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At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Long-term outcome of learning and memory in children following severe closed head injury.

Seventeen children aged 5-16 years old (M = 11.3, SD = 2.97, Range= 6.25-16.00) were assessed between 4-5 years post-severe closed head injury, using the Wide Range Assessment of Memory and Learning (WRAML). Compared to age and sex matched controls, this group demonstrated deficits in the ability to learn new information, particularly their rate of learning. Deficits were more apparent with verbal than visual material. There were no indications of differences in delayed recall as measured by the amount of information lost nor in recognition memory. Results indicate that retrieval deficits may be an important component of memory difficulties in severe closed head injury. Educational implications are considered.

Adolescent↗
PubMed2005

Early growth and adult health outcomes--lessons learned from the Helsinki Birth Cohort Study.

Slow growth during fetal life and infancy is often followed by accelerated weight gain in childhood. These patterns of growth seem to precede the development of coronary heart disease (CHD) and type 2 diabetes in adult life. Patterns of growth associated with CHD and type 2 diabetes in adult life are described based upon findings from the Helsinki Birth Cohort Study. We are beginning to understand that adult degenerative diseases are associated with different patterns of early growth. Yet it is not clear what optimal growth is and how it can be achieved. Most data suggest that the development of many non-communicable diseases involve a number of interactions including genetic ones. Therefore these diseases can best be focused upon from a life cycle perspective.

Child, Preschool↗
PubMedDate not supplied

Competency outcomes for learning and performance assessment. Redesigning a BSN curriculum.

In an atmosphere in which disgruntled students appeal to their legislators for intervention and faculty give few unsatisfactory clinical grades, the faculty of this state supported school of nursing began a two-step process to strengthen the assessment of students. The first step consisted of the appointment of a testing committee to provide faculty with ongoing assistance with test construction. The next concerned clinical evaluation.

Competency-Based Education↗
PubMed1998

Preventing nosocomial infections in the intensive care unit--lessons learned from outcomes research.

Patients in an ICU are at increased risk for a nosocomial infection. Infection control practices to reduce these risks have often been based on scant information. A recent trend to base infection control practices on actual patient outcome data has often provided surprising results. Basic measures such as good handwashing and appropriate patient isolation must be followed. Routine venous catheter placement does not increase the risk of bacteremia, and increases procedure morbidity. The role of different catheter dressings and antibiotic-impregnated catheters in reducing bacteremia is unclear. Nosocomial pneumonias and ventilator-associated pneumonia are common in the ICU. Outcome studies suggest that infrequent changes of ventilatory circuits do not increase the risk of ventilator-associated pneumonia, while allowing substantial cost savings. Manipulation of the pH or flora of the gastrointestinal tract seems to have little influence on patient outcomes, even if there may be a slight reduction in nosocomial pneumonias. Although large randomized trials may be outside the scope of hospital infection control programs and ICUs, any hospital should be able to implement outcomes-based studies of changes in infection control policies and procedures.

Cross Infection↗
PubMed1998

Improving end-of-life care in the intensive care unit: what's to be learned from outcomes research?

Current recommendations about the care of dying patients advise that healthcare professionals understand and respect the goals, priorities, needs, and suffering of each dying patient and have command of the skills and resources required to address these concerns. Studies of important features of terminal illness, current use and outcome of intensive care for the terminally ill, and interventions designed to improve the outcome of care for patients who die in ICUs are reviewed to examine discrepancies between recommendations and the reality of ICU care for dying patients. Evidence indicates that it is difficult to predict the time of death or determine patient preferences about treatment prior to death. The utilization of intensive care prior to death varies widely across the United States and is a function of available resources more than individual patient need or choice. The pattern of withdrawal of life-sustaining treatment also varies widely and does not seem to follow guidelines. Families of deceased patients report that care could be improved by increased attention to analgesia and communication. The largest interventional study, the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT), which provided physicians with information about patient prognosis and preferences for care, did not alter outcomes of end-of-life care. Smaller but successful interventional studies have included examination of an alternative team that provides care tailored to the needs of dying patients, a service tailored to promote family contact with the dying patient, and proactive consultation to facilitate care planning and communication with families. Research suggests that clinicians should be cognizant of the difficulty of predicting death and anticipate the need to change the goals of care as therapeutic trials fail; anticipate and treat bothersome symptoms of dying patients; recognize that family support and contact between the dying patient and family facilitate decision-making and acceptance of death; and facilitate the coordination of care and the development of alternative care teams in order to optimize end-of-life care.

Advance Care Planning↗
PubMed2006

A case for learning-centered curricula.

Nurses must be able to anticipate and manage the care of patients with complex conditions in a rapidly changing, highly technological health care environment. Yet many of today's nursing programs are failing to provide curricula to meet the changing needs of students who will work in that environment. Typical teacher-centered programs are content heavy and focus on what faculty want to teach, not what students need to learn. Learning-centered education shifts the focus from teaching to student learning. Learning-centered programs identify student learning outcomes that are reflective of current nursing practice, use authentic assessment, and provide learning experiences that move students toward the achievement of outcomes. This article describes the major benefits of a learning-centered curriculum, and a model depicts the dynamic relationship among learning experiences, assessment, and student learning outcomes. We also offer suggestions for nursing faculty who are considering the move from teacher-centered to learning-centered curricula.

Adult↗
PubMedDate not supplied

Use of cloze and contrast word procedures in repeated storybook reading: targeting multiple domains.

UNLABELLED: The purposes of this study were: (1) to implement an intervention approach for children with language and phonological impairments, targeting multiple linguistic domains within a unitary activity, and (2) to investigate whether any observed changes in selected outcome measures were associated with particular scaffolding procedures. The intervention approach employed a variety of scaffolding procedures (cloze procedures; cloze procedures with expansions; contrast words) within an interactive repeated storybook reading activity. It was delivered across 12 sessions to three kindergarten children with language and phonological impairments. Pre-treatment and post-treatment probes, together with treatment data, provided indices of the semantic and phonological complexity of the participants' utterances. Changes in complexity levels were observed in all participants. Associations between increases in outcome measures and use of particular scaffolding techniques were identified. LEARNING OUTCOMES: (1) The reader will learn a rationale for use of cloze procedures, cloze procedures with expansions, and contrast words during repeated storybook reading as an intervention for some children with both language and phonological disorders. (2) The reader will learn how to implement cloze procedures, cloze procedures with expansions, and contrast words during repeated storybook reading. (3) The reader will learn how various outcome measures (e.g., level of semantic complexity) may be used to track change in performance over time.

Articulation Disorders↗
PubMed1999

Evaluating assessment: the missing link?

BACKGROUND: Methods chosen for assessment and the manner in which they are applied are so intimately associated with how individuals learn that developing appropriate assessment strategies is a key part of effective curriculum development. THE ASSESSMENT CYCLE: We describe a four-stage assessment cycle identifying important steps in assessment. Each step is described in detail, stressing its key aspects, including: the need for clear assessment policy and strategy, the importance of assessment blueprints in planning assessment, the need for effective feedback when presenting results, and the essential, but often overlooked, need to evaluate the assessment process itself. EVALUATING ASSESSMENT: This final evaluation stage is the most important part of the assessment cycle and can be divided into four levels. The first level includes evaluating each question in the assessment, the second level is concerned with establishing validity and reliability, the third level centres on the assessment process and review of assessments by external examiners and the fourth level involves evaluation over several assessments. RELATING ASSESSMENT TO THE CURRICULUM: This long-term evaluation should examine whether existing assessments are congruent with the curriculum and relate to all facets of the students' learning experiences. This is particularly important in a curriculum where the learning outcomes of student-centred learning are emphasized. Changes in the assessment of postgraduate trainees and increasing emphasis on peer review of clinicians will raise the profile of these outcomes in undergraduate education.

Curriculum↗
PubMed2006

The effects of different forms of feedback on fuzzy and verbatim memory of science principles.

BACKGROUND: Previous models of the effects of feedback account for lower-order learning outcomes but do not adequately describe experimental findings for higher-order learning. AIMS: Based on a connectionist model of feedback effects, this investigation aims to show that feedback that allows only one learner response facilitates proposition-specific verbatim encoding, while feedback that requires the learner to try again on error facilitates relational fuzzy encoding. Sample and methods. Volunteer high school students were randomly assigned to one of 5 print-based lesson treatments that consisted of four science expository texts with adjunct inference-level questions covering science principles. The five treatments included delayed feedback, single-try immediate feedback, multiple-try immediate feedback, and two control treatments, questions without feedback, and text only. A post-test given 5 days after instruction was designed to measure both verbatim and fuzzy outcomes. RESULTS: Multiple-try immediate feedback was best for paraphrased post-test questions (fuzzy) and worse for verbatim post-test questions. CONCLUSIONS: Fuzzy trace theory complements a connectionist model of feedback, and may provide a fruitful approach for describing the effects of feedback on different learning outcomes.

Adolescent↗
PubMed2004

Simulation in undergraduate medical education: bridging the gap between theory and practice.

OBJECTIVE: To evaluate the use of simulation-based teaching in the medical undergraduate curriculum in the context of management of medical emergencies, using a medium fidelity simulator. DESIGN: Small groups of medical students attended a simulation workshop on management of medical emergencies. The workshop was evaluated in a post-course questionnaire. SUBJECTS: All Year 4 medical students allocated to the resuscitation rotation during the first half of 2002. MAIN OUTCOME MEASURES: Student perceptions of learning outcomes, the value of the simulation in the undergraduate curriculum and their self-assessed improved mastery of workshop material. RESULTS: A total of 33 students attended the workshop and all completed questionnaires. Students rated the workshop highly and found it a valuable learning experience. In all, 21 (64%) students identified teamwork skills as key learning points; 11 (33%) felt they had learnt how to approach a problem better, particularly in terms of using a systematic approach, and 12 (36%) felt they had learnt how to apply their theoretical knowledge in a clinical setting better. All 33 students were positive about the use of simulation in their training; 14 students wrote that simulation should be used more or should be mandatory in training; 5 students commented positively on the realism of the learning experience and a further 5 said they valued the opportunity to learn new skills in a safe environment. CONCLUSION: This study demonstrates that medical students value simulation-based learning highly. In particular, they value the opportunity to apply their theoretical knowledge in a safe and realistic setting, to develop teamwork skills and to develop a systematic approach to a problem. A medium fidelity simulator is a valuable educational tool in medical undergraduate education.

Attitude of Health Personnel↗
PubMedDate not supplied

Vocational and social outcomes of adults with chronic aphasia.

UNLABELLED: Vocational and social outcomes of rehabilitation, such as employment, Social Integration, and life satisfaction, are critical determinants of the usefulness of rehabilitation. The purpose of this study was to describe the employment status, Social Integration, and perceived life satisfaction of adults with chronic aphasia 2 years after discharge from an intensive treatment program. Among the 20 survey respondents, 62% of those who had been working prior to aphasia onset were also working at the time of follow-up. Those who were working before but not after onset had higher Home Integration scores. There was a relatively large perceived change in communication from clinic discharge to the 2-year follow-up. Eighty-five percent of the respondents indicated a positive life satisfaction rating. There was a significant positive relationship between Home Integration and life satisfaction ratings. The results are discussed in relation to other reports of employment and social outcomes for stroke and aphasia. LEARNING OUTCOMES: As a result of this activity, the participant will be able to: (1) identify factors that may contribute to the successful return to work for adults with chronic aphasia; (2) describe the vocational and social outcomes of a select group of adults with chronic aphasia after participation in an intensive treatment program; and (3) discuss future need areas in understanding vocational and social participation for adults with chronic aphasia after intervention.

Adult↗
PubMed2000

Development of a pharmacy residency program in home care.

A residency training program developed by a college of pharmacy in conjunction with a home care company is described. The 12-month program is based on the ASHP Residency Learning System and the goal statements and educational objectives of ASHP's accreditation standard for pharmacy practice residency training with emphasis in home care. Establishing the program involved identifying goals, objectives, and learning experiences consistent with the expected outcomes. Specific objectives for meeting goals in four categories--practice foundation skills, direct patient care, drug information and drug policy development, and practice management--were linked to expected program outcomes. Learning experiences that would lead to achievement of the program objectives and outcomes were selected and organized into one- to eight-week rotations (e.g., in acute care, care of pediatric patients, pain management, nutrition, patient education and counseling, and administration and practice management). Throughout the program, residents gain experience in pharmaceutical services and research. Skills in care planning and monitoring are emphasized, as is practicing pharmaceutical care in an interdisciplinary environment. Residents who have completed the program have found employment immediately as pharmacy managers of home infusion centers. Pharmacy residency training in home care provides the experience needed to function as a competent clinician and manager who can identify and solve problems to improve patient care.

Education, Pharmacy↗
PubMedDate not supplied

Perceptual ratings of vocal characteristics and voicing features in untreated patients with unilateral vocal fold paralysis.

UNLABELLED: This study used visual analog scales to obtain perceptual ratings of features of voice production in subjects with unilateral vocal fold paralysis (UVFP), including clarity of laryngeal articulation, consistency of loudness across the utterance and the voiced/voiceless distinction. Recordings of repeated /i/, /isi/, and /izi/ from subjects diagnosed with UVFP and control subjects were randomly re-recorded, and then rated by five listeners. Significant differences in ratings (Smirnov test, p < 0.01) were found between groups for "aphonia", "severity", "clarity of articulation", "overall loudness", "consistency of loudness" and "amount of effort". Four of five raters agreed on the accuracy of /s/ or /z/ productions for only 54% of the samples from the subjects with UVFP. Voiceless and voiced cognates were equally likely to be rated as inaccurate. Results suggested that these variables were sensitive to changes in voice production resulting from paralysis, and may be useful in measuring treatment outcomes and spontaneous recovery of function. LEARNING OUTCOMES: As a result of reading this manuscript the reader will (1) gain an understanding of types of perceptual scales and how to develop the set of vocal characteristics to be used in distinguishing patients with UVFP and those without, (2) learn which vocal characteristics listeners are able to use to successfully distinguish between patients with UVFP and those without and (3) understand the possible role for perceptual ratings in tracking changes in vocal characteristics in subjects over time following treatment or spontaneous recovery of function.

Adult↗
PubMed2004

So how do you feel about that? Assessing reflective practice.

Despite a lack of evidence base, reflective practice remains a central feature of education for many professional groups. In addition, current trends in learning, teaching and assessing require a robust alignment between learning outcomes and assessed course work [Active Learning Higher Educat. 2 (2002) 145)]. Varied definitions of what it means to be a 'reflective practitioner' and limited research make it difficult to know how and what to assess [Reflective Practice in Nursing, Blackwell Science]. Assessment of reflective practice frequently requires students to recount narratives about their practice and both formative feedback and assessment criteria make it clear that such narratives must demonstrate the students' application of appropriate and safe professional practice. This paper suggests that only three 'stories' are legitimate and identifies these as 'valedictory' 'condemnatory' and 'redemptive' This conclusion drawn is that the imperative to do well academically discourages students from engaging in honest and open reflection. This being the case, it may be argued that the assessment of reflective practice is a potential barrier to the personal growth and integrity that programmes are trying to nurture.

Clinical Competence↗
PubMed2006

Nociceptive plasticity inhibits adaptive learning in the spinal cord.

Spinal plasticity is known to play a role in central neurogenic pain. Over the last 100 years researchers have found that the spinal cord is also capable of supporting other forms of plasticity including several forms of learning. To study instrumental (response-outcome) learning in the spinal cord, we use a preparation in which spinally transected rats are given shock to the hind leg when the leg is extended. The spinal cord rapidly learns to hold the leg in a flexed position when given this controllable shock. However, if shock is independent of leg position (uncontrollable shock), subjects fail to learn. Uncontrollable shock also impairs future learning. As little as 6 min of uncontrollable shock to either the leg or the tail generates a learning deficit that lasts up to 48 h. Recent data suggest links between the learning deficit and the sensitization of pain circuits associated with inflammation or injury (central sensitization). Here, we explored whether central sensitization and the spinal learning deficit share pharmacological and behavioral features. Central sensitization enhances reactivity to mechanical stimulation (allodynia) and depends on the N-methyl-d-aspartate receptor (NMDAR). The uncontrollable shock stimulus that generates a learning deficit produced a tactile allodynia (Exp. 1) and administration of the NMDAR antagonist MK-801 blocked induction of the learning deficit (Exp. 2). Finally, a treatment known to induce central sensitization, intradermal carrageenan, produced a spinal learning deficit (Exp. 3). The findings suggest that the induction of central sensitization inhibits selective response modifications.

Analysis of Variance↗