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For example, at the individual level, interviewees indicated a number of issues that may impact training outcomes, including trainees' background knowledge and experience, their life circumstances, and their motivation: "... who did you select [for the training]?
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Language and cultural barriers between teachers and learners, between the on-site ultrasound practitioner and referral radiologist, may impact on training efficacy, practitioner proficiency and interpretation of results.
The use of clinical assistants[ 30, 31], and expanded roles for nurses[ 32] has the potential to considerably reduce the non-operative workload per trainee[ 31, 33], although where nurses are being trained as surgical care practitioners the volume of procedures required for their training may impact heavily on the number remaining for surgical trainees[ 33].
Our results suggest that an Intensivist's base specialty of training may impact patient outcomes and practice patterns.
It would appear likely that these differences in constraints encountered would alter hand rim propulsion biomechanics in ways that may impact on the overall training required to maximise performance as well as the injury risk to the upper extremities.
Furthermore, differences in GP training across countries may impact on the consulting behaviours.
Furthermore, this systematic review builds on previous research by examining specific training parameters that may impact the efficacy of dual-task interventions.
In a system where a majority of code status discussions occur between patients and physicians in training, physician unfamiliarity may impact patient knowledge and decision making [ 20].
The shift in the training model in 2012 may impact the understaffing of EM specialists during "off hours".
We are unaware of how these differences may impact performance and development of professional competence during training and beyond.
22 27 Additionally there may be problems accessing appropriately trained physiotherapists 38 39 and poor medication adherence 40 41 may impact on effectiveness.
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