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PubMed2005

Attitude towards computer-based learning: determinants as revealed by a controlled interventional study.

BACKGROUND: Curriculum-wide implementation of computer-based learning (CBL) in undergraduate medical education remains elusive. Unlike many pilot tests of singular learning programmes, dropout rates are high and acceptance seems low in the long run. We studied the effect of a new CBL programme, suitable for curriculum-wide implementation, on Year 3 medical students' attitudes towards CBL. METHODS: Students from 2 universities participating in a mandatory pharmacology course were given access to a CBL programme covering cardiovascular drug therapy in a controlled randomised study (n = 167). Learner properties and attitude towards CBL were measured using psychometric scales, and knowledge by multiple-choice questions (pre- and post-test). RESULTS: Attitude towards CBL worsened in the CBL group (n = 70). Individual learners' properties did not explain this effect. The perceived programme quality was rated only 'average', which may contribute to the lower post-test values of attitude towards CBL. Learning outcomes were similar between the control group (n = 97) and students using CBL (n = 44). Learning efforts were shifted from self-study towards CBL. CONCLUSION: The initial enthusiasm of students was not maintained when using a programme designed to complement or even replace traditional teaching. Curriculum-wide implementation of CBL might be hampered by the discouragement of users.

Attitude of Health Personnel↗

PubMed2007

Medical students' learning of anatomy: memorisation, understanding and visualisation.

INTRODUCTION: There is much subjective discussion, but few empirical data that explore how students approach the learning of anatomy. AIMS: Students' perceptions of successful approaches to learning anatomy were correlated with their own approaches to learning, quality of learning and grades. METHODS: First-year medical students (n = 97) studying anatomy at an Australian university completed an online survey including a version of the Study Process Questionnaire (SPQ) that measures approaches to learning. The quality of students' written assessment was rated using the Structure of Observed Learning Outcomes (SOLO) taxonomy. Final examination data were used for correlation with approaches and quality of learning. RESULTS: Students perceived successful learning of anatomy as hard work, involving various combinations of memorisation, understanding and visualisation. Students' surface approach (SA) scores (mean 30 +/- 3.4) and deep approach (DA) scores (mean 31 +/- 4.2) reflected the use of both memorisation and understanding as key learning strategies in anatomy. There were significant correlations between SOLO ratings and DA scores (r = 0.24, P < 0.01), between SA scores and final grades (r = - 0.30, P < 0.01) and between SOLO ratings and final grades (r = 0.61, P < 0.01) in the subject. CONCLUSIONS: Approaches to learning correlate positively with the quality of learning. Successful learning of anatomy requires a balance between memorisation with understanding and visualisation. Interrelationships between these three strategies for learning anatomy in medicine and other disciplines require further investigation.

Anatomy↗

PubMed2006

The outcomes of partnerships with mental health service users in interprofessional education: a case study.

This paper reports findings from a 5-year evaluation (1998-2003) of a postqualifying programme in community mental health in England which made a sustained attempt to develop partnerships with service users. Users were involved in the commissioning of the programme and its evaluation, as trainers and as course members. The evaluation employed mixed methods to assess: learners' reactions to user-trainers and users as course members; changes in knowledge, attitudes and skills; and changes in individual and organisational practice. Data were collected from participant observation of training, 23 individual and 18 group interviews with students and their managers (n=13), and student ratings of knowledge and skills at the beginning and end of the programme (n=49). The quality of care provided by students was rated by service users (n=120) with whom they worked, using a user-defined questionnaire. The quality of care, and mental health and quality of life outcomes were compared to those for two comparison groups (n=44) in areas where no training had taken place. In general, the students reported positive learning outcomes associated with the partnership orientation of the programme, and learning directly from and with service users. A higher proportion of programme users reported good user-centred assessment and care planning, and showed greater improvement in life skills compared to the comparators. This case study provides evidence of the value of partnership working with service users in interprofessional postqualifying education in mental health. The success is attributed to the design of the programme and the responsiveness of the programme board, which included service users. It may provide a useful model for programmes elsewhere and for other user groups. The case study itself provides a possible model for the systematic evaluation of partnerships with users in education and training.

Community Mental Health Services↗

PubMed2005

Embedding cancer care within pre-registration nurse education programmes: policy, practice and opportunities for change.

This paper discusses policy and professional drivers which outline the need for, and inclusion of cancer education within pre-registration nursing curricula within the UK. It also evaluates arguments in favour of the development of separate and distinctive cancer modules within nurse training programmes against those advocating a more integrated or thematic approach. The authors suggest that there are advantages and disadvantages to each strategy, and argue that the most important factor irrespective of the approach taken, is that cancer learning outcomes are clearly enunciated within all pre-registration nursing curricula and constructively aligned against teaching, learning and assessment strategies which may encompass a single module or entire programme. The authors then discuss their personal experience of teaching cancer care using both approaches and posit one suggestion for an embedded pre-registration cancer-care curriculum developed as the catalyst for a broader debate on the scope and content of cancer-care education within pre-registration nursing curricula.

Curriculum↗

PubMed2005

Using simulation-based training to improve patient safety: what does it take?

BACKGROUND: Through simulations health care workers can learn by practicing skills taught and experiencing mistakes before interacting with an actual patient. A number of areas within the health care industry are currently using simulation-based training to help individuals and teams improve patient safety. WHAT IS SIMULATION-BASED TRAINING? The key components of simulation-based training are as follows: performance history/skill inventory, tasks/competencies, training objectives, events/exercises, measures/metrics, performance diagnosis, and feedback and debrief. WHAT DOES IT TAKE FOR SIMULATION-BASED TRAINING TO BE EFFECTIVE? To be effective, simulation-based training must be implemented appropriately. The guidelines are as follows: understand the training needs and requirements; instructional features, such as performance measurement and feedback, must be embedded within the simulation; craft scenarios based on guidance from the learning outcomes; create opportunities for assessing and diagnosing individual and/or team performance within the simulation; guide the learning; focus on cognitive/psychological simulation fidelity; form a mutual partnership between subject matter experts and learning experts; and ensure that the training program worked. CONCLUSION: The health care community can gain significantly from using simulation-based training to reduce errors and improve patient safety when it is designed and delivered appropriately.

Guidelines as Topic↗

PubMedDate not supplied

Teaching stoma-management skills: the importance of self-care.

Patients undergoing stoma formation have to make major physical and psychological adjustments following surgery. Research indicates that the early promotion of stoma-management skills is, therefore, a critical concern for the hospital-based stoma care nurse. This article aims to explore how the stoma care nurse specialist can best utilize teaching opportunities in the pre- and post-operative periods. Teaching should be approached in an organized manner, underpinned by sound principles of teaching and learning using teaching plans where appropriate to ensure that no vital aspects are omitted. Realistic learning outcomes should be established in consultation with the patient according to his/her readiness and ability to learn. An organized exchange of information between hospital and community will ensure that teaching and support are continued following discharge from hospital promoting positive adjustment to stoma formation and thus facilitating successful rehabilitation.

Humans↗

PubMed2002

An interactive, student-centered approach, adopting the SOLO taxonomy, for learning to analyze laboratory data in veterinary clinical pathology.

INTRODUCTION: The purpose of this study was to describe and evaluate an interactive, student-centered teaching strategy for learning to analyze laboratory data in veterinary clinical pathology. The strategy was designed to operate in tutorials of approximately one hour duration and adopted the structure of the observed learning outcome (SOLO) taxonomy in order to align with outcomes and assessment components of unit of study design and to encourage a deep approach to learning. METHODOLOGY: The teaching strategy adopted group discussion and reflective observation as core activities. Students worked alone in identifying abnormal laboratory data, in pairs in discussing possible reasons for the abnormalities, and in two larger groups in deciding on conclusions for, and further investigation and management of, the case. The final debriefing brought the two groups together to reflect, question, and reach a consensus about the case. The teaching strategy was evaluated on the basis of its success in encouraging interaction through discussion, developing self confidence in analyzing laboratory data, and enhancing understanding as to how the disciplines of veterinary clinical pathology and veterinary medicine interrelate. Evaluation used self-reflection, peer feedback, and a student questionnaire. CONCLUSION: The teaching strategy provided the opportunity for students to develop and practice an approach to the analysis of laboratory data in a manner consistent with current educational thinking on student-centered learning. The use of group discussion and significant reflective practice not only enhanced interpersonal skills but also encouraged a deep approach to learning, leading to ownership of knowledge and increased awareness of the worth of veterinary clinical pathology in the investigative process.

Animals↗

PubMedDate not supplied

Using metacognition to promote certification success: the Testing Health Promotion Plan.

Metacognition, the process of knowing one's personal learning behaviors, is a powerful force in the educational repertoire of nursing staff development faculty who seek to promote optimal learning outcomes for practicing nurses. Metacognition also supports major goals of educational evaluation which include improvements in learning, instruction, and performance. In this article, metacognition is scrutinized from the perspectives of learning theory and memory processing. Implications for promoting successful certification results are presented.

Certification↗

PubMed1996

Developing behavioral objectives for perioperative staff development.

Behavioral objectives (i.e., clear statements that describe intended instructional outcomes) are a crucial component of educational planning for perioperative staff development. Properly written objectives promote positive learning outcomes such as increased motivation, better retention of information, and improved instructional accountability. This article describes the advantages of using behavioral objectives, gives a historical perspective of their development, presents a practical "how-to" approach to formulating them, and delineates their link to the selection of appropriate evaluation methods.

Behavior↗

PubMed2005

Marking criteria for assessing practice-based portfolios at masters' level.

Whilst portfolios have increasingly been used to assess attainment and competence in nursing and other health care professions for over a decade, the assessment processes and criteria for assessing them have remained largely rudimentary and undeveloped. In fact, assessment often remains localised, impressionistic and dependent upon the interpretation and adaptation of criteria developed generically for work at this level within individual Higher Education Institutes (HEIs). This paper presents Masters' level marking criteria for portfolios from practice-based healthcare disciplines developed from the Quality Assurance Agency (QAA) descriptors of Masters level achievement and graduateness [Quality Assurance Agency for Higher Education, 2001. The Framework for Higher Education Qualifications in England, Scotland, Northern Ireland] in combination with practice-based outcomes. A six-stage methodology was devised to analyse these descriptors, develop, re-order, test and refine them in order to enhance their applicability to portfolios from practice-based disciplines. As part of this process the emerging criteria were tested against existing portfolios. Extracts from these are presented to illustrate the criteria. Two case study sites from diverse areas of England are used where Masters' courses in nursing and healthcare disciplines are offered. For portfolios to be effective in demonstrating Masters' level academic criteria, learning outcomes and advanced professional practice they need to demonstrate coherent structure, conclusions drawn from reflection on practice and a body of evidence that is coherent with, and linked to their reflective commentaries. The marking criteria presented to assess these attributes incorporate features of the structures, processes and outcomes of both practice and learning. The strategy can be used by both assessors and students, in formative and summative assessment, to identify student attainments, strengths and weaknesses.

Education, Nursing, Graduate↗

PubMed2002

Student--teacher connection in clinical nursing education.

BACKGROUND: The trend toward humanistic nursing education has called for a transformed student-teacher relationship that fosters learning and growth of students and teachers. Although such a relationship has been claimed to form the basis for student-teacher connection and to be a positive influence on students' learning outcomes, there is a paucity of research exploring these claims. Neither the nature of student-teacher connection nor the processes by which it occurs have been described. AIMS: A research study was undertaken to explore and describe undergraduate nursing students' experiences of connection within the student-teacher relationship and the effects of student-teacher connection on students' learning experiences in clinical nursing education. RESEARCH DESIGN: The qualitative research approach of interpretive description was chosen for this study. Unstructured interviews and a focus group were used to collect data from eight undergraduate nursing students. Data were analysed using the process of constant comparative analysis, and revealed four interrelated major categories that formed a description of the students' experience of student-teacher connection. FINDINGS: This article presents part of the findings of this study. After describing the nature of student-teacher connection, the discussion focuses on the influence of teachers and other factors on the formation of student-teacher connection. Relevance is given to this discussion by describing the outcomes of connection for students' clinical learning experiences.

Adolescent↗

PubMed2005

Language-learning disorders and youth incarceration.

UNLABELLED: Many speech-language pathologists are serving delinquent boys with language-learning disorders who are both current and former residents of correctional institutions. These youngsters demonstrate personal maladjustments that have a negative impact on school performance and socialization. Those boys within chaotic families are at risk of poverty, institutionalization, and substance abuse. Boys with language-learning disorders, who have encountered the law, need to be provided with services through collaborative and individualized efforts toward improving language skills, learning, and re-incorporating them into society. Further investigations are needed in order to clarify how the elements of personal, family, neighborhood, school and service conditions serve as either protective or risk factors for a life of incarceration in these individuals. LEARNING OUTCOMES: As a result of this presentation, the reader will understand the complex relationship among language-learning disorders, poverty, poor school performance, and delinquency in boys. The reader will become aware of the elements that should be present in school and correctional services in order to prevent recidivism in boys with language-learning disorders who have had problems with the law.

Humans↗

PubMed2005

Auditory-visual speech integration by adults with and without language-learning disabilities.

UNLABELLED: Auditory and auditory-visual (AV) speech perception skills were examined in adults with and without language-learning disabilities (LLD). The AV stimuli consisted of congruent consonant-vowel syllables (auditory and visual syllables matched in terms of syllable being produced) and incongruent McGurk syllables (auditory syllable differed from visual syllable). Although the identification of the auditory and congruent AV syllables was comparable for the two groups, the reaction times to identify all syllables were longer in the LLD compared to the control group. This finding is consistent with previous research demonstrating slower processing in learning disabled individuals. Adults with LLD also provided significantly fewer integration-type or McGurk responses compared with their normal peers when presented with speech tokens representing a mismatch between the auditory and visual signal. These results suggest the poor integration for auditory-visual speech previously documented in children with poor language skills also occurs in adults with LLD. LEARNING OUTCOMES: The reader will be able to (1) describe the McGurk effect; (2) describe group differences (language learning disabled and control adults) in auditory and auditory-visual speech perception of consonant-vowel syllables.

Acoustic Stimulation↗

PubMed2003

Putting your course on the Web: lessons from a case study and systematic literature review.

BACKGROUND: Education via the Internet offers enormous potential, but many online courses are pedagogically or technically weak and many good projects are never mainstreamed. METHOD: In drawing up our recommendations to address the issues around putting a course on the web, we drew on 3 main sources of data: an extensive in-depth course evaluation; a systematic review of the literature, and questions raised by participants on our training-the-trainers courses. RECOMMENDATIONS: For any web-based course to succeed, 10 overlapping and iterative areas of activity must be addressed. These are: the market for the course; course aims and intended learning outcomes; choice of software platform; staff training needs; writing high quality study materials; design features for active learning; technical and administrative challenges; evaluation and quality improvement; mainstreaming the course within the institution, and financial viability.

Computer-Assisted Instruction↗

PubMed1982

Learning to nurse: the family as the unit of care.

How can we prepare nurses who will have as their focus of practice, the health of the family unit? This paper describes the learning outcomes which were generated from a short term experience in a curriculum where the major thrust is learning to nurse families in a health promoting way. Students were provided with experience with families who were undergoing an important family event, e.g., coping with the short term hospitalization of a child. An exploration and analysis of these experiences revealed for students the content of nursing families who are in the process of dealing with this particular event of family living. This content related to the acquisition of nursing skills of an interpersonal, technical and decision-making nature as well as the development of knowledge which provides the basis for nursing the family as the unit of care.

Adult↗

PubMed2007

Anatomical dissection as a teaching method in medical school: a review of the evidence.

CONTEXT: Discussions about dissection as a teaching method in gross anatomy are characterised by a lack of objective evidence. METHODS: A search for such evidence in the literature produced 14 relevant papers. These were reviewed for objective data on the effect of cadaver dissection on cognitive learning outcomes. RESULTS: All reviewed studies compared groups of students exposed to different teaching approaches, including active dissection, learning on prosected material, or a combination with computerised teaching aids. Study and course designs varied substantially and student groups compared were not always homogeneous. In all studies, compared learning experiences differed in more than 1 variable, and assessment of anatomical knowledge was not standardised. DISCUSSION: It is difficult to interpret and generalise from the results of the reviewed studies. Considering the bias that must be assumed for teachers who develop new course designs and compare these with traditional ones, the review shows a slight advantage for traditional dissection over prosection. CONCLUSIONS: More sophisticated research designs may be necessary to solve the general problem of the small measurable impact of educational interventions and to come to scientifically sound conclusions about the best way to teach gross anatomy. Such research will have to include sufficient sample sizes, the use of validated assessment instruments, and a discussion of the educational significance of measured differences. More educational research in anatomy is necessary to counterbalance emotional arguments about dissection with scientific evidence. Anatomical knowledge is too important to future doctors to leave its teaching to the educational fashion of the day.

Anatomy↗

PubMed2005

The influence of context on students' approaches to learning: a case study.

This paper gives an account of a small-scale longitudinal study that examined changes in conceptions and approaches to learning as 14 students experience a problem-based learning (PBL) curriculum for the first time. The course in oral biology aimed to encourage conceptual understanding of the topic and improve student learning through its PBL curriculum and assessment method. Those who entered the course with a surface approach and fragmented conception of learning left with a deep-learning approach, cohesive conception and quality learning outcomes. There were no observable changes in the students who started the course with a deep-learning approach and cohesive conception, except for two who reported surface approaches and fragmented conceptions at the end. These two students also achieved the lowest examination scores. To help explain these findings we examine the wider context for student learning including student motivation.

Attitude↗

PubMed2002

Global minimum essential requirements in medical education.

The process of globalization is increasingly evident in medical education and makes the task of defining global essential competences required by 'global physicians' an urgent matter. This issue was addressed by the newly established Institute for International Medical Education (IIME). The IIME Core Committee developed the concept of 'global minimum essential requirements' ('GMER') and defined a set of global minimum learning outcomes that medical school students must demonstrate at graduation. The 'Essentials' are grouped under seven broad educational domains with a set of 60 learning objectives. Besides these 'global competences', medical schools should add national and local requirements. The focus on student competences as outcomes of medical education should have deep implications for curricular content as well as the educational processes of medical schools.

Attitude of Health Personnel↗