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Russell Jago - One of the best experts on this subject based on the ideXlab platform.
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a revised Teaching Assistant led extracurricular physical activity programme for 8 to 10 year olds the action 3 30r feasibility cluster rct
Public Health Research, 2019Co-Authors: Byron Tibbitts, Alice Porter, Chris Metcalfe, Emma L Bird, Jane Powell, Russell Jago, Emily Sanderson, Simon J SebireAbstract:Background Many children do not meet the recommended guidelines for physical activity. The after-school period may be a critical time for children to participate in physical activity. Teaching Assistants are important within the school system and could be trained to deliver after-school physical activity programmes. Our previous work showed that a Teaching Assistant-led after-school physical activity intervention held promise. Objectives To examine the feasibility, evidence of promise and cost of Action 3:30R, a revised after-school physical activity intervention. Design A cluster-randomised feasibility study, including process and economic evaluations. Setting The setting was 12 primary schools in south-west England. Participants The participants were Year 4 and 5 children (aged 8–10 years). Intervention Two Teaching Assistants from each intervention school attended a 25-hour (5-day) training course focused on how to deliver an after-school physical activity programme. As Action 3:30 is grounded in self-determination theory, the training focused on promoting children’s autonomy, belonging and competence. Teaching Assistants received resources to aid them in delivering a 60-minute after-school physical activity programme twice per week for 15 weeks (i.e. 30 sessions). Main outcome measures Measures focused on feasibility outcomes and evidence of promise. Feasibility measures included the recruitment of schools and pupils and the attendance at the after-school programme. Evidence of promise was measured by comparing accelerometer-determined minutes of moderate to vigorous physical activity between the arms at follow-up. Process evaluation measures were conducted using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. The cost of delivery was also assessed. Results Twelve primary schools were recruited and 41% of eligible pupils consented, 49% of whom were girls. Schools were randomised after baseline measures: six to the intervention arm (n = 170 pupils) and six to the control arm (n = 165 pupils). Two schools allocated to the intervention arm withdrew from the study before the start of the intervention, leaving 111 pupils in the intervention arm. The intervention training was well attended and positively received; eight out of nine Teaching Assistants attended 100% of the sessions. Action 3:30R clubs were well attended; 74% of pupils attended at least 50% of the 30 sessions. Mean weekday moderate to vigorous physical activity did not differ between the arms at follow-up (–0.5 minutes, 95% confidence interval –4.57 to 3.57 minutes). The process evaluation revealed that Action 3:30R was received positively by pupils, Teaching Assistants and key contacts in intervention schools. Pupils enjoyed Action 3:30R, and Teaching Assistants and pupils perceived the Teaching style to be autonomy-supportive. Economic evaluation showed that Action 3:30R is inexpensive; the estimated cost of the programme after 1 year was £1.64 per pupil per session. Limitations A reason for withdrawing was given by one school but not by the other. The reason given was an inability to release staff for training. Conclusions Action 3:30R is a low-cost, feasible after-school programme that engages a range of pupils and offers continuing professional development to Teaching Assistants. However, Action 3:30R does not show evidence of promise in increasing levels of moderate to vigorous physical activity and does not warrant a trial evaluation. Future work Future research should focus on improving the quality of current after-school provision in primary schools to increase physical activity. Trial registration Current Controlled Trials ISRCTN34001941. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 19. See the NIHR Journals Library website for further project information.
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action 3 30r process evaluation of a cluster randomised feasibility study of a revised Teaching Assistant led extracurricular physical activity intervention for 8 to 10 year olds
BMC Public Health, 2019Co-Authors: Byron Tibbitts, Alice Porter, Simon J Sebire, Chris Metcalfe, Emma L Bird, Jane Powell, Russell Jago, Emily SandersonAbstract:Numerous interventions to increase children’s physical activity levels are published, yet, few studies report indicators of external validity. Process evaluations are critical for assessing intervention implementation, sustainability and effectiveness. A mixed-methods process evaluation, using the RE-AIM framework, was conducted to evaluate the internal and external validity of Action 3:30R, a revised Teaching Assistant-led after-school intervention which aimed to increase physical activity in children aged 8–10 years and was underpinned by Self-determination Theory (SDT). Data were collected and reported in line with the five components of RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance). Quantitative measures included logbooks, registers and self-reported Teaching-efficacy, autonomy support, child enjoyment and perceived exertion questionnaires. Questionnaire data were collected at three points throughout the 15-week intervention. Observations by trained researchers were also conducted to assess fidelity to the intervention manual and its underpinning theory. Post-intervention focus groups with pupils and interviews with Teaching Assistants (TAs), school staff and external stakeholders explored the implementation and potential sustainability of Action 3:30R from stakeholders’ perspectives. Action 3:30R appealed to a broad range of pupils, including girls and less-active pupils. The Action 3:30R TA training was implemented as intended and was perceived as valuable professional development. Releasing staff for training was a barrier in two of the six intervention schools, which were unable to deliver the intervention as a result. Pupils enjoyed the intervention, and the Action 3:30R core principles underpinned by SDT were implemented with high fidelity, as was the intervention itself. Scheduling conflicts with other clubs and lack of parental support were perceived as the main barriers to recruitment and attendance. Lack of space and season were cited as the main barriers affecting the quality of delivery. The study shows evidence of maintenance, as one intervention school decided to continue Action 3:30R beyond the study. Funding and continued TA training were suggested as factors which may affect the maintenance of Action 3:30R. Action 3:30R is an enjoyable, autonomy-supportive after-school programme, which engages a range of pupils and offers TAs valuable training. RE-AIM provided helpful structure and is recommended for intervention evaluations. ISRCTN34001941 . Prospectively registered 01/12/2016.
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action 3 30r protocol for a cluster randomised feasibility study of a revised Teaching Assistant led extracurricular physical activity intervention for 8 to 10 year olds
Pilot and Feasibility Studies, 2017Co-Authors: Byron Tibbitts, Alice Porter, Simon J Sebire, Chris Metcalfe, Emma L Bird, Jane Powell, Russell JagoAbstract:Approximately half of 7-year-old children do not meet physical activity (PA) recommendations. Interventions targeting primary school children’s afterschool discretionary time could increase PA. Teaching Assistants (TAs) are a school resource and could be trained to deliver after-school PA programmes. Building on earlier work, this paper describes the protocol for a cluster randomised feasibility study of a Teaching Assistant-led after-school intervention aimed at increasing PA levels of year 4 and 5 children (8–10 years old). Phase 1—pre-baseline: 12 schools will be recruited. In all schools, self-reported PA will be measured in all consenting year 3 and 4 children. In four schools, pupils will additionally wear a waist-worn Actigraph accelerometer for 7 days. Phase 2—baseline: schools will be randomised to one of two enhanced recruitment strategies being tested for children: (1) a club briefing and (2) the briefing plus a taster Action 3:30 session. Up to 30 children per school will be able to attend Action 3:30 sessions and will provide baseline data on height, weight, psychosocial variables and accelerometer-measured PA. Phase 3—intervention and follow-up: Schools randomised into intervention or control arm. Intervention schools (n = 6) will receive a 15-week after-school programme when children are in years 4 and 5, run by TAs who have attended a 25-h Action 3:30 training programme. Control schools (n = 6) will continue with normal practice. Follow-up measures will be a repeat of baseline measures at the end of the 15-week intervention. Phase 4—process evaluation: session attendance, perceived enjoyment and perceived exertion will be assessed during the intervention, as well as the economic impact on schools. Post-study qualitative assessments with TAs, school contacts and pupils will identify how the programme could be refined. Accelerometer-determined minutes of moderate-to-vigorous physical activity (MVPA) per day will be calculated as this is likely to be the primary outcome in a future definitive trial. The Action 3:30 cluster randomised feasibility trial will assess the public health potential of this intervention approach and provide the information necessary to progress to a definitive cluster randomised controlled trial. ISRCTN34001941 . Registered 01/12/2016.
Vijay K Mittal - One of the best experts on this subject based on the ideXlab platform.
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effect of establishing a Teaching Assistant case minimum on general surgery residents 18 year comparison of a single institution to national data
Journal of The American College of Surgeons, 2020Co-Authors: Prakash Jayanthi, Mitesh Patel, Vijay K MittalAbstract:Background Teaching Assistant (TA) cases are a training mainstay, due to increased resident autonomy. Since 2014, the American Board of Surgery (ABS) requires a 25 TA case minimum for graduating resident eligibility for board certification. Herein, we analyze our institution's experience compared with the national average, for any change effected by the requirement. Study Design ACGME case log data were obtained for the July 2001 to June 2018 academic years. We compared average TA cases of our program against the national average and national 50th percentile: 2001 to 2014, and 2014 to 2018 academic years. The program TA cases were also broken down by category, with a comparison before and after 2014. Values of p were calculated using a t-test and Mann-Whitney U test. Results From July 2001 to June 2018, our program averaged 30.1 TA cases/resident, and national 50th percentile average was 28.1. For July 2001 to June 2014 AY (aka pre-2014) and July 2014 to June 2018 AY (aka post-2014) cases per resident, our program averages were 24.9 and 46.1, respectively, and the national 50th percentile averages were 24.4 and 40.3, respectively—both statistically significant increases. Average program percentiles were 46.4 (pre-2014), and 61.5 (post-2014), and 59.6% of program cases logged were biliary, large intestine, and hernia (2001 to 2018 AY), with a statistically significant increase in several case subcategories post-2014. Conclusions Teaching Assistant cases are an invaluable resource for residents, fostering increased autonomy. Since the 2014 minimum, a statistically significant increase in TA cases was noted in our program and nationally. The majority of sub-categories logged were core procedures. Unequivocally, the TA case minimum requirement has made a difference. This will hopefully lead to increased autonomy and therefore, more comfortable and capable general surgeons. Wide variability is noted in what counts as a TA case, with further clarification needed by the ACGME and ABS.
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variations in Teaching Assistant case experience during general surgical residency
American Surgeon, 2018Co-Authors: Mitesh Patel, Harit Kapoor, Vijay K MittalAbstract:In 2014 to 2015, the American Council for Graduate Medical Education required that graduating surgical residents must complete 25 cases as a Teaching Assistant (TA). The definition of TA varies among programs. The purpose of this study is to gain insight into how many cases residents log as a TA, the operative setting, and the types of cases performed. An online survey of 21 questions was sent via email to all general surgery program directors across the nation between August and October of 2015. Questions regarding the number of cases performed as TA, types of cases performed, and the operative setting were asked. We received 88 responses of 200 surveys sent. Fifty-two per cent of programs stated that their graduating residents log more than 25 cases as TA on graduating. All 88 respondents stated that senior residents acted as TAs in the operating room; of these respondents, 59 per cent stated that senior residents acted as TAs in the clinic also, 66 per cent on floors, and 70 per cent in the emergency room. The definition of TA differs among programs. Also, the types of cases that residents log as TA varies among programs as there are no clear guidelines set by the American Council for Graduate Medical Education as to what constitutes a TA case. Nonetheless, in most programs, senior residents perform more than 25 TA cases.
William E Wischusen - One of the best experts on this subject based on the ideXlab platform.
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a conceptual framework for graduate Teaching Assistant professional development evaluation and research
CBE- Life Sciences Education, 2016Co-Authors: Todd D Reeves, Gili Marbachad, Kristen R Miller, Judith S Ridgway, Grant E Gardner, Elisabeth E Schussler, William E WischusenAbstract:This essay proposes a conceptual framework for biology graduate Teaching Assistant professional development evaluation and research with three overarching variables for consideration: outcome varia...
Byron Tibbitts - One of the best experts on this subject based on the ideXlab platform.
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a revised Teaching Assistant led extracurricular physical activity programme for 8 to 10 year olds the action 3 30r feasibility cluster rct
Public Health Research, 2019Co-Authors: Byron Tibbitts, Alice Porter, Chris Metcalfe, Emma L Bird, Jane Powell, Russell Jago, Emily Sanderson, Simon J SebireAbstract:Background Many children do not meet the recommended guidelines for physical activity. The after-school period may be a critical time for children to participate in physical activity. Teaching Assistants are important within the school system and could be trained to deliver after-school physical activity programmes. Our previous work showed that a Teaching Assistant-led after-school physical activity intervention held promise. Objectives To examine the feasibility, evidence of promise and cost of Action 3:30R, a revised after-school physical activity intervention. Design A cluster-randomised feasibility study, including process and economic evaluations. Setting The setting was 12 primary schools in south-west England. Participants The participants were Year 4 and 5 children (aged 8–10 years). Intervention Two Teaching Assistants from each intervention school attended a 25-hour (5-day) training course focused on how to deliver an after-school physical activity programme. As Action 3:30 is grounded in self-determination theory, the training focused on promoting children’s autonomy, belonging and competence. Teaching Assistants received resources to aid them in delivering a 60-minute after-school physical activity programme twice per week for 15 weeks (i.e. 30 sessions). Main outcome measures Measures focused on feasibility outcomes and evidence of promise. Feasibility measures included the recruitment of schools and pupils and the attendance at the after-school programme. Evidence of promise was measured by comparing accelerometer-determined minutes of moderate to vigorous physical activity between the arms at follow-up. Process evaluation measures were conducted using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. The cost of delivery was also assessed. Results Twelve primary schools were recruited and 41% of eligible pupils consented, 49% of whom were girls. Schools were randomised after baseline measures: six to the intervention arm (n = 170 pupils) and six to the control arm (n = 165 pupils). Two schools allocated to the intervention arm withdrew from the study before the start of the intervention, leaving 111 pupils in the intervention arm. The intervention training was well attended and positively received; eight out of nine Teaching Assistants attended 100% of the sessions. Action 3:30R clubs were well attended; 74% of pupils attended at least 50% of the 30 sessions. Mean weekday moderate to vigorous physical activity did not differ between the arms at follow-up (–0.5 minutes, 95% confidence interval –4.57 to 3.57 minutes). The process evaluation revealed that Action 3:30R was received positively by pupils, Teaching Assistants and key contacts in intervention schools. Pupils enjoyed Action 3:30R, and Teaching Assistants and pupils perceived the Teaching style to be autonomy-supportive. Economic evaluation showed that Action 3:30R is inexpensive; the estimated cost of the programme after 1 year was £1.64 per pupil per session. Limitations A reason for withdrawing was given by one school but not by the other. The reason given was an inability to release staff for training. Conclusions Action 3:30R is a low-cost, feasible after-school programme that engages a range of pupils and offers continuing professional development to Teaching Assistants. However, Action 3:30R does not show evidence of promise in increasing levels of moderate to vigorous physical activity and does not warrant a trial evaluation. Future work Future research should focus on improving the quality of current after-school provision in primary schools to increase physical activity. Trial registration Current Controlled Trials ISRCTN34001941. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 19. See the NIHR Journals Library website for further project information.
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action 3 30r process evaluation of a cluster randomised feasibility study of a revised Teaching Assistant led extracurricular physical activity intervention for 8 to 10 year olds
BMC Public Health, 2019Co-Authors: Byron Tibbitts, Alice Porter, Simon J Sebire, Chris Metcalfe, Emma L Bird, Jane Powell, Russell Jago, Emily SandersonAbstract:Numerous interventions to increase children’s physical activity levels are published, yet, few studies report indicators of external validity. Process evaluations are critical for assessing intervention implementation, sustainability and effectiveness. A mixed-methods process evaluation, using the RE-AIM framework, was conducted to evaluate the internal and external validity of Action 3:30R, a revised Teaching Assistant-led after-school intervention which aimed to increase physical activity in children aged 8–10 years and was underpinned by Self-determination Theory (SDT). Data were collected and reported in line with the five components of RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance). Quantitative measures included logbooks, registers and self-reported Teaching-efficacy, autonomy support, child enjoyment and perceived exertion questionnaires. Questionnaire data were collected at three points throughout the 15-week intervention. Observations by trained researchers were also conducted to assess fidelity to the intervention manual and its underpinning theory. Post-intervention focus groups with pupils and interviews with Teaching Assistants (TAs), school staff and external stakeholders explored the implementation and potential sustainability of Action 3:30R from stakeholders’ perspectives. Action 3:30R appealed to a broad range of pupils, including girls and less-active pupils. The Action 3:30R TA training was implemented as intended and was perceived as valuable professional development. Releasing staff for training was a barrier in two of the six intervention schools, which were unable to deliver the intervention as a result. Pupils enjoyed the intervention, and the Action 3:30R core principles underpinned by SDT were implemented with high fidelity, as was the intervention itself. Scheduling conflicts with other clubs and lack of parental support were perceived as the main barriers to recruitment and attendance. Lack of space and season were cited as the main barriers affecting the quality of delivery. The study shows evidence of maintenance, as one intervention school decided to continue Action 3:30R beyond the study. Funding and continued TA training were suggested as factors which may affect the maintenance of Action 3:30R. Action 3:30R is an enjoyable, autonomy-supportive after-school programme, which engages a range of pupils and offers TAs valuable training. RE-AIM provided helpful structure and is recommended for intervention evaluations. ISRCTN34001941 . Prospectively registered 01/12/2016.
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action 3 30r protocol for a cluster randomised feasibility study of a revised Teaching Assistant led extracurricular physical activity intervention for 8 to 10 year olds
Pilot and Feasibility Studies, 2017Co-Authors: Byron Tibbitts, Alice Porter, Simon J Sebire, Chris Metcalfe, Emma L Bird, Jane Powell, Russell JagoAbstract:Approximately half of 7-year-old children do not meet physical activity (PA) recommendations. Interventions targeting primary school children’s afterschool discretionary time could increase PA. Teaching Assistants (TAs) are a school resource and could be trained to deliver after-school PA programmes. Building on earlier work, this paper describes the protocol for a cluster randomised feasibility study of a Teaching Assistant-led after-school intervention aimed at increasing PA levels of year 4 and 5 children (8–10 years old). Phase 1—pre-baseline: 12 schools will be recruited. In all schools, self-reported PA will be measured in all consenting year 3 and 4 children. In four schools, pupils will additionally wear a waist-worn Actigraph accelerometer for 7 days. Phase 2—baseline: schools will be randomised to one of two enhanced recruitment strategies being tested for children: (1) a club briefing and (2) the briefing plus a taster Action 3:30 session. Up to 30 children per school will be able to attend Action 3:30 sessions and will provide baseline data on height, weight, psychosocial variables and accelerometer-measured PA. Phase 3—intervention and follow-up: Schools randomised into intervention or control arm. Intervention schools (n = 6) will receive a 15-week after-school programme when children are in years 4 and 5, run by TAs who have attended a 25-h Action 3:30 training programme. Control schools (n = 6) will continue with normal practice. Follow-up measures will be a repeat of baseline measures at the end of the 15-week intervention. Phase 4—process evaluation: session attendance, perceived enjoyment and perceived exertion will be assessed during the intervention, as well as the economic impact on schools. Post-study qualitative assessments with TAs, school contacts and pupils will identify how the programme could be refined. Accelerometer-determined minutes of moderate-to-vigorous physical activity (MVPA) per day will be calculated as this is likely to be the primary outcome in a future definitive trial. The Action 3:30 cluster randomised feasibility trial will assess the public health potential of this intervention approach and provide the information necessary to progress to a definitive cluster randomised controlled trial. ISRCTN34001941 . Registered 01/12/2016.
Nirusha Lachman - One of the best experts on this subject based on the ideXlab platform.
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can a Teaching Assistant experience in a surgical anatomy course influence the learning curve for nontechnical skill development for surgical residents
Anatomical Sciences Education, 2016Co-Authors: Mark J Heidenreich, Tashinga Musonza, Wojciech Pawlina, Nirusha LachmanAbstract:The foundation upon which surgical residents are trained to work comprises more than just critical cognitive, clinical, and technical skill. In an environment where the synchronous application of expertise is vital to patient outcomes, the expectation for optimal functioning within a multidisciplinary team is extremely high. Studies have shown that for most residents, one of the most difficult milestones in the path to achieving professional expertise in a surgical career is overcoming the learning curve. This view point commentary provides a reflection from the two senior medical students who have participated in the Student-as-Teacher program developed by the Department of Anatomy at Mayo Clinic, designed to prepare students for their Teaching Assistant (TA) role in anatomy courses. Both students participated as TAs in a six week surgical anatomy course for surgical first Assistant students offered by the School of Health Sciences at Mayo Clinic. Development of Teaching skills, nontechnical leadership, communication, and assessment skills, are discussed in relation to their benefits in preparing senior medical students for surgical residency.
