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Alternate methods of teaching: use of self-learning packets.

Self-directed learning takes multiple forms, all of which allow a person to study at an individual pace and direction. By applying principles of adult learning and various other styles of learning, self-directed learning can be used as an alternative method of education. The focus of this article is one type of self-directed learning, self-learning packets. The step-by-step process of designing a self-learning packet is covered. Various methods of topic selection and the key components of self-learning packet design are included. Finally, the usefulness of alternative methods of education such as self-learning packets is examined by cost analysis.

Costs and Cost Analysis↗

CPR training without an instructor: development and evaluation of a video self-instructional system for effective performance of cardiopulmonary resuscitation.

Traditional classroom-based instruction of cardiopulmonary resuscitation (CPR) has failed to achieve desired rates of bystander CPR. Video self-instruction (VSI) is a more accessible alternative to traditional classroom instruction (TRAD), and it achieves better CPR skill performance. VSI employs a 34-min training tape and an inexpensive manikin. VSI combines simplified and reordered content focusing on the delivery of one-rescuer CPR with the 'practice-as-you-watch' approach of an exercise video. Performance of CPR skills immediately following VSI was compared to performance immediately following TRAD using an instrumented manikin, a valid and reliable skill checklist, and an overall competency rating. Compared with TRAD subjects, VSI subjects performed more compressions correctly (P < 0.001), more ventilations correctly (P < 0.001), and more assessment and sequence skills correctly (P < 0.001). TRAD subjects delivered twice as many compressions that were too shallow, and underinflated the lungs twice as often. VSI subjects were rated 'competent' or better 80.0% of the time, compared with TRAD subjects, who achieved this rating only 45.1% of the time (P < 0.001). TRAD subjects were rated to be 'not competent' in performing CPR nearly 10 times more often than VSI subjects (P < 0.001). Subjects 40 years of age and older performed better after VSI than after TRAD. Superior skill performance among subjects exposed to VSI persisted 60 days following training. VSI has the potential to reach individuals unlikely to participate in TRAD classes because of its greater convenience, lower cost, and training in about 0.50 h compared with 3-4 h for TRAD classes.

Adult↗

One-session therapist directed exposure vs two forms of manual directed self-exposure in the treatment of spider phobia.

Fifty-two patients with spider phobia, fulfilling the DSM-III-R criteria for simple phobia, were assessed with behavioral, physiological and self-report measures. They were randomly assigned to five different treatment conditions: (1) one session therapist-directed exposure (maximum 3 hours), (2) specific manual-based treatment in the home, (3) specific manual-based treatment at the clinic, (4) general manual-based treatment in the home and (5) general manual-based treatment at the clinic. The results show that therapist-directed one-session treatment was significantly more effective than three of the manual-based treatments, both at the post-treatment and follow-up stages. Specific manual-based treatment at the clinic was significantly more successful than the other manual-based treatments, but only at follow-up. The proportion of clinically significant improved patients at follow-up was 80% in the therapist-directed group compared to 63% for the specific manual-based treatment at the clinic, 10% for specific manual-based treatment in the home, 9% for general manual-based treatment in the home, and 10% for general manual-based treatment at the clinic. The conclusion that can be drawn is that one-session therapist-directed treatment is the treatment of choice for spider phobia but manual-based treatment is a good alternative in some cases.

Adolescent↗

Efficacy of a minimal contact version of a multimodal smoking cessation program.

A five-week multimodal smoking cessation program was delivered in two formats: Weekly Contact Group meetings led by graduate student leaders versus a minimal contact By-Mail version consisting of weekly mailings of program materials. By-Mail subjects also had access to a "hotline" number they could call with questions and problems. Of 43 smokers who began the Contact Group program, 37% were abstinent at one-year follow-ups; 41% of the 49 By-Mail subjects were abstinent at one year. These results suggest that cost effective minimal contact cessation programs can benefit the many smokers who are unwilling or unable to visit cessation clinics.

Adult↗

Development of transferable skills during short special study modules: students' self-appraisal.

Special study modules (SSMs) were introduced into the Leeds undergraduate medical curriculum following recommendations by the General Medical Council (GMC). The main rationale behind such project work is to enable students to develop the skills and attitudes necessary for future self-directed learning along with the knowledge required to practise as competent doctors. At the University of Leeds, the students complete SSM monitoring forms for each SSM in the fourth year, aimed at allowing students to self-evaluate the SSMs. In addition, it provides useful feedback from the students on the themes of the projects as well as on the transferable skills developed by the students during their individual SSMs. The aim of the study was to identify the themes pursued in each project, look at the transferable skills developed and evaluate the differences or similarities between the type of project pursued and the themes and skills identified in the different specialities. A total of 181 monitoring forms of fourth-year students were analysed for the themes and the transferable skills identified. There were 55 students each in Obstetrics and Gynaecology and Paediatrics and 50 students each in Psychiatry and General Practice/Public Health. The results from the four specialities were compared for themes and skills identified. Overall, health and prevention was the commonest theme identified followed by communication skills (64.4% and 62.7% respectively). All transferable skills were well represented in the different specialities with information gathering and learning/organizational skills identified by most students as the major component. The feedback from the students is positive in terms of a wide range of transferable skills developed and most of the themes identified by the GMC are being pursued.

Clinical Competence↗

Using a self-learning module to teach nurses about caring for hospitalized children with tracheostomies.

The purpose of this study was to determine the effectiveness of using a self-learning module (SLM) to teach nurses about caring for hospitalized children with tracheostomies. Data analysis using an independent samples t test showed that statistically significant learning occurred after completion of the SLM (p = 0.014, n = 85). These findings can influence the way staff education is provided, giving the nurse educator an alternative, cost-effective, and timesaving method of presenting information.

Child↗