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Historically, clinical trialists developed DMC expertise and experience with "on the job training". Clinical trialists have recognized a large and growing gap between the demand and supply of trained DMC members due in part to the huge increase in ongoing clinical trials. A critical need exists to increase the supply of DMC trained clinicians and biostatisticians. Despite a rich collection of published training material, many have recommended a mentoring process to train clinical trialists and data scientists lacking DMC experience. We propose that academic, regulatory, industry and other leaders in clinical trials support including investigators lacking DMC experience as members of a DMC so that they can be trained to learn about the DMC processes during conduct of an actual trial"., (© 2023. The Author(s), under exclusive licence to The Drug Information Association, Inc.)

Aim: This study aimed to investigate students' learning journeys across the duration of a new registered nurse degree apprenticeship programme and to develop an understanding of the contextual factors, mechanisms and outcomes involved., Background: Registered nurses are the largest group of healthcare workers globally, but shortages exist. To encourage existing UK healthcare employees into nursing, national investment was made into Registered Nurse Degree Apprenticeships. In 2018 a UK health service organisation and a university collaboration led to development of a nursing degree apprenticeship programme. Research into these novel undergraduate programmes in nursing is lacking, with scarce evidence or understanding of processes and experiences involved in such programmes., Design and Methods: An exploratory qualitative design informed by realistic evaluation was employed. Three sequential semi-structured interviews were conducted with an entire cohort (n=8) across the 18-month programme (24 interviews). Focused interviews were also undertaken with practice assessors (n=8) involved in the apprentices' journey. Initial thematic analysis was followed by application of Realist Evaluation principles and a temporal lens to move beyond qualitative description., Results: Analysis identified four interrelated temporal themes, each comprising contextual factors, mechanisms and outcomes acting to inhibit or facilitate transition across the apprenticeship journey: (1) Starting out (Latent Ambition, enhanced motivation and expectations): programme availability and conditions enabled enactment of ambitions to become qualified nurses, preconceived assumptions regarding roles influenced expectations. (2) Initial stages (Identity dissonance, transition to academia, becoming a student nurse) related to changing identity and re-conceptualisation of their role to student nurse, alongside transitioning into higher education. (3) Travelling through (Being an apprentice, social capital, self-efficacy and confidence) facilitated confident integration into placements, although over confidence could be risky. Academic struggles prompted some episodes of emotional dissonance. (4) Moving beyond to become registered nurses (Confidence, empowerment and loyalty in the transition to becoming a nurse) saw apprentices transform, with revised understandings of nursing, increased empowerment and self-efficacy. All expressed gratitude and loyalty for the apprenticeship opportunity, with all securing jobs in their employing organisation., Conclusion: This study is one of the first of its kind, providing detailed insight into processes experienced by students over the duration of a novel apprenticeship programme. Analysis identified several factors that facilitated and inhibited progress in participants' 'learning journeys', mapping context, mechanism, outcome configurations which came into play at various stages. These were influential in successful completion of the programme by all apprentices, resulting in the development of competent Registered Nurses., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: However, Professor Debbie Porteous is Head of the Department where this programme is delivered, Julie Derbyshire and Karen Corder are leads on this programme. Barbara Foggo worked within the employing NHS Trust but had no direct involvement in the programme and Alison Steven has no conflict of interest., (Copyright © 2023. Published by Elsevier Ltd.)

Cardiovascular medicine and practice in recent times have evolved as complex procedures are performed to manage difficult cases. The majority of these interventions are done percutaneously in order to minimize patient risk. Additionally, training specialist in handling these interventions require a lot of exposure to them; as such, patients are at higher risk of errors and complications from trainees before attaining expertise. In order to avoid these possible risks to patients and ensure their safety, using simulation commonly in cardiovascular specialist education is a possible trend in the future. This article aims to review randomized controlled trials that were performed in cardiology and vascular medicine regarding the use of simulating models to transfer skills to trainees. This study is a systematic review that includes publications dated from 2010 from any country and only in English. The search involved several combinations of search terms from medical subject headings (MeSH). Keywords in the title, abstract, and text for the population, intervention, control, and outcomes were first done in a pilot search to establish the sensitivity of the search strategy. Studies were searched in PubMed, Medline, Cochrane Library, Embase, CINAHL, and Hirani. Data were presented in the PRISMA flowchart and tabular form. A total of 389 studies were obtained from five databases using the search strategies. Eighty-nine studies were excluded for duplication. The total number of studies that did not meet the inclusion criteria was 269, and they were excluded based on abstract and title screening. Another 18 studies were excluded based on full-text screening. In this study, 13 articles were selected ranging from 2011 to 2022. The majority of the outcomes of the study demonstrated that simulation tutoring complements traditional methods of training. Countries of publication were the United States of America, Canada, Italy, Korea, California, Ireland, Germany, Belgium, Switzerland, United Kingdom, Netherlands, and France. Procedures simulated include coronary angiography, transseptal catheterization, cardiopulmonary resuscitation, ultrasound-guided radial artery cannulation, diagnostic angiograms, coiled carotid terminus aneurysms in the setting of subarachnoid hemorrhage, middle cerebral artery embolectomies, renal artery angioplasty/stenting, endovascular aneurysm repair, transvenous pacing wire, intra-aortic balloon pump, and pericardiocentesis. Despite the accredited drawback of availability and cost noted with simulation-based education, there is evidence that it offers many advantages compared to traditional teaching methods. From this study, simulation-based teaching has been shown to effectively transfer skills to trainees especially when used as an adjunct to the apprenticeship method. As a result, we recommend that virtual reality education should be integrated with real-life teaching in modern cardiovascular modules as this will help ensure early skill transfer while maintaining patient safety., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kweki et al.)

There are not enough board certified behavior analysts (BCBAs) with specialization in the treatment of individuals with autism to meet the growing patient demand for applied behavior analysis (ABA) treatment. In addition, there are no streamlined, organization-led fieldwork supervision systems to aid in the professional development of Trainees to meet this need. This article describes enhancements made to the Apprentice Model (Hartley et al., 2016), emphasizing the mutual benefit to the Apprentice, the Supervising BCBA, the organization for which they are both employed, and perhaps most important, the field of behavior analysis. Within the organization where the Apprentice Model has been adopted, 88% of Apprentices who took the exam, since the 2022 modifications were applied, passed on their first attempt despite attending universities with 2021 reported pass rates ranging from 34%-60% (Behavior Analysts Certification Board [BACB], 2023). In addition, through the 6-year history of the adoption of the Apprentice Model, 70% of the organization's BCBAs who supervise a caseload of patients were prior Apprentices. Structuring a wide-scale supervision model within an organization creates opportunities for the Trainee to experience high-quality tailored fieldwork, it allows the Supervising BCBA to provide supervision under a well-organized and structured framework, and it permits the organization to employ high-quality, newly certified BCBAs to begin meeting patient treatment needs., Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-023-00799-9., Competing Interests: Conflicts with InterestWe have no conflict of interest to disclose., (© Association for Behavior Analysis International 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Along with surgeons, anesthesia professionals, and RN circulators, surgical technologists are essential members of the perioperative team. Despite a partnership with a local community college that offered a surgical technologist degree program, Norton Healthcare in Louisville, Kentucky, continued to experience a shortage of surgical technologists. To meet demands, the clinical educators at the facility developed an in-house Surgical Technologist Apprentice Program (STAP). The STAP consists of six weeks of didactic learning and hands-on training in an OR simulation laboratory, followed by a six-month preceptorship in the OR. This program has proven invaluable, particularly as the COVID-19 pandemic increased the need for personnel who are not only skilled in the OR but also can provide essential frontline patient care when needed. Together, the STAP and the college partnership offer a career-building opportunity for those in entry-level positions who may not otherwise be able to afford to train for this specialized role., (© AORN, Inc, 2023.)

Background: Apprenticeships are a common pathway for young people transitioning into the workforce. Apprentices often face many employment-related challenges and have high levels of psychological distress, drug and alcohol use, and suicidal ideation. Little is known about the attitudes of apprentices toward using smartphone apps to support their mental health and the content that would engage them., Objective: This study explored (1) apprentices' interest in using an app to support their mental health and (2) the healthy coping strategies used to manage their mental well-being in the face of workplace challenges, in order to inform future app content., Methods: A mixed methods study was conducted with 54 apprentices (50/54 male, 93%) with a mean age of 22.7 (SD 5.7) years. Participants completed a survey on preferred ways of using an app to support mental health. Across 8 focus groups, participants were asked to describe healthy strategies they used to cope with occupational stressors., Results: Only 11% (6/54) of participants currently used a well-being app, but there was high interest in using an app to support their friends (47/54 participants, 87%) and develop self-help strategies to manage or prevent mental health issues (42/54 participants, 78%). Four major types of coping behaviors were identified: (1) social connection for disclosure, advice, and socializing; (2) pleasurable activities, such as engaging in hobbies, time-outs, and developing work-life separation; (3) cognitive approaches, including defusing from thoughts and cognitive reframing; and (4) self-care approaches, including exercise, a healthy diet, and getting adequate sleep., Conclusions: There is interest among apprentices to use an app with a positive well-being focus that helps them to develop self-management skills and support their friends. Apprentices utilized a range of healthy behaviors to cope with workplace stressors that can be incorporated into mental health apps to improve uptake and engagement. However, many of the preferred coping strategies identified are not those focused on by currently available apps, indicating the need for more targeted digital interventions for this group., (©Isabella Choi, Katherine Petrie, Rochelle Einboden, Daniel Collins, Rose Ryan, David Johnston, Samuel B Harvey, Nicholas Glozier, Alexis Wray, Mark Deady. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 18.08.2022.)

Background: Inability to advance to an oral diet, or oral feeding intolerance, is a common complication in patients with acute pancreatitis associated with worse clinical outcomes. The factors related to oral feeding intolerance are not well studied., Objective: We aimed to determine the incidence and risk factors of oral feeding intolerance in acute pancreatitis., Methods: Patients were prospectively enrolled in the Acute Pancreatitis Patient Registry to Examine Novel Therapies in Clinical Experience, an international acute pancreatitis registry, between 2015 and 2018. Oral feeding intolerance was defined as worsening abdominal pain and/or vomiting after resumption of oral diet. The timing of the initial feeding attempt was stratified based on the day of hospitalization. Multivariable logistic regression was performed to assess for independent risk factors/predictors of oral feeding intolerance., Results: Of 1233 acute pancreatitis patients included in the study, 160 (13%) experienced oral feeding intolerance. The incidence of oral feeding intolerance was similar irrespective of the timing of the initial feeding attempt relative to hospital admission day (p = 0.41). Patients with oral feeding intolerance were more likely to be younger (45 vs. 50 years of age), men (61% vs. 49%), and active alcohol users (44% vs. 36%). They also had higher blood urea nitrogen (20 vs. 15 mg/dl; p < 0.001) and hematocrit levels (41.7% vs. 40.5%; p = 0.017) on admission; were more likely to have a nonbiliary acute pancreatitis etiology (69% vs. 51%), systemic inflammatory response syndrome of 2 or greater on admission (49% vs. 35%) and at 48 h (50% vs. 26%), develop pancreatic necrosis (29% vs. 13%), moderate to severe acute pancreatitis (41% vs. 24%), and have a longer hospital stay (10 vs. 6 days; all p < 0.04). The adjusted analysis showed that systemic inflammatory response syndrome of 2 or greater at 48 h (odds ratio 3.10; 95% confidence interval 1.83-5.25) and a nonbiliary acute pancreatitis etiology (odds ratio 1.65; 95% confidence interval 1.01-2.69) were independent risk factors for oral feeding intolerance., Conclusion: Oral feeding intolerance occurs in 13% of acute pancreatitis patients and is independently associated with systemic inflammatory response syndrome at 48 h and a nonbiliary etiology., (© 2020 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.)

Apprentices in many sectors are exposed to increased health risks and show low levels of physical activity (PA). Environmental and policy approaches seem to be promising tools for PA promotion as they can positively influence the context in which PA occurs. This article reports results from a German research project (2015-2018) that developed and implemented measures for PA promotion in the field of vocational education (VE). A participatory approach-cooperative planning (COP)-involving researchers as well as stakeholders from policy and practice was used in two VE settings-nursing care and automotive mechatronics. We assessed the extent to which new capacities for PA promotion were created by conducting semi-structured interviews with stakeholders from both sectors (n = 12) and one group interview with nursing students (n = 4). Transcripts were analysed using qualitative content analysis. Findings show that new capacities were created mainly in the form of resources and opportunities and that several measures for PA promotion (e.g. a regular lesson on the issue of PA and health and a tutoring system) were successfully integrated into VE routines. However, establishing new organizational goals and obligations appeared to be challenging. Moreover, the article presents influencing factors, such as the participation of the main actors that strongly supported the process of capacity building within their organization. We conclude that COP seems promising in creating new capacities for PA promotion in the field of VE, and therefore has the potential to promote a physically active lifestyle among apprentices., (© The Author(s) 2020. Published by Oxford University Press.)

Background: Young people are at heightened risk for mental health problems. Apprenticeships are common pathways into the workforce at a critical developmental period. However, in some cases the working conditions for apprentices present significant challenges to mental wellness. As apprentices are unlikely to utilize traditional services, eHealth and mHealth interventions are a useful means of delivering interventions to this group. The aim of the current paper is to: (1) qualitatively explore the utility of an existing mental health app within an apprentice population; and (2) evaluate the usability, acceptability, feasibility and preliminary efficacy of a modified version of the app ( HeadGear Apprentice ), designed to reduce depressive symptoms in an apprentice working population. Methods: Study One: Twenty-six apprentices (aged 18-30) took part in one of eight (90-min) focus groups. Participants explored the HeadGear app, took part in group discussions, and completed uMARS questionnaires. Modifications were made to the app based on feedback. Study Two: In the follow-up pilot testing, 47 apprentices downloaded and used the modified app over 30 days. Assessment occurred online at baseline, 5-weeks, and 3-months post-baseline. Feasibility was evaluated using consent rates, adherence and attrition. Acceptability was assessed using questionnaires and a post-study interview. Depression, anxiety, well-being, and work performance scores were used to assess preliminary efficacy. Results: Overall, the app was well-received in both studies, with high self-reported scores for acceptability and utility. However, engagement-both in terms of self-report and adherence-was an issue in both studies. In Study Two, users completed approximately one-third of the app's therapeutic content, with increased usage associated with improved outcomes. This had implications for the preliminary effectiveness of the app [depression as measured by the PHQ-9 Cohen's d = 0.27 (95%CI:-0.16-0.69)]. At follow-up users reported improvements in all outcomes, but overall only change in well-being reached statistical significance [ Cohen's d = -0.29 (95%CI:-0.72-0.14)]. Conclusion: Overall, findings from the two studies suggest that an eHealth tool, HeadGear Apprentice , was an acceptable and well-received intervention when adapted to young apprentices. However, questions remain regarding how to improve engagement and adherence to the program. These questions appear critical to effectiveness. The two studies also have implications for awareness raising in this population. Whilst preliminary results were encouraging, these improvements, along with a full-scale efficacy trial, are needed to better understand the utility of smartphone applications for mental health in this population. Trial registration: ACTRN12618001475235 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375875&isReview=true., (Copyright © 2020 Deady, Glozier, Collins, Einboden, Lavender, Wray, Gayed, Calvo, Christensen, Harvey and Choi.)

Background: The clinical features and outcomes of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) are not well-established., Objective: To evaluate the clinical characteristics of HTG-AP in an international, multicenter prospective cohort., Methods: Data collection was conducted prospectively through APPRENTICE between 2015 and 2018. HTG-AP was defined as serum TG levels >500 mg/dl in the absence of other common etiologies of AP. Three multivariate logistic regression models were performed to assess whether HTG-AP is associated with SIRS positive status, ICU admission and/or moderately-severe/severe AP., Results: 1,478 patients were included in the study; 69 subjects (4.7%) were diagnosed with HTG-AP. HTG-AP patients were more likely to be younger (mean 40 vs 50 years; p < 0.001), male (67% vs 52%; p = 0.018), and with a higher BMI (mean 30.4 vs 27.5 kg/m 2 ; p = 0.0002). HTG-AP subjects reported more frequent active alcohol use (71% vs 49%; p < 0.001), and diabetes mellitus (59% vs 15%; p < 0.001). None of the above risk factors/variables was found to be independently associated with SIRS positive status, ICU admission, or severity in the multivariate logistic regression models. These results were similar when including only the 785 subjects with TG levels measured within 48 h from admission., Conclusion: HTG-AP was found to be the 4th most common etiology of AP. HTG-AP patients had distinct baseline characteristics, but their clinical outcomes were similar compared to other etiologies of AP., Competing Interests: Declaration of competing interest The Authors declare that there is no conflict of interest., (Copyright © 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Psychiatry's evolution has entailed clinical, educational, research, and administrative missions. Faculty development efforts concern ways in which professional identity, attitudes and skills are transmitted and enhanced from generation to generation. Top-down efforts by national and international organizations and bottom-up movements by individuals in numerous local settings have helped faculty and guided the profession forward. Organizations have provided new faculty with access to mentors and peers across the country, training opportunities, and up-to-date information on emerging scientific, pedagogical, and regulatory trends. Additional innovations and evaluation regarding best practices for faculty development initiatives in psychiatry are needed., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: Construction workers face barriers to healthy eating, including work organization and environmental factors, that can affect productivity and lead to chronic conditions. The objective was to evaluate the effectiveness of an online nutrition training to improve knowledge and behaviors and evaluate the feasibility of conducting this training among apprentices in the highway construction trades., Methods: A pretest-posttest control group design was used. The intervention was conducted using a Web-based electronic learning platform., Results: A total of 36 highway construction apprentices (78% male) completed the study. Intervention participants demonstrated improvements in knowledge immediately after the training, reported modest weight loss, decreased body mass index, and decreased fast food consumption compared with control participants. However, increases in knowledge were not seen at follow-up. The training content and format were well-received, indicating that electronic learning approaches were acceptable for this population., Conclusions and Implications: This project established the acceptability of using an online nutrition training to promote health among apprentices., (Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: We have established a multicenter international consortium to better understand the natural history of acute pancreatitis (AP) worldwide and to develop a platform for future randomized clinical trials., Methods: The AP patient registry to examine novel therapies in clinical experience (APPRENTICE) was formed in July 2014. Detailed web-based questionnaires were then developed to prospectively capture information on demographics, etiology, pancreatitis history, comorbidities, risk factors, severity biomarkers, severity indices, health-care utilization, management strategies, and outcomes of AP patients., Results: Between November 2015 and September 2016, a total of 20 sites (8 in the United States, 5 in Europe, 3 in South America, 2 in Mexico and 2 in India) prospectively enrolled 509 AP patients. All data were entered into the REDCap (Research Electronic Data Capture) database by participating centers and systematically reviewed by the coordinating site (University of Pittsburgh). The approaches and methodology are described in detail, along with an interim report on the demographic results., Conclusion: APPRENTICE, an international collaboration of tertiary AP centers throughout the world, has demonstrated the feasibility of building a large, prospective, multicenter patient registry to study AP. Analysis of the collected data may provide a greater understanding of AP and APPRENTICE will serve as a future platform for randomized clinical trials., Competing Interests: None