Application of methods of system analysis for modeling the process of distance learning

A mathematical model of distance learning based on control theory in the form of an inhomogeneous linear differential equation is proposed. On the basis of the coefficients of assimilation and forgetting, determined with the help of special tests, it is possible to predict, in some approximation, the level of current knowledge of both the individual trainee and the group or stream of students.

Description of a training protocol to improve research reproducibility for dignity therapy: an interview-based intervention

Background Dignity Therapy (DT) has been implemented over the past 20 years, but a detailed training protocol is not available to facilitate consistency of its implementation. Consistent training positively impacts intervention reproducibility. Objective The objective of this article is to describe a detailed method for DT therapist training. Method Chochinov's DT training seminars included preparatory reading of the DT textbook, in-person training, and practice interview sessions. Building on this training plan, we added feedback on practice and actual interview sessions, a tracking form to guide the process, a written training manual with an annotated model DT transcript, and quarterly support sessions. Using this training method, 18 DT therapists were trained across 6 sites. Results The DT experts’ verbal and written feedback on the practice and actual sessions encouraged the trainees to provide additional attention to eight components: (1) initial framing (i.e., clarifying and organizing of the patient's own goals for creating the legacy document), (2) verifying the patient's understanding of DT, (3) gathering the patient's biographical information, (4) using probing questions, (5) exploring the patient's story thread, (6) refocusing toward the legacy document creation, (7) inviting the patient's expression of meaningful messages, and (8) general DT processes. Evident from the ongoing individual trainee mentoring was achievement and maintenance of adherence to the DT protocol. Discussion The DT training protocol is a process to enable consistency in the training process, across waves of trainees, toward the goal of maintaining DT implementation consistency. This training protocol will enable future DT researchers and clinicians to consistently train therapists across various disciplines and locales. Furthermore, we anticipate that this training protocol could be generalizable as a roadmap for implementers of other life review and palliative care interview-based interventions.

889 A Window to Individual Surgical Training Plans

Introduction A recent publication in the Plastic and Reconstructive Surgery journal (Rohrich et al., 2020) has attracted controversy for its generalised approach to “millennial” plastic surgeons. We suggest that surgeons in training, trainers and colleagues need to adjust their focus from the group to the individual in order to maximise clinical performance, quality of working life and quality of care delivered to patients. Method We outline a simple model, adapted from the Johari window tool, with the aim of delivering a job and training plan with which all parties are content. It considers individual ability to process scenarios and perform tasks (bandwidth), and the resources available to the individual trainee, to assess each aspect of the role. Results No two clinicians have the same strengths and weaknesses, and no two posts are identical. The Johari-like matrix allows trainers and trainees to identify which activities are firmly within the bandwidth and resources of the trainee, those which are clearly not, and those which may cause some concern and require further discussion or modification. Conclusions In this model, we suggest a framework which may help surgeons in training and trainers alike and provide a means of recording this longitudinally as individuals or roles evolve.

Quantifying the impact of the COVID-19 pandemic on orthopaedic trainees

Aims We aim to objectively assess the impact of COVID-19 on mean total operative cases for all indicative procedures (as outlined by the Joint Committee on Surgical Training (JCST)) experienced by orthopaedic trainees in the deanery of the Republic of Ireland. Subjective experiences were reported for each trainee using questionnaires. Methods During the first four weeks of the nationwide lockdown due to COVID-19, the objective impact of the pandemic on each trainee’s surgical caseload exposure was assessed using data from individual trainee logbook profiles in the deanery of the Republic of Ireland. Independent predictor variables included the trainee grade (ST 3 to 8), the individual trainee, the unit that the logbook was reported from, and the year in which the logbook was recorded. We used the analysis of variance (ANOVA) test to assess for any statistically significant predictor variables. The subjective experience of each trainee was captured using an electronic questionnaire. Results The mean number of total procedures per trainee over four weeks was 36.8 (7 to 99; standard deviation (SD) 19.67) in 2018, 40.6 (6 to 81; SD 17.90) in 2019, and 18.3 (3 to 65; SD 11.70) during the pandemic of 2020 (p = 0.043). Significant reductions were noted for all elective indicative procedures, including arthroplasty (p = 0.019), osteotomy (p = 0.045), nerve decompression (p = 0.024) and arthroscopy (p = 0.024). In contrast, none of the nine indicative procedures for trauma were reduced. There was a significant inter-unit difference in the mean number of total cases (p = 0.029) and indicative cases (p = 0.0005) per trainee. We noted that 7.69% (n = 3) of trainees contracted COVID-19. Conclusion During the COVID-19 pandemic, the mean number of operative cases per trainee has been significantly reduced for four of the 13 indicative procedures, as outlined by the JCST. Reassignment of trainees to high-volume institutions in the future may be a plausible approach to mitigate significant training deficits in those trainees worst impacted by the reduction in operative exposure.

Supervisor or mentor: is there a difference? Implications for paediatric practice

The formal roles of educational and clinical supervisor focus on education planning and goal setting against required training elements. Assessment of performance is integral to these roles that necessarily involve some elements of developmental support to trainees. Mentoring is increasingly seen as a desirable route to support doctors in training. Definitions vary, but core expectations of mentors are that they encourage personal development and offer psychosocial support to a trainee within a longitudinal relationship. A key question is whether a supervisor is the appropriate individual to act as a mentor to an individual trainee. The supervisor's role as an assessor of performance can pose challenges and potential conflicts when providing support relating to other personal needs of trainees along their career paths. It is apparent from the literature that mentoring is a multifaceted role, with different actions required of mentors and supervisors. There is evidence that mentorship can affect specialty choice, academic output and commitment to organisations. Addressing the challenges posed by an ideal of providing mentoring to all trainees is potentially as important as ensuring supervisors of competence. The potential benefits for the profession are of enhancing the development and retention of trainees of high calibre within the paediatric discipline.