Search

Background and Aim In 2015, the Japanese Society of Gastroenterological Surgery (JSGS) initiated data verification in the gastroenterological section of the National Clinical Database (NCD) and reported high accuracy of data entry. Remote audits were introduced for data validation on a trial basis in 2016 and formally accepted into use in 2017‐2018. The aim of this study was to audit the data quality of the NCD gastroenterological section for 2016‐2018 and to confirm the high accuracy of data in remote audits. Methods Each year, 45‐46 hospitals were selected for audit. Twenty cases were randomly selected in each hospital, and the accuracy of patient demographic and surgical outcome data (46 items) was compared with the corresponding medical records obtained by visiting the hospital (site‐visit audit) or by mailing data from the hospital to the JSGS office (remote audit). Results A total of 136 hospitals were included, of which 88 (64.7%) had a remote audit, and 124 936 items were evaluated with an overall data accuracy of 98.1%. There was no significant difference in terms of data accuracy between site‐visit audit and remote audit. Accuracy, sensitivity, and specificity of mortality were 99.7%, 89.7%, 100% for site‐visit audits and 99.8%, 97.3%, 100% for remote audits, respectively. Mean time spent on data verification per case of remote audits was shorter than that of site‐visit audits (10.0 minutes vs 13.7 minutes, P, The Japanese National Clinical Database (NCD) covers > 95% of the surgical operations carried out in Japan. The aim of this study was to audit the data quality of the NCD gastroenterological section for 2016‐2018. The audits showed that NCD data are reliable and characterized by high accuracy.

Author(s): Spetz, Joanne; Pourat, Nadereh; Chen, Xiao; Lee, Christopher; Martinez, Ana; Xin, Kong; Hughes, Dana | Abstract: BackgroundAlthough access to dental care has improved over time, many children still face difficulty in obtaining services. One strategy to increase access is through mobile dental services, often in collaboration with schools, Head Start programs, and school-based health centers. This study evaluates a large mobile dental care program based in Minnesota.MethodsThematic analysis of interview data collected during a 2-day site visit and multivariate regression analysis of electronic records of patients (adults and children) that received care from 2000 through 2015, representing 84,279 unique patients.ResultsThe number of patients increased from 5558 in 2000 to 13,863 in 2015. There was a decline in the share of preventive procedures over this period, from 45.7% to 29.4%, and an increase in the share of patients seen at fixed sites. The interview data revealed that program growth relied on relationships with school leaders, expanded scope of practice for dental assistants and dental therapists, and high Medicaid reimbursement.ConclusionsMobile dental care programs can increase both preventive and restorative dental care for individuals who otherwise would not easily access oral health care services; mobile dental programs could be an option in many other communities and schools.

The Study Within A Trial (SWAT) programme exists to ‘embed research within research, so as to resolve uncertainties about the different ways of designing, conducting, analysing and interpreting evaluations of health and social care’ (1). Published in this journal in 2013, a template for the first SWAT protocol outlined an investigation into the effects of site visits by the Principal Investigator on recruitment in multi-centre randomized controlled trials (1). We have now designed a SWAT protocol to extend this question and ask ‘does it matter who conducts the site visit?’ Our aim is to provide a protocol which trials can implement to address this research question.

Objective To obtain information about aged care services in rural New South Wales public hospitals, and to describe key operational aspects of their service delivery models. Design A mixed methods design was used to combine data collected from: (i) a survey of public hospitals and (ii) qualitative site visits in a sample of eleven rural sites. Setting Rural public hospitals in NSW, Australia. Participants Qualitative data were collected from multidisciplinary clinicians, managers and community service providers who participated in site visits in 2010 and from surveys of NSW public hospitals in 2009/10 about aged care and dementia services. Results Survey and site visit findings demonstrated that rural hospitals have fewer secure beds for managing patients with disturbed behaviour due to dementia and delirium and fewer speciality aged care staff than metropolitan hospitals. Site visit participants also described how secure environments can aid care for people with dementia even in the absence of clinical specialists. Conclusion The care of people with dementia in rural hospitals is constrained by access to specialist aged care staff and the physical environment of the hospital. Clinicians are adept at maximising resources to manage diagnosis and transitions for people with dementia. Further understanding of how key operational aspects of clinical leadership and environmental modifications impact on a range of patient outcomes would be valuable.

While qualitative methods have gained considerable recognition in medical education research, employing multiple qualitative data sources in assessing long-term educational impact is rare. Utilising in-depth data analysis method to six cross-sectional cohorts (2004-2009) of students' reflection papers (n = 213), this article demonstrates how students experienced subtle but important shifts in their attitudes (including personal, professional and spiritual domains) after making field visits to a hospice centre as part of the Special Needs Dentistry module. For retrospective assessment of learning retention, a pilot focus group was conducted with three junior faculty members who participated in the field visits to a hospice during their own undergraduate training. A subsequent focus group was conducted with graduates of the 2008 (n = 8) cohort using a refined discussion guide arising from the analysis of pilot group results. Graduates were unanimous in stating that the visits had sown 'seeds' in their minds and hearts, seeds which started to grow after they completed dental school and began to practice. This is demonstrative of the long-term positive educational impact of the pedagogical design that entailed a special site visit coupled with post-visit debrief and written reflection.

For 3 decades the Council for Accreditation of Counseling and Related Educational Programs (CACREP) accreditation process has assured quality in counselor training at the both the doctoral and master's level. CACREP accreditation implies that a counselor training program conforms to standards of excellence in the preparation of counselors and counselor educators. In the past 30 years the number of CACREP-accredited counselor training programs has grown significantly. At present, there are 607 CACREP-accredited programs in 262 institutions (C. Bobby, personal communication, September 15, 2011). The process leading to CACREP accreditation is a labor-intensive one that entails a number of steps. One of the most important steps in the CACREP review process is the campus site visit (CACREP, 2009b). The site visit takes place after an institution has completed a self-study of its program or programs that has been reviewed by the CACREP Board of Directors. After a successful review, the CACREP Board will approve an institutional site visit. The site visit generally involves a three- to four-member team, usually from comparable institutions, coming to a campus for a 3-day review of the counselor training program(s). This article reviews the CACREP site visit process and issues related to its evolution over the past 30 years. * The Evolution of Counselor Training Models CACREP site visits began with review teams traveling to counselor training programs that were generally located in one (or several) academic unit(s) physically housed at one public or private university site. Although this remains the predominant model, the progression of time has seen a number of other counselor training configurations emerge. It is not unusual today to find site teams reviewing programs that are conducted online or in a hybrid fashion (i.e., a combination of live and online instruction), conducted at multiple sites by the same institution, or conducted by proprietary schools (for-profit businesses) that provide counselor training within a corporate educational framework. Each one of these contemporary educational configurations presents a unique challenge for site teams in their efforts to evaluate a program's compliance with CACREP Standards. * The Nature of the Site Visit The CACREP site visit is a mechanism for the CACREP Board of Directors to actually view the inner workings of a counselor training program. Therefore, the site visit team becomes the "eyes" of the board in reviewing a program. The role of the team is to be the board's representative on campus to verify the program self-study. The visit also provides an opportunity for the team to examine issues that are identified in the initial board review of the program self-study as well as answer questions and provide suggestions for program improvement (CACREE 2009b). It is important to note that a site team generally spends only 3 days on campus, so they are able to get only a snapshot of the program at a moment in time. However, this impression has usually been sufficient to make solid judgments about the quality of a program and its compliance with the CACREP Standards. During its time on campus, the site team will meet with key program stakeholders, including full-time and adjunct faculty, current and former students, university administrators, and internship supervisors. The members of the team will question these stakeholders about their perceptions of the counseling program(s) and solicit their suggestions for improving the nature of the training. In addition to these meetings, the team usually visits practicum and internship sites and may observe classes in session. The team will also conduct a review of documentation available in files and tour the program clinical training facilities and campus library. Over the years, technology has had a significant impact on the nature of the CACREP site visit. This has been particularly evident with aspects of reviewing program record keeping, classroom and clinical facilities, and library resources. …

This article describes how the interactive learning methods employed during a short (1.5 h) class visit to a nearby stream engaged undergraduate students in their own exploration of riparian ecology. We describe how the use of a published field study conducted at this stream site served as an effective learning tool to help students contextualize ecological research-based findings. During the outing, students worked in groups using a “stream station worksheet” and participated in facilitated discussions to relate their observations to the findings of the published field study. An anonymous survey of students Opinions after the site visit revealed positive responses, reflecting success in achieving the desired learning objectives. We discuss how the site visit has been enhanced from previous years to increase effective student learning and how this type of activity could be applied to other ecology or fisheries courses by utilizing appropriately chosen local research.

With the increasing popularity of private sale sites, it has become more important to understand those shoppers regularly visiting these sites. To date, no published studies have reported on shoppers of private sale sites. The current study was designed to divide shoppers of private sale sites into distinct fashion consumer groups based on their levels of fashion leadership, and to examine their differences in shopping behaviours. Data were collected from a convenience sample of 164 women aged 18 and older who were members of at least one private sale site. The respondents were recruited mainly using a snowball sampling technique, which relied on chain referrals to identify eligible participants. Factor analysis results suggested that fashion leadership consisted of two dimensions: fashion opinion leadership and fashion innovativeness. The respondents were divided into four groups, named fashion followers, fashion opinion leaders, fashion innovators and innovative communicators, based on their scores on the two dimensions of fashion leadership. In order to compare characteristics of the four groups, a series of anova were conducted and significant group differences were found in hedonic shopping, site visit frequency, and purchase intention. The significantly higher levels of visit frequency and purchase intention for innovative communicators indicate that this group represents a valuable market segment for online private sale companies to target. Implications for future research and limitations were also discussed.

Purpose: The purpose of this study was (a) to identify nurse practitioner (NP) preceptor expectations of university faculty members and students, (b) to understand the best methods of communication between university faculty members and the preceptors, and (c) to elicit issues for improvement for the precepting experience. Data sources: This study was a cross-sectional descriptive design. A survey was sent to all clinicians who precepted NP students from the University of Hawaii from 2003 to 2004 (n= 108). Conclusions: The response rate was 67% (28% males and 72% females) with a mean age of 46.3 years. Sixty-eight percent of the respondents were NPs, 28% were doctors, and 4% were nurse midwives. The majority of preceptors expected two site visits per semester (51%), that faculty members should observe two patient visits with students (57%), and 65% said the first site visit should occur in the first 4 weeks of the semester. Implications for practice: Conducting an assessment of preceptor's issues and expectations of faculty site visits can improve relationships with preceptors and secure and maintain clinical placements for NP students. Recommendations include improving communication, establishing guidelines for site visits, and periodic assessment of progress in preceptor–student relationships.

OBJECTIVES: To evaluate and characterize routine blood glucose monitoring practices in nursing homes and assisted living facilities (ALFs). DESIGN: Cross-sectional, self administered survey and facility site visit. SETTING: Two hundred eighty-nine licensed long-term care facilities in Pinellas County, Florida. PARTICIPANTS: Stratified random sample of 48 long-term care facilities (17% overall sample). MEASUREMENTS: Data on facility characteristics, infection control policies, staff practices, and equipment used for blood glucose monitoring. Differences between facilities in each stratum were compared and evaluated using the Pearson chi-square or Fisher exact test. RESULTS: Fifteen nursing homes and 17 small and 16 large ALFs participated; 53 declined (48% participation rate). Bloodborne pathogen training (P=.02), hepatitis B vaccination (P=.003), and blood glucose monitoring (P

OBJECTIVES: To identify models for senior mentor programs (SMPs), critical factors in program development, achievement of goals and objectives, effect on medical school environment, and future of programs. DESIGN: Ten SMPs were systematically selected to represent a variety of medical schools, geographic regions, and program types. The National Senior Mentor Program Evaluation relied upon archived data within the programs and new data collected during site visits. Archived data included internally conducted program evaluations, student course evaluations, and survey and focus group results. Site visit data were collected from key informant interviews with program staff and faculty, medical school leadership and students, and older adults serving as mentors. SETTING: Ten U.S. medical schools with SMPs. PARTICIPANTS: Evaluation participants at each site included program faculty, key medical school administrators, participating students, and mentors. MEASUREMENTS: Program evaluation. RESULTS: All 10 programs demonstrated a positive effect on student attitudes toward older adults. Student acceptance of the programs was strong, and mentor acceptance and support were extraordinary. Eight of the 10 programs were operating in 2008 and having considerable effect on medical school environments. Most of the operating programs expect to be continuing for 5 or more years into the future. CONCLUSIONS: The findings of the national evaluation point toward continuation and likely growth of the senior mentor phenomenon in U.S. medical education.

The aim was to test whether a well-designed educational package on the implementation of kangaroo mother care (KMC) used on its own can be as effective in implementing KMC in a healthcare facility as the combination of a visiting facilitator used in conjunction with the package. Setting: Thirty-four hospitals in KwaZulu-Natal Province South Africa. The hospitals were paired with respect to their geographical location and annual number of births at the facility. One hospital in each pair was randomly allocated to receive either the implementation package alone (group A) or the implementation package and visits from a facilitator (group B). Hospitals in group B received three facilitation visits. All hospitals were evaluated by a site visit 8 mo after launching the process and were scored by means of a progress-monitoring tool. Successful implementation was regarded as demonstrating evidence of practice (score > 10) during the site visit. Group B scored significantly better than group A (p < 0.05). All 17 hospitals in group B demonstrated evidence of practice with the median score of the group being 15.44 (range 10.29--22.94). Twelve of the hospitals in group A demonstrated evidence of practice and the median score was 11.33 (range 1.08--21.13). Successful implementation was achieved in most of the hospitals irrespective of the strategy used. However facilitation with an implementation package was clearly superior to using a package alone. Some sites do not need facilitation for successful implementation. (authors)

Racioethnic minorities have constituted a substantial portion of new labor market entrants in the past decade (Fullerton & Toossi, 2001). Yet, the recruitment literature has not attended to issues of racioethnicity, and more specifically, how racioethnic groups may differ in the factors used to determine job acceptance intentions after site visits. This article aims to rectify that omission by providing a theoretical model explaining how organizational and surrounding community attributes differentially affect the decision-making process of minority and majority group job applicants. Several individual difference moderators (i.e., racioethnic identity, social dominance orientation, other-group orientation, and perceived job opportunities) also are discussed in terms of their potential influence on job acceptance intentions. The article concludes with coverage of relevant research and practical implications of the racioethnic model of site visit reactions.

Being prepared for an Occupational Safety and Health Administration (OSHA) inspection can save a facility money, as well as potentially protect employees from serious illness or injury. This article explains the OSHA inspection process, types of violations that may be cited and the appeals process for employers and employees. Actual citations given in four recent OSHA health care facility inspections are discussed and general recommendations to prepare for an OSHA site visit are given.

Objective To determine the present state of colonoscopic screening practice for patients at a high risk of developing colorectal cancer. Methods We assessed colonoscopic screening practice in nine colorectal surgery or gastroenterology units referring patients to the regional genetics centre in the North-west of England. The validity of the pedigree was confirmed by inspection of Hospital records, use of cancer registries and records of general practitioners across the United Kingdom. The screening activity at the participating centres was investigated by means of a questionnaire, site visit and study of case notes. Results One hundred and eight high risk families were identified. Outside the genetics unit, family history was not taken in a structured manner and family pedigree was not confirmed. In four units screening was offered directly by the consultant surgeon. Differing protocols for screening were in place in six units, but were frequently not adhered to. Colonoscopy completion rates were known in only four units (range 83–97%). Frequency of screening varied from 2 to 5 years. Recording of information was minimal outside the patients’ records and there were no dedicated databases. Facilities for families to be screened together existed in three units and the psychological effect of screening was not determined outside the genetics centre. Conclusions Screening practice should be standardized and specific criteria met before regular screening is initiated. A dedicated database should be established to record information from units screening patients at high risk of colorectal cancer.

This article draws on evidence from a partnership action research project concerning curriculum organization in three English primary schools. Using a case‐study of site visit planning, teaching and learning in an age 5‐11 rural primary school, it argues that, despite major centralizing initiatives such as the English National Curriculum and OFSTED inspection systems, teacher planning remains a complex, variable and necessarily individualized activity. The teacher planning discussed has been highly commended through a local school inspection under the OFSTED system; but the teachers’ organically influenced views of planning contrast with the more mechanistic written guidance from governmental and advisory bodies. Such centralized advice, driven by the assumption that educational improvement means ‘raising standards’, tends to model formulaic planning procedures which ignore evidence of how rich teacher thinking and planning can be in practice. The argument is made not simply to undermine national...

A successful air-based remediation system, now frequently chosen for sites contaminated with VOCs, demands a thorough understanding of the nature and distribution of the VOCs and the soil air permeabilities. Considering likely remediation methods during the site investigation allows collection of all data needed for method selection and design within a single, highly efficient site visit. A case history illustrates how to integrate several data collection and testing activities into a single site visit.

The Curriculum Outcomes Review and Evaluation (CORE) system of outcomes assessment used in the accreditation of Canadian Dental Faculties by the Commission on Dental Accreditation of the Canadian Dental Association is described. The CORE system, which has become an integral part of the regular accreditation site visit of Canadian dental predoctoral programs consists of (a) two methods of chart review, (b) assessment of the performance of a random sample of final year students in both diagnosis and treatment planning and in case presentation, (c) a structured observation in the clinical setting, (d) the application of a detailed and focused survey instrument prior to the site visit, and (e) the solicitation of feedback from involved students, faculty members, school administrators and accreditation site visitors. The overall response to the CORE program was favorable and plans to expand the program to dental hygiene accreditation are described.

The University of Missouri-Columbia has been a major training ground in counseling psychology for more than 40 years. Its development and influence on the field are explored through the use of historical archives and comments from faculty, graduates, and APA site visit reports.

Black bass conservation committee members on site visit to the Devils River, Texas (L-R: Tim Birdsong, Tim Churchill, Joe Slaughter, Mike Allen, Jim Long, Wes Porak, and Mike Tringali), June 2012. ...

The training of an otolaryngologist-head and neck surgeon is an increasingly complex educational process that spans at least 5 years, beginning with the early “Match” and ending with successful completion of an accredited otolaryngology residency training program. We will discuss nuances of the selection and match process for incoming residents, current ACGME accreditation guidelines, and regulations for training including the new duty hours requirements and trends from other specialties. Successful novel approaches will also be presented. In addition, we will consider potential future changes, both internal and external to the specialty, that could impact the training of otolaryngologists. This miniseminar will be of interest to current residents and medical students, faculty that participate in a training program, and practicing otolaryngologists. Residency training is not directed using an exact “formula,” and there are many successful models of good training. The Panel represents a spectrum of “insider” personnel from the ACGME, RRC, and the San Francisco Match. The Panel will also provide views from a senior otolaryngology resident and program directors from both a small and large program. Invited speaker presentations will be followed by a dynamic audience-participatory discussion related to these topics. The Panel will discuss: (1) The Otolaryngology Match: trends, misconceptions, and maximizing the resident selection process; (2) Mastering the ACGME accreditation process and Program Requirements; (3) Duty Hour regulations: specifics and solutions; (4) Presenting your Program during the ACGME site visit experience; (5) Future horizons and directions.

In 1990, the AAPM published Essentials and Guidelines for Hospital Based Medical Physics Residency Training Programs (Report 36). Since then, many clinical residencies were initiated. Simultaneously, the Committee for Accreditation of Medical PhysicsEducation Programs (CAMPEP) began a program of accreditation, charging the Residency Education Program Review Committee with this task. As of March 2005, there are 12 accredited programs with more applying. Today we will discuss; the forthcoming update to AAPM Report 36, the accreditation process and sources of funding, and most importantly we will hear from three resident graduates in regards to their training and how their careers have progressed post residency. AAPM Report Number 36 gathers in one document the didactic knowledge and concepts that constitute the foundation of clinical medical physics. It lists equipment and procedures that embodies the breadth of medical physicist practice in radiationoncology, diagnostic imaging, and nuclear medicine. The new version acknowledges AAPM Report Number 79 “Academic Program Recommendations for Graduate Degrees in Medical Physics” as providing the standard for basic medical physics knowledge. However, didactic knowledge and concepts specific to specialized area of medical physics practice have been retained. Most of the equipment and procedures listed in the original report have been retained and many new ones have been added. Obvious examples include computed radiography, PET imaging, and IMRT. CAMPEP offers accreditation of clinical residency programs in radiationoncology or medical imagingphysics. The goal is to ensure a residency program provides rigorous and thorough clinical training (24 months) in a similar fashion to that provided by medical residency training programs. The graduating resident should be prepared to start the board certification process. The Process of CAMPEP accreditation requires a program submit a self‐assessment report giving evidence of consistency clearly stated guidelines. After report review, a survey team conducts a program site visit to validate the assessment. If successful, accreditation is granted for 5 years with brief annual update submissions. To facilitate the application process, guidelines are available for download from campep.org. In addition, an application template is available from this link. Funding is an important issue that has many solutions. CMS (formally HCFA) offers reimbursement to facilities with accredited programs. This falls under the paramedical education category, whereby portions of direct cost (salary & benefits) can be reimbursed. In addition, the AAPM (with co‐support from Varian) and ASTRO supply grants ideal for established or startup programs, respectively. This symposium should be attended by, directors of physics programs, physics educators, and students contemplating residency programs. Educational Objectives: 1. To understand the history and necessity of residency programs 2. Receive and update on AAPM Report 36 on Essentials and Guidelines 3. Learn about the accreditation process 4. Sources of funding for residency programs 5. Obtain a clear picture of residency from resident graduates

Purpose: To describe the approval process for enrolling patients on NCI‐funded cooperative group clinical trials with proton therapy and the impact of data obtained from the process. Methods: Institutions interested in participating in clinical trials with proton therapy must first complete five RPC‐coordinated approval steps for each proton delivery Method: a) completion of the proton facility questionnaire; b) annual monitoring of beam output; c) electronic transfer of treatment plans; d) successful completion of baseline anthropomorphic proton phantoms; and e) successful completion of a dosimetry review visit and corresponding site visit report. The RPC implemented a new fee structure for proton therapy site visits on 1/1/2013, establishing a cost‐share between the NCI/MGH Federal Share Funds and the institutions visited. These visits consist of QA review as well as dosimetric measurements with an ion chamber, 2D ion chamber array, and multi‐layer ion chamber to evaluate treatment delivery. Once an institution is approved for clinical trials with protons, there may be additional credentialing for specific trials, such as irradiations of the RPC's protocol‐specific anthropomorphic proton phantoms. Results: To date, the RPC has approved eight proton centers for use of proton therapy in clinical trials. These approvals cover scattered, uniform scanning, and spot scanning proton therapy delivery techniques. The RPC has performed 12 proton therapy site visits and has consensus data to establish acceptance criteria for site visit measurements that will ensure clinical trial consistency. With some institutions going through the approval process for a second or third delivery modality, the RPC anticipates eight proton centers will have 12 new beam delivery systems approved for use of proton therapy in clinical trials by the end of 2013. Conclusion: The RPC's proton therapy approval process and credentialing requirements help ensure consistency across clinical trial participants. Work supported by grants CA10953, CA059267, and CA81647 (NCI, DHHS).

Dental hygiene students from Hudson Valley Community College were introduced to the subject of developmental disabilities during their senior year. Each student received three hours of lecture and spent one afternoon in the dental clinic of the O. D. Heck Developmental Center. The Personal Attribute Inventory was administered to the students before and after the program to determine attitudes about mental retardation. A determination was made as to whether the timing of the visit to the center, relative to the presentation of the lectures, made a difference in students' attitudes. No statistically significant difference in attitudes was found between the beginning and the end of the year, and there were no changes in attitudes attributable to the placement of the lectures vis-a-vis the site visit.

The traditional evaluation model used in accrediting professional-education programs is discussed and the field of psychology is used as an example. The evaluation model followed in the recently implemented accreditation mechanism for rehabilitation-counselor education (RCE) programs is also discussed. The evaluation model makes some significant departures from the traditional model. A survey-research approach is used to substitute in part for the traditional site visit, and more comprehensive program-evaluation data, going beyond the traditional reliance on faculty and students, are collected. Further, data on the competence of graduates are employed in the evaluation process. Possible implications of the RCE model are discussed as they relate to the currently evolving accreditation procedure for counselor-education programs, as well as the accreditation procedures in other professions.

As a result of a reported incident which resulted in the unintended overexposure of several hundred patients, teletherapy installations throughout the United States were evaluated to verify the accuracy of teletherapy equipment calibrations. Selected licensees received TLDs for exposure under specified conditions. Site visits were made to each licensee showing an apparent discrepancy greater than +/- 5% and intercomparison measurements made. This paper describes results of a sampling of 373 teletherapy licensees and the success of site visits in reducing final discrepancies to less than +/- 5%. TLD and site visit measurement techniques, results, comparison with data from other studies, and possible sources of uncertainty in the management of a large-scale screening program are discussed.