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At least 343 records · Page 19Linked to original sources

PubMed2002

Translating learning principles into practice: a new strategy for learning clinical skills.

AIM: There are data to suggest that medical school may not adequately prepare doctors for practice and that there are deficiencies in undergraduate teaching of skills in history taking, physical examination, diagnosis and management (clinical skills). There is a need to re-evaluate methods by which we can teach clinical skills effectively. This aim of this review was to describe the literature concerning the important principles underpinning effective clinical learning. Subsequently a structured learning tool and teaching process was developed in order to support these principles. METHOD: The principles of effective clinical learning were derived after a search of the medical education and relevant behavioural science literature. Consequently, a structured learning tool and teaching process was developed in order to potentiate the translation of these principles into practice for medical school training in clinical skills. RESULTS: Ten principles were derived from the 68 articles referred to in this review. These were: making active decisions, an individual focus to learning, gaining experience, feedback to the learner, reciprocal learning, holistic care, relevant learning, feasibility, cost efficiency and mentoring. A process for history taking, physical examination and management plan was developed for medical students which incorporated these principles. CONCLUSION: Relevant literature can provide the foundations for teaching and learning methods in medical education. We plan to trial this method and evaluate the impact on student learning outcomes.

Clinical Competence↗

PubMed2005

Communication in collaborative discovery learning.

BACKGROUND: Constructivist approaches to learning focus on learning environments in which students have the opportunity to construct knowledge themselves, and negotiate this knowledge with others. Discovery learning and collaborative learning are examples of learning contexts that cater for knowledge construction processes. We introduce a computer-based learning environment in which the two forms of learning are implemented simultaneously. We focus on the interaction between discovery learning and collaborative learning. AIM: We aim to investigate which communicative activities are frequently used in the discovery learning process and which communicative and discovery activities co-occur. SAMPLE: The study involved 21 pairs of 10th-grade students enrolled in pre-university education, ranging from 15 to 17 years of age. METHOD: Participants worked in dyads on separate screens in a shared discovery learning environment. They communicated using a chat box. In order to find a possible relationship between communicative activities and discovery learning processes, correlational analysis and principal component analysis were performed. RESULT: Significant relationships were found between communicative and discovery activities, as well as five factors combining the communicative process and the discovery learning processes. Communicative activities are performed most frequently during the activities in generating hypotheses, experimental design, and conclusion construction. Argumentation occurs less than expected, and is associated with the construction of conclusions, rather than generating hypotheses. CONCLUSION: Communicative activities co-occur with discovery activities most of the time, as we expected. Further research should concentrate on means to augment communicative and discovery activities that are related to positive learning outcomes.

Adolescent↗

PubMedDate not supplied

A comparison of training strategies to enhance use of external aids by persons with dementia.

UNLABELLED: The purpose of this study was to compare the effectiveness of two training approaches, Spaced Retrieval (SR) and a modified Cueing Hierarchy (CH), for teaching persons with dementia a strategy goal involving an external memory aid. Twenty-five persons with dementia living in either community or nursing home settings received training on two individual-specific strategy goals, one with each training approach. Results revealed that significantly more goals were attained using SR procedures than CH, but that a majority of participants learned to use external aids using both strategies. There were no significant differences in the number of sessions required to master goals in either condition; however, significantly more SR goals were maintained at both 1-week and 4-months post-training compared to CH goals. Mental status was not significantly correlated with goal mastery, suggesting the potential benefits of strategy training beyond the early stages of dementia. LEARNING OUTCOMES: As a result of this activity, the reader will be able to (1) identify ways to enable persons with dementia to make effective use of external memory aids; (2) describe a method, Spaced Retrieval, by which persons with dementia can learn and retain information; and (3) describe two approaches to working with persons with dementia to train a strategy learning goal.

Aged↗

PubMed2006

Outcomes of interprofessional education for Community Mental Health Services in England: the longitudinal evaluation of a postgraduate programme.

We report a comprehensive, longitudinal evaluation of a two-year, part-time postgraduate programme designed to enable health and social care professionals in England to work together to deliver new community mental health services, including psychosocial interventions (PSIs). The study tracked three successive cohorts of students (N = 111) through their learning. Outcomes were assessed according to the Kirkpatrick/Barr et al. framework using a mixed methodology, which employed both quantitative measures and interviews. The students evaluated the programme positively and appreciated its focus on interprofessional learning and partnership with services users, but mean levels of stress increased and almost one quarter dropped out. There was considerable evidence of professional stereotyping but little evidence of change in these during the programme. Students reported substantial increases in their knowledge and skills in multidisciplinary team working and use of PSIs (p < 0.001). Experiences in the implementation of learning varied; in general, students reported significantly greater role conflict (p = 0.01) compared to a sample of their team colleagues (N = 62), but there was strong evidence from self-report measures (p < 0.001) and work-place interviews that the students' use of PSIs had increased. Users with severe mental health problems (N = 72) randomly selected from caseloads of two cohorts of students improved over six months in terms of their social functioning (p = 0.047) and life satisfaction (p = 0.014). Having controlled statistically for differences in baseline score, those in the intervention (programme) group retained a significant advantage in terms of life skills (p < 0.001) compared to service users in two non-intervention comparison groups (N = 133). Responses on a user-defined measure indicated a high level of satisfaction with students' knowledge, skills and personal qualities. We conclude that that there is strong evidence that a well-designed programme of IPE can be effective in helping students to learn new knowledge and skills, and to implement their learning in the workplace. Further, we consider that there is some modest evidence of the benefits of such learning for service users.

Adult↗

PubMed1999

Education and training module for a specialist registrar: a move forward in specialist registrar education.

A new post was created in Portsmouth. This produced the opportunity, for a new and innovative approach to the education and training module for the specialist registrar (SpR) training programme. The GP tutor with supervision from the university, designed, implemented and evaluated the module. It took place during the first five months of the SpR contract. The method used was a case study in which the SpR was encouraged to reflect on practice. The learning outcomes were documented initially by the GP tutor and,finally, by the SpR using a logbook based on the dental professional development log. Reflecting on practice enabled the SpR to produce the evidence of her own learning and plan her future learning needs. The project highlights the advantages and problems of reflecting on practice. These issues must be addressed if the conflict between the need to produce the competent doctor and the demands of an educationally sound programme are to be resolved, to create critical thinking and autonomous lifelong, self-directed learners.

Education, Medical↗

PubMed1988

Patient education.

The 120 studies included in this review were grouped in relation to five categories of variables basic to a theory of instruction in patient education. Findings in the studies related to the characteristics of the patient as learner support the following variables as significant for a theory of instruction: demographic characteristics including age, race, duration and type of illness, educational level, and family preparedness. Selected psychological variables are significant as they interact with teaching approaches. Given only two studies in which the characteristics of the nurse as teacher were the main variables, no inferences for a theory of instruction could be drawn. However, the findings from those studies combined with results from studies in which characteristics of the nurse were secondary variables support the importance of this category of variables. The educational preparation, motivation, values, and job description of the nurse implementing patient teaching appear to be significant variables for a theory of instruction. Investigators explored a wide range of teaching strategies in the studies of patient teaching. The setting for teaching, group and individual teaching, and a variety of instructional strategies all prove promising at the operational level. The instructional strategies were too diverse to allow analysis at a level of abstraction beyond the operational. Findings in this review also support characteristics of the health care setting as an important category of variables for a theory of instruction. The organizational structure, a quality assurance framework, and valuing patient teaching appear to be significant variables. Patient education research provides a rich data source for future developments in theory, practice, and research. The effectiveness of patient education as a nursing intervention is clearly established. Furthermore, positive learning outcomes are associated with a broad range of teaching strategies, content areas, and patient populations. Systematic explorations of the characteristics of the patient as learner, the nurse as teacher, and the health care setting as a learning environment are still necessary for developing a theory of instruction for patient education. Future researchers should attend to phenomena unique to patient education rather than to duplicating general educational research. Instead of the investigator-driven research approach that characterizes research to date, replication should be encouraged. Future research should be designed to link theory and research and thereby contribute to the further development of a theory of instruction in patient education.

Cardiac Rehabilitation↗

PubMedDate not supplied

Curriculum revision: product innovation for quality outcomes.

The education of any professional discipline rests on a curricular foundation that reflects the discipline's theory and knowledge bases, practice patterns, and unique skills. In addition, professional health care education must respond to and reflect changes in technology, societal definitions of health and wellness, and broad social issues such as access to care, health care funding, and changing patient demographics. These issues are interwoven with efforts to also provide high-quality education with positive learning outcomes. In this article, the authors describe a school of nursing's efforts to revise its curriculum to reflect a professional shift in focus to community-based nursing practice and the goals of the federal health goals outlined in Healthy People 2010. The revision also served as the starting point for a change in the process through which the college will seek accreditation in the future; this process-Academic Quality Improvement Program-requires institutions of higher learning to use a continuous quality model as its base.

Community Health Services↗

PubMed2001

Approaches to learning in science: a longitudinal study.

BACKGROUND: Longitudinal studies of students' approaches to learning in higher education can tell us much about the impact of the tertiary experience. More information about teaching and learning practices and how students respond to these may enable educators to better assist students to gain the maximum benefit from their tertiary studies. AIMS: The study set out: (i) to monitor the change in approaches to learning over a three-year period; (ii) to evaluate the relationship between student age, sex and university entry mode on students' approaches to learning; and (iii) to evaluate the predictive validity of the SPQ scales on one mode of learning outcome, that being annual GPA. SAMPLES: The sample consisted of 200 commencing students studying in a science course at an Australian university. METHOD: The Biggs SPQ was administered in a first-year chemistry class and repeated at intervals of 4 and 8 months. This was followed by administration by post after 16 months and 30 months. RESULTS: Student approach to learning is dynamic and amenable to change as a result of the learning experience. Of the three SPQ scales, the achieving approach appears to undergo the greatest change with time, while the deep approach showed a consistent positive correlation with assessment outcomes. Student age was a major factor in both the SPQ scores and assessment outcomes but no gender effect was evident. CONCLUSIONS: Students see university study, and in particular the first year, as a survival course and adopt strategies suited to that task. Older students adopt approaches to study which differ from their younger colleagues and as a consequence they are in general more successful in the tertiary environment.

Adolescent↗

PubMed2006

Genetics education in the nursing profession: literature review.

AIM: This paper reports a literature review exploring genetics education for nursing professionals. The aim was to contribute to the debate about the future direction of such education. BACKGROUND: Advances in genetics science and technology have profound implications for health care and the growing importance and relevance of genetics for everyday nursing practice is increasingly recognized. METHOD: A search was conducted in February 2005 using the CINAHL and Google Scholar databases and the keywords nurse, midwife, health visitor, education and genetics. Papers were included if they were published in English between 1994 and 2005 and included empirical data about genetics education in nursing. In addition, attempts were made to access the grey literature, with requests for information on research, for example, to members of the Association of Genetic Nurses and Counsellors and searches of relevant websites. FINDINGS: Agreement on the relevance of genetics for nursing practice is extensive. Empirical evidence of the learning needs of practitioners highlights widespread deficits in knowledge and skills, and low confidence levels. Provision of nursing education in genetics is patchy and insubstantial across a number of countries, further hampered by lack of strategic development. Significant progress has been made in the identification of learning outcomes for nurses. Research on the delivery of genetics education is limited, but the role of skills-based training, use of clinical scenarios, and importance of assessment have all been identified as factors that can promote learning. CONCLUSION: Whilst areas of good performance were revealed, many studies identified gaps in professional competence and/or education. New initiatives are underway to support genetics education and its integration into professional practice, but further research is needed on the most effective forms of educational delivery, and an international collaborative approach to this should be considered.

Clinical Competence↗

PubMed1993

Accreditation of prior learning: andragogy in action or a 'cut price' approach to education?

The rapid changes in nurse education are proceeding within the wider context of developments in adjacent educational fields, which are themselves subject to external influences, and one such development is the accreditation of prior experiential learning (APEL). In order to be critically aware of the potential involved in embracing this concept, it is necessary to clarify and examine the influencing factors which guide the current andragogical climate of nurse education, and those which predispose to the recognition of APEL. Utilizing a case-study approach, this paper will examine the relevant issues as they relate to experienced students pursuing the learning outcomes of Project 2000, and will address the question of value for all parties concerned.

Accreditation↗

PubMed2001

Students' perception of problem-based learning in the medical curriculum of the Faculty of Medicine, University of Colombo.

INTRODUCTION: Problem-based learning (PBL) is used as an instructional method in the system-based modules of the new innovative curriculum of the Colombo Medical Faculty in Sri Lanka. This study was undertaken to assess whether objectives of having PBL to facilitate acquisition of desirable learning skills and generic skills had been achieved. The perceived advantages and disadvantages of PBL were also studied. MATERIALS AND METHODS: The study population comprised third year medical students who had completed 12 PBL sessions. A self-administered questionnaire, which measured learning outcomes and acquisition of generic skills on a 5-point Likert rating scale, was used. RESULTS: The response rate was 87.2% (n = 188). Eighty per cent of students were aware of the rationale for having PBL and of learning from recommended material. Seventy-five per cent knew the competencies that could be acquired from PBL and two-thirds knew about the importance of small group discussions. PBL had helped to improve communication skills in 57% and problem solving skills in 52%. The main disadvantage was that it was time-consuming. Only 46.6% were satisfied with the participation of colleagues in the group. Seventy-six per cent felt that PBL could be better conducted. CONCLUSION: Awareness of concepts of PBL, reasons for its inclusion in the curriculum and educational advantage was high. The main disadvantage perceived was that it was time-consuming. There is a need to improve the conduct of PBL and, provide guidance and awareness programme for students.

Attitude↗

PubMedDate not supplied

Outcome assessment in aphasia: a survey.

UNLABELLED: There has been a marked increase in attention to the measurement of "outcomes" after speech-language intervention for adult aphasia. Consumers, speech-language pathologists (SLPs), and funding sources desire evidence of therapy outcomes that improve communication and enhance the quality of life for people with aphasia. While many assessment tools are available to measure outcomes after aphasia therapy, there is little information regarding the use of these tools in everyday practice by SLPs. Therefore, the current investigation was undertaken to identify and describe the practices of SLPs relative to outcome assessment in aphasia. An online survey of outcome assessment practices was distributed. Results revealed that 85% of the 94 respondents reportedly perform outcome assessment. A majority of respondents reported barriers to assessment such as time and funding limitations. Considerable variability existed in the types of assessments and the actual tools reported. The impact of the results on clinical practice is discussed. LEARNING OUTCOMES: As a result of this activity the reader will be able to (1) define outcome assessment in aphasia, (2) describe patterns of outcome assessment in aphasia as reported by survey respondents, and (3) describe a conceptual framework for situating outcome assessment in aphasia.

Adult↗

PubMed2001

Structuring student learning in the primary care setting: where is the evidence?

Over the past two decades, the majority of medical schools in the USA have embarked upon curricular initiatives to enhance the teaching of ambulatory or office-based primary care. Identifying characteristics of these primary care experiences that make for the most effective learning is a top priority in medical education research. In this paper we examine what is known about the influence of variability in the structure of primary care experiences on student learning outcomes. We examine the questions of how rotations are scheduled, who does the teaching and where the teaching takes place. Given the variability in curricula across the 125 accredited medical schools in the USA and the absence of agreed-upon objectives, outcomes or assessment measures for primary care education, it is not surprising that the current literature has fallen short in providing definitive answers. There is much debate about the benefits of community vs. campus sites, longitudinal vs. block experiences, and the influence of specialty training of the preceptor, but little in the current literature to guide and substantiate a programme's choice. What can be concluded with relative confidence is that clinics currently offer more active student experiences than do private offices, that students may be more satisfied with rural experiences than with urban or suburban experiences, and that longitudinal and block experiences have different learning advantages. Research in primary care medical education will benefit from the current movement towards a cross-institutional consensus on educational objectives and outcome measures and on the general application of a more rigorous research methodology.

Clinical Competence↗

PubMed2003

The promise of new ideas and new technology for improving teaching and learning.

There have been enormous advances in our understanding of human learning in the past three decades. There have also been important advances in our understanding of the nature of knowledge and new knowledge creation. These advances, when combined with the explosive development of the Internet and other technologies, permit advances in educational practices at least as important as the invention of the printing press in 1460. We have built on the cognitive learning theory of David Ausubel and various sources of new ideas on epistemology. Our research program has focused on understanding meaningful learning and on developing better methods to achieve such learning and to assess progress in meaningful learning. The concept map tool developed in our program has proved to be highly effective both in promoting meaningful learning and in assessing learning outcomes. Concept mapping strategies are also proving powerful for eliciting, capturing, and archiving knowledge of experts and organizations. New technology for creating concept maps developed at the University of West Florida permits easier and better concept map construction, thus facilitating learning, knowledge capture, and local or distance creation and sharing of structured knowledge, especially when utilized with the Internet. A huge gap exists between what we now know to improve learning and use of knowledge and the practices currently in place in most schools and corporations. There are promising projects in progress that may help to achieve accelerated advances. These include projects in schools at all educational levels, including projects in Colombia, Costa Rica, Italy, Spain, and the United States, and collaborative projects with corporate organizations and distance learning projects. Results to date have been encouraging and suggest that we may be moving from the lag phase of educational innovation to a phase of exponential growth.

Comprehension↗

PubMed2000

Assessment of graduates and diplomates in practice in the UK--are we measuring the same level of competence?

With the recent proliferation in nursing degree programmes over the last 10 years and a suggestion that nursing moves towards an all-graduate profession, the profession as well as the consumer needs to be sure that they are getting 'value added' with this 'higher level' practitioner. This paper revisits the debate on the meaning of competence in relation to fitness for practice. In particular it examines the expectations of the profession of newly registered practitioners at both diploma and degree levels of practice. It questions whether there is a difference in their level of competence at point of registration and whether it is possible to measure it. The paper presents a reflective approach to promoting ideas already emerging from the literature in relation to this measurement. It suggests a more effective use of students' portfolios of evidence against stated learning outcomes as well as their specific achievements in a range of transferable skills. A partnership approach between student, practitioner/assessor and academic could usefully share responsibilities of the assessment of competence and ultimately empower the individual for their life-long learning.

Clinical Competence↗

PubMedDate not supplied

Levels of evidence: universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI).

UNLABELLED: Levels of evidence differ according to the audience addressed. Implementation of universal newborn hearing screening requires responses to a complex myriad of diverse groups: the general public, families with children who are deaf or hard of hearing, the deaf and hard of hearing communities, hospital administrators, physicians (pediatricians, general practitioners, ear nose and throat physicians, geneticists), managed care, Medicaid, insurance agencies, and politicians. The level of evidence required by medical/health agencies and task forces may differ from the levels of evidence available in education and intervention. Issues related to the low incidence of the disability, the lack of a normal distribution within the disability study, the obstacles to random assignment to treatment, and designs that include a control group with "no treatment" have implications legally and ethically for the professional providing services to families and children who are deaf or hard of hearing. This session will discuss issues related to "convenience samples," number of subjects included in research studies, and the population required to obtain a large enough sample of children with low-incidence disabilities. The level of evidence required to demonstrate sensitive periods of development, which are a critical element for justification of implementing a universal newborn hearing screening includes both behavioral and neurological information. Sensitive periods may have different duration for different aspects of development, such as social-emotional development, auditory and speech development, or language development. Further complicating the question of sensitive periods of development are the distinct possibility that different sensitive periods exist for development of age-level vocabulary, for establishing English phonology, or for mastering English syntax. Research outcomes provide evidence that age of identification of hearing loss is reduced, that age of intervention initiation is lowered, and that the outcomes of intervention are better because of the establishment of a screening program. Most professionals in communication disorders believe that screening is not the actual cause of better developmental outcomes but that the age when children begin to have access to language and communication and the characteristics of the intervention are the primary cause of better outcomes. Screening is the avenue through which access to quality intervention is made available. The research still remains at an infant level of development such that there is very little evidence for the efficacy of specific characteristics of the intervention provided. LEARNING OUTCOMES: (1) The learner will be able to identify the obstacles in conducting research on the effectiveness of intervention of children identified through universal newborn hearing screening programs. (2) The learner will be able to identify the type of research on developmental outcomes of children with early-identified hearing loss.

Cost-Benefit Analysis↗

PubMedDate not supplied

Female incarcerated adolescents with language problems talk about their own communication behaviors and learning.

UNLABELLED: Qualitative methodology was used to explore communication behaviors of 13 female adolescents with language problems who resided in a correctional facility. Girls between ages of 13 and 17 were interviewed on four questions about their communication behaviors and school learning experiences. Data were analyzed from three triangulated sources that included interviews, a review of school records, and test results from the Clinical Evaluation of Language Fundamentals-3, the Adolescent WORD Test (WORD Test), the Comprehensive Assessment of Spoken Language (CASL), and the Peabody Picture Vocabulary Test-III (PPVT-III). Themes emerging from the interviews were: (a) how teenagers communicate with friends, parents, and authority; (b) participants' views about themselves; and (c) how they describe their learning in school. Many spoke about their feelings and interactions as well as their struggles with listening, thinking, speaking, and reading. Implications raise concerns of whether the current educational system is adequately considering how language deficits and disorders impact this troubled population. LEARNING OUTCOMES: (1) Readers will understand how female adolescents with language problems who resided in a correctional facility view their communication with friends and authority figures such as parents, teachers, and correctional educators. (2) Readers will understand the views of adolescents about their learning experiences at school prior to when they were committed to a correctional facility. (3) Readers will understand examples of language behaviors that may have related to why some of the participants struggled with learning in school.

Adolescent↗

PubMed1997

Undergraduate nursing students' perceptions of their clinical learning environment.

The clinical learning environment (CLE) is an interactive network of forces influencing student learning outcomes in the clinical setting. This study used mixed methods to identify factors characterizing students' perceptions of the CLE. The sample consisted of 229 undergraduate students in the second or third year of their biophysical nursing strand. The five subscales of the Clinical Learning Environment Scale, 'staff-student relationships', 'nurse manager commitment', 'patient relationships', 'student satisfaction' and 'hierarchy and ritual', were supported by qualitative data obtained from student interviews. Interpersonal relationships between the participants in the CLE were crucial to the development of a positive learning environment. Student satisfaction with the CLE was both a result of, and influential in creating, a positive learning environment. Nurse educators, clinical venues, and all others participating in the undergraduate nursing students' clinical education, must collaborate in order to create a CLE which promotes the development of well-educated registered nurses capable of providing safe, cost-effective patient care.

Adult↗