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Little is known about tobacco smoking and health risk drinking among apprentices at vocational schools. The aim of this study was to determine the proportions of subjects who smoke or drink alcohol in a risky way, their preparedness to stop smoking, and the proportions of smokers and risk drinkers according to occupational groups and general school education. The methods included a survey of all apprentices in their first year of vocational training and all trainees in a course of preparation for occupation in a north-eastern region of Germany. All vocational schools of the study region participated. At the time of the survey, 77.9% of the apprentices were present. Among them, 99.8% (N=1 124) filled in questionnaires. The data revealed that among the total sample 61.2% were daily or less than daily current smokers. Among adults, 8.2%, among those at age 17 or younger 12.9% had a mean daily consumption of more than 12 grams (females) or more than 24 grams (males) of pure alcohol. These proportions were 12.6-18.0% among apprentices of blue collar occupations and 2.8-6.5% among apprentices of white collar or health occupations. Among subjects who had left school without graduation, 85.0%, and among those with the highest school education 36.9% were current smokers. It is concluded that vocational schools are a suitable and essential setting to reach a high risk population concerning tobacco smoking or unhealthy alcohol consumption. © Georg Thieme Verlag KG Stuttgart · New York.

Background: Continuing professional development of nurses is increasingly necessary to keep abreast of rapid changes in nursing care. Concurrently, the nursing workforce is growing older. Therefore, future strategies for continuing professional development should be directed at both younger and older nurses. Although there is some evidence that various personal, organisational and social factors result in lower participation of older workers in development activities, age-related differences in continuing professional development among nurses remain under-explored. Objective: This study explored nurses' and their managers' perceptions of the differences in continuing professional development between younger and older nurses. Design: A qualitative study using focus groups. The interviews were analysed using a thematic analysis strategy. Settings: A large academic hospital in the Netherlands. Participants: 22 nurses in three age groups (20-34 years, 35-49 years and 50-65 years) and 10 nurse managers participated in four focus groups. Results: Six themes regarding differences in continuing professional development for younger and older nurses emerged from the data: (1) level of focus, (2) creating possibilities to leave the bedside, (3) ambitious young nurses, (4) same resources, different requirements, (5) ceiling in courses for older nurses, and (6) social status and self esteem. Overall, participants seemed to conceptualise continuing professional development along three dimensions: purpose, level of formality of learning activities, and scope of development. Conclusions: The findings suggest that participants perceive differences in continuing professional development between younger and older nurses. Its purpose and the contributing learning activities are considered to change during the lifespan. When developing strategies for continuing professional development, the requirements and needs of different age groups need to be taken into account. Whether the scope of professional development is confined to " keeping up to date" or used more broad, including " expansion of skills and knowledge" seems to relate more to nurses' attitudes towards work than to their age. © 2012 Elsevier Ltd.

[No abstract available]

Background: Training for Australian general practice, or family medicine, can be isolating, with registrars (residents or trainees) moving between rural and urban environments, and between hospital and community clinic posts. Virtual communities of practice (VCoPs), groups of people sharing knowledge about their domain of practice online and face-to-face, may have a role in overcoming the isolation associated with general practice training. Objective: This study explored whether Australian general practice registrars and their supervisors (trainers) would be able to use, and would be interested in using, a VCoP in the form of a private online network for work and training purposes. It also sought to understand the facilitators and barriers to intention to use such a community, and considers whether any of these factors may be modifiable. Methods: A survey was developed assessing computer, Internet, and social media access and usage, confidence, perceived usefulness, and barriers, facilitators, and intentions to use a private online network for training purposes. The survey was sent by email link to all 139 registrars and 224 supervisors in one of Australia's 17 general practice training regions. Complete and usable responses were received from 131 participants (response rate=0.4). Results: Most respondents had access to broadband at home (125/131, 95.4%) and at work (130/131, 99.2%). Registrars were more likely to spend more than 2 hours on the Internet (P=.03), and to use social media sites for nonwork purposes (P=.01). On a 5-point Likert scale, confidence was high (mean 3.93, SD 0.63) and was negatively associated with higher age (P=.04), but not associated with training stage. Social media confidence was lower, with registrars more confident than supervisors for almost all social media activities. On a 5-point Likert scale, overall usefulness was scored positively (n=123, mean 3.63, SD 0.74), and was not significantly associated with age or training level. The main concerns of respondents were worries about privacy (registrar: 61/81, 75.3%; supervisor: 30/50, 60.0%) and insufficient time (registrar: 41/81, 50.6%; supervisor: 36/50, 72.0%). Using a multivariate generalized linear regression model, training stage and perceived usefulness were positively predictive, and concerns about privacy and time were negatively predictive of intention to use a private online network. Conclusions: General practice registrars and supervisors are interested in using a private online network, or VCoP, for work and training purposes. Important considerations are the extent to which concerns such as privacy and usefulness may be overcome by training and support to offset some other concerns, such as time barriers. Participants at an early stage in their training are more receptive to using an online network. More senior registrars and supervisors may benefit from more training and promotion of the online network to improve their receptiveness.

INTRODUCTION: Undertaking training in rural areas is a recognised way of helping recruit staff to work in rural communities. Postgraduate year two medical doctors in New Zealand have been able to undertake a three-month placement in rural practice as part of their pre-vocational training experience since November 2010. AIM: To describe the experience of a rural general practice team providing training to a postgraduate year two medical trainee, and to describe the teaching experience and range of conditions seen by the trainee. METHODS: A pre- and post-placement interview with staff, and analysis of a logbook of cases and teaching undertaken in the practice. RESULTS: The practice team's experience of having the trainee was positive, and the trainee was exposed to a wide range of conditions over 418 clinical encounters. The trainee received 22.5 hours of formal training over the three-month placement. DISCUSSION: Rural general practice can provide a wide range of clinical experience to a postgraduate year two medical trainee. Rural practices in New Zealand should be encouraged to offer teaching placements at this training level. Exposure to rural practice at every level of training is important to encourage doctors to consider rural practice as a career.

Background Pre- and postgraduate education is meant to be competency-based. Over the last two decades various competency frameworks have been published. One competency is professionalism, a definition of which has not yet been developed but is being discussed in the literature. The aim of this qualitative study is an approximation to professionalism among German general practitioners and general practitioner trainees. Methods A qualitative study was conducted by interviewing seven pairs of GPs and their trainees. All interviews were recorded and transcribed. The analysis was performed according to Mayring supported by the software Atlas.ti. Results Four categories of professionalism emerged: responsibility towards patients, responsibility towards other professionals, responsibility towards the society and responsibility towards oneself. Professionalism was perceived as important for general practice in Germany. In addition, barriers of professional behaviour have been identified. Conclusion The perception of professionalism among German GPs and GP trainees is in accordance with the frameworks of professionalism found in the literature. These results underline the need for conceptualising professionalism among general practice trainees in Germany.

This article describes the application of mastery learning in the development and implementation of a clinical skills training program for primary care nurses. The objective of the training program was to equip primary care nurses with the clinical skills to triage and administer bronchodilator therapy to patients presenting to the primary care clinic with acute exacerbations of asthma or chronic obstructive pulmonary disease. The positive outcomes of this program support the idea that mastery learning is an effective competency-based training method for clinical skills acquisition. However, variations in training duration and dropout rates should be taken into consideration when planning mastery learning-based training programs. © SLACK Incorporated.

Background/aim: Occupational therapy educators are challenged to provide students with practical experiences which prepare them for ever changing health-care contexts on graduation. Role-emerging placements have been widely used internationally to help meet this challenge, but research into the learning experiences of students during these innovative placements is limited. This research investigated the enablers and barriers to learning from the perspectives of students on such placements from two European universities. Methods: Two separate qualitative studies tracked 10 final year students. Interviews explored their learning experiences prior to, during and after an eight- or 10-week role-emerging placement in a range of settings. Results: Four themes emerged, which were (1) adapting to less doing, more thinking and planning; (2) understanding the complexity of collaboration and making it work; (3) emotional extremes; and (4) realising and using the occupational therapy perspective. Conclusions: These placements presented a 'roller coaster' of authentic learning experiences which created the opportunity for students to use occupation in practice and develop skills for collaborative working in an interprofessional environment. Whereas students viewed their role-emerging placement experiences positively, challenges included the emotional responses of students and placement pace. Findings suggest the need for supportive student placement experiences in both established and role-emerging areas to prepare students for a range of opportunities in an uncertain future. © 2013 Occupational Therapy Australia.

That humans would make provision for the development of their offspring is to be expected, given the length of time between birth and maturity we experience as a species. And there is evidence from early in recorded human history of provision for apprenticeship and markets in training and instruction. Nevertheless, it is only in the last few centuries that provision of formal instruction and schooling has become widespread and indeed has become a gauge of potential for economic development. Economists since Adam Smith, if not earlier, have argued that the performance of an economy has been infiuenced by the education of its work force (Johnson 1937). These developments call for consideration of both the causes and consequences of the rise of education in historical perspective. © 2013 selection and editorial material, Robert Whaples and Randall E. Parker.

Objective: The aim of this study is to test the acceptance and efficacy of an individualised text messaging (SMS)-based intervention to support smoking cessation in apprentices of vocational schools. Methods: The SMS program MyWay, which generated individualised text messages to support smoking cessation based on an online assessment and a weekly SMS assessment, was developed. The text messages were based on the Transtheoretical Model of Behavior Change and sent to the programme participants over a period of 3 months. The programme was tested in 62 school classes at 6 vocational schools in Bremen, Germany, where 1 086 apprentices participated in an online assessment addressing demographic and smoking related variables. Results: A total of 415 persons (38%) fulfilled the inclusion criteria "daily cigarette smokingo", "ownership of a cell phoneo" and "regular use of text messagingo". Of these, 210 persons (51%) participated in the programme. A 6-month follow-up telephone interview for the evaluation of the SMS programme and the assessment of smoking-related variables could be conducted in 125 (60%) of the 210 programme participants. Compared to the baseline assessment, the smoking prevalence (7-day-point prevalence abstinence, 11%) and the intention to stop smoking (p<0.01) were higher at the 6-month follow-up. Furthermore, cigarette craving was lower at 6-month follow-up among persons who still smoked at this point in time (p<0.01). Conclusions: In comparison to other smoking cessation services, this intervention approach allows us to reach a substantial part of smokers in vocational schools. The text messaging programme is promising for the support of smoking cessation in young adults. © Georg Thieme Verlag KG Stuttgart · New York.