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PubMed2005

Adding problem-based learning tutorials to a traditional lecture-based curriculum: a pilot study in a dental school.

This article reports on the implementation of a problem-based learning (PBL) tutorial in our advanced program for second year students within an existing curriculum. The program was opened on the last 5 days of the summer vacation and students could volunteer to be part of the group. Students separated themselves into small groups by random sampling. The PBL tutorials were done during the first 3 days for medical problems according to our original scenarios (based on medical cases), and during the last 2 days, students made presentations of their learning outcomes, using information technology (IT) by themselves. Throughout this program, students were expected to engage in self-learning, except for a 1(1/2)-h group session with a tutor. Assessment was done by attendance at a group session and by portfolio analysis. Following the portfolio analysis, students identified the number of learning issues (group A, 26 +/- 7 issues; group B, 20 +/- 3 issues; group C, 21 +/- 7 issues). Research, by questionnaire, revealed that 84% of the students were strongly interested in each scenario and 95% of the students felt familiar with each scenario. The levels of satisfaction with the tutor were different in the three groups. All of the students were comfortable in the discussion room and IT center. These results suggested that PBL tutorials are supported by the scenario, the tutor, and the location of the group session, as well as by self-learning. Moreover, one of the most important factors for a PBL tutorial that the student is ready for the free discussions and has enough time for individual self-learning.

Computer-Assisted Instruction↗

PubMedDate not supplied

Concurrent task sequencing in single-phoneme phonologic treatment and generalization.

UNLABELLED: Phonologic treatments have traditionally been designed to teach a target speech sound starting with presumed easy teaching tasks and progressing to harder tasks. This investigation evaluated the effects on single-phoneme acquisition, generalization, and maintenance of Concurrent Treatment, which randomly intermixed presumed easy and hard teaching tasks were utilized. A multiple-baseline-across-subjects design was used with 4- to 7-year-old participants with /s/ misarticulations. All four participants rapidly acquired /s/ and showed generalization to untaught exemplars ranging from syllables to connected speech. Two participants showed generalization to within-clinic conversations and across settings. Results suggested that an easy-to-hard task sequence may be unnecessary for successful treatment outcomes and that the concurrent sequence may be beneficial. Implications for treatment design and future research are discussed. LEARNING OUTCOMES: (1) As a result of this activity, the participant will be able to explain the difference between incremental and concurrent task sequence. (2) As a result of this activity, the participant will be able to explain the procedures of Concurrent Treatment. (3) As a result of this activity, the participant will be able to explain the results of the experimental investigation of Concurrent Treatment.

Articulation Disorders↗

PubMed2003

Intravenous catheter training system: computer-based education versus traditional learning methods.

BACKGROUND: Virtual reality simulators allow trainees to practice techniques without consequences, reduce potential risk associated with training, minimize animal use, and help to develop standards and optimize procedures. Current intravenous (IV) catheter placement training methods utilize plastic arms, however, the lack of variability can diminish the educational stimulus for the student. This study compares the effectiveness of an interactive, multimedia, virtual reality computer IV catheter simulator with a traditional laboratory experience of teaching IV venipuncture skills to both nursing and medical students. METHODS: A randomized, pretest-posttest experimental design was employed. A total of 163 participants, 70 baccalaureate nursing students and 93 third-year medical students beginning their fundamental skills training were recruited. The students ranged in age from 20 to 55 years (mean 25). Fifty-eight percent were female and 68% percent perceived themselves as having average computer skills (25% declaring excellence). The methods of IV catheter education compared included a traditional method of instruction involving a scripted self-study module which involved a 10-minute videotape, instructor demonstration, and hands-on-experience using plastic mannequin arms. The second method involved an interactive multimedia, commercially made computer catheter simulator program utilizing virtual reality (CathSim). RESULTS: The pretest scores were similar between the computer and the traditional laboratory group. There was a significant improvement in cognitive gains, student satisfaction, and documentation of the procedure with the traditional laboratory group compared with the computer catheter simulator group. Both groups were similar in their ability to demonstrate the skill correctly. CONCLUSIONS; This evaluation and assessment was an initial effort to assess new teaching methodologies related to intravenous catheter placement and their effects on student learning outcomes and behaviors. Technology alone is not a solution for stand alone IV catheter placement education. A traditional learning method was preferred by students. The combination of these two methods of education may further enhance the trainee's satisfaction and skill acquisition level.

Adult↗

PubMed2002

Teaching and learning about human sexuality in undergraduate medical education.

BACKGROUND: Effective management of the doctor's role in relation to human sexuality requires sensitivity and tact, an ability to put patients at ease, use of appropriate language, and therapeutic, non-discriminatory attitudes. However, previous research suggests that medical students and doctors may hold negative attitudes towards homosexuality and some forms of sexual behaviour. Some educational programmes have started to help students develop communication skills for sexual health consultations, but little work has addressed the broader issue of attitudes and values which may underlie behaviour. It is vital that medical students begin early the process of reflection and recognition of how their attitudes and values might influence their care of patients. In this paper we report on a course designed to initiate this process at Leicester-Warwick Medical School (LWMS). COURSE DESCRIPTION: The course utilizes techniques of desensitization, problem-solving and reflection to enable the students to achieve the learning outcomes, which are primarily oriented towards reflection and self-development. It uses a variety of teaching and learning strategies, combining peer learning with self-directed learning, and small-group learning with whole class learning. COURSE EVALUATION: We report observations and a before-and-after questionnaire study of students' views and attitudes. This evaluation suggests that the course is successful in reducing students' anxieties about human sexuality and improving their confidence in developing appropriate skills. CONCLUSIONS: The LWMS course is one model which might be used to begin the process of encouraging medical students to develop ways of appropriately managing their responsibilities in relation to human sexuality.

Attitude to Health↗

PubMed1990

Concept-based learning activities in clinical nursing education.

Few substantive changes are evident in clinical learning activities. This article reports the development, use, and beginning research on the Concept-based Learning Activity (CBLA), an innovative clinical learning activity. The main difference between this and current clinical learning activities is the relationship between student and client. Students study and perform selected aspects of the client's nursing management. Focus on specific objectives and best use of clinical time can be achieved with this model. Implementation of the CBLA requires collaboration with nursing staff. Students, staff, and teachers indicate many advantages to the CBLA, including flexibility, focus on learning, efficacy in use of clinical time, and recognition of the student as a capable learner. Formal evaluation of CBLA use indicates positive staff nurse perceptions. Statistically significant results were found when staff nurse groups who used the CBLA were compared with those who did not. Further studies are needed to evaluate learning outcomes.

Education, Nursing, Baccalaureate↗

PubMed2003

The effect of communication on nursing student outcomes in a Web-based course.

This study compared the effectiveness of different instructional communication methods in a Web-based course on students' cognitive learning, satisfaction, and motivation to complete the course. A total of 174 undergraduate nursing students were selected randomly and assigned to experimental or control groups. Instruments included a demographic data form, two examinations on course material, a course satisfaction scale, and calculation of completion rates. All students received identical didactic Web-based instructional materials. However, type of communication varied among groups. No significant group differences were found for cognitive learning or motivation to complete the course. A significant group difference was found for student satisfaction with the course, indicating carefully planned communication strategies can improve satisfaction. A need for technical support also was evident. More research is needed to determine the best strategies to enhance student learning outcomes and decrease student attrition in Web-based courses.

Adult↗

PubMed2006

Influence of clerkship experiences on clinical competence.

BACKGROUND: Clerkship experiences are considered crucial for the development of clinical competence. Yet whether there is a direct relationship between the nature and volume of patient encounters and learning outcomes is far from clear. Some evidence in the literature points towards the importance of clinical supervision on student learning, but the relationship between clinical supervision, patient encounters and student competence remains unclear. OBJECTIVES: This study aimed firstly to determine the variation in students' clinical experiences within and across sites; secondly, to identify the causes of this variation, and thirdly, to investigate the consequences of this variation on students' competence. METHODS: Clerkship students at 12 hospital sites recorded their patient encounters in logbooks. Site characteristics that might influence the variation in patient encounters were collected. Student competence was determined by 3 independent indicators: a practical end-of-clerkship examination; a theoretical end-of-clerkship examination, and an evaluation of professional performance. A model was developed to test the available clerkship data using structural equation modelling (SEM) software. RESULTS: Analysis of the logbooks revealed a large variation in the number of patients encountered by students. The average length of patient stay, number of patients admitted, and quality of supervision accounted partly for this variation. An increased number of patient encounters did not directly lead to improved competence. Quality of supervision turned out to be crucially important because it directly impacted student learning and also positively influenced the number of patient encounters. CONCLUSION: Monitoring the effectiveness of clerkship by merely asking students to keep a tally of the problems and diseases they encounter, without paying attention to the quality of supervision, does not contribute towards improving student learning.

Clinical Clerkship↗

PubMed1998

A comparison of international learning experiences for baccalaureate nursing students: developed and developing countries.

As faculty seek creative learning opportunities for students in a changing social, political, and health care environment, knowledge about international learning experiences can provide critical information for decision making. This study sought the answer to two questions: What are the learning outcomes of an international experience for baccalaureate nursing students and what are the similarities and differences in what students learn in developed and developing countries? Using grounded theory methodology, 14 students who had participated in international learning experiences were interviewed. Three major categories emerged from the data analysis: personal and professional growth, empirical knowledge, and the learning experience. More similarities than differences were identified among the students who had traveled to developing versus developed countries. The findings suggest that international experiences need to include the opportunity to provide direct nursing care. A proposed model for such experiences is presented.

Adult↗

PubMed1995

Ten ways to create a motivating learning environment.

This article provides a wide variety of "how-tos" that can increase the results of a training session. It suggests that high-performance training goes far beyond presentation of the material. There are both general and specific behaviors that can be used to increase the learning outcomes.

Adult↗

PubMed1993

Biologic factors as predictors of social outcome of epilepsy in intellectually normal children: a population-based study.

We studied social outcome for all the normally intelligent children in our province with onset of epilepsy between 1977 and 1985 (excluding absence and "minor motor" seizures). After follow-up averaging 7 1/2 years, the 337 patients were 7 to 28 years of age. Outcome measures were age dependent. Of those old enough to be at risk, the percentage with each unfavorable outcome was as follows: school failure 34%, use of special educational resources 34%, mental health consultation 22%, psychotropic medication 5%, unemployment 20%, social isolation 27%, inadvertent pregnancy 12%, and criminal conviction 2%. In social isolation 27%, inadvertent pregnancy 12%, and criminal conviction 2%. In a multivariate model correcting for number of potential unfavorable outcomes (based on age at end of follow-up), many variables related to epilepsy, seizure control, and electroencephalographic findings were not associated with social outcome. Only two variables were associated with at least one unfavorable outcome--learning disorder (p < 0.001) and more than 21 seizures before treatment was begun (p < 0.03). The only variable with no unfavorable outcome was simple partial seizures (p < 0.003). Sensitivity and specificity of this model were 54% and 68%, respectively, indicating that social outcome for these children was often not related to biologic factors reflected by the medical details and clinical course of their disorder.

Adolescent↗

PubMed2002

A variable structure, less resource intensive modification of problem-based learning for pharmacology instruction to health science students.

A less resource intensive but more structured modification of problem-based learning was developed to teach pharmacology to pharmacy students in classes of 90 students. The method utilizes an active learning tool developed from cognitive science and cognitive learning theory. This case-based approach was developed to address the need to teach problem-solving skills to relatively large classes while conserving faculty and other resources. The method involves students working through cases in small groups according to a prescribed format. Groups are chosen at random to present the case to the whole class followed by open but structured discussion. Students bring recommended texts to class and groups are asked to answer questions relating to the material in the case, or to determine how the way their approach to the case would differ if patient parameters or medications in the case were altered utilizing the required texts. Each class begins with a short 1-min quiz on the fact-based material to be discussed that day and ends with a wrap-up of critical issues or principles learned. Continual probing of "what" and "why" characterizes each class meeting. Examinations are predominately open book and follow the same format as the in class cases. Learning outcomes for each general topic are provided at the beginning of the semester. Although the method does require students to learn pharmacology "facts", it places the facts within the context of application to practice. Rather than memorizing lists of side effects, for example, the format requires utilizing the side effects list and information about them to appropriately counsel the patient on how to deal with each and/or to suggest modifications in the therapy. Since implementing this method in an endocrine pharmacology course, student performance on problem-solving examinations has improved. Additionally, student evaluation of the method is extremely positive.

Adult↗

PubMed2006

Professionalism in long-term care settings.

UNLABELLED: Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in long-term care. Excellence in service also involves meeting third party payers' requirements, teamwork, and advocacy. In addition, professionalism is demonstrated through maintaining privacy, ethical practice, staff and family in-service and counseling, and self-care. Innovative programming also involves developing new outcome measures and environmental engineering that enhances the communication skills and opportunities of elders in long-term care settings. LEARNING OUTCOMES: As a result of this activity, the participant will: (1) describe the changing nature of long-term care settings and residents, (2) understand the broad and complex professional skills that contribute to excellence in practice in this setting.

Aged↗

PubMed2000

Task-based learning: the answer to integration and problem-based learning in the clinical years.

INTRODUCTION: Integrated teaching and problem-based learning (PBL) are powerful educational strategies. Difficulties arise, however, in their application in the later years of the undergraduate medical curriculum, particularly in clinical attachments. Two solutions have been proposed - the use of integrated clinical teaching teams and time allocated during the week for PBL separate from the clinical work. Both approaches have significant disadvantages. Task-based learning (TBL) is a preferred strategy. In TBL, a range of tasks undertaken by a doctor are identified, e.g. management of a patient with abdominal pain, and these are used as the focus for learning. Students have responsibility for integrating their learning round the tasks as they move through a range of clinical attachments in different disciplines. They are assisted in this process by study guides. METHOD: The implementation of TBL is described in one medical school. One hundred and thirteen tasks, arranged in 16 groups, serve to integrate the student learning as they rotate through 10 clinical attachments. RESULTS: This trans-disciplinary approach to integration, which incorporates the principles of PBL offers advantages to both teachers and students. It recognizes that clinical attachments in individual disciplines can offer rich learning opportunities and that such attachments can play a role in an integrated, as well as in a traditional, curriculum. In TBL, the contributions of the clinical attachments to the curriculum learning outcomes must be clearly defined and tasks selected which will serve as a focus for the integration of the students' learning over the range of attachments.

Clinical Clerkship↗

PubMed2003

Learning from lives: a model for health and social care education in the wider community context.

OBJECTIVES: To develop and evaluate a model for medical education which draws upon the whole frontline workforce in primary care and which enables medical students to develop skills and competencies in patient-centred teamworking across organisational boundaries. METHODS: Over a period of 3 years, 517 undergraduate medical students undertook a 4-week community hospital-based attachment developed in partnership with frontline staff. Pre- and post-course questionnaires and qualitative evaluation were sought from students, patients, tutors and frontline staff. RESULTS: The performance of students in assessment was very good. Before receiving the assessment results, students perceived a high degree of achievement of the specified learning outcomes and reported significant changes in attitude. Qualitative comments were overwhelmingly positive, with clear indications that students appreciated the unique learning opportunities available in this model. Patients were very positive about continuing involvement and valued the opportunity to influence future doctors. Staff were enthusiastic and committed despite competing service pressures. CONCLUSIONS: We have successfully developed a partnership model of community-based education and shown that it leads to significant changes in attitude in students and enables them to learn in an active, patient-focused way about the complexities of delivery of care outside the secondary care environment. We have identified the key requirements for implementation of the model in other centres.

Clinical Competence↗

PubMed2005

Are students' beliefs about knowledge and learning associated with their reported use of learning strategies?

BACKGROUND: Although considerable research has examined beliefs and learning outcomes (e.g. Schommer, 1990, 1993a, 1993b; Schommer & Dunnell, 1997), little has looked at the relationship between beliefs and the actual learning process. AIMS: This research examines the relationship between beliefs about learning and knowledge, and reports of learning strategy-use relevant for successful text comprehension. SAMPLE: Participants were 81 Norwegian university students who had studied from 1 to 4 years in a range of disciplines. METHOD: Students' beliefs about knowledge and learning were measured with the Schommer Epistemological Questionnaire (SEQ; Schommer, 1998b). Learning strategies particularly useful for text-based learning were measured with the Motivated Strategies for Learning Questionnaire (MSLQ; Pintrich, Smith, Garcia, & McKeachie, 1991). A correlational analysis between measures and full regression analyses of how beliefs influence strategy selection were performed. RESULTS: Beliefs about how thoroughly knowledge is integrated in networks (simple) and how fixed the ability to learn is from birth (fixed) contributed significantly to reported strategy use: Simple to rehearsal and organizational strategies, fixed to elaboration and critical thinking strategies, and a combination of simple and fixed to strategies relevant to the thoughtful monitoring of learning tasks. Beliefs about how certain knowledge is (certain) and how quickly learning can be expected to occur (quick) were not found to contribute to reported learning- strategy use in any significant way. CONCLUSION: Some, but not all, beliefs about knowledge and learning offer insight into students' reported use of learning strategies relevant for reading course literature.

Adult↗

PubMed2006

Instrumental learning in hyperdopaminergic mice.

In two experiments we investigated the effects of elevated dopaminergic tone on instrumental learning and performance using dopamine transporter knockdown (DAT KD) mice. In Experiment 1, we showed that both DAT KD mice and wild-type controls were similarly sensitive to outcome devaluation induced by sensory specific satiety, indicating normal action-outcome learning in both groups. In Experiment 2, we used a Pavlovian-to-instrumental transfer procedure to assess the potentiation of instrumental responding by Pavlovian conditional stimuli (CS). Although during the Pavlovian training phase the DAT KD mice entered the food magazine more frequently in the absence of the CS, when tested later both groups showed outcome-selective PIT. These results suggest that the elevated dopaminergic tone reduced the selectivity of stimulus control over conditioned behavior, but did not affect instrumental learning.

Animals↗

PubMed2004

Teaching dermatology.

How might teachers optimize the learning of dermatology? Learning outcomes derived from the curriculum will clarify the requirements of dermatology courses for teachers as well as learners. Clinical teachers must learn to exploit opportunities for teaching, use time effectively, target teaching at the right level and evaluate what the students have learnt. Students should have opportunities to participate actively in clinics, under appropriate supervision, as well as to observe clinicians working with patients. Although new technologies may complement clinical teaching, these are no substitute for clinical experience.

Clinical Competence↗

PubMed2006

Deep dissection: motivating students beyond rote learning in veterinary anatomy.

The profusion of descriptive, factual information in veterinary anatomy inevitably creates pressure on students to employ surface learning approaches and "rote learning." This phenomenon may contribute to negative perceptions of the relevance of anatomy as a discipline. Thus, encouraging deep learning outcomes will not only lead to greater satisfaction for both instructors and learners but may have the added effect of raising the profile of and respect for the discipline. Consideration of the literature reveals the broad scope of interventions required to motivate students to go beyond rote learning. While many of these are common to all disciplines (e.g., promoting active learning, making higher-order goals explicit, reducing content in favor of concepts, aligning assessment with outcomes), other factors are peculiar to anatomy, such as the benefits of incorporating clinical tidbits, "living anatomy," the anatomy museum, and dissection classes into a "learning context" that fosters deep approaches. Surprisingly, the 10 interventions discussed focus more on factors contributing to student perceptions of the course than on drastic changes to the anatomy course itself. This is because many traditional anatomy practices, such as dissection and museum-based classes, are eminently compatible with active, student-centered learning strategies and the adoption of deep learning approaches by veterinary students. Thus the key to encouraging, for example, dissection for deep learning ("deep dissection") lies more in student motivation, personal engagement, curriculum structure, and "learning context" than in the nature of the learning activity itself.

Anatomy↗