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Results for “skill learning”

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PubMed1995

Memory deficits in a demented patient with probable corticobasal degeneration.

Anterograde and retrograde amnesia in a patient with probable corticobasal degeneration (pCBD) and dementia were studied in a university medical center setting. The patient with pCBD and four comparison patients of comparable global mental status (Mini-Mental State Exam) who met NINCDS-ADRDA criteria for Alzheimer's disease (AD) were included. Standard neuropsychological tests of naming, intelligence, achievement, verbal fluency, anterograde and remote verbal and visuospatial memory, and motor skill learning were given. The pCBD patient exhibited a progressive asymmetric akinetic-rigid syndrome, which was unresponsive to Sinemet. His initially mild, intellectual deficits consisted of apraxia, slowed speech, and word-finding and memory difficulties. Over a 2-year period, a dementia syndrome developed, which involved more-serious deficits in praxis and naming, as well as impairments in spelling, calculation, verbal fluency, IQ, anterograde verbal and visuospatial memory, and motor skill learning. When tested by recall methods, the pCBD patient exhibited marked deficits on several tests of remote memory; however, on recognition testing, he performed normally on the Famous Faces Test and on a test of geographical knowledge, which measures remote visuospatial memory. By contrast, the four AD patients, who showed equivalent naming difficulties, less-severe fluency deficits, and normal motor skill learning, showed severe impairments in recalling and recognizing the names of famous people from photographs. A magnetic resonance imaging (MRI) scan of the pCBD patient showed marked frontal and parietal lobe atrophy and central atrophy, with ventriculomegaly that was greater on the left side of the brain. The temporal lobes were relatively spared, and the amygdalae, hippocampi, and temporal horns were of normal size.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2005

Off-line learning of motor skill memory: a double dissociation of goal and movement.

Acquiring a new skill requires learning multiple aspects of a task simultaneously. For example, learning a piano sonata requires learning the musical notes and being able to implement this goal by learning the appropriate sequence of finger movements. After practice, skill continues to develop off-line during a period of consolidation. Here we show that different aspects of a procedural memory are processed separately during consolidation: Only the movement sequence is enhanced over the day; whereas only the goal is enhanced over a night of sleep. This double dissociation suggests that distinct systems, enhancing different aspects of a procedural memory, support improvements during consolidation. Consolidation is not a single process; instead, there are multiple routes to off-line learning, and the engagement of these distinct mechanisms is determined by when consolidation takes place.

Adult↗

PubMed1985

Communication skills teaching, learning and assessment.

This paper outlines an introductory course in teaching communication skills to medical students in a preclinical context. The aims of the course, its content and teaching methods are described. Novel features include the active participation of selected patients in teaching and assessment, and the use of a form of role-play named 'listening triads'. The main focus of the paper is assessment, and results are recorded, relating to a class of 114 second-year students during the academic session 1983-84. Assessment of the students' learning was measured by Modified Essay Question (MEQ); students' problems face-to-face with patients were identified by patients, students, and by staff members observing interactions. Problems of fitting these educational assessments into a traditional academic 'certifying' type of assessment remain unresolved at present. This course was found to be acceptable by the preclinical students, and their lack of clinical knowledge did not appear to interfere with their learning. They were enthusiastic about the supervised contact with patients, which appeared to contribute significantly to the way the course was received.

Communication↗

PubMedDate not supplied

Multiple learning tasks in patients with ideomotor apraxia.

The Authors studied a group of patients with ideomotor apraxia (LBD+) to verify if these patients had some difficulties in multiple learning tasks in respect to non-apraxic patients and normal control subjects. All five groups were submitted to gesture learning task, motor skill learning task, supra-span (Corsi) learning task. The results indicate that learning difficulties were present in LBD+ patients, as demonstrated by their low performance in gesture sequence, motor skill and score of block-tapping supra-span task. This fact may be seen as a basic learning deficit and therefore linked to memory impairment. On the other hand, this could be tied to an aspecific more diffuse deterioration of attention if we consider that our apraxic patients had a greater cerebral lesion than non-apraxic patients.

Aged↗

PubMedDate not supplied

A comparison of two reading interventions for children with reading disabilities.

This study compared the effectiveness of two reading interventions in a public school setting. Forty-five second-grade children with reading disabilities were randomly assigned to a 6-week phonological awareness, word analogy, or math-training program. The two reading interventions differed from each other in (a) the unit of word analysis (phoneme versus onset-rime), (b) the approach to intervention (contextualized versus decontextualized), and (c) the primary domain of reading instruction (oral versus written language). Results indicate that children in both reading programs achieved significant gains in beginning reading skills, learning the specific skills taught in their respective programs, and applying what they had learned to uninstructed material on several transfer-of-learning measures, in comparison to children in the control group. For children in both reading intervention groups, the most significant mediator of growth in oral reading fluency was a child's initial level of word identification skill. Implications of these findings are that systematic, high quality reading intervention can occur in a small group, public school setting and that there are several different paths to the remediation of children with reading disabilities.

Child↗

PubMed1998

A simple model for learning stereotactic skills in ultrasound-guided amniocentesis.

BACKGROUND: Amniocentesis is an important procedure for antenatal diagnosis but requires stereotactic skill acquisition that may be facilitated by the use of a model. TECHNIQUE: A model using a gelatin mold with "targets" within is created. The model is used to facilitate development of stereotactic skills and to demonstrate technique principles for ultrasound-guided amniocentesis. EXPERIENCE: The model has been incorporated into an educational program for antenatal diagnosis within a residency and provides a reasonable simulation of clinical features important in learning genetic amniocentesis. CONCLUSION: The use of this model augments the learning of important skills needed for ultrasound-guided amniocentesis.

Amniocentesis↗

PubMed1998

Learning manual skills in anesthesiology: Is there a recommended number of cases for anesthetic procedures?

UNLABELLED: The learning process is a multidimensional function with a wide intra- and interindividual scattering. To determine the learning process in anesthesia, we evaluated 11 first-year residents according to their rate of success or failure when applying manual anesthesiological skills, such as performance of spinal, epidural, or brachial plexus anesthesia and tracheal intubation or insertion of an arterial line. Epidural anesthesia was the most difficult procedure (P < 0.05). Significant differences were found between epidural anesthesia and tracheal intubation (P < 0.05), insertion of an arterial line (P < 0.05), and brachial plexus block (P < 0.05), as well as between spinal anesthesia and orotracheal intubation (P < 0.05). Learning curves are a valid tool for monitoring institutional and individual success. IMPLICATIONS: To investigate the learning process in anesthesia, typical anesthetic procedures were performed by inexperienced residents during their first year. Learning curves were generated for each procedure performed. Epidural anesthesia was the most difficult procedure to perform (P < 0.05).

Anesthesia, Epidural↗

PubMed2005

Distinct neural systems underlie learning visuomotor and spatial representations of motor skills.

Motor skill learning depends upon acquiring knowledge about multiple features of sequential behaviors, including their visuomotor and spatial properties. To investigate the neural systems that distinguish these representations, we carried out functional magnetic resonance imaging (fMRI) as healthy adults learned to type sequences on a novel keyboard. On the initial training day, learning-related changes in brain activation were found in distributed cortical regions, only a subset of which correlated with improvements in movement time (MT), suggesting their preeminence in controlling movements online. Subjects received extended training on the sequences during the ensuing week, after which they returned to the scanner for another imaging session. Relative to performance at the end of the first training day, continued plasticity was most striking in the inferior parietal cortex and new areas of plasticity were uncovered in the caudate and cerebellum. Plasticity in these regions correlated with reaction time (RT), suggesting their role in planning sequences before movement onset. Two transfer conditions probed for "what" subjects learned. The probe for visuomotor learning produced increased activation in visual analysis (left inferior visual cortex) and advance planning (left caudate) systems. The probe for spatial learning produced increased activation in visuomotor-transformation (left dorsal visual pathway) and retrieval (left precuneus) systems. Increased activity in all of these regions correlated with increased RT, but not MT, indicating that both transfer conditions interfered with the neural representation of plans for the sequences, but not processes that controlled their implementation. These findings demonstrated that neuroanatomically dissociable systems support the acquisition of visuomotor and spatial representations of actions.

Adolescent↗

PubMed2003

The effectiveness of grammar instruction for individuals who use augmentative and alternative communication systems: a preliminary study.

This study examined the effectiveness of an instructional program designed to teach grammar skills to individuals who communicated via augmentative and alternative communication (AAC). A single-subject, multiple probe across behaviors design was used to measure the effect of the instructional program on the acquisition and maintenance of the skills learned. Two adults with cerebral palsy participated in the study. The instructional program was used to teach 2 grammatical forms to each participant. Word order in adjective phrases and inversion of the auxiliary do in wh- questions was targeted for 1 participant; use of possessive pronouns and inclusion of to when using infinitives as modal verbs was targeted for the second participant. The instructional program was shown to be effective. Both participants learned to produce the grammatical forms taught. One participant maintained these skills for at least 2 months after the completion of instruction; the other participant required additional instruction in order to maintain the skills learned. Although based on a small sample, the results suggest that intervention can help individuals who use AAC improve their grammar skills. Limitations of the study are discussed, along with directions for future research.

Adult↗

PubMed2006

Motor-skill learning-associated gene regulation in the striatum: effects of cocaine.

Psychostimulant-induced molecular changes in cortico-basal ganglia-cortical circuits play a critical role in addiction and dependence. These changes include alterations in gene regulation particularly in projection neurons of the sensorimotor striatum. We previously showed that cocaine-induced gene regulation in such neurons is dependent on the behavior performed during drug action. Rats trained on a running wheel under the influence of cocaine for 4 days subsequently displayed greater c-fos induction by cocaine than untrained controls. This effect was selective for the sensorimotor striatum, which is known to mediate forms of motor learning. In the present study, we investigated whether this enhanced cellular responsiveness was associated with learning of wheel running or with prolonged running (exercising), by assessing c-fos inducibility after 1, 2, or 8 days of training. Wheel training was performed after injection of cocaine (25 mg/kg) or vehicle, and c-fos induction by a cocaine challenge was measured 24 h later. Rats that trained under cocaine (but not vehicle) showed a greater c-fos response in the striatum compared to locked-wheel controls. This effect was present after the 1-day training, peaked after 2 days, and dissipated by 8 days of training. Similar effects were found for substance P, but not enkephalin, expression. These changes in striatal gene regulation paralleled improvement in wheel running, which was facilitated by cocaine. Thus, these training-induced molecular changes do not appear to represent exercising effects, but may reflect motor learning-associated neuronal changes altered by cocaine. Such cocaine effects may contribute to aberrant motor learning implicated in psychostimulant addiction.

Animals↗

PubMed1994

Explicit memory, procedural learning and lexical priming in Alzheimer's disease.

Different aspects of memory functions were studied in two groups of patients with Alzheimer's disease (AD) and in normal elderly controls. The tests included: explicit memory tests with free and cued recall, and recognition measures; learning of a motor skill; learning of a perceptual skill with verbal material; a priming task with the word stem completion paradigm. The data confirmed that, besides severe impairment for all measures of explicit memory, AD patients were able to learn and retain normally a motor skill in the rotor pursuit task, even across a long retention interval. Moreover, sparing of procedural learning was not restricted to motor tasks, since patients learned normally a mirror-reading task, demonstrating (a) rapid acquisition of the procedure, and (b) acquisition of item-specific information for repeated words. This last effect is accounted for in terms of repetition priming effects rather than of explicit memory strategies, since patients had also normal repetition effect in the word stem completion paradigm.

Aged↗

PubMed2004

Altered expression of BDNF and its high-affinity receptor TrkB in response to complex motor learning and moderate exercise.

We report that rats learning complex motor skills or exercising moderately show changes in expression of brain-derived neurotrophic factor (BDNF) and its receptor, TrkB protein, in cerebellum and motor cortex. It is now known that physical activity increases expression of some neurotrophins. We examined the time course of BDNF and TrkB expression after 1, 3, 5, 7 or 14 days in one of three conditions: (1) an "acrobatic" motor skill learning condition (AC), (2) a motor activity condition (moderately paced running on a flat track; MC) and (3) an inactive social-only control (SC) that served as a baseline group. Expression levels of BDNF and TrkB were evaluated by measuring relative optical density of the immunocytochemical reaction product. In cerebellar molecular layer, expression of BDNF correlated significantly with time spent in AC and MC over the first 7 days of training and remained elevated after 14 days of AC but not of MC. Changes in TrkB protein expression in cerebellar molecular layer mirrored those for BDNF during the first 7 days of training, but subsequently its expression subsided to the control level. In motor cortex, a significant increase in BDNF and TrkB protein expression was detected in the upper layers after 14 days in AC. Increased expression of BDNF, but not of TrkB, was observed in upper motor cortical layers after 14 days of MC. These data indicate that complex motor learning and moderate physical activity with little learning produce different effects on the expression pattern of BDNF and its receptor and may have implications for neural plasticity arising from such experiences.

Analysis of Variance↗

PubMed2003

Learning the skills of flexible sigmoidoscopy - the wider perspective.

BACKGROUND: Nurse-led gastrointestinal endoscopy is a priority clinical area in the UK. Endoscopic procedures are challenging to learn, requiring a combination of technical competence (manipulating a flexible endoscope and interpreting the findings) and interpersonal skills (engaging effectively with a conscious patient who is frequently apprehensive). This paper explores the potential of an innovative, scenario-based approach which links a simulated patient with a computer-driven virtual reality (VR) training device for flexible sigmoidoscopy. Within this safe yet realistic quasi-clinical environment, learners carry out the procedure while interacting with the 'patient'. Communication skills are assessed by simulated patients, while quantitative performance data relating to the procedure is generated automatically by the VR simulator. METHODS: This pilot study took place within a nurse practitioner endoscopy course. A mixed methodology combined qualitative and quantitative data (observation and interview studies, communication rating scales and a range of computer-generated output measures from the VR simulator) in a multifaceted evaluation. RESULTS: Seven nurses took part in the study. Participants found the scenarios to be a convincing and powerful learning experience. All experienced high levels of anxiety. Simulated patients identified strengths in participants' communication skills, together with areas for development. Simulator-based practice led to an improvement in objective performance measures. DISCUSSION: Scenario-based training provides a powerful learning experience, allowing participants to build their technical expertise and apply it within a holistic clinical context without the risk of causing harm. We used this pilot study as a springboard for discussions over wider implications of procedure-based skills training, locating it within the literature on expertise and situated learning.

Clinical Competence↗

PubMed2003

Contextual interference in learning precision skills.

This research studied the effect of different organisations of practice (blocked and random) on the learning of three different types of throwing. 35 male students practiced three precise throws for 3 wk. Initially the subjects were separated into two groups who trained under different conditions of practice (blocked and random). All subjects improved significantly from initial performance, with both blocked practice and random practice. At the end of acquisition no differences were found between the groups. No significant differences were found on retention tests carried out 48 hr., 4 wk., and 8 wk. after the training period.

Adult↗

PubMed1985

Memory disorders associated with Huntington's disease: verbal recall, verbal recognition and procedural memory.

Two experiments were conducted to evaluate the hypothesis that the memory disorders of Huntington's Disease (HD) patients are characterized by deficiencies in both retrieval mechanisms and the acquisition of procedural (skill-based) information. In the first study, verbal recall and recognition tests were administered to HD patients, amnesics and normal control (NC) subjects. Although the two patient groups were impaired relative to NC subjects on both recall and recognition of word lists, the performance of the HD patients was superior to that of the amnesics on the recognition test. In the second experiment early HD (EHD), advanced HD (AHD), amnesic and NC subjects were compared in the acquisition of the 'Tower of Hanoi' puzzle. Both the NC subjects and EHD patients acquired the solution of this puzzle after repeated trials, whereas the AHD and amnesic patients evidenced little improvement. However, on a recognition test assessing memory for facts about the puzzle, both the EHD and AHD patients were superior to the amnesic subjects. These results are consistent with the retrieval hypothesis but are equivocal with regard to the HD patients' proposed deficit in skill learning. Since the 'Tower' puzzle may rely heavily on both problem solving and skill learning capabilities, it may be of limited value in searching for double dissociations between patient groups and the acquisition of skill-based and data-based knowledge.

Adult↗

PubMed2001

Prefrontal lesions impair the implicit and explicit learning of sequences on visuomotor tasks.

OBJECTIVE: (1) To verify whether the prefrontal cortex (PFC) is specifically involved in visuomotor sequence learning as opposed to other forms of motor learning and (2) to establish the role of executive functions in visuomotor sequence learning. BACKGROUND: Visuomotor skill learning depends on the integrity of the premotor and parietal cortex; the prefrontal cortex, however, is essential when the learning of a sequence is required. METHODS: We studied 25 patients with PFC lesions and 86 controls matched for age and educational level. Participants performed: (1) a Pursuit Tracking Task (PTT), composed of a random tracking task (perceptual learning) and a pattern tracking task (explicit motor sequence learning with learning indicated by the decrease in mean root square error across trial blocks), (2) a 12-item sequence version of a serial reaction time task (SRTT) with specific implicit motor sequence learning indicated by the rebound increase in response time when comparing the last sequence block with the next random block, and (3) a neuropsychological battery that assessed executive functions. RESULTS: PFC patients were impaired in sequence learning on the pattern tracking task of the PTT and on the SRTT as compared to controls, but performed normally on the PTT random tracking task. Learning on the PTT did not correlate with learning on the SRTT. PTT performance correlated with planning functions while SRTT performance correlated with working memory capacity. CONCLUSIONS: The PFC is specifically involved in explicit and implicit motor sequence learning. Different PFC regions may be selectively involved in such learning depending on the cognitive demands of the sequential task.

Adult↗

PubMed1981

Brain space for a learned task.

Forty-six adult male and female canaries were sacrificed, their brains were weighed and the volume of several brain nuclei reconstructed from the cresyl violet-stained material. Two forebrain vocal control nuclei, hyperstriatum ventrale, pars caudale (HVc) and nucleus robustus archistriatalis (RA), were approximately 4 and 3 times larger, respectively, in males than in females, confirming previous findings. There was no consistent right-left asymmetry in the volume of these nuclei in males and females. Twenty-five male birds in this study had their song repertoire recorded during the peak of the singing season. They were sacrificed 3 to 4 months later. The size of the song repertoire, measured as number of different syllable types, showed a positive and significant correlation with the size of HVc and RA. There was no significant correlation between size of the syllable repertoire and age, brain weight or the volume of two brain nuclei not involved in song control. This is the first time that the amount of brain allotted to a specific learned skill has been shown to correlate positively with the amount of that skill that is learned. Interestingly, too, there was a positive and significant correlation between testis weight at the end of the breeding season and the volume of RA at that time, suggesting a hormone-mediated seasonal modulation of part of the brain space occupied by song control pathways. This material seems well suited for studying the relation between space and learning, and the manner in which this relation is influenced by gonadal hormones.

Animals↗

PubMed2000

Improving dietetics education with interactive communication technology.

Changes occurring in health care, education, and technology are altering dietetics education. A model of learnercentered, cooperative, distance education based on interactive online technology is described for use in a dietetic internship. Evaluation of this model includes review of key-feature exams, results of computer attitudes surveys, use of the technology by interns, exit interviews, and performance on the examination for registered dietitians. In a pilot study of the model with 8 subjects, comfort using the Internet improved significantly. Use of interactive communication technology in dietetics education has the potential to improve competency, technological aptitude, professional partnering skills, and lifelong learning skills.

CD-I↗