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PubMed2002

Integrating on campus problem based learning and practice based learning: issues and challenges in using computer mediated communication.

The Faculty of Nursing, University of Newcastle, Australia, has been keen to initiate strategies that enhance student learning and nursing practice. Two strategies are problem based learning (PBL) and clinical practice. The Faculty has maintained a comparatively high proportion of the undergraduate hours in the clinical setting in times when financial constraints suggest that simulations and on campus laboratory experiences may be less expensive.Increasingly, computer based technologies are becoming sufficiently refined to support the exploration of nursing practice in a non-traditional lecture/tutorial environment. In 1998, a group of faculty members proposed that computer mediated instruction would provide an opportunity for partnership between students, academics and clinicians that would promote more positive outcomes for all and maintain the integrity of the PBL approach. This paper discusses the similarities between problem based and practice based learning and presents the findings of an evaluative study of the implementation of a practice based learning model that uses computer mediated communication to promote integration of practice experiences with the broader goals of the undergraduate curriculum.

Anecdotes as Topic↗
PubMed2002

Teaching basic life support skills using self-directed learning, a self-instructional video, access to practice manikins and learning in pairs.

Applying adult learning principles in healthcare education is increasingly recognised as useful and effective. We designed and evaluated an educational package for medical student basic life support (BLS) skills that placed the responsibility of skill acquisition with the learner. The package provided hardcopy and web based information, an in-house produced audio-video tape demonstrating BLS, and open access to manikins in a Skills Centre where the students learnt in pairs. Students determined when they were ready to be assessed. This assessment was performed by two independent observers using the Resuscitation Council (UK) BLS assessment sheet. Two groups, comprising in total 51 fourth year medical students were assessed, 47 were found to be competent in performing BLS on their first assessment. Of the remaining four, three were assessed as competent after further self-directed learning and retesting. Only one student required personal tutoring prior to success. Self-directed learning is a successful method of mastering BLS. Where failure occurred, it was due to inadequate student learning in the Skills Centre. The importance of practice needs emphasis in future use of the programme, as does the virtual guarantee of success, if all steps are followed. A similar programme could be devised for other technical skills.

Audiovisual Aids↗
PubMedDate not supplied

On-line learning in changing environments with applications in supervised and unsupervised learning.

An adaptive on-line algorithm extending the learning of learning idea is proposed and theoretically motivated. Relying only on gradient flow information it can be applied to learning continuous functions or distributions, even when no explicit loss function is given and the Hessian is not available. The framework is applied for unsupervised and supervised learning. Its efficiency is demonstrated for drifting and switching non-stationary blind separation tasks of acoustic signals. Furthermore applications to classification (US postal service data set) and time-series prediction in changing environments are presented.

Algorithms↗
PubMed2003

Selection for differences in avoidance learning: the Syracuse strains differ in anxiety, not learning ability.

In this review the derivation of the Syracuse (SHA/Bru and SLA/Bru) strains of hooded rats that were selectively bred for differences in active two-way shuttle-box avoidance learning is described, together with a summary of the behavioral, hormonal, anatomical, physiological, and pharmacological characteristics that covary with the realized phenotypes. A selective genetic analysis is also described, which indicates that all of the five assessed covariates cosegregate with the avoidance phenotypes and are, therefore, closely linked to the high- and low-avoidance genotypes, which also suggests that a relatively few closely linked genes underlie the realized phenotypes. The low-avoidance phenotype seems best characterized in terms of high levels of state/trait anxiety, whereas the reverse is true of the high-avoidance phenotype. Anomalous endocrine data seem not to be consistent with the behavioral interpretation and remain to be resolved. However, it also seems clear that having selected for a difference in avoidance learning, the realized phenotypes do not involve the fundamental neurobiological substrates of associative or instrumental learning. Rather, differences in factors in the affective domain (state and/or trait anxiety) that influence performance, rather than learning, per se, appear to have been selected genetically.

Animals↗
PubMed1979

Learned helplessness and learned effectiveness: effects of explicit response cues on individuals differing in personal control expectancies.

Female undergraduates (n = 62) who scored as extreme internals or externals on the Mirels Personal Fate Control Scale participated in a partial replication of Hiroto's learned helplessness experiment. Lights were added to the treatment apparatus, which made explicit to subjects the contingency or noncontingency between their responses and the termination of an aversive tone. As predicted, the performance of internals was significantly impaired by uncontrollability (learned helplessness), while that of externals was facilitated by controllability (learned effectiveness). Externals performed as well as internals in the "escapable" condition, but their performance was inferior to that of internals in the control condition. Following "inescapable" treatment, internals performed worse than externals. These results are supportive of Lefcourt's theory of cue explication. Implications for locus of control and learned helplessness research are discussed.

Acoustic Stimulation↗
PubMed2002

Simplified learning in complex situations: knowledge partitioning in function learning.

The authors explored the phenomenon that knowledge is not always integrated and consistent but may be partitioned into independent parcels that may contain mutually contradictory information. In 4 experiments, using a function learning paradigm, a binary context variable was paired with the continuous stimulus variable of a to-be-learned function. In the first 2 experiments, when context predicted the slope of a quadratic function, generalization was context specific. Because context did not predict function values, it is suggested that people use context to gate separate learning of simpler partial functions. The 3rd experiment showed that partitioning also occurs with a decreasing linear function, whereas the 4th study showed that partitioning is absent for a linearly increasing function. The results support the notion that people simplify complex learning tasks by acquiring independent parcels of knowledge.

Humans↗
PubMed2002

Models of performance in learning multisegment movement tasks: consequences for acquisition, retention, and judgments of learning.

Participants learned different keystroke patterns, each requiring that a key sequence be struck in a prescribed time. Trials of a given pattern were either blocked or interleaved randomly with trials on the other patterns and before each trial modeled timing information was presented that either matched or mismatched the movement to be executed next. In acquisition, blocked practice and matching models supported better performance than did random practice and mismatching models. In retention, however, random practice and mismatching models were associated with superior learning. Judgments of learning made during practice were more in line with acquisition than with retention performance, providing further evidence that a learner's current ease of access to a motor skill is a poor indicator of learning benefit.

Adolescent↗
PubMed2001

Behaviour modification and gentle teaching workshops: management of children with learning disabilities exhibiting challenging behaviour and implications for learning disability nursing.

BACKGROUND: Challenging behaviours (behaviour difficulties) represent a problem of considerable clinical significance for learning disability nurses, and a source of much human distress. Gentle teaching is a relatively new approach to dealing with behavioural difficulties, and has been received with enthusiasm by clinicians, but has so far received little empirical support. The current study attempted to compare gentle teaching with a well-established alternative (behaviour modification) and a control group. OBJECTIVES: To examine the comparative effectiveness of gentle teaching, behaviour modification and control interventions for challenging behaviour amongst children with learning disabilities. DESIGN: Nonrandomized controlled trial. SETTING: Service users' homes in East Yorkshire. PARTICIPANTS: Seventy-seven children who presented with learning disabilities and challenging behaviour (behaviour difficulties) and their parents. PROCEDURE: One-day workshops in were offered by recognized authorities in either behaviour modification or gentle teaching that were not otherwise involved with the research project. Forty-one participants were recruited to the gentle teaching condition; 36 to behaviour modification; 26 to the control group. Random allocation was not possible, because of the slow uptake by interested parents. Measures was preintervention, and at assessment points up until 12 months following intervention. ANALYSIS: Quantitative analysis of pre-post differences between the groups, using t-test. RESULTS: In general, no significant differences were found between the treatment groups and controls. Significant improvements were found for both gentle teachingand behaviour modification children over controls on the AAMR ABS XVII (social engagement) subscale. Controls had more contact with medical practitioner (GP) services than behaviour modification children and less than gentle teaching children. CONCLUSION: Although very few differences were found between the three groups, those that did exist generally favoured behaviour modification. Implications for service provision and learning disability nursing practice are described.

Adolescent↗
PubMed2005

Perceptual learning in clear displays optimizes perceptual expertise: learning the limiting process.

Human operators develop expertise in perceptual tasks by practice or perceptual learning. For noisy displays, practice improves performance by learned external-noise filtering. For clear displays, practice improves performance by improved amplification or enhancement of the stimulus. Can these two mechanisms of perceptual improvement be trained separately? In an orientation task, we found that training with clear displays generalized to performance in noisy displays, but we did not find the reverse to be true. In noisy displays, the noise in the stimulus limits performance. In clear displays, performance is limited by noisiness of internal representations and processes. Our results suggest that training in one display condition optimizes the limiting factor(s) in performance in that condition and that noise filtering is also improved by exposure to the stimulus in clear displays. The asymmetric pattern of transfer implies the existence of two independent mechanisms of perceptual learning, which may reflect channel re-weighting in adult visual system. These results also suggest that training operators with clear stimuli may suffice to improve performance in a range of clear and noisy environments by simultaneous learning by two mechanisms.

Humans↗
PubMed2005

Can a dedicated teaching and learning environment in ambulatory care improve the acquisition of learning outcomes?

Current trends in undergraduate medical education are moving away from traditional ward based learning to ambulatory care teaching. We wanted to know whether students gain more learning outcomes from a dedicated ambulatory teaching environment than a conventional outpatient clinic. A comparative evaluation study using a semi-structured student questionnaire and a structured patient questionnaire was performed. Results indicated the learning environment and organization of the teaching in the Ambulatory Care Teaching Centre (ACTC) rated higher. Surprisingly, however, more learning outcomes were achieved in the conventional outpatient clinic setting, but each venue demonstrated particular strengths with regard to individual outcomes. The level of patient satisfaction in the ACTC was high implying patient care was not adversely affected utilizing this setting. This information will inform practice for the content of future teaching sessions in the outpatient setting.

Ambulatory Care↗
PubMed2006

Cooperative learning: a new application of problem-based learning in mental health training.

Interaction in problem-based learning (PBL) tutorials is not necessarily cooperative, which may account for variation in learning outcomes. Therefore, a cooperative assessment structure was introduced in a PBL course and the difference examined between this method and individual, lecture-based learning in mental health training. Experimental student groups gained more knowledge between pre- and post-test than did control groups, and the experimental students who scored low on the pre-test made the greatest gains. Groups that reported greater cooperation tended to have higher achievement scores. Experimental students felt that cooperation helped them learn but it also took more time and was sometimes chaotic.

Clinical Clerkship↗
PubMed2005

Case-based learning in cross-professional groups - the development of a pre-registration interprofessional learning programme.

This paper describes the development and evaluation of an interprofessional learning (IPL) programme at the pre-registration level. The principal aim of the study was to investigate whether case-based learning in cross-professional groups is a feasible and an effective way to conduct interprofessional education (IPE). Student volunteers from five different health professional training programmes were allocated to two groups: an intervention group and a control group. Interprofessional attitudes of all students were measured at the beginning and at the end of the study. Group members fed back their views about their learning experience after the 9-week long intervention. The study reports significant effects of the intervention on students' attitudes to different health professions. For example, students in the intervention group tended to view each profession as more 'caring' when compared to the control group. Student feedback was positive, with the main message to integrate the programme in the timetable and to introduce an opportunity for IPE in future years. The initial findings reported in this paper show that this is a feasible and an effective way to deliver IPE across the wide range of professions in the study and that the learning programme was viewed positively by the students who took part.

Attitude of Health Personnel↗
PubMed1979

The inability to transfer classroom learning to clinical nursing practice: a learning problem and its remedial plan.

The inability to transfer classroom knowledge to clinical nursing practice is a common learning problem encountered by many nursing students. Manifestations of this problem may involve both the academic performance and personal development of the students: inability to solve problems in nursing situations; inflexibility and rigidity in the exercise of nursing care; fragmentation of nursing care; and apathy towards clinical practice. Because of the seriousness of this learning problem, a plan must be formulated to rectify it. This plan is developed with major emphasis on the teaching process, the student and the curriculum. One of the important roles of a teacher is to help students understand many widely useful relationships, principles or generalizations. In order to enhance transfer, nursing students must be given ample opportunities to apply the learned principles in a variety of nursing situations. Learning is a self-active process; an ideal transfer demands the students' conscious realization that transfer is possible. Students need to be committed to the belief that particular facts in the classroom study are pertinent in other situations. To promote transfer, the curriculum must be designed in such a way so that it has transfer value in terms of the students' goals and purposes. Furthermore, proper sequence of curricular activities is crucial if transfer of classroom knowledge to clinical practice is to occur.

Adaptation, Psychological↗
PubMed1988

Observation as a method of learning: a useful learning experience or a waste of time?

In medical schools, most clinical teaching takes place in small groups in which the teacher and/or one of the students carry out the interview, examination or procedure, while one or more of the other members of the group looks on. Students, then, are as often watchers as doers. What do students learn from observing someone else doing something, and what can be done to enhance the effectiveness of this learning process? The authors attempted to answer these questions. They conducted an experimental study designed to evaluate student experience as observers. The data garnered from this study indicated that students regarded learning by observation as a useful, even valuable, experience. The data also suggested that the effectiveness of this learning experience was derived from a shared sense of immediate, emotionally charged, highly interactive participation in the proceedings, and that the teacher's catalytic function was essential to this process.

Adolescent Psychiatry↗
PubMed1996

Brain structure and task-specific increase in expression of the gene encoding syntaxin 1B during learning in the rat: a potential molecular marker for learning-induced synaptic plasticity in neural networks.

The mRNAs encoding the synaptic vesicle proteins syntaxin 1B and synapsin I were measured using in situ hybridization in several brain regions--the dentate gyrus, CA3 and CA1 of the hippocampus, the parietal, the motor and prefrontal cortices and the core and shell of the accumbens--of rats that were learning a spatial reference or working memory task on a radial arm maze. The mRNA encoding syntaxin 1B was significantly increased in all hippocampal regions in rats learning the working memory task, whereas it was increased in the prelimbic area of the prefrontal cortex and the shell of the accumbens in rats learning the spatial reference memory task. No change in mRNA encoding syntaxin 1B was observed in the motor and parietal and cortices or the core of the accumbens, and the mRNA encoding synapsin I was not significantly different from that of naive caged controls or rats running the maze for continuous reinforcement in any of the brain structures examined. These results demonstrate that the gene encoding a key member of synaptic vesicle function is up-regulated in a task- and brain-specific manner during learning. They are discussed in terms of the potential role this protein may play in trans-synaptic propagation of plasticity within specific neural networks as a function of the information required in the laying down of different types of memory.

Animals↗
PubMed1983

Learned helplessness: the role of individual differences in learned resourcefulness.

The term 'learned resourcefulness' refers to an acquired repertoire of behaviours and skills by which a person self-regulates internal events (such as emotions, pain, and cognitions) that interfere with the smooth execution of a target behaviour. Sixty undergraduate students were rated as either high resourceful (HR) or low resourceful (LR) according to their scores on Rosenbaum's Self-Control Schedule. Subjects were then pre-treated with inescapable, escapable or control aversive tone followed by anagram solution testing. As hypothesized the learned helplessness phenomenon, the interference with new learning following inescapable aversive events, appeared only in LR subjects and not in HR subjects. No relationship was found between subjects' causal attributions for their performance on the noise task and their subsequent performance on the anagrams as would be predicted from the attributional part of the recent reformulation of the learned helplessness model. It was concluded that subjects' general repertoire of self-control skills, and their general expectations for self-efficacy, might be at least as important in explaining the generalization of helplessness from the training task to the test task as the kinds of causal attributions subjects make for their performance on the training task.

Adaptation, Psychological↗
PubMed1996

Contract learning, clinical learning and clinicians.

Current trends in education and training emphasise that learners, whether they are school children, students or adults, need to acquire generic skills and personal characteristics which will enable them to become independent self-directed learners. This will enable them to continue the process of learning throughout their lives. Recent recommendations for the reform of undergraduate medical education, for training of hospital doctors and general practitioners, and the higher profile now being given to continuing medical education, reflect the strength of this particular educational current sweeping through all levels of medical education. Learning contracts, developed through negotiation between a teacher and a learner, are especially effective educational tools for stimulating independent learning. This paper examines the theoretical basis of contract-learning and its relevance to clinical settings.

Education, Medical↗