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Learning to cope and living with cancer. Learning-needs assessment in cancer patient education.

Giving of information to cancer patients and their family members regarding the disease, the treatment procedures and the adaptation process for living with the uncertainty inherent in a diagnosis of cancer, is as reported often not effective due to peoples' failure to understand. The impact of emotional stress creates communication difficulties. Information not based on assessed learning needs and considered individual differences as to learning militates against proper understanding. In developing an educational programme a study has been carried out aiming to assess learning needs. Cancer patients (n = 50), their family members (n = 20) and staff members within cancer care (n = 30) were asked to answer a need assessment questionnaire. The patients/family members indicated an extensive desire to learn about cancer and its ramifications, whereas staff members indicated that they seldom were approached regarding some questions in the area. The findings support the appropriateness for providing a structured patient education programme based on assessed needs and planned to meet individual differences in learning readiness and learning capabilities, that would complement the information currently given by staff members.

Adaptation, Psychological↗

[A plan of the life-long learning support system of UOEH--possibility for the introduction of distance learning system by the Internet].

In order to keep up with the rapid advance in knowledge and skills in various industrial sectors, the needs for the life-long learning has increased recently. This is also the case for the University of Occupational and Environmental Health, Japan, which has as its aim the education of occupational health specialists. In fact, there are many universities and colleges which have organized some post-graduate courses for the workers. However, most of these courses are for workers who can come to classes in the daytime or evening. In the case of UOEH, it is not enough to organize such type of classes in order to respond to the social needs, because it has to offer an opportunity of life-long learning for all occupational health specialists in all parts of Japan. In order to solve this problem, it is recommended that a distance learning system based on modern information technology such as the internet be organized. In this report, the authors present the distance learning system of Wisconsin University in the USA, and that of Tamagawa Gakuen University of Japan. After evaluating these two systems, a plan for a life-long learning support system of UOEH is suggested, which consists of a distance learning system based on the internet.

Education, Continuing↗

Learning in the Place navigation task, not the New-learning task, is altered by prenatal methamphetamine exposure.

Adult rats (prenatally methamphetamine-exposed, saline-exposed and controls) were tested for learning in the Morris water maze. Rats were tested in 4 consecutive days using two different types of learning tests: "Place navigation test" (stable platform position) and "New-learning test" (platform position changed daily). Males exposed prenatally to methamphetamine were slower in the Place navigation learning test than were both the control and saline-exposed males. There were no differences in the New-learning test between groups.

Amphetamine-Related Disorders↗

Why children learn color and size words so differently: evidence from adults' learning of artificial terms.

An adult simulation study examined why children's learning of color and size terms follow different developmental patterns, one in which word comprehension precedes success in nonlinguistic matching tasks versus one in which matching precedes word comprehension. In 4 experiments, adults learned artificial labels for values on novel dimensions. Training mimicked that characteristic for children learning either color words or size words. The results suggest that the learning trajectories arise from the different frames in which different dimensions are trained: Using a comparison (size-like) training regimen helps learners pick out the relevant dimension, and using a categorization (color-like) training regimen helps the learner correctly comprehend and produce dimension terms. The results indicate that the training regimen, not the meanings of the terms or the specific dimensions, determines the pattern of learning.

Adult↗

Profiles of effective tutors in problem-based learning: scaffolding student learning.

OBJECTIVES: Research on tutoring in problem-based learning has not focused so far on the variation in tutoring and how this variation can be interpreted by conceptions about effective tutoring. DESIGN: This study focuses on the profiles of tutors generated by means of an instrument, the so-called Tutor Intervention Profile (TIP), and tries to determine which profiles are more or less effective. The TIP contains four dimensions of tutor behaviour: (1) elaboration; (2) directing the learning process; (3) integration of knowledge; and (4) stimulating interaction and individual accountability. SETTING: The medical school of the University of Maastricht, The Netherlands. SUBJECTS: Sixty-seven tutors who run 67 tutorial groups across three units (courses) in the academic year 1996-97. RESULTS: It appeared that high, average and low performing tutors differ in their performance on each of the four dimensions of the TIP. Several different profiles of tutor performance could be distinguished, which were more or less effective. One group of tutors demonstrated a tutor intervention profile that was characterized as relying more on the use of expert knowledge, whereas another group of tutors was characterized as relying more on their abilities to stimulate the learning process in the tutorial group. The tutor intervention profile that was perceived by students as most effective showed high scores on each of the four dimensions, as expected. Notably, a tutor stressing the learning process in the tutorial group was perceived as more effective than a tutor stressing content (expert tutor). This is especially true for a relatively poor scoring tutor. CONCLUSIONS: The results of this study are consistent with research on human tutoring and research on tutoring in problem-based learning.

Educational Measurement↗

Temporo-frontal disconnection impairs visual-visual paired association learning but not configural learning in Macaca monkeys.

Cynomolgus monkeys were tested in two computer-controlled visual associative memory tasks. The monkeys chose between visual objects on a screen by touching one. In the configural learning task one correct object and one wrong object were presented in each trial. Each of these two objects was composed of two coloured alphanumeric characters abutted together. The designation of the objects as 'correct' or 'wrong' followed a configural rule: e.g. if AB and CD are correct objects then AD and CB are wrong. In the paired association learning task in each trial three spatially separate objects (single alphanumeric characters) were presented. The central object was an instruction cue and the designation of the side objects as 'correct' or 'wrong' choices followed a paired association rule: e.g. if A, C and B are presented (C in the centre) then A is correct and B is wrong; however, if A, D and C are presented then C is correct and A is wrong. Disrupting the direct cortico-cortical interaction between the inferior temporal cortex and the prefrontal cortex by uncinate fascicle transection led to a learning deficit in the paired association task but not in the configural task. These results suggest that the uncinate fascicle facilitates visual-visual associative learning only in the specific case where a visual object acts as an instruction cue to guide the conditional choice of another, spatially separate object, and they support the evidence for a specific role of the uncinate fascicle in the learning of conditional tasks with visual instruction cues.

Animals↗

Evidence of nonverbal learning disability among learning disabled boys with sensory integrative dysfunction.

The presumed sensorimotor basis of the nonverbal learning disability syndrome was investigated among 90 learning disabled boys (M age = 6 yr., 8 mo., SD = 12.2 mo.) with sensory integrative dysfunction. The majority of the boys were Caucasian, lower to middle socioeconomic status, and from urban, English-speaking families. 14% (n = 13) of the boys satisfied core discrepancy criteria for nonverbal learning disability, including both a significantly higher Wechsler Verbal than Performance IQ and a higher standard score in Reading than Arithmetic on the Wide Range Achievement Test. Compared with a control group of 19 boys from the same sample who had no significant discrepancies, boys with nonverbal learning disability had significantly greater weaknesses in space visualization and visuomotor coordination. As predicted, rote verbal memory and syntactical strengths were also exhibited by boys with nonverbal learning disability, but the two groups did not differ significantly.

Child↗

Creating a virtual community of learning predicated on medical student learning styles.

UNLABELLED: To create a virtual community of learning within the Indiana University School of Medicine, learning tools were developed within ANGEL to meet the learning needs and habits of the medical students. METHODS: Determined by student feedback, the integration of digital audio recordings of class lectures into the course management content with several possible outputs was paramount. The other components included electronic enhancement of old exams and providing case-based tutorials within the ANGEL framework. RESULTS: Students are using the curriculum management system more. Faculty feel more secure about their intellectual property because of the authentication and security offered through the ANGEL system. The technology applications were comparatively easy to create and manage. The return on investment, particularly for the digital audio recording component, has been substantial. CONCLUSION: By considering student learning styles, extant curriculum management systems can be enhanced to facilitate student learning within an electronic environment.

Audiovisual Aids↗

Genetic differences in avoidance learning by Rattus norvegicus: escape/avoidance responding, sensitivity to electric shock, discrimination learning, and open-field behavior.

The behaviors of rats selectively bred for either good or poor shuttle box avoidance learning were studied. The results of Experiment 1 indicated that the phenotypic difference in avoidance learning is not associated with differences in speed of escape or avoidance responding. Differences between the lines in frequency of intertrial responses (ITRs), which appear during training but not during pretest, suggest that ITRs in animals of the low-avoidance (SLA) line are more suppressed by electric shock than in animals of the high-avoidance (SHA) line. This result suggests that SLA animals may be more emotionally responsive than SHA animals. Experiment 2 demonstrated that the animals of the two lines do not differ in absolute sensitivity to electric shock, and Experiment 3 showed that the poor performance of the SLA line is not due to an inability to learn. Experiment 3 also provided evidence which suggests that the poor avoidance learning by SLA animals is due to their emotional reactivity. Observations of open-field behavior in Experiment 4 are consistent with this hypothesis. The major consistent correlate of the phenotypic difference in avoidance learning is greater emotionality or emotional reactivity in SLA than in SHA animals.

Animals↗

Severity of cognitive impairment in Alzheimer's disease affects list learning using the California Verbal Learning Test (CVLT).

Impairment in list learning is considered a primary symptom of Alzheimer's disease (AD), yet there are no published reports examining the relationship between list learning and severity of cognitive impairment. We gave nine-item and 16-item versions of the California Verbal Learning Test (CVLT; Delis et al., 1987), a standardized shopping list assessment of memory, to 24 AD patients (mean age = 76.2 +/- 8.1; mean years of education = 13.8 +/- 2.4), who were stratified into four groups based on MMSE scores (mean = 16.0 +/- 5.6). ANOVAs revealed severity effects for total list learning (p < 0.001), the first trial (p < 0.001), the last trial (p < 0.001) and short- and long-delay recall measures. Most of these differences seemed due to floor effects. For example, the modal number of words recalled after a delay was 0 by subjects with MMSE scores below 21. Severity of cognitive impairment was associated with the proportion of intrusions such that the most severely demented subjects gave almost entirely intrusion responses. Surprisingly, list length did not significantly affect any of the free recall measures. Our results suggest that list learning and recall seem to be lost relatively early in AD. Measures of list recall like the CVLT may not be useful in tracking severity of cognitive impairment over time.

Aged↗

Approaches to learning spatial relationships in gross anatomy: perspective from wider principles of learning.

When students learn spatial relationships in gross anatomy, as in other areas of study, fundamentals should be learned first; otherwise confusion results. The fundamentals in gross anatomy are defined not in conceptual terms but by principles of visual perception. In particular, they derive from Gestalt principles such as collinearity and symmetry, which generally make learning and recognition of visual patterns easier. The collinearity (straight line formations) and symmetry in the body cavities are obvious when one studies the empty cavities, or body cavities with only a few symmetrical structures in place. These principles are, however, totally obscured if one starts one's study, as in traditional dissection, with the body cavities crammed full of a complex mass of interlocking organs. and their ducts, vessels, etc. Therefore, it is recommended that learning gross anatomy (especially of the body cavities) would be an easier exercise if it started with empty body cavities, then building up, with a careful sequence of prosections, to the more complex and realistic anatomy of the full cavities. This system of learning is perceptually preferable to traditional dissection. However, it needs to be enlivened in several ways, e.g., with respect to design principles evident in anatomical structure (especially for the musculoskeletal system), developmental processes, and sometimes by explicit reference to clinical relevance.

Anatomy↗

Adults with self-reported learning disabilities in Slovenia: findings from the international adult literacy survey on the incidence and correlates of learning disabilities in Slovenia.

This study of adults with self-reported learning disabilities (SRLD) in Slovenia is part of a larger secondary analysis of the data from the International Literacy Survey project (IALS). The purpose of the study was to examine the characteristics of 79 (2.68%) individuals who reported experiencing learning disabilities and compare them to the general population on a variety of indicators of educational background, employment status, and reading and writing activities at work and at home. The proficiency scores of the SRLD individuals were lower in all three literacy domains (prose, document and quantitative literacy). In prose literacy 77.9% of SRLD adults performed at Level 1 and only 7.8% reached the level necessary for a modern technological society. Experiencing learning disabilities was not related to gender or age, however, results showed significant differences between the levels achieved by older and younger people with SRLD. In SRLD groups aged 40 years and above, no one achieved more than the second level of literacy in any domain. Learning disabilities were reported more frequently in rural areas. SRLD groups achieve significantly lower educational attainment, and lower employment status, with a preference for manual labour or craft. These findings are of critical importance. SRLD people report that poorer literacy skills are an obstacle to their progression in employment. In the Slovene sample, the SRLD group stands out for low scores in quantitative literacy. Results show that they are less active, pick up information only auditorily or in short written form. They need more frequent help from relatives in literacy activities. Interpretation of the IALS data on SRLD presents many problems. These include amongst others, problems in terminology, different background factors, and the validity of self-report measures. However, the study also raises many interesting challenges for future research and policy. Increasing the availability of support, assistance and counselling for adolescents and adults with learning disabilities remains a very important goal for dyslexia and LD policies in Slovenia.

Adolescent↗

Leg position learning by an insect. I. A heat avoidance learning paradigm.

A new learning paradigm which employs a natural aversive stimulus, tightly constrains learned behavior and demonstrates learning in individual animals is described. Locusts were restrained so that only the femoro-tibial joint of a single metathoracic leg was free to move. Animals were required to maintain a particular range of femoro-tibial joint angle to avoid heating of the head. The position of the tibia was sampled by an on-line computer which set the limits of joint angle and controlled the aversive stimulus while storing data for further analysis. Control animals received patterns of aversive stimuli identical to those received by experimental animals but independent of their own joint position. Quantitative evaluation of the learned behavior of individual animals allowed the identification of three different behavioral strategies by which learning was achieved.

Animals↗

Possible role of intramembrane receptor-receptor interactions in memory and learning via formation of long-lived heteromeric complexes: focus on motor learning in the basal ganglia.

Learning in neuronal networks occurs by instructions to the neurons to change their synaptic weights (i.e., efficacies). According to the present model a molecular mechanism that can contribute to change synaptic weights may be represented by multiple interactions between membrane receptors forming aggregates (receptor mosaics) via oligomerization at both pre- and post-synaptic level. These assemblies of receptors together with inter alia single receptors, adapter proteins, G-proteins and ion channels form the membrane bound part of a complex three-dimensional (3D) molecular circuit, the cytoplasmic part of which consists especially of protein kinases, protein phosphatases and phosphoproteins. It is suggested that this molecular circuit has the capability to learn and store information. Thus, engram formation will depend on the resetting of 3D molecular circuits via the formation of new receptor mosaics capable of addressing the transduction of the chemical messages impinging on the cell membrane to certain sets of G-proteins. Short-term memory occurs by a transient stabilization of the receptor mosaics producing the appropriate change in the synaptic weight. Engram consolidation (long-term memory) may involve intracellular signals that translocate to the nucleus to cause the activation of immediate early genes and subsequent formation of postulated adapter proteins which stabilize the receptor mosaics with the formation of long-lived heteromeric receptor complexes. The receptor mosaic hypothesis of the engram formation has been formulated in agreement with the Hebbian rule and gives a novel molecular basis for it by postulating that the pre-synaptic activity change in transmitter and modulator release reorganizes the receptor mosaics at post-synaptic level and subsequently at pre-synaptic level with the formation of novel 3D molecular circuits leading to a different integration of chemical signals impinging on pre- and post-synaptic membranes hence leading to a new value of the synaptic weight. Engram retrieval is brought about by the scanning of the target networks by the highly divergent arousal systems. Hence, a continuous reverberating process occurs both at the level of the neural networks as well as at the level of the 3D molecular circuits within each neuron of the network until the appropriate tuning of the synaptic weights is obtained and, subsequently, the reappearance of the engram occurs. Learning and memory in the basal ganglia is discussed in the frame of the present hypothesis. It is proposed that formation of long-term memories (consolidated receptor mosaics) in the plasma membranes of the striosomal GABA neurons may play a major role in the motivational learning of motor skills of relevance for survival. In conclusion, long-lived heteromeric receptor complexes of high order may be crucial for learning, memory and retrieval processes, where extensive reciprocal feedback loops give rise to coherent synchronized neural activity (binding) essential for a sophisticated information handling by the central nervous system.

Animals↗

Modeling perceptual learning with multiple interacting elements: a neural network model describing early visual perceptual learning.

We introduce a neural network model of an early visual cortical area, in order to understand better results of psychophysical experiments concerning perceptual learning during odd element (pop-out) detection tasks (Ahissar and Hochstein, 1993, 1994a). The model describes a network, composed of orientation selective units, arranged in a hypercolumn structure, with receptive field properties modeled from real monkey neurons. Odd element detection is a final pattern of activity with one (or a few) salient units active. The learning algorithm used was the Associative reward-penalty (Ar-p) algorithm of reinforcement learning (Barto and Anandan, 1985), following physiological data indicating the role of supervision in cortical plasticity. Simulations show that network performance improves dramatically as the weights of inter-unit connections reach a balance between lateral iso-orientation inhibition, and facilitation from neighboring neurons with different preferred orientations. The network is able to learn even from chance performance, and in the presence of a large amount of noise in the response function. As additional tests of the model, we conducted experiments with human subjects in order to examine learning strategy and test model predictions.

Humans↗

Medical students' mindset for reflective learning: a revalidation study of the reflection-in-learning scale.

The aims of this paper are to examine the measurement properties of the Reflection-in-Learning Scale (RLS) and to identify whether there are relationships between RLS scores early in the medical program and outcomes of the students' academic activity later on. The 14-item RLS was administered to second-year students (N = 275) at start and at end of the third semester, after the students had reviewed their previous learning experience with the Course Valuing Inventory. The internal consistency, temporal stability and dimensionality of the RLS scores were investigated in relation to the start-end perspectives. Furthermore, a 2-year follow-up allowed the assessment of the relationships of third-term RLS scores with sixth-term measures of both academic achievement and diagnostic reasoning as appraised by the Diagnostic Thinking Inventory (DTI). Findings indicate that RLS data have acceptable unidimensionality and consistency of measurement, notwithstanding a significant individual-context interaction. Repeated measures revealed distinct patterns of RLS scores relating to perceived self-efficacy on the ability to reflect. Third-term RLS scores were significant, albeit weak, predictors of sixth-term cognitive achievement and DTI-related diagnostic reasoning ability. In conclusion, the results do not support a major explanatory role for RLS on knowledge representation. Nevertheless, the findings appear to substantiate the construct validity of this tool as an index of the students' frame of mind as regards reflective learning. They suggest that the RLS captures a self-regulation or cognitive housekeeping dimension of the students' reflective learning. The individual pattern of such (reflective) activity is likely to vary with specific learning conditions.

Adolescent↗

Spatial learning, discrimination learning, paw preference and neocortical ectopias in two autoimmune strains of mice.

NZB and BXSB mice were given a battery of behavioral tests including paw preference, water escape, Lashley III maze, and discrimination learning. Their brains were then evaluated for cortical ectopias. The incidence of ectopias was 40.5% in NZBs and 48.5% in BXSBs. In the NZB strain left-pawed ectopic mice (both male and female) had the fastest swimming time in the water escape test, while right-pawed ectopics were the slowest. The same findings were obtained for left- and right-pawed ectopic BXSB males, but not for the females. However, on discrimination learning the BXSB males had the exact opposite pattern: right-pawed ectopics were the best learners while left-pawed ectopics were the worst. Male BXSBs and both male and female NZBs were manifesting autoimmune disease at the time of testing, while female BXSBs were not, suggesting that autoimmunity is a necessary background condition for the differential expression of ectopias and paw preference upon learning processes. The finding that the left-pawed ectopic BXSB mice, who were the poorest learners in the non-spatial discrimination learning test, learned best in the spatial water escape test is in agreement with the Geschwind hypothesis that pathological events during brain development may, in some instances, produce superiority of function.

Animals↗

Nurse Education Tomorrow Conference 1990. How nurses learn and how to improve the learning environment.

This paper considers some of the evidence that can help nurse teachers more effectively prepare nurses for practice. In particular it is concerned with how students learn and how teachers can improve the learning environment. There are four main sections to the paper. The first looks at learning styles and considers the importance of matching teaching style to the learning style of the student. The second section considers the research into the process of integrating theory and practice in nursing education and the relationship between theory, the classroom and the clinical area. The next section of the paper looks at factors influencing the process of becoming a nurse. Socialising agents such as people and techniques are reviewed in the light of research evidence from nursing and similar professions. Finally the paper represents a series of ways in which it is possible to assess and improve the learning environment for the student nurse, including human aspects, equipment and information.

Education, Nursing↗