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PubMedDate not supplied

Patterns of interference in sequence learning and prism adaptation inconsistent with the consolidation hypothesis.

The studies reported here used an interference paradigm to determine whether a long-term consolidation process (i.e., one lasting from several hours to days) occurs in the learning of two implicit motor skills, learning of a movement sequence and learning of a visuo-motor mapping. Subjects learned one skill and were tested on that skill 48 h later. Between the learning session and test session, some subjects trained on a second skill. The amount of time between the learning of the two skills varied for different subjects. In both the learning of a movement sequence and the learning of a visuo-motor mapping, we found that remote memories were susceptible to interference, but the passage of time did not afford protection from interference. These results are inconsistent with the long-term consolidation of these motor skills. A possible difference between these tasks and those that do show long-term consolidation is that the present tasks are not dynamic motor skills.

Adaptation, Physiological↗

PubMed1995

Phonological awareness and visual skills in learning to read Chinese and English.

It is well known that phonological awareness is closely related to reading skill in children who are learning to read an alphabetic script such as English. In this study, the relationship between phonological awareness and reading skill was also investigated in children living in Hong Kong and Taiwan who were learning to read Chinese. This is because children from Taiwan learn a phonological script, known as Zhu-Yin-Fu-Hao, before they are taught to read any Chinese characters. In addition, a high proportion of Chinese characters contain a "phonetic" component which might be used by Chinese readers when they are recognising Chinese words. Consequently, the performance of 137 8-year-old primary children from Britain, Hong Kong and Taiwan on tests of phonological awareness, visual skills and reading ability was examined. Although there were significant correlations between Chinese reading and phonological awareness, the results of a series of regression analyses did not support the view that differences in phonological awareness per se are a primary cause of differences in reading ability amongst children learning to read Chinese. In contrast, performance on the phonological awareness tests (rhyme and phoneme detection) was significantly related to the reading ability of British children even after the effects of IQ and vocabulary had been partialled out. The results also showed that a test of visual skills (visual paired associates learning) was significantly related to the reading ability of the children in Hong Kong and Taiwan, but not to the reading of the British children. In addition, the nature of rhyme and phoneme deletion skills differed in children from Britain and Hong Kong. Whereas British children found it more difficult to delete the first phoneme from an initial consonant blend (e.g., deleting /s/ from star) than from a word which contained a single consonant before the vowel (e.g., deleting /s/ from sit), children from Hong Kong showed exactly the opposite pattern. In addition, performance on a phoneme deletion test appeared to be strongly influenced by whether or not the child had learnt an alphabetic script in the language in which they were being tested.

Awareness↗

PubMedDate not supplied

Sleep-dependent learning and motor-skill complexity.

Learning of a procedural motor-skill task is known to progress through a series of unique memory stages. Performance initially improves during training, and continues to improve, without further rehearsal, across subsequent periods of sleep. Here, we investigate how this delayed sleep-dependent learning is affected when the task characteristics are varied across several degrees of difficulty, and whether this improvement differentially enhances individual transitions of the motor-sequence pattern being learned. We report that subjects show similar overnight improvements in speed whether learning a five-element unimanual sequence (17.7% improvement), a nine-element unimanual sequence (20.2%), or a five-element bimanual sequence (17.5%), but show markedly increased overnight improvement (28.9%) with a nine-element bimanual sequence. In addition, individual transitions within the motor-sequence pattern that appeared most difficult at the end of training showed a significant 17.8% increase in speed overnight, whereas those transitions that were performed most rapidly at the end of training showed only a non-significant 1.4% improvement. Together, these findings suggest that the sleep-dependent learning process selectively provides maximum benefit to motor-skill procedures that proved to be most difficult prior to sleep.

Adolescent↗

PubMed1980

Blind evaluation of body reflexes and motor skills in learning disability.

Motor dysfunctions have been associated with learning disabilities in casual observation and systematic study. However, most prior work has concentrated solely on high-level skills and has been subject to observer bias. In this study, boys with learning disability were blindly compared with paired controls on measures of postural and equilibrium reflexes as well as skills. Learning-disabled children as a group showed significant deficits on all measures; a few, however, were totally without deficit. The implications of these findings for controversies about the role of motor dysfunction in learning disabilities are examined.

Child↗

PubMed2006

Teaching and learning consultation skills for paediatric practice.

Effective consultations with patients and their families are important for patient satisfaction, adherence to treatment, and recovery from illness. Communication problems among health professionals are common. Fortunately, the skills of effective communication can be taught and learned. This paper highlights evidence based approaches to teaching these skills with minimal resources.

Child↗

PubMed2003

Similar network activated by young and old adults during the acquisition of a motor sequence.

In this functional MRI (fMRI) study, we investigated ageing effects on motor skill learning. We applied an adapted version of the serial reaction time (SRT) task to extensive groups of young (N=26) and elderly (N=40) subjects. Since indications have been provided for age-related shrinkage of brain regions assumed to be critical to motor skill learning, we tested the hypothesis that age effects on implicit sequence learning are larger on a neurofunctional level than on a behavioural level. The SRT task consisted of two identical scan sessions, in which subjects had to manually trail an asterisk appearing serially in one of four spatial positions by means of button-pressing. Reliable response time reductions were already found in the first session for both the young and the elderly groups, when comparing a fixed sequence condition to a random sequence, but the learning effect was greater for the young subjects. In the second session, though, both groups showed a similar degree of learning. This indicates that implicit sequence learning is still intact in elderly adults, but that the rate of learning is somewhat slower. Reliable learning-related changes in brain activity were also observed. A similar network of brain regions was recruited by both groups during the fixed compared to the random sequence, involving several regions that have been previously associated with implicit sequence learning, including bilateral parietal, and frontal regions, the supplementary motor area (SMA), cerebellum and the basal ganglia. The direct group comparison did not reveal any differences in brain activity. In addition, we did not observe any significant differences in activity when comparing the different sessions either, neither for the young nor for the elderly subjects. Hence, we did not find indications for an age-related functional reorganisation of neural networks involved in motor sequence learning. In view of earlier reports of pronounced ageing effects on the performance on declarative memory tasks, our finding of age-related sparing of processes that sustain motor skill learning, provides further support for the proposition of different memory systems relying on different brain substrates.

Adult↗

PubMed2003

Neocortical mechanisms in motor learning.

The ability to learn novel motor skills has fundamental importance for adaptive behavior. Neocortical mechanisms support human motor skill learning, from simple practice to adaptation and arbitrary sensory-motor associations. Behavioral and neural manifestations of motor learning evolve in time and involve multiple structures across the neocortex. Modifications of neural properties, synchrony and synaptic efficacy are all related to the development and maintenance of motor skill.

Animals↗

PubMedDate not supplied

Helping expand nurse practitioner students' clinical skills repertoire: learning minor procedures.

This course is immensely popular with students. Many express a sense of accomplishment in knowing that they have performed a specific procedure at least once before facing the requirement in the clinical setting. Students who complete the course have a firm foundation in minor procedures and are knowledgeable about indications, contraindications, and methods to perform the procedure before facing that first patient in the clinical setting. They have also accumulated a set of procedures, patient discharge instructions, and a bibliography that can be reviewed before performing a procedure for the first time in the clinical setting. Combining clinical hands-on skills with the experience of writing a step-by-step procedure reinforces learning and is a valuable skill that can be used in clinical practice after graduation. Although many of the students will only apply a portion of the skills they learn in this course, they express a significant boost in self-confidence, a decrease in anxiety level, a sense of accomplishment in their skills, and a definite edge in securing a nurse practitioner position in a competitive healthcare marketplace.

Educational Measurement↗

PubMed2002

Learning difficulties, social intelligence, and self-concept: connections to bully-victim problems.

Learning skills, social intelligence, and self-concept were related to each other and to bully-victim problems among fifth-grade children (79 boys and 62 girls, aged 11-12 years). In addition to exploring connections between single variables, a person-oriented approach was applied in order to analyze children's value patterns with respect to learning skills, self-concept, and social intelligence, and how these value patterns are related to bully-victim problems. Social intelligence was found to be positively correlated with learning skills, but negatively related to victimization. Bullying was positively correlated with self-concept scores. However, this was true only of boys. According to cross-tabulations, there were significantly more bullies among children with learning difficulties (LD) than would have been expected by chance. Victimization, on the other hand, was not related to LD. LD children's proposed victim status was in some degree supported by cluster analysis: a group of LD children emerged, who not only scored high on bullying, but also tended to be victimized by others. In addition, two groups of bullies appeared: one whose members could be interpreted as socially unskilled and another as socially skilled. This finding is in line with recent theoretical reasoning, which calls into question the idea of bullies as a unified group, lacking in social skills.

Aggression↗

PubMedDate not supplied

Age differences in learning maintenance skills: a field study.

The effects of age and previous relevant experience on learning anxiety, strategies, and performance were studied in 43 workers aged 25 to 49 during a 1-week maintenance vocational training course. The results showed that increased age was associated with higher training-related anxiety as measured at the beginning of the course. However, no age difference could be found in the level of knowledge assessed after 3 days of training. This was confirmed by another problem-solving-type test that took place on the last day. Previous experience had no effect on anxiety, and it did enable us to predict higher scores for the first test but not for the second one. Analysis of behavior strategies revealed that older trainees consulted and annotated the course material more often than the younger ones during the learning process. The results are discussed in relation to those obtained in previous laboratory and field studies on the same subject.

Adult↗

PubMed1999

Midazolam effects on implicit and explicit memory processes in healthy subjects.

RATIONALE: Studying midazolam-induced amnesia offers an interesting approach to the organization of normal memory processes, since memory performance can be studied in the same subject in "on" and "off" drug conditions. OBJECTIVE: The present study investigated the effect of midazolam on skill learning. The task and the experimental design we used also allowed us to assess the effect of midazolam on priming and explicit memory. METHODS: Eighteen patients who underwent minor ear surgery and who were anaesthetized with intravenous midazolam, and 18 matched control subjects participated in a mirror reading task on 2 separate days. Patients were tested under midazolam on day 1 and without any medication on day 2. The mirror reading task was made of French words, some of which repeated across trial blocks, others being new. RESULTS: Patients under midazolam read new mirror written words faster with practice, which attested for intact skill learning. Moreover, they read repeated words faster than new words with practice, which was interpreted as reflecting intact priming abilities. These spared implicit memory capacities were observed along with severe explicit memory impairments. Learning for both new and repeated mirror written words on day 2 was similar in patients and in controls, which was interpreted as suggesting that the implicit learning that occurred on day 1 under midazolam was normal. CONCLUSIONS: The quality of skill learning, both in terms of speed of and lasting effect, was normal under midazolam in the task we used. In the context of the present task, midazolam offers an interesting, reversible model of amnesia.

Adult↗

PubMed2001

Analysis of the quality and efficiency in learning laparoscopic skills.

OBJECTIVES: This study demonstrates the application of time-action analysis to the evaluation of task performance of diagnostic laparoscopy with laparoscopic ultrasonography. METHODS: The first 25 diagnostic laparoscopies with laparoscopic ultrasonography performed by a surgical resident were analyzed and compared with the outcomes of these procedures performed by an experienced surgeon. The time, actions, and correctness of task performance were evaluated. Furthermore, outcome correctness and postoperative complications were assessed. RESULTS: No postoperative complications occurred. The resident made one wrong diagnosis, for which the cause was detected by peroperative analysis. Additionally, 1% of the subtasks were performed only partially, 4% not at all, and 2% using the wrong technique. The efficiency for most diagnostic tasks remained significantly lower than that of the experienced surgeon (p < 0.001). CONCLUSIONS: Time-action analysis can be used to provide detailed insight into the quality and efficiency of learning surgical skills. It enables objective measurement of correctness in task performance as well as time and action efficiency.

Ampulla of Vater↗

PubMed2007

Aging affects motor learning but not savings at transfer of learning.

Two important components of skill learning are the learning process itself (motor acquisition) and the ability to transfer what has been learned to new task variants (motor transfer). Many studies have documented age-related declines in the ability to learn new manual motor skills. In this study, I tested whether the degree of savings at transfer of learning is similarly affected by advancing age. Young and older adults made aiming movements with a joystick to hit targets presented on a computer screen, with real-time feedback display of their movement. They adapted to three different rotations of the feedback display in a sequential fashion, with return to the normal feedback display between each. Adaptation performance was better when it was preceded by other adaptive experiences, regardless of age.

Adult↗

PubMed2000

The effects of a children's summer camp programme on weight loss, with a 10 month follow-up.

OBJECTIVE: To assess the long-term effects of a multidisciplinary approach involving structured fun-type skill learning physical activities in the treatment of obese and overweight children. DESIGN: A longitudinal investigation incorporating repeated measurements before and after the 8 week intervention and after the 44 week follow-up period. METHODS: The camp programme (Massachusetts, USA) utilised structured fun-based skill learning physical activities, moderate dietary restriction and behaviour modification. The primary aims of the intervention were to reduce body mass and promote the maintenance of the reduction in body mass using an alternative to standard exercise prescription. SUBJECTS: One-hundred and ninety-four children (64 boys and 130 girls, aged 12.6+/-2.5y) enrolled at a summer weight loss camp, of which 102 children (38 boys and 64 girls aged 13.6+/-2.4y) returned 1 y later. MEASUREMENTS: On commencement of the programme all children were assessed for body mass and stature. At follow-up, data was available on 102 subjects for body mass and stature. RESULTS: Over the 8 week intervention significant reductions (P= 0.00) in body mass were obtained. During the 44 week follow-up significant increases (P= 0.00) were noted in body mass, body mass index (BMI) and stature, but as expected there were large variations in the responses. One year after the initial measures had been taken mean body mass and BMI were lower than at the start of the intervention, BMI significantly so (week 0, 32.9 +/- 7.4 kg/m2; week 8 29.1 +/- 6.5 kg/m2; week 52, 30.05 +/- 7.04 kg/m2); (P= 0.00). Stature increased significantly (week 0, 1.58 +/- 0.12 m; week 52, 1.64 0.11 m) (P= 0.00) during this period, demonstrating a reduction in mean body mass over a 1 y period whilst subjects continued to increase in stature. When changes in BMI are analysed with the use of standard scores, there is a non-significant increase (P=0.07) in BMI during the follow-up phase and 89% of children had a lower BMI than at week 0. CONCLUSIONS: These findings suggest that the use of a structured fun-based skill learning programme may provide an alternative method of exercise prescription to help children prolong the effects of the 8 week intervention. Further investigations will help identify the key factors that are necessary for long-term lifestyle modification.

Adolescent↗

PubMed1996

Learning fibreoptic skills in ear, nose and throat clinics.

We have compared the progress of anaesthetists taught fibreoptic techniques on awake patients in ear, nose and throat clinics with that of anaesthetists taught by traditional methods. Twelve anaesthetists participated in the study and were randomly allocated to the ear, nose and throat group or to the traditional training group. Each individual in the ear, nose and throat group attended the outpatient clinic and performed ten nasendoscopies on awake patient, whose upper airway had been anaesthetised with cocaine, under the supervision of an ear, nose and throat surgeon. Each individual in the traditional roup performed ten nasendoscopies on anaesthetised oral surgery inpatients under the supervision of an anaesthetist. To assess the effectiveness of the two training methods, each anaesthetist in each group then attempted ten fibreoptic nasotracheal intubations on anaesthetised oral surgery patients. There was no significant difference between either the success rates or mean successful tracheoscopy times between the two groups. Nasendoscopy training in the ear, nose and throat clinic appears to be good way of learning fibreoptic skills, which can then be readily applied to fibreoptic tracheal intubation in anaesthetic practice.

Adult↗

PubMed2001

Psychomotor function and learning clinical skills: a critical appraisal.

The practice of clinical medicine involves performing a large number of practical procedures so that psychomotor function is of considerable importance, particularly to trainees mastering new skills. Performance of motor skills by trainees is usually assessed by faculty in a random, unorganised, subjective manner without clearly stated criteria of satisfactory performance. This review discusses objective assessment of motor skills utilising psychometric principles in anaesthesia and surgery. In addition, the role of simulators will be discussed within the context of learning new motor skills.

Anesthesiology↗

PubMed2003

[Learning clinical skills].

INTRODUCTION: The purpose of this study was to analyse the learning environment of medical students in a medical ward and on the basis of this study to make specific suggestions as to how the students' clinical stay in a ward can be optimized. These suggestions were implemented and the effect evaluated. MATERIAL AND METHODS: This is a qualitative study. Through observations and interviews with students and staff in the ward the learning environment was analysed. After that an evaluation of the implemented project was carried out in a questionnaire to the ward and in interviews with the persons involved in the project. RESULTS: The result of the study concerning analysis and improvement of the students' stay can briefly be summarized as follows: The students' position in the unit can be characterized as that of an observer rather than as an active working participant in the ward. With this there is a risk that the medical student's trainee stay in a ward will turn into a "work-experience placement", the primary purpose of which will be for the medical student just to dip into the profession. This has consequences for the students' learning process in securing that the students acquire the necessary practical qualifications and acquire essential personal qualifications, such as self-dependence and abilities in decision-making and working under pressure. DISCUSSION: The study shows that doctors and students agree on the aim of the students' trainee stay: To involve the students in a working partnership in order to obtain the best learning experience. The study concludes that it is difficult to change well-established routines despite good intentions of all parties involved. Therefore, the study rises the question on how new routines are established in the educational culture of medicine.

Clinical Competence↗

PubMed1988

Acquisition of attention skill in pervasively hyperactive children.

The hypothesis that pervasively hyperactive children have disturbed attention and fail to acquire learning skills is tested. Attention and learning skills are defined here in terms of the controlled versus automatic processing distinction. In this report 12 pervasively hyperactive children and 12 controls were compared for their ability to develop automatic information processing during a memory recognition task. It was predicted that, if hyperactive children failed to adopt task-appropriate cognitive sets, automatic processing would either fail or develop more slowly than in controls. The data indicated that the groups differed in task efficiency: hyperactive children were slower, within-subject variance of reaction time was greater, and errors occurred more frequently than in controls. However, group differences could not be explained in terms of an attention dysfunction or an inability to develop automatic processing in the hyperactive child.

Attention↗