-to-face learning (e.g., focus groups, interviews, online monitoring). The educational implications of this study are discussed and analyzed considering specificities and differences of each modality.

Course reaction scale in e-learning: adaptation and factor structure / Escala de reação ao curso em educação a distância: adaptação e estrutura fatorial / Escala de reacción al curso en enseñanza virtual: adaptación y estructura factorial

This paper aims to adapt and analyze the factor structure and psychometric properties of the Reaction to Instructional Proceedings Scale in Distance Education (ERPI-EAD) and its relation with the effectiveness of training at work. In total, 3,600 employees from a Brazilian public bank participated in this study by answering the ERPI-EAD after taking part in an online course. We measured training transfer with a self-evaluation scale. Internal consistency, confirmatory factor analysis, and multiple regressions were conducted. A one-factor structure and a high level of fit for the model were found. The participants' satisfaction with the course was related to the effectiveness of training. We suggest using the ERPI-EAD as a reliable and valid measure that predicts the effectiveness of training, can contribute to collect relevant information to improve instructional aspects and ensure better performance results in the workplace.

O presente trabalho tem como objetivo adaptar e analisar a estrutura fatorial e as propriedades psicométricas da Escala de Reação aos Procedimentos Instrucionais em Educação a Distância (ERPI-EAD) e sua relação com a efetividade do treinamento no trabalho. Participaram deste estudo 3.600 funcionários de um banco estatal brasileiro respondendo à ERPI-EAD depois de realizar um curso on-line. Mediu-se o impacto do treinamento no trabalho em amplitude com uma escala de autoavaliação. Foram realizadas análises de consistência interna, fatorial confirmatória e regressões múltiplas. Uma estrutura unifatorial e um alto nível de ajuste para o modelo foram encontrados. A satisfação dos participantes com o curso esteve relacionada à efetividade do treinamento. Sugere-se o uso da ERPI-EAD como uma medida confiável e válida, que prediz a efetividade de treinamento, contribui para a coleta de informações relevantes à melhora dos aspectos instrucionais e assegura melhores resultados de desempenho no trabalho.

El objetivo de este estudio fue adaptar y examinar la estructura factorial y las propiedades psicométricas de la Escala de Reacción al Curso en Enseñanza Virtual (ERC-EV) y su relación con la eficacia de la formación en el trabajo. Un total de 3.600 empleados de un Banco estatal brasileño participó en el estudio respondiendo a la ERC-EV después de haber participado en una teleformación. Se midió la transferencia de la formación con una escala de autoevaluación. Análisis de consistencia interna, factoriales confirmatorios y regresiones múltiples fueron realizados. Una estructura de un único factor y un alto nivel de ajuste para el modelo fueron encontrados. La satisfacción de los participantes con el curso estuvo relacionada con la eficacia de la formación. Se sugiere el uso de la ERC-EV como una medida fiable y válida, que predice la eficacia de la formación, puede ayudar a recoger información relevante para la mejora de los aspectos de la instrucción y asegurar mejores resultados de rendimiento en el trabajo.

Estrutura Fatorial e Propriedades Psicométricas da Escala de Suporte à Transferência de Treinamento / Factor Structure and Psychometric Properties of the Scale of Support for Training Transfer

RESUMO: O estudo objetivou analisar a estrutura fatorial e as propriedades psicométricas da Escala de Suporte à Transferência de Treinamento (ESTT) e sua relação com a efetividade do treinamento no trabalho. Um total de 1.540 funcionários de um banco estatal brasileiro participou do estudo respondendo à ESTT e à escala de impacto do treinamento no trabalho em amplitude depois de realizar um curso online. Foram realizadas análises de consistência interna, fatorial confirmatória e de regressões múltiplas. Uma estrutura com três fatores foi encontrada, bem como um alto nível de ajuste para os modelos. As medidas apresentam evidências de validade de construto e o suporte percebido pelos participantes esteve positivamente relacionado com a transferência de competências para o trabalho e desempenho geral.

ABSTRACT: This study aimed to analyze the factor structure and psychometric properties of a Training Transfer Support Scale (STTS) and its relationship with the effectiveness of training at work. A total of 1,540 employees of a public Brazilian bank participated in this study by responding to the STTS and a measure of transfer of training after taking part in an online course. Reliability analysis, confirmatory factor analysis, and multiple regressions were conducted. A three-factor structure was found and a high level of fit for the models. Evidence of the construct validity of the measures was obtained, and the participants' perception of support was positive related to the transfer of training to the workplace and overall performance.

Qualitative analysis of the subjective evaluation of home-care training by resident trainees / 医学教育

The aim of this research was to explore the educational effects of home-care training on resident trainees which have not previously been deliberately examined. We performed a qualitative study. Focus-group interviews were conducted to explore the views of residents who underwent medical training in 3 different settings: inpatient, outpatient, and home-care. Analysis of the interview data revealed 8 categories of resident experiences and their views on the effects of home-care training: 1)recognition of the importance of the concerns of the patient and the family in medical communication; 2)development of patient-centered and family-centered attitudes; 3)acquisition of the knowledge and skills of management, other than medical management, in home-care; 4)appropriate cooperation with other health professionals; 5)recognition of options for care settings; 6)knowledge of the community; 7)recognition of healthcare resources in the community; and 8)acquision of effective use of medical knowledge and skills. The findings of this study suggest that home-care training is effective for helping residents to develop patient-centered communication skills and attitudes and to develop management skills for a multidisciplinary team in the community to complement medical training in inpatient and outpatient settings.