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PubMed2005

Promoting practical clinical management learning: the current situation about Information and Communications Technology capability development in student nurses.

AIM: This paper is about work-based learning in information management for student nurses. It seeks, through a literature review, to make a case for and promote Information and Communications Technology capability development in student nurses within their clinical environment. BACKGROUND: The profession of nursing, like many other jobs, is facing the increasing usage of information technology in day-to-day operations. Admission and discharges of patients have been held on computer databases since at least the 1980s. With the new Labour Government in 1997, increasing focus was placed on the effectiveness of the National Health Service and using computers as one way to assist in achieving greater effectiveness. Nurse education therefore needed to reflect this need and support trainee nurses to acquire skills in Information and Communications Technology. This paper is part of an ongoing professional doctorate inquiry into Information and Communications Technology capability development in student nurses. EVALUATION: A literature search was conducted on teaching information and technology skills via Cumulative Index to Nursing and Allied Health Literature. Most of the available studies were neither based on the UK nor were they about student nurses. As there is a dearth of published work in this specific area, relevant, related and tangential literature was reviewed. KEY ISSUES: It is argued that current practice and published work on Information and Communications Technology capability development by student nurses hardly exists. The literature confirmed that success in this area requires sound change management, an understanding of National Health Service culture, and effective people leadership skills. Nurse educators and managers need to pay more attention to understand how organizations work, particularly organizations where student nurses carry out their work. CONCLUSIONS: As the search revealed a significant gap in the literature in this area, a practical conceptual framework to fully analyse, develop and implement sustained Information and Communications Technology capability in student nurses is proposed.

Clinical Nursing Research↗
PubMed2006

Weekly active-learning activities in a drug information and literature evaluation course.

OBJECTIVES: To incorporate learning activities into the weekly 2-hour Drug Information and Literature Evaluation class sessions to improve student ability and confidence in performing course objectives, as well as to assess student perception of the value of these activities. METHODS: In-class activities that emphasized content and skills taught within class periods were created and implemented. Three different surveys assessing student ability and confidence in completing drug information and literature retrieval and evaluation tasks were administered prior to and following the appropriate class sessions. At the completion of the course, an additional evaluation was administered to assess the students' impressions of the value of the learning activities. RESULTS: Students reported increased ability and confidence in all course objectives. The teaching activities were also stated to be useful in students' learning of the material. CONCLUSIONS: Incorporation of weekly learning activities resulted in an improvement in student ability and confidence to perform course objectives. Students considered these activities to be beneficial and to contribute to the completion of course objectives.

Curriculum↗
PubMed1993

Early learning.

Cost information is crucial to purchasers and providers of community services but producing reliable costings is easier said than done. Ann Netten reports.

Budgets↗
PubMedDate not supplied

Long-term outcome of learning and memory in children following severe closed head injury.

Seventeen children aged 5-16 years old (M = 11.3, SD = 2.97, Range= 6.25-16.00) were assessed between 4-5 years post-severe closed head injury, using the Wide Range Assessment of Memory and Learning (WRAML). Compared to age and sex matched controls, this group demonstrated deficits in the ability to learn new information, particularly their rate of learning. Deficits were more apparent with verbal than visual material. There were no indications of differences in delayed recall as measured by the amount of information lost nor in recognition memory. Results indicate that retrieval deficits may be an important component of memory difficulties in severe closed head injury. Educational implications are considered.

Adolescent↗
PubMed2006

Subcategory learning in normal and language learning-disabled adults: how much information do they need?

PURPOSE: The purpose of this experiment was to determine if nonreferential morphophonological information was sufficient to facilitate the learning of gender subcategories (i.e., masculine vs. feminine) in individuals with normal language (NL) and those with a history of language-based learning disabilities (HLD). METHOD: Thirty-two adults listened for 18 min to a familiarization set of Russian words that included either 1 (single-marked) or 2 (double-marked) morphophonological markers indicating gender. Participants were then tested on their knowledge of both trained and untrained members of each gender subcategory. RESULTS: Testing indicated that morphophonological information is sufficient for lexical subcategory learning in both NL and HLD groups, although the HLD group had lower overall accuracy. The HLD group benefited from double-marking relative to single-marking for subcategory learning. CONCLUSION: The results demonstrated that learning through implicit mechanisms occurred after a relatively brief exposure to the language stimuli. In addition, the weaker overall learning by the HLD group was facilitated when multiple cues to linguistic subcategory were available in the input group members received.

Adult↗
PubMed2003

The interaction between cost-management and learning for major surgical procedures - lessons from asymmetric information.

The theory of the learning curve states that learning effects are of particular importance in industries, where human skills play an important role. Consequently, one would expect to find large learning effects for surgical procedures because the physician's experience is quite important for this type of work. For hospitals, there exists indeed a well-documented effect that shows a positive relationship between the number of a certain type of surgery being performed and its resulting quality (volume-outcome relationship). Empirical analyses of the impact of learning on the average cost of a procedure, however, have noted a conspicuous absence of learning effects. Using a mechanism design approach, the paper analyzes a model of quality and cost-management for a hospital, where learning effects are included into the cost function and asymmetric information exists between management and physician. It seeks to answer the question, whether recommendations from a symmetric information scenario with respect to learning carry over to a health care setting, where informational problems tend to be pronounced and severe. If surgery volume interacts with physicians' informational rents, an optimal management reaction to the presence of learning may result in a policy, which is the exact opposite of the one under symmetric information.

Clinical Competence↗
PubMed2004

Characteristics of non-verbal memory impairment in bipolar disorder: the role of encoding strategies.

BACKGROUND: There is evidence that individuals with bipolar disorder exhibit neuropsychological impairments not only during episodes of depression or mania but also when they are euthymic. One of the most consistently reported cognitive problems in euthymic individuals with bipolar disorder is impairment in episodic memory. Learning and memory depend on individuals' ability to organize information during learning. A recent study by our group showed that verbal episodic memory impairments in euthymic patients with bipolar I disorder (BP-I) are mediated by difficulties in organizing verbal information appropriately during learning. The purpose of the present study was to determine whether memory impairments in euthymic individuals with BP-I extend to non-verbal memory and whether non-verbal memory impairments are mediated by difficulties in organizing non-verbal information during encoding. METHOD: Study participants were 25 euthymic, remitted individuals with BP-I and 25 age, gender and education matched control participants. Participants completed the Rey-Osterrieth Complex Figure Test (RCFT), a well-established measure of non-verbal memory that enables assessment of organization during learning. RESULTS: Compared to control participants, BP-I participants showed impaired performance on the RCFT immediate recall. They also relied less on organizational strategies during encoding. Multiple regression modeling indicated that group differences between control and BP-I participants in long-delayed free recall did not remain statistically significant when effects of lower organization were partialled out. CONCLUSIONS: Non-verbal memory problems in individuals with bipolar disorder, while euthymic, are mediated by poor use of non-verbal organization strategies during encoding, but do not appear to reflect deficits in retention of information.

Adult↗
PubMed2004

Automatic prediction of protein domains from sequence information using a hybrid learning system.

MOTIVATION: We describe a novel method for detecting the domain structure of a protein from sequence information alone. The method is based on analyzing multiple sequence alignments that are derived from a database search. Multiple measures are defined to quantify the domain information content of each position along the sequence and are combined into a single predictor using a neural network. The output is further smoothed and post-processed using a probabilistic model to predict the most likely transition positions between domains. RESULTS: The method was assessed using the domain definitions in SCOP and CATH for proteins of known structure and was compared with several other existing methods. Our method performs well both in terms of accuracy and sensitivity. It improves significantly over the best methods available, even some of the semi-manual ones, while being fully automatic. Our method can also be used to suggest and verify domain partitions based on structural data. A few examples of predicted domain definitions and alternative partitions, as suggested by our method, are also discussed. AVAILABILITY: An online domain-prediction server is available at http://biozon.org/tools/domains/

Algorithms↗
PubMed2005

Problem-based and case-based learning in respiratory care education.

Problem-based learning has been used in respiratory therapy education for a relatively short time. The purpose of PBL is to produce a graduate who has improved critical thinking and life-long learning skills. On a practical note, another goal is to help the graduate pass the NBRC Clinical Simulation examination. PBL is the use of cases to provide a stimulus for the specification of learning issues, or objectives, which the students research and discuss. The heart of the PBL process is the tutorial group, composed ofa group of five to seven students and a faculty facilitator. Students work through the case, listing facts, testing hypotheses, learning pharmacology,and studying the learning issues of the case. Information is learned in thecontext of the patient case, rather than in isolated classes. Cases are presented in the progressive-disclosure model. Student evaluation consists of written examinations, self- and peer evaluation, and with an independent case study process. Program evaluation has shown that students enjoy the process and think that they are performing clinically better than their non-PBL peers. Pass rates for the Clinical Simulation examination are above the national average. A more in-depth study of program outcomes is indicated.

Allied Health Personnel↗
PubMed2003

Primary health care provision for adults with a learning disability.

BACKGROUND: During the last decade, primary care has been designated as the main provider of health care to people with learning disabilities. Practice nurses based in primary care teams are increasingly the first points of contact with health services. They make an important contribution to promoting good health, with health screening and illness prevention work being a significant part of their role. However, little is known about their views or involvement regarding the provision of primary care for people with learning disabilities. There is therefore a need to explore the nursing perspective, from within primary care, on the current provision of care for people with a learning disability. RESEARCH AIM: To inform the learning disability service of the role of primary care in current service provision for people with learning disabilities. RESEARCH METHOD: A survey of all practice nurses currently employed by Grampian Health Board in Aberdeen was conducted in June 2001. An initial pilot study was conducted in primary care and learning disability services. Data collection took place during June and July 2001. All practice nurses working in the geographical region of Grampian were invited to participate. RESULTS: Communication barriers exist, preventing access to health screening and treatment for some people with learning disabilities. Independent living skills, for example dietary management and budgeting, require additional community support. These conditions pose complex problems for practice nurses and other members of the primary care team. CONCLUSION: This study indicates a need for closer support and partnership with the learning disability service. The factors necessary for providing health care to people with learning disabilities extend beyond the domain of primary care teams. The findings of this survey have important implications for education and support to enable carers and professionals to provide a high standard of care.

Adult↗
PubMed2001

Higher-order-statistics-based detection of vehicles in still images.

We present a statistical pattern recognition scheme for detecting vehicles in still images. The methodology involves pattern classification using higher-order statistics (HOS) in a clustering framework. The proposed method approximately models the unknown distribution of the image patterns of vehicles by learning HOS information about the vehicle class from sample images. Given a test image, statistical information about the background is learned "on the fly." An HOS-based decision measure derived from a series expansion of the multivariate probability density function in terms of the Gaussian function and Hermite polynomials is used to classify test patterns as vehicles or otherwise. Experimental results on real images with cluttered background are given to demonstrate the performance of the proposed method. When tested on real aerial images, the method gives good results, even for complicated scenes. The detection rate is found to be quite good, while the false alarms are very few. The method can serve as an important step toward building an automated traffic monitoring system.

Journal Article↗
PubMed2002

Differential involvement of the hippocampus and temporal lobe cortices in rapid and slow learning of new semantic information.

The present study examined the rapid and slow acquisition of new semantic information by two patients with differing brain pathology. A partial double dissociation was found between the patterns of new learning shown by these two patients. Rapid acquisition was impaired in a patient (YR) who had relatively selective hippocampal damage, but it was unimpaired in another patient (JL) who, according to structural MRI, had an intact hippocampus but damage to anterolateral temporal cortex accompanied by epileptic seizures. Slow acquisition was impaired in both patients, but was impaired to a much greater extent in JL. The dissociation suggests that the mechanisms underlying rapid and slow acquisition of new semantic information are at least partially separable. The findings indicate that rapid acquisition of semantic, as well as episodic information, is critically dependent on the hippocampus. However, they suggest that hippocampal processing is less important for the gradual acquisition of semantic information through repeated exposure, although it is probably necessary for normal levels of such learning to be achieved.

Adult↗
PubMed1993

The first 15 years: what has been learned about the Cancer Information Service and the implications for the future.

The Cancer Information Service (CIS) has been in existence for over 15 years. During that period, lessons have been learned that have been used to increase the effectiveness of the network. This paper lists 12 of those lessons, covering issues such as giving sophisticated medical information; reaching diverse target audiences; using the mass media; developing systems needed for quality assurance, research, and information technology; and nurturing a local-national partnership. The paper also discusses major accomplishments of the program and lists recommendations for meeting the challenges to be faced by the CIS in the future.

Female↗
PubMed1985

Control of children's observing responses by information feedback during visual discrimination learning.

Four experiments examined the control of observing responses by information feedback during visual discrimination learning. Second-grade children participated in Experiment 1; kindergarten, second-, and fifth-grade children were subjects in Experiments 2 and 3, and grade 5 and adult subjects were tested in Experiment 4. In order to view the stimuli, subjects in Experiments 1, 2, and 3 activated lights in viewing boxes; in Experiment 4, stimulus fixations were measured using a corneal reflection technique. Fifth graders and adults observed the discriminative stimuli for longer times on trials following negative feedback than on trials following positive feedback; in contrast, kindergartener's observing was not affected by type of feedback. Second graders showed smaller and less reliable reactions to type of feedback than did older subjects. These results support the view that visual observing is controlled by cognitive processes associated with hypothesis testing.

Child↗
PubMed1997

Lessons learned from producing health information booklets for deploying U.S. military personnel.

Health information booklets deliver information to large groups quickly and economically. Rapidly deploying soldiers are a group that needs such information. Military personnel responsible for the health of troops should know of the materials produced to meet this need so that they can facilitate booklet distribution. The Walter Reed Army Institute of Research within the U.S. Army Medical Research and Material Command has produced health information booklets in support of deployments to Southwest Asia, Somalia, Rwanda, Haiti, and the former Republics of Yugoslavia. This article describes these booklets' content, use during military operations, distribution, costs, and benefits. A discussion of lessons learned includes steps to develop and evaluate health information and is followed by an explanation of the current situation. We offer suggestions to improve the booklet development process; our experience may be helpful to others developing health information materials for military personnel or civilians.

Books↗
PubMedDate not supplied

The multistate learning collaborative, states as laboratories: informing the national public health accreditation dialogue.

The Multistate Learning Collaborative on Performance and Capacity Assessment or Accreditation of Public Health Departments (MLC) is an initiative undertaken with the Exploring Accreditation Project (EAP). The EAP is jointly funded by the Robert Wood Johnson Foundation (RWJF) and the Centers for Disease Control and Prevention (CDC), and staffed collaboratively by the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO) to explore the implications and feasibility of a national public health accreditation system. The MLC, also financially supported through grants from RWJF, is designed under the auspices of the National Network of Public Health Institutes (NNPHI) and the Public Health Leadership Society (PHLS) to enhance the accreditation/assessment activities already underway in each of the grantee states; to promote learning among the states participating in the collaborative; to disseminate information to state and local health departments nationally; and to inform the work of the EAP. Five states with mature accreditation or assessment programs were selected from among 18 applicants. This article describes the ongoing work, including breakthroughs and challenges, in these natural "laboratories" so that this information may be a resource for other states as well as nationally.

Accreditation↗
PubMed2004

Informed consent skills in internal medicine residency: how are residents taught, and what do they learn?

PURPOSE: Obtaining informed consent is an essential skill in internal medicine (IM). The authors' informal observations and formal testing revealed deficiencies in residents' informed consent skills. This study evaluated how residents acquire informed consent skills and how informed consent skills are addressed in Canadian IM residency programs. METHOD: A questionnaire was delivered to all 16 IM program directors in Canada, asking how informed consent is taught and assessed. At the University of Saskatchewan IM residency program, residents were assessed through an objective structured clinical examination station, written examination, and a self-assessment questionnaire. RESULTS: No consistent approach to teaching or evaluating informed consent skills exists within Canadian IM programs. Program directors and residents identified informal mentoring by residents as an important learning modality. Although residents performed well in discussing procedural indications and techniques, discussing risks was inadequate. Residents focused on general and minor risks but avoided discussing serious risks and had difficulty discussing the frequency of complications. Residents lacked a structured approach to assessing capacity and often assessed only comprehension. Residents were unfamiliar with concepts such as material risk, implied consent, and therapeutic privilege. CONCLUSION: Explicit training in informed consent skills is urgently needed. Informal mentoring must be recognized as an important training method for informed consent and supported by appropriate teaching and evaluation strategies to ensure that resident-instructors do so effectively.

Canada↗