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The Clinician Scholars Program (CSP) was designed to expand the HIV care workforce by improving the clinical capacity of clinicians in underserved areas. This evaluation assessed program participants' long-term practice changes and system changes. The year-long program combined mentoring, training, and on-site clinical observation. Qualitative interviews (N = 46) were conducted with Scholars at least 2 years following CSP, supplemented by a 2023 survey. Multiple coders analyzed transcripts using open coding. Thematic analysis explored practice changes and efforts to move patients along the HIV care continuum. Findings indicate positive long-term impacts of CSP regarding the HIV care continuum and care system engagement. Over 90% of Scholars remained working in HIV care, with 75% maintaining or increasing patient loads and 72% making changes to their clinical practice. This training model appears to enhance care along the HIV care continuum and may be adaptable to other contexts that address complex chronic conditions. [ABSTRACT FROM AUTHOR]

Lack of training for school clinicians in evidence-based practices (EBPs) contributes to underutilization of such services for youth with attention-deficit/hyperactivity disorder (ADHD). Advances in web-based technology and videoconferencing have allowed for expanded access to and optimization of training. We describe the development and outcomes of a novel web-based platform for training school clinicians to gain skills in EBPs for school-age youth with ADHD. The training platform is adapted from an empirically supported, in-person training for a school-home behavioral intervention (Collaborative Life Skills program) and includes skill modules for working with teachers, parents, and students. Training methods include web-accessed manuals/handouts, skill example video clips, automated progress monitoring tools, and consultation/in-session coaching via videoconferencing. We gathered stakeholder qualitative and quantitative feedback during discovery and design phases of the iterative development. We then evaluated the usability, acceptability, fidelity and clinician and student outcomes of the remote training program. Focus group themes and qualitative feedback identified clinician preferences for remote training features (e.g., interactive, brief, role-plays/coaching methods), video tools (recorded samples of skills and therapy sessions), and progress monitoring tools (e.g., clear, easy to use). Clinician usability ratings of the platform were high with most components rated as moderately to very useful/easy to use. Clinician ratings of usability, fidelity implementing the treatment, and their EBP knowledge and confidence following training were favorable. Student's outcomes were similar to those achieved in prior studies of clinician in-person training. Results support the promise of remote, web-based clinician training for the dissemination of evidence-based practices.

IntroductionClinician implicit racial bias (IB) may lead to lower quality care and adverse health outcomes for Black patients. Educational efforts to train clinicians to mitigate IB vary widely and have insufficient evidence of impact. We developed and pilot-tested an evidence-based clinician IB curriculum, “REACHing Equity.”MethodsTo assess acceptability and feasibility, we conducted an uncontrolled one-arm pilot trial with post-intervention assessments. REACHing Equity is designed for clinicians to: (1) acquire knowledge about IB and its impact on healthcare, (2) increase awareness of one's own capacity for IB, and (3) develop skills to mitigate IB in the clinical encounter. We delivered REACHing Equity virtually in three facilitated, interactive sessions over 7–9 weeks. Participants were health care providers who completed baseline and end-of-study evaluation surveys.ResultsOf approximately 1,592 clinicians invited, 37 participated, of whom 29 self-identified as women and 24 as non-Hispanic White. Attendance averaged 90% per session; 78% attended all 3 sessions. Response rate for evaluation surveys was 67%. Most respondents agreed or strongly agreed that the curriculum objectives were met, and that REACHing Equity equipped them to mitigate the impact of implicit bias in clinical care. Participants consistently reported higher self-efficacy for mitigating IB after compared to before completing the curriculum.ConclusionsDespite apparent barriers to clinician participation, we demonstrated feasibility and acceptability of the REACHing Equity intervention. Further research is needed to develop objective measures of uptake and clinician skill, test the impact of REACHing Equity on clinically relevant outcomes, and refine the curriculum for uptake and dissemination.ClinicalTrials.gov ID: NCT03415308.

Safety planning is a critical evidence-based intervention used to prevent suicide among individuals who report suicidal ideation or behavior. There is a dearth of research on optimal ways to disseminate and implement safety plans in community settings. The present study examined one implementation strategy, a 1-hour virtual pre-implementation training, designed to teach clinicians to effectively use an electronic safety plan template (ESPT), integrated with suicide risk assessment tools, in the context of a measurement feedback system. We examined the effect of this training on clinician knowledge and self-efficacy in use of safety planning as well as ESPT completion rates. Thirty-six clinicians across two community-based clinical psychology training clinics completed the virtual pre-implementation training as well as pre- and post-training knowledge and self-efficacy assessments. Twenty-six clinicians completed a 6-month follow-up term. Clinicians reported significant improvements in self-efficacy and knowledge from pre- to post-training. They retained significant improvements in self-efficacy and a trend toward greater knowledge at the 6-month follow-up. Of the clinicians who worked with suicidal youth, 81% attempted to use an ESPT and 63% successfully completed all sections of the ESPT. Reasons for partial completion included technological difficulties and time constraints. A brief virtual pre-implementation training can improve clinician knowledge and self-efficacy in use of an ESPT with youth at risk for suicide. This strategy also holds the potential to improve the adoption of this novel evidence-based intervention in community-based settings. [ABSTRACT FROM AUTHOR]

Objectives: To describe the development and refinement of an implicit bias recognition and management training program for clinical trainees. Methods: In the context of an NIH-funded clinical trial to address healthcare disparities in hypertension management, research and education faculty at an academic medical center used a participatory action research approach to engage local community members to develop and refine a "knowledge, awareness, and skill-building" bias recognition and mitigation program. The program targeted medical residents and Doctor of Nursing Practice students. The content of the two-session training included: didactics about healthcare disparities, racism and implicit bias; implicit association test (IAT) administration to raise awareness of personal implicit bias; skill building for bias-mitigating communication; and case scenarios for skill practice in simulation-based encounters with standardized patients (SPs) from the local community. Results: The initial trial year enrolled n = 65 interprofessional participants. Community partners and SPs who engaged throughout the design and implementation process reported overall positive experiences, but SPs expressed need for greater faculty support during in-person debriefings following simulation encounters to balance power dynamics. Initial year trainee participants reported discomfort with intensive sequencing of in-person didactics, IATs, and SP simulations in each of the two training sessions. In response, authors refined the training program to separate didactic sessions from IAT administration and SP simulations, and to increase safe space, and trainee and SP empowerment. The final program includes more interactive discussions focused on identity, race and ethnicity, and strategies to address local health system challenges related to structural racism. Conclusion: It is possible to develop and implement a bias awareness and mitigation skills training program that uses simulation-based learning with SPs, and to engage with local community members to tailor the content to address the experience of local patient populations. Further research is needed to measure the success and impact of replicating this approach elsewhere. [ABSTRACT FROM AUTHOR]

Abstract Stem cell therapeutics and regenerative medicine have taken a strong foothold in biomedicine. However, most physicians are currently not adequately prepared to identify, refer, and deliver safe regenerative therapies. To understand this gap, we sought to characterize published literature on current physician training in regenerative medicine. Our scoping review describes current training strategies to bridge the gap and integrate such education into medical curricula for adequate training.

Introduction: Dysfunctional exercise (DEX) is common among individuals with an eating disorder (ED) and poses significant challenges to treatment and recovery. While safe and nutritionally supported physical activity can enhance treatment outcomes without hindering weight restoration, clinicians often hesitate to address DEX with their patients. This mixed-method study aimed to evaluate the impact of a Safe Exercise at Every Stage (SEES) informed training on clinician knowledge and self-efficacy in managing DEX during ED treatment., Methods: Clinicians from a national ED centre completed measures of knowledge and self-efficacy about managing DEX before (n = 96) and after (n = 44) a synchronous virtual training. A subset of participants (n = 7) participated in semi-structured interviews to gather their perceptions of exercise in the context of EDs and feedback on the training., Results: Paired sample t-tests revealed a significant increase in both self-efficacy and knowledge following the SEES training. Thematic analysis identified three key themes: (1) the Current State, (2) the Training Impact and (3) bridging the Gap Through Staff and Community Support. Results are contextualized within the broader ED field, highlighting how training and policy changes can enhance clinician confidence in managing DEX., Conclusion: DEX continues to be preceived as a core ED symptom. To improve its managment clinician training and shifts in overarching field ideologies are needed. Providing programme-wide training is fundamental to equipping clinicians with the skills needed to address DEX and ultimately improve patient outcomes., (© 2025 John Wiley & Sons Ltd.)

Objective: The study assessed the impact on clinicians' 'perception of skills' in postdisaster evidence-informed care (EIC) following participation in an online training programme implemented following the Queensland floods and cyclones of 2010-11, clinician confidence to provide EIC, the frequency clinicians used EIC and barriers to providing postdisaster specialist mental health care., Design: Clinician perception of pre and posttraining skills, confidence in providing therapies such as trauma-focused cognitive behaviour therapy (TF-CBT), frequency of therapies provided and clinician perception of barriers to the programme were assessed quantitatively and qualitatively., Participants and Setting: Clinical staff (n = 60) employed by the 2010-11 postdisaster mental health programme participated in an online survey conducted over the last 12 weeks of 2012. After the programme concluded an independent audit of the clinical record of mental health clients treated by clinicians employed in the specialist mental health programme was undertaken., Main Outcome Measure(s): Perception of clinical skills in various EIC modalities was completed pre and posttraining. Confidence to provide a treatment was rated on a five-point scale. The clinical record audit identified the treatments provided to clients. Barriers to programme delivery were rated on a five-point scale, with qualitative feedback highlighting programme concerns., Results: Posttraining clinicians perceived skills in TF-CBT (p < 0.0001), cognitive behaviour therapy (CBT) (p < 0.001) and exposure therapy (p < 0.001) had improved. Following training, clinicians described themselves as moderately to extremely confident in implementing TF-CBT (87%), exposure therapy (80%) and skills for psychological recovery (SPR) (88%). Clinical records analysis indicates that 25% of cases received no TF-CBT, while 43% received one to five sessions. Barriers to care included a lack of cross-service relationships. Recommendations focused on training and early commencement of intervention programmes., Conclusion: The study echoes the findings of the 2020 Australian Bushfire Royal Commission recommendations that highlighted a need for clinician training in postdisaster EIC and the availability of clinicians with specialised postdisaster mental health skills., (© 2025 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Peer review is an essential cornerstone of scientific advancement. This process involves understanding study design, data analytics, and interpretation of the evidence. For clinicians who are performing their initial peer reviews, and even for seasoned reviewers who assess complex manuscripts, it can be helpful to have a standard approach. We therefore provide a conceptual framework for peer review which builds upon experiences that are already familiar to trainees and practicing clinicians, by drawing parallels between patient encounters and peer review. This framework has been used in successive years as a didactic tool for our trainees who are being mentored toward excellence in peer review., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Introduction: Palliative care (PC) education is not uniformly provided across U.S. medical schools. While PC competencies for medical students have been articulated, no student-facing, unifying framework for competency-based PC learning exists., Methods: In 2022, we developed a student-facing organizing framework (the "6 Ps") based on existing PC competencies and created a pocket card introducing foundational PC concepts organized within the 6 Ps framework. In 2023, we provided a mandatory 15-minute session to introduce the 6 Ps and pocket card to the first-year class of our large, urban medical school. We provided voluntary pre- and post- session surveys to evaluate usability and impact of the framework and pocket card., Results: One hundred-twenty students of the 204-student class (59%) attended. Survey response rate was 106/120 (88%) pre-session and 101/120 (84%) post-session. Following the session, students agreed the 6 Ps was a good framework for conceptualizing PC (95/101; 94%), that the pocket card was understandable (96/101; 95%), and they would use the pocket card to teach fellow students about PC (85/101; 84%). Nearly all students endorsed learning novel concepts (95/100; 95%). Pre/post session comparison of self-assessed confidence approaching hypothetical clinical tasks, such as educating a patient about PC and hospice, revealed significant improvement ( P < .01)., Discussion: First-year medical students were able to use the 6 Ps framework and pocket card after a brief introduction, endorsing new learning and demonstrating significant gains in knowledge and self-assessed confidence. Medical educators across schools may consider adopting this novel tool and approach to introduce or support student learning about PC., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Stem cell therapeutics and regenerative medicine have taken a strong foothold in biomedicine. However, most physicians are currently not adequately prepared to identify, refer, and deliver safe regenerative therapies. To understand this gap, we sought to characterize published literature on current physician training in regenerative medicine. Our scoping review describes current training strategies to bridge the gap and integrate such education into medical curricula for adequate training. [ABSTRACT FROM AUTHOR]

Objectives: To conduct an exploratory analysis comparing in-person vs. virtual training programs about contraceptive care among clinicians and staff at 14 healthcare agencies in Washington state.Methods: Survey data from in-person trainings were collected between July 2019 and March 2020 and from virtual trainings between June 2020 and January 2021.Primary Outcomes: changes in contraceptive knowledge, understanding of contraceptive counseling and care, and participant engagement and experience with the training.Results: Post-survey response rates for in-person trainings were 82% for clinicians and 72% for support staff while post-survey response rates for virtual trainings were 48% for clinicians and 43% for staff. Average knowledge scores for in-person clinician trainings increased from 63% prior to training to 80% post-training (p < 0.05), knowledge scores for virtual clinician trainings increased from 72% to 86% (p < 0.05), and the pre-to-post change in scores between training modalities was similar (p > 0.05 for the score difference). Average knowledge scores among in-person support staff trainings increased from 63% to 84% (p < 0.05), scores among virtual support staff trainings increased from 68% to 87% (p < 0.05) and, again, the pre-to-post change in scores between training modalities was similar (p > 0.05 for the score difference). Only minimal differences in survey scores between modalities were observed on most measures of participant engagement and experience with the trainings (p > 0.05 for most score differences).Conclusions: These exploratory results suggest that in-person and virtual contraceptive care trainings yielded comparable results among both clinicians and support staff.Implications: Results from this post-hoc analysis of survey data suggest a general equivalency of effectiveness between in-person trainings and virtual trainings, although in-person trainings may be more satisfying or engaging for participants. Further work and research is needed to inform strategies for making virtual trainings more engaging and satisfying for participants. [ABSTRACT FROM AUTHOR]

Clients seeking sex therapy can bring into the clinical space a vibrant religious, spiritual and/or faith practice. Even those clients who do not consider themselves religious, often come to sex therapy with a prior relationship to a religion or with a higher power. While this relationship can be a source of strength, it may include a history of trauma, pain, and grief. This intersection of sexuality and faith can be a powerful clinical space; however, it is not without its challenges, specifically when shame, guilt and remorse are associated with the client's sexual experiences. Mental health professionals skilled in sex therapy are ideally positioned to support these clients; however, they are rarely trained in incorporating client religious issues. This paper seeks to expand professional discourse on supporting clients at the intersection of sexual and faith well-being. First, we discuss why mental health clinicians focused on sex therapy need to incorporate a faith informed practice lens. Next, three case studies are presented to highlight the intersection of psychosexualtherapy and a client's faith. The discussion section subsequently highlights preparation needed by mental health professionals and offers suggestions for better professional training in this specialty area. Finally, faith informed clinical interventions are presented. People seeking a sex therapist bring their spirituality, religion, faith, or belief practices to therapy. Clinicians must acknowledge this aspect of a client's life and recognize that it can play a key role in their healing. Sex therapists rarely receive training in faith issues. This paper attempts to bridge that gap. [ABSTRACT FROM AUTHOR]

Support for memory difficulties remains a significant unmet need for survivors of stroke. Memory skills group training of compensatory strategies can be effective for improving everyday memory function. However, access to these services remains limited. We aimed to evaluate the fidelity, acceptability, and effectiveness of implementing an evidence-based memory group in real-world clinical settings, to establish a potentially scalable implementation model. The program was facilitated at one acute and one community-based rehabilitation health service. Three clinical neuropsychologists received comprehensive training in facilitating the program. Implementation followed the Knowledge to Action framework, and implementation outcome measures included fidelity monitoring of adherence and competence, as well as clinician and participant reports of acceptability. The clinical effectiveness outcome was attainment of memory-specific goals using Goal Attainment Scaling at post-intervention and six-week follow-up. The training process resulted in full adherence to the program content and demonstration of all essential clinical competencies. The program was acceptable and enjoyable for the clinicians and participants (n= 19, 63% male, 73% ischemic stroke). Participants demonstrated high levels of goal attainment (>80% at follow-up), comparable in magnitude to previous controlled trials. The stroke memory skills program has the potential to be implemented successfully in real-world clinical settings using the Knowledge to Action framework, incorporating comprehensive clinician training. [ABSTRACT FROM AUTHOR]

This article contributes to knowledge and practice of core processes that are shared by evidence-based alcohol or other drug (AOD) therapies. It is the fourth in a series with this aim, and here we discuss perhaps the most universally acknowledged ingredient of effective therapy – the therapeutic relationship. We consider various related terms and definitions in the literature, but in the present review, we offer a definition that underscores the context of behavior change. This study conducted a literature review and qualitative content analysis to derive a set of principles and practices for facilitating and maintaining the therapeutic relationship. The sources for this review included government-issued practice guidelines, therapy manuals or books, demonstration videos, and peer-reviewed articles (61 sources). The content analysis was performed in NVIVO, and reliability analysis showed moderate agreement between raters (kappa = 0.60). Six principles and 16 practices were identified. The distribution of principles and practices could be broken into three categories: 1) the facilitation of client behavior change mechanisms (i.e., self-determination, motivation, self-efficacy), 2) partnership considerations (e.g., goal and task alignment), and 3) therapist interpersonal skills (e.g., empathy). The therapeutic relationship is foundational to the behavior change process. We frame it as a combination of broader interpersonal considerations and attention to key mechanisms of client behavior change. The present work provides a novel resource for trainees, clinicians, and clinical supervisors interested in fostering therapy relationships with clients in AOD or other behavior change settings. • This review and qualitative study operationalized the therapeutic relationship. • Sixty-one source documents and videos were examined. • Six principles and 16 practices were identified. • Principle and practices relate to client mechanisms, collaboration, and interpersonal skills. • This work informs a fidelity-based approach to the therapeutic relationship. [ABSTRACT FROM AUTHOR]

Understand how physicians' uncertainty tolerance (UT) in clinical care relates to their personal characteristics, perceptions and practices regarding shared decision making (SDM). As part of a trial of SDM training about colorectal cancer screening, primary care physicians (n = 67) completed measures of their uncertainty tolerance in medical practice (Anxiety subscale of the Physician's Reactions to Uncertainty Scale, PRUS-A), and their SDM self-efficacy (confidence in SDM skills). Patients (N = 466) completed measures of SDM (SDM Process scale) after a clinical visit. Bivariate regression analyses and multilevel regression analyses examined relationships. Higher UT was associated with greater physician age (p =.01) and years in practice (p = 0.015), but not sex or race. Higher UT was associated with greater SDM self-efficacy (p < 0.001), but not patient-reported SDM. Greater age and practice experience predict greater physician UT, suggesting that UT might be improved through training, while UT is associated with greater confidence in SDM, suggesting that improving UT might improve SDM. However, UT was unassociated with patient-reported SDM, raising the need for further studies of these relationships. Developing and implementing training interventions aimed at increasing physician UT may be a promising way to promote SDM in clinical care. • Physician tolerance of uncertainty was associated with confidence in engaging in SDM. • Tolerance of uncertainty was not associated with patient-reported SDM. • Both older age and greater years in practice predicted greater uncertainty tolerance. • Improving uncertainty tolerance may improve SDM skills. [ABSTRACT FROM AUTHOR]

Abstract Background Clinicians draw on instructional approaches when training patients with anaphylaxis to use adrenaline autoinjectors, but patient use is poor. Psychological barriers to these behaviours exist but are not considered routinely when training patients to use autoinjectors. Health Psychology principles suggest exploring these factors with patients could improve their autoinjector use. Objective To evaluate the impact of a 90‐minute workshop training clinicians in strategies and techniques for exploring and responding to psychological barriers to autoinjector use with patients. Attendees’ knowledge, confidence and likelihood of using the strategies were expected to improve. Methods Impact was evaluated using a longitudinal mixed‐method design. Twenty‐nine clinicians (general and specialist nurses, general practitioners, and pharmacists) supporting patients with anaphylaxis in UK hospitals and general practice attended. Self‐rated knowledge, confidence, and likelihood of using the strategies taught were evaluated online 1 week before, 1 to 3, and 6 to 8 weeks after the workshop. Clinicians were invited for telephone interview after attending to explore qualitatively the workshop impact. Results χ2 analyses were significant in most cases (P

Abstract Background The aim of this study was to identify any associations between predictor variables, mainly clinician training and dental implant outcome, among the residents in different departments and to compare statistical analysis with the use of MATLAB R2017a™ to SAS version 9.4. Methods Dental records were reviewed from January 1, 2011, to December 31, 2015. Two thousand forty-eight dental implants were placed on 471 patients seen by residents from the departments of Periodontics, Prosthodontics, and Oral and Maxillofacial Surgery (OMFS) at Louisiana State University Health Sciences Center School of Dentistry. The following parameters were investigated by means of multilevel logistic regression analysis: demographics, implant parameters, department, and residents’ year of training. Results A total of 1449 implants were included in the study. Overall, within a 1–5-year time period, 1343 (92.6%) implants had survived and 106 (7.4%) implants failed. Discipline (p = 0.0004), residents’ year of training (p

Traumatic brain injury (TBI) can lead to significant psychological distress, but few psychologists in Australia are trained in working with this complex clinical group. Despite government funding to provide video-consulting (VC) services in Australia, uptake before COVID-19 was limited. This mixed methods study evaluated whether training in eHealth and evidence based TBI psychological therapies increased provider uptake of VC in clinical practice, and delivery of mental health services to individuals with TBI. Mental health professionals completed a range of self-report measures before (n = 50), after (n = 48), and four months following (n = 30) a one-day workshop. Participants' TBI knowledge, client-base and levels of access, confidence, motivation and attitudes toward VC were assessed. Knowledge did not increase after training but participants had significant increases in their confidence and motivation to using VC at follow up. Significant reductions in pragmatic barriers to using VC were reported post training and at follow up, all barrier categories indicated significant reductions. There was no significant change in clinical practice of the participants. Training to increase TBI knowledge requires specific assessment tools and although training appears to reduce barriers to using VC, uptake in clinical practice may require additional supervision and warrants further research. [ABSTRACT FROM AUTHOR]

Purpose: Given the current and increasing awareness of the opioid crisis, this study aimed to characterise the types of analgesic prescription for conservatively managed renal colic. Methods: This was a retrospective cohort study of consecutive patients presenting to the Emergency Department (ED) in 2014–2019. Patients were included if they had radiographically confirmed obstructing calculus, managed conservatively without intervention, and were given a prescription for analgesia on discharge. Patient demographics were recorded and analysed. Opioid, non-opioid, and alpha-blocker medications were compared according to patient and disease parameters, and clinician training. Oral morphine equivalents (OMEs) were used to compare prescribed quantities. Subgroup analyses of stone size and location were performed. Results: Our analysis included 1761 patients with confirmed renal colic: median age of 50 years (16–96). Altogether, 88% of included patients were prescribed opioids on discharge, while only 68% were prescribed non-opioids (p < 0.001). Oxycodone immediate release was the most frequently prescribed analgesic. Logistic regression modelling controlling for patient and disease characteristics significantly predicted more non-opioid (p < 0.001) and alpha-blocker (p = 0.037) prescription with clinician training < 3 years. Linear regression modelling demonstrated that clinicians training < 3 years predicted lower OMEs per prescription compared to clinicians with ≥ 3 years of training (p = 0.001). Subgroup analyses supported similar predictions with training. Conclusions: Prescribing patterns are associated with different clinician experience levels. However, a substantial amount of opioids are still given overall on patient discharge regardless of the clinician experience. Educational interventions aimed at reducing the opioid prescription rate and quantities may be considered for clinicians of all training levels. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to determine if association exists between evidence-based provider training and clinician proficiency in electronic health record (EHR) use and if so, which EHR use metrics and vendor-defined indices exhibited association.Materials and Methods: We studied ambulatory clinicians' EHR use data published in the Epic Systems Signal report to assess proficiency between training participants (n = 133) and nonparticipants (n = 14). Data were collected in May 2019 and November 2019 on nonsurgeon clinicians from 6 primary care, 7 urgent care, and 27 specialty care clinics. EHR use training occurred from August 5 to August 15, 2019, prior to EHR upgrade and organizational instance alignment. Analytics performed were descriptive statistics, paired t-tests, multivariate correlations, and hierarchal multiple regression.Results: For number of appointments per 30-day reporting period, trained clinicians sustained an average increase of 16 appointments (P < .05), whereas nontrained clinicians incurred a decrease of 8 appointments. Only the trained clinician group achieved postevent improvement in the vendor-defined Proficiency score with an effect size characterized as moderate to large (dCohen = 0.625).Discussion: Controversies exist on the return of investment from formal EHR training for clinician users. Previously published literature has mostly focused on qualitative data indicators of EHR training success. The findings of our EHR use training study identified EHR use metrics and vendor-defined indices with the capacity for translation into productivity and generated revenue measurements.Conclusions: One EHR use metric and 1 vendor-defined index indicated improved proficiency among trained clinicians. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment associated with schizophrenia (CIAS) negatively impacts daily functioning, quality of life, and recovery, yet effective pharmacotherapies and practical assessments for clinical practice are lacking. Despite the pivotal progress made with establishment of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for clinical research, implementation of the full MCCB is too time-consuming and cost-ineffective for most clinicians in clinical practice., Study Design: Here we discuss current assessments in relation to delivery format (interview-based and performance-based), validity, ease of use for clinicians and patients, reliability/reproducibility, cost-effectiveness, and suitability for clinical implementation. Key challenges and future opportunities for improving cognitive assessments are also presented., Study Results: Current assessments that require 30 min to complete would have value in clinical settings, but the associated staff training and time required might preclude their application in most clinical settings. Initial profiling of cognitive deficits may require about 30 min to assist in the selection of evidence-based treatments; follow-up monitoring with brief assessments (10-15 min in duration) to detect treatment-related effects on global cognition may complement this approach. Guidance on validated brief cognitive tests for the strategic monitoring of treatment effects on CIAS is necessary., Conclusions: With increased advancements in technology-based and remote assessments, development of validated formats of remote and in-person assessment, and the necessary training models and infrastructure required for implementation, are likely to be of increasing clinical relevance for future clinical practice., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.)

To determine the effect of offering a subset of the Emergency Neurological Life Support (ENLS) course modules on provider knowledge and self-reported confidence in acute management of neurocritically ill patients in a low-middle income country (LMIC). Eight ENLS modules were provided by in-person lecture using English to Khmer translated slides and a medical translator to physicians and nurses of 2 hospitals in Phnom Penh, Cambodia in May 2019. Providers included emergency, neurology, neurologic surgery, and general intensive care. Demographics, pre- and postcourse knowledge of ENLS content areas, and pre- and postcourse confidence in managing neurocritically ill patients were assessed. Data were pooled across both hospitals for analysis. A total of 57 health care providers were approached for participation: 52 (25 physicians, 27 nurses) participated; 45 completed all study instruments. Pre- and postcourse knowledge scores showed no significant differences between providers. Postcourse, 37/45 (82.2%) participants reported that the content had prepared them for acute management of neurocritically ill patients. Satisfaction with module content ranged from 77.8%–80.0% per module. For the 8 modules, a majority of participants agreed that course material had provided them with knowledge and skills to provide acute care for patients' neurologic emergencies (68.4%–88.6%). Provision of ENLS course module content increased LMIC provider self-reported knowledge and confidence in acute management of neurocritically ill patients immediately postcourse. Tailoring ENLS course presentation to a particular LMIC setting warrants additional investigation, as does the effect of ENLS course training on neurocritically ill patient outcomes in the LMIC setting. [ABSTRACT FROM AUTHOR]

Background This article describes the provincial dissemination of HEARTSMAP, an evidence-based emergency department (ED) psychosocial assessment and disposition decision tool for clinician use with children and youth. Methods HEARTSMAP was disseminated in partnership with local, child and youth mental health teams, as part of a quality improvement initiative implemented in British Columbia EDs. The target audience of education sessions were clinicians working in ED settings responsible for paediatric psychosocial assessments. We used the RE-AIM framework to evaluate the reach, effectiveness, adoption, implementation, and maintenance of HEARTSMAP dissemination, analyzing data from session evaluation forms and online tool data. Results Education sessions reached 475 attendees, in 52 of 95 British Columbia EDs. HEARTSMAP training was well received by clinicians with 96% describing effective content including increased comfort in conducting paediatric psychosocial assessments and confidence in disposition planning after training. Clinicians identified unclear processes and lack of local resources as the main barriers to implementation. One-third of the attendees expressed willingness to use the tool, and 27% of registered clinicians have used the tool postimplementation. Conclusions Our approach reached and effectively trained clinicians from over half of the province's EDs to use HEARTSMAP for emergency paediatric psychosocial assessments. For some, this provided greater comfort and confidence for these assessments and the following disposition decisions. This evaluation provides valuable insights on training clinicians to use a paediatric mental health tool within diverse ED settings and emphasized the need for ongoing support and institutional engagement to facilitate local, infrastructural, and operational processes for adoption and maintenance, postdissemination. [ABSTRACT FROM AUTHOR]

Background: Clinicians draw on instructional approaches when training patients with anaphylaxis to use adrenaline autoinjectors, but patient use is poor. Psychological barriers to these behaviours exist but are not considered routinely when training patients to use autoinjectors. Health Psychology principles suggest exploring these factors with patients could improve their autoinjector use. Objective: To evaluate the impact of a 90‐minute workshop training clinicians in strategies and techniques for exploring and responding to psychological barriers to autoinjector use with patients. Attendees' knowledge, confidence and likelihood of using the strategies were expected to improve. Methods: Impact was evaluated using a longitudinal mixed‐method design. Twenty‐nine clinicians (general and specialist nurses, general practitioners, and pharmacists) supporting patients with anaphylaxis in UK hospitals and general practice attended. Self‐rated knowledge, confidence, and likelihood of using the strategies taught were evaluated online 1 week before, 1 to 3, and 6 to 8 weeks after the workshop. Clinicians were invited for telephone interview after attending to explore qualitatively the workshop impact. Results: χ2 analyses were significant in most cases (P < .05), with sustained (6‐8 weeks) improvements in knowledge, confidence, and likelihood of using the strategies taught. Thematic analysis of interview data showed the workshop enhanced attendees' knowledge of the care pathway, understanding of patient's experience of anaphylaxis as psychological not purely physical, and altered their communication with this and other patient groups. However, interviewees perceived lack of time and organisational factors as barriers to using the strategies and techniques taught in clinical contexts. Conclusion: Training clinicians in psychologically informed strategies produce sustained improvements in their confidence and knowledge around patient autoinjector education, and their likelihood of using strategies in clinical practice. Clinical Relevance: Exploring psychological barriers should be part of training patients with anaphylaxis in autoinjector use. [ABSTRACT FROM AUTHOR]

Introduction: The Clinician Scholars Program is designed to improve the capacity and quality of HIV care by training clinicians in underserved areas. A mentoring approach is used to deliver individualized educational opportunities over the course of a year focused on preparing clinicians to provide high-quality patient-centered HIV care. Evaluation of the program has illustrated increases in knowledge, skills, and practice behavior, yet critical domains remain unexplored, particularly the potential for the program to affect professional identity formation and networking between individual clinicians. Methods: Qualitative exit interviews (N = 50) were conducted over 4 years of the Clinician Scholars Program. Interviews were transcribed and analyzed using an open-coding process with multiple coders. Interrater reliability was assessed. Themes related to professional development and networking emerged. Results: Thematic analysis revealed changes in several professional development domains, including self-efficacy, HIV care clinician identity, and career development. In addition, clinicians began to develop key connections with mentors, other clinicians, and health systems--gaining a foundation in the HIV care community, enabled and strengthened by growth in professional confidence and competence within the clinician's care context. Discussion: Evaluations of clinical training programs often focus on knowledge and skill gains without addressing professional identity development and place within the care community. This study illustrates that a longitudinal clinician training program has the potential to influence professional identify development, particularly affect how clinicians view themselves as a resource in the HIV care community and begins to facilitate necessary connections to other clinicians and the wider care system. [ABSTRACT FROM AUTHOR]

Implementation of woman-centred care in evidence-based maternity practice requires clinicians to be skilled in shared decision-making, yet there is limited training or research into such interventions. Shared decision-making enables women to make informed decisions in partnership with clinicians where there are varied clinical options in relation to indications for and timing of planned birth. We aimed to develop a shared decision-making training intervention and evaluate its feasibility and acceptability to midwives and obstetricians. The intervention was co-designed by midwifery and medical clinician-researchers, and a consumer representative. Online training and demonstration videos were distributed to midwives and obstetricians in three Sydney hospitals, followed by two online workshops in 2021 and 2022 where participants practised shared decision-making in roleplaying scenarios tailored to timing of birth. Training was evaluated using post-workshop and post-training surveys and semi-structured qualitative interviews. The training workshop format, duration and content were well received. Barriers to the uptake of shared decision-making were time, paternalistic practices and fear of repercussions of centring women in the decision-making process. The intervention enabled midwifery and medical colleagues to learn communication repertoires from each other in woman-centred discussions around timing of birth. Roleplay scenarios enabled participants to observe and provide feedback on their colleagues' shared decision-making practices, while providing a space for collective reflection on ways to promote, and mitigate barriers to, its implementation in practice. Shared decision-making training supports maternity clinicians in developing skills that implement woman-centred care in the timing of planned birth. [ABSTRACT FROM AUTHOR]

Purpose of state:The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users. Methods:The WMTP and WMT-Q were developed through an iterative process. Results:A convenience sample of clinicians (n = 17), manual wheelchair (n ∞ 5), power wheelchair users (n = 4) and caregivers (n = 4) provided feedback on the training programme. A convenience sample of clinicians (n = 38), manual wheelchair (n = 25), and power wheelchair users (n = 30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1) = 0.48 to ICC(3,1) = 0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p < 0.007). Conclusion:The WMTP will continue to be revised as it is further implemented. The WMT-Q is an acceptable instrument to measure pre- and post-training maintenance knowledge.Implications for RehabilitationThe Wheelchair Maintenance Training Program can be used to educate rehabilitation clinicians and technicians to improve wheelchair service and delivery to end users.This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers.This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown.This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited. [ABSTRACT FROM PUBLISHER]

Introduction: While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts. This article provides a case example describing our organizational context, what was done, and with what effect and makes our example and lessons learned available to others. Methods: We developed a new educational QI program that was jointly planned and implemented by a group comprising major QI stakeholders. This project was intended to create horizontal organizational linkages between continuing professional development, clinicians, the hospital, and QI department and produce QI activities that aligned with the strategic objectives of senior management. Results: The group developed and implemented a curriculum based on Lean methodology and concepts from the Institute for Health Care Improvement Model for Improvement. Two cohorts (27 teams) completed the training and planned and implemented QI projects. All projects were aligned with organizational quality, safety, and patient experience goals. The majority of projects met their aim statements. Discussion: This case description provides an example of successful horizontal integration of an AMCs' QI functions to disseminate knowledge and implement meaningful QI aligned with strategic objectives (vertical integration). [ABSTRACT FROM AUTHOR]

Training is a key implementation strategy used in healthcare settings. This study aimed to identify a range of clinician training techniques that facilitate guideline implementation, promote clinician behavior change, optimize clinical outcomes, and address implicit biases to promote high-quality maternal and child health (MCH) care. A scoping review was conducted within PubMed, CINAHL, PsycInfo, and Cochrane databases using iterative searches related to (provider OR clinician) AND (education OR training). A total of 152 articles met the inclusion/exclusion criteria. The training involved multiple clinician types (e.g., physicians, nurses) and was predominantly implemented in hospitals (63%). Topics focused on maternal/fetal morbidity/mortality (26%), teamwork and communication (14%), and screening, assessment, and testing (12%). Common techniques included didactic (65%), simulation (39%), hands-on (e.g., scenario, role play) (28%), and discussion (27%). Under half (42%) of the reported training was based on guidelines or evidence-based practices. A minority of articles reported evaluating change in clinician knowledge (39%), confidence (37%), or clinical outcomes (31%). A secondary review identified 22 articles related to implicit bias training, which used other reflective approaches (e.g., implicit bias tests, role play, and patient observations). Although many training techniques were identified, future research is needed to ascertain the most effective training techniques, ultimately improving patient-centered care and outcomes.

Cognitive behavioral therapy (CBT) is often referred to as the "gold standard" treatment for mental health problems, given the large body of evidence supporting its efficacy. However, there are persistent questions about the generalizability of CBTs to culturally diverse populations and whether culturally sensitive approaches are warranted. In this review, we synthesize the literature on CBT for ethnic minorities, with an emphasis on randomized trials that address cultural sensitivity within the context of CBT. In general, we find that CBT is effective for ethnic minorities with diverse mental health problems, although nonsignificant trends suggest that CBT effects may be somewhat weaker for ethnic minorities compared to Whites. We find mixed support for the cultural adaptation of CBTs, but evidence for cultural sensitivity training of CBT clinicians is lacking, given a dearth of relevant trials. Based on the limited evidence thus far, we summarize three broad models for addressing cultural issues when providing CBT to diverse populations.

Background context Neck pain is a common musculoskeletal complaint responsive to manual therapies. Doctors of chiropractic commonly use manual cervical distraction, a mobilization procedure, to treat neck pain patients. However, it is unknown if clinicians can consistently apply standardized cervical traction forces, a critical step toward identifying an optimal therapeutic dose. Purpose To assess clinicians' proficiency in delivering manually applied traction forces within specified ranges to neck pain patients. Study design An observational study nested within a randomized clinical trial. Sample Two research clinicians provided study interventions to 48 participants with neck pain. Outcome measures Clinician proficiency in delivering cervical traction forces within three specified ranges (low force, less than 20 N; medium force, 21–50 N; and high force 51–100 N). Methods Participants were randomly allocated to three force-based treatment groups. Participants received five manual cervical distraction treatments over 2 weeks while lying prone on a treatment table instrumented with force sensors. Two clinicians delivered manual traction forces according to treatment groups. Clinicians treated participants first without real-time visual feedback displaying traction force and then with visual feedback. Peak traction force data were extracted and descriptively analyzed. Results Clinicians delivered manual cervical distraction treatments within the prescribed traction force ranges 75% of the time without visual feedback and 97% of the time with visual feedback. Conclusions This study demonstrates that doctors of chiropractic can successfully deliver prescribed traction forces while treating neck pain patients, enabling the capability to conduct force-based dose response clinical studies. [ABSTRACT FROM AUTHOR]

Background: Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective: The present study explored the role of prior training in evidence-based treatments (EBTs) on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the naturalistic decision making (NDM) cognitive theory to (1) examine potential associations between EBT training and decision-making processes (novice vs. expert type), and (2) explore how client and family contextual information affects clinical decision-making. Methods: Forty-eight clinicians across two groups (EBT trained = 14, Not EBT trained = 34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog 'think aloud' method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out loud. Responses were coded according to NDM theory. Results: MANOVA results were significant for EBT training status such that EBT trained clinicians displayed cognitive processes more closely aligned with 'expert' decision-makers and non-EBT trained clinicians' decision processes were more similar to 'novice' decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. Conclusion: This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice. [ABSTRACT FROM AUTHOR]

Mindfulness-based cognitive therapy (MBCT) is a relatively new therapeutic approach that is rooted in mindfulness-based stress reduction and cognitive behavioral therapy. Leading MBCT requires a radically different method than other forms of group facilitation. We are currently conducting a multi-site, randomized controlled trial (RCT) of a mindfulness intervention for individuals with a traumatic brain injury where the development of the facilitators' capacity to provide the intervention is as important to the study as the RCT component itself. Thus, the first year of the study was devoted to training ten clinicians to deliver the intervention. The training included a 2-day retreat to introduce mindfulness, teleconferences, support from an experienced instructor and other facilitators within the group, a 5-day professional MBCT training program, and the development of a personal meditation practice. It culminated with trialing the intervention with 'healthy' participants (e.g., friends, family, colleagues). Sessions from six facilitators were recorded and assessed by an external reviewer experienced in the delivery of MBCT who provided qualitative feedback. Four facilitators demonstrated consistency and adherence to the skills assessed. Upon completion of the trial intervention, 93.5 % of healthy group participants indicated that the classes were engaging or stimulating and 96.9 % reported that they used the skills acquired. We feel we provided a training program that remained flexible to the needs of the facilitators. [ABSTRACT FROM AUTHOR]

Background: Improving clinicians' interest, confidence, and commitment in using evidence-based treatment (EBT) is often an aim of training clinicians in EBT. However, the degree to which these areas actually improve through training and what their relationship is to treatment integrity is unknown.Method: Using data from a multi-site study (Martino et al., 2010) comparing three methods of clinician training in motivational interviewing (MI), changes in interest, confidence, and commitment over time and their relationship to MI adherence and competence were assessed using mixed-effects regression models. Individual patterns of change were examined through cluster analysis.Results: Interest, confidence, and commitment declined over time across training conditions with two distinct patterns: 76% clinicians largely maintained strong interest in MI over time with only slight decreases in confidence and commitment (the "maintainers"), while 24% began with lower initial interest, confidence, and commitment, which subsequently declined over time (the "decliners"). Interest and commitment were not associated with MI adherence and competence; confidence was associated with increased competence in the use of advanced MI strategies. However, decliners demonstrated greater use of MI-inconsistent techniques than maintainers overall (d=0.28).Conclusions: Training in MI may have an unintended consequence of diminishing clinicians' interest, confidence, or commitment in using MI in practice. While attitudinal variables in this study show mixed relationships to MI integrity, they may have some utility in identifying less enthusiastic participants, better preparing them for training, or tailoring training approaches to meet individual training needs. [ABSTRACT FROM AUTHOR]

Spirituality is an essential aspect of person-centered compassionate care. Data demonstrate that the majority of patients with serious or chronic illness would like their clinicians to address their spirituality and to provide spiritual care but that the majority of clinicians do not provide such care. Reasons cited include lack of training. This paper pilots and evaluates the impact of spirituality training on providers' self-reported awareness and ability to address patient spirituality and to provide compassionate care. Thirty-eight clinicians were trained and 18 completed the pre/post-training evaluation surveys. The data demonstrated increased self-reported ability to perform spiritual screening (pre-training mean of 2.59, SD = 1.33 increased to post-training mean of 4.41, SD = 0.51). The self-reported ability to identify a patient's spiritual resources of strength improved from pre-training mean of 3.27 (SD = 1.16) to post-training mean of 4.53 (SD = 0.83). Ability to identify a patient's spiritual distress improved from pre-training mean of 2.81 (SD = 1.22) to post-training mean of 0.31 (SD = 0.60). The self-reported ability to chart the patient's spiritual strengths improved from mean of 2.69 (SD = 1.25) to post-training 4.31 (SD = 0.48). The self-reported ability to discuss patients' spiritual strengths and/or distress with others in the healthcare team increased from mean of 2.76 (SD = 1.30) to post-training mean of 4.47 (SD = 0.51). The self-reported ability to identify appropriate interventions increased from pre-training mean of 2.59 (SD = 1.23) to post-training mean of 4.24 (SD = 0.44). There were also improvements in self-reported abilities to: (a) establish appropriate boundaries with patients; (b) apply the concept of compassionate presence to clinical care; (c) understand the role of spirituality in professional life; and (d) identify ethical issues in inter-professional spiritual care. We conclude that it is possible to train clinicians to address patients' spiritual needs and provide discipline appropriate spiritual care. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the co-delivery style of lay and clinician co-tutors of courses for patients, and courses for clinicians to support their patients’ self-management skills. Methods: Motivational style of course delivery was assessed in 37 patient course sessions and 14 clinician workshops by independent observers using four Self Determination Theory rating scales and ethnographic notes. Forty-five tutors and 35 attendees were interviewed about their experience of co-delivered courses. Results: Lay and clinician tutors had similar motivational styles, with significant differences between the four motivational style scales; patient courses (F(3, 216)=3.437, p =.018); and clinician courses (F(3, 78)=3.37, p =.025). The courses were experienced as co productive in style as suggested during interviews, but adherence to manuals limited the tutors’ contributions. Lay and clinician tutors scored higher on providing structure and engaging participants than they scored on supporting autonomous decision making and involvement. Conclusion: Co-delivery was a successful model, affording opportunities to demonstrate co-production skills. Practice implications: There is more scope to enable lay and clinician tutors to use their respective expertise in supporting self-management, and for tutor training to encourage a less didactic delivery style. [Copyright &y& Elsevier]

Objective: The relationships between the occupational, educational, and verbal-cognitive characteristics of health care professionals and their motivational interviewing (MI) skills before, during, and after training were investigated. Method: Fifty-eight community-based addiction clinicians (M = 42.1 years, SD = 10.0; 66% Female) were assessed prior to enrolling in a 2-day MI training workshop and being randomized to one of three post-workshop supervision programs: live supervision via tele-conferencing (TCS), standard tape-based supervision (Tape), or workshop training alone. Audiotaped sessions with clients were rated for MI skillfulness with the Motivational Interviewing Treatment Integrity (MITI) coding system v 2.0 at pre-workshop and 1, 8, and 20 weeks post-workshop. Correlation coefficients and generalized linear models were used to test the relationships between clinician characteristics and MI skill at each assessment point. Results: Baseline MI skill levels were the most robust predictors of pre- and post-supervision performances. Clinician characteristics were associated with MI Spirit and reflective listening skill throughout training and moderated the effect of post-workshop supervision method on MI skill. TCS, which provided immediate feedback during practice sessions, was most effective for increasing MI Spirit and reflective listening among clinicians with no graduate degree and stronger vocabulary performances. Tape supervision was more effective for increasing these skills among clinicians with a graduate degree. Further, TCS and Tape were most likely to enhance MI Spirit among clinicians with low average to average verbal and reasoning performances. Conclusions: Clinician attributes influence the effectiveness of methods used to promote the acquisition of evidence- based practices among community-based practitioners. [ABSTRACT FROM AUTHOR]

Objective: Training through traditional workshops is relatively ineffective for changing counseling practices. Teleconferencing supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI). Method: Ninety-seven drug treatment counselors completed a 2-day MI workshop and were randomized to live supervision via teleconferencing (TCS; n = 32), standard tape-based supervision (tape; n = 32), or workshop alone (workshop; n = 33). Supervision conditions received 5 weekly supervision sessions at their sites using actors as standard patients. Sessions with clients were rated for MI skill with the Motivational Interviewing Treatment Integrity (MITI) Coding System pre-workshop and 1, 8, and 20 weeks post-workshop. Mixed-effects linear models were used to test training condition on MI skill at 8 and 20 weeks. Results: TCS scored better than workshop on the MITI for spirit (mean difference = 0.76; p < .0001; d = 1.01) and empathy (mean difference = 0.68;p < .001; d = 0.74). TCS was superior to workshop in reducing MI non-adherence and was superior to workshop and tape in increasing reflection to question ratio. Tape was superior to TCS in increasing complex reflections. Percentage of counselors meeting proficiency differed significantly between training conditions for the most stringent threshold (spirit and empathy scores -> 6). Conclusions: TCS shows promise for promoting new counseling behaviors following participation in workshop training. However, further work is needed to improve supervision methods to bring more clinicians to high levels of proficiency and facilitate dissemination of evidence-based practices. [ABSTRACT FROM AUTHOR]

Whither, or wither, empirically supported therapies? Increasingly rigorous research in behavioral therapies has yielded a large number of effective therapies, but comparatively little work, demonstrating that integrating empirically supported therapies (ESTs) into standard practice results in meaningful improvements in patient outcomes. Methodology and strategies for evaluating ESTs and their effectiveness in clinical practice is a fairly recent innovation, and a host of unanswered questions remain regarding issues such as selection among different ESTs and what type of ESTs should be emphasized in dissemination efforts, what type of clinicians should be trained in what type of ESTs, the most effective training strategies for various types of clinicians, the need for ongoing supervision to maintain minimum levels of treatment fidelity and skill. In this review, we call for broader use of new research strategies and methods relevant to dissemination of ESTs; these may include adaptive designs, identification of mechanisms of action to foster greater emphasis on effective change principles, training and adoption trials, as well as novel implementation strategies including computer-assisted therapy and computer-assisted training. [ABSTRACT FROM AUTHOR]

The implementation of evidence-based treatments (EBTs) in community behavioral health settings is a recommended practice, yet training experienced by community-based clinicians may require novel and creative training methods. The current study focused on creating a training protocol for Alternative for Families: a Cognitive-Behavioral Therapy from both evidence-based foundations and community-based agency feedback to promote better EBT integration into agencies. Twenty-four clinicians from three agencies were trained using a community-informed training protocol. Outcomes for clinician-reports of organizational functioning, self-reports of skill and knowledge, and observational single-subject data of clinician skills were assessed. Minimal improvements were found for clinician skills across self-report and observations. More research on tailoring trainings to meet needs of community agencies and clinicians should be explored to determine best practice in wide-scale implementation efforts., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: This work builds on a small body of literature that explores core processes in psychotherapy, behavior change, and evidence-based alcohol or other drug (AOD) therapies. Here, this paper discusses two separate but dependent processes. The research team defines goal setting and goal monitoring as collaborative processes where clinicians and clients identify and formulate therapeutic goals; actionable objectives; and revisit, measure, and renegotiate these plans via a standardized procedure over time.Method: Study methods included a literature review and qualitative content analysis to derive a set of principles and practices of goal setting and monitoring. The research team used source documents (i.e., literature reviews, therapy manuals, and government-issued practice guidelines) and videos (i.e., therapy demonstration videos), and we performed analyses in NVIVO.Results: The study identified ten principles and 32 practices. The principles suggest that goal setting and monitoring can be characterized as a collaborative, explicit, and standardized approach to engaging in goal-directed therapeutic work. The term goal-directed therapeutic work connotes a shift toward a more accountable frame for care than has been previously emphasized in the literature. The identified practices were organized into five sub-themes related to goal setting (10 practices), goal monitoring (10 practices), as well as practices specific to mechanisms of goal pursuit and behavior change. These practices involved ways to attend to client self-determination (4 practices), motivation (4 practices), and self-efficacy (4 practices).Conclusions: Goal setting and monitoring are a collaborative means of mapping and tracking a course of mutually accountable treatment. The current work is a novel resource for trainees, clinicians, and clinical supervisors interested in care based on evidence-based principles and practices of AOD and other behavior change therapies. [ABSTRACT FROM AUTHOR]

Interventional radiological procedures have significantly increased the probability for the expression of deterministic detriment to the patient. It is the responsibility of the consulting medical physicist to undertake the responsibility that (i) appropriate equipment is specified and purchased; (ii) the equipment purchased produces the best possible image quality for the minimum dose; (iii) accurate dosimetry is measured, calculated and recorded; (iv) interventional physicians and surgeons are adequately trained in the fundamental techniques that will minimize the dose to both patients and staff, while maintaining high image quality; and (v) interventional protocols, record keeping and patient follow-up, in the case of deterministic doses, are appropriately implemented. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to identify any associations between predictor variables, mainly clinician training and dental implant outcome, among the residents in different departments and to compare statistical analysis with the use of MATLAB R2017a™ to SAS version 9.4. Methods: Dental records were reviewed from January 1, 2011, to December 31, 2015. Two thousand forty-eight dental implants were placed on 471 patients seen by residents from the departments of Periodontics, Prosthodontics, and Oral and Maxillofacial Surgery (OMFS) at Louisiana State University Health Sciences Center School of Dentistry. The following parameters were investigated by means of multilevel logistic regression analysis: demographics, implant parameters, department, and residents' year of training. Results: A total of 1449 implants were included in the study. Overall, within a 1–5-year time period, 1343 (92.6%) implants had survived and 106 (7.4%) implants failed. Discipline (p = 0.0004), residents' year of training (p < 0.0001), and implant systems (p = 0.0024) showed significant associations with implant outcome. Periodontics had a survival rate of 94.14% followed by Prosthodontics (91.48%) and OMFS (89.64%). The survival rates of implants by year of training were as follows: third-year Periodontics and OMFS (94.20%), second-year (89.38%), and first-year (88.6%). Conclusion: The level and type of clinician training had an impact on implant outcome in different residency programs. Further studies will be necessary to identify the reasons for the differences in implant failure rates. [ABSTRACT FROM AUTHOR]