The impact of laparoscopic surgery on health care delivery. The learning curve: skills and privileges.
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Cholecystectomy, Laparoscopic↗
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Results for “skill learning”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Evaluation of an interactive multimedia application to learn interpersonal skills.
A multidisciplinary team from Ryerson Polytechnic University in Toronto collaborated to produce an interactive multimedia application to teach interpersonal communication skills. The purpose of this educational prototype was to provide a module to accompany an introductory course in communication skills. Though it is based on a scenario specific to a group of health care professionals, it is hoped that the application would be useful to a variety of learners.
Communication↗
Hemispheric teaching strategies in the acquisition and retention of a motor skill.
An extreme preference in processing information within either the left or right hemisphere is known as hemisphericity. A previous study investigating hemisphericity as a factor in motor skill learning (Murray, 1979) found that matching subjects' hemisphericity characteristics with hemispherical teaching strategies enhanced skill acquisition. In contrast, our study examined the effects of hemispherical teaching strategies on a group of subjects who did not present hemisphericity. Right-handed male high school students were randomly assigned to either a left hemisphere, right hemisphere, or an interhemispherical teaching condition. Subjects in the right hemisphere and interhemispherical conditions performed and learned the skill more effectively than subjects in the left hemisphere teaching condition. The right hemisphere and interhemispherical groups performed comparably in acquisition; however, the interhemispherical group showed significantly better retention of the skill. Motor skill acquisition and retention for nondominant processors appears best served by directing both verbal and nonverbal attention to the skill.
Adolescent↗
Gray matter differences between musicians and nonmusicians.
Musicians learn complex motor and auditory skills at an early age and practice these specialized skills extensively from childhood through their entire careers. Using a voxel-by-voxel morphometric technique, we found gray matter volume differences in motor as well as auditory and visuospatial brain regions comparing professional musicians (keyboard players) with matched amateur musicians and nonmusicians. These multiregional differences might represent structural adaptations in response to long-term skill learning and repetitive rehearsal of these skills. This is supported by finding a strong association between structural differences, musician status, and practice intensity as well as by a wealth of supporting animal data showing structural changes in response to long-term motor training.
Brain↗
Reduction of antisocial behavior in poor children by nonschool skill-development.
PALS (for "participate and learn skills") was a nonschool skill-development program offered to all children 5-15 years of age living in a publicly supported housing complex in Ottawa, Ontario. While participation was excellent, none but marginal and possibly nonexistent spillover effects on school performance or behavior in the home were observed. However, clear and statistically significant changes occurred on unobtrusive measures of antisocial behavior outside home and school. A cost-benefit analysis indicated that potential savings, primarily in reduced vandalism but also in reduced police and fire costs, greatly exceeded the cost of mounting the program.
Achievement↗
[Learning and memory].
INTRODUCTION: The paper briefly reviews current knowledge on learning and memory processes, considered at the behavioral, cognitive and neural levels. DEVELOPMENT: After establishing the distinction between different learning processes (behavioral learning, skill acquisition and information acquisition processes), the specific learning phenomena belonging to each of these varieties are analyzed. Associative learning is described as a behavioral (pavlovian conditioning and instrumental learning) and cognitive (predictive learning and categorization) process. Also described are the properties of perceptual and motor learning, as those of the processes by which cognitive skills (e.g., rule learning) are acquired. Then, the distinction between short-term and long-term memory is discussed, referring to short-term memory as a working memory system that assists the performance of a variety of thinking and reasoning tasks. Finally, the two main long-term memory theories are discussed, considering the semantic/episodic and implicit/explicit memory dichotomies.
Animals↗
Students' learning of volleyball skills.
An examination of 222 students' learning of skill in volleyball was conducted in classes. Analysis indicated that over an eight-lesson unit performance for both serve and forearm pass improved. When classes were the unit of analysis five classes showed significant improvement on the serve and four on the pass. Present data provide a base for study of instructional effectiveness in physical education.
Humans↗
Evaluation of morphological plasticity in the cerebella of basketball players with MRI.
Cerebellum is a key structure involved in motor learning and coordination. In animal models, motor skill learning increased the volume of molecular layer and the number of synapses on Purkinje cells in the cerebellar cortex. The aim of this study is to investigate whether the analogous change of cerebellar volume occurs in human population who learn specialized motor skills and practice them intensively for a long time. Magnetic resonance image (MRI)-based cerebellar volumetry was performed in basketball players and matched controls with V-works image software. Total brain volume, absolute and relative cerebellar volumes were compared between two groups. There was no significant group difference in the total brain volume, the absolute and the relative cerebellar volume. Thus we could not detect structural change in the cerebellum of this athlete group in the macroscopic level.
Adult↗
Transcranial magnetic stimulation and the motor learning-associated cortical plasticity.
It has been well established that repetitive motor performance and skill learning alter the functional organization of human corticomotoneuronal system. Over the past decade, transcranial magnetic stimulation (TMS) has helped to demonstrate motor practice and learning-related changes in corticomotoneuronal excitability and representational plasticity. It has also provided some insights into the mechanisms underlying such plasticity. TMS-derived indices show that motor practice, skill acquisition and learning are associated with an increase in cortical excitability and a modulation of intracortical inhibition partly related to the amount of GABA-related inhibition. It has been suggested that these changes in excitability might be related to learning and motor memory formation in the motor cortex. However, it has proved difficult to relate different aspects of TMS-derived representational plasticity with specific behavioral outcomes. A better understanding of the relationship between TMS measurements of practice-related cortical plasticity and underlying mechanisms, in the context of associated changes in behavior, will facilitate the development of techniques and protocols that will allow predictable modulation of cortical plasticity in health and disease.
Animals↗
Cerebellum activation associated with performance change but not motor learning.
The issue of whether the cerebellum contributes to motor skill learning is controversial, principally because of the difficulty of separating the effects of motor learning from changes in performance. We performed a functional magnetic resonance imaging investigation during an implicit, motor sequence-learning task that was designed to separate these two processes. During the sequence-encoding phase, human participants performed a concurrent distractor task that served to suppress the performance changes associated with learning. Upon removal of the distractor, participants showed evidence of having learned. No cerebellar activation was associated with the learning phase, despite extensive involvement of other cortical and subcortical regions. There was, however, significant cerebellar activation during the expression of learning; thus, the cerebellum does not contribute to learning of the motor skill itself but is engaged primarily in the modification of performance.
Brain↗
A short transitional course can help medical students prepare for clinical learning.
BACKGROUND AND OBJECTIVES: Despite the move toward integrated 4-year medical school curricula, many medical schools still offer a "2+2" curriculum divided into preclinical and clinical phases. These phases represent distinct learning environments that require different learning skills. To prepare students for learning in the clinical environment of the second 2 years, many medical schools offer transitional experiences before the third-year clerkships. Few of these transitional courses have published evaluations, and there is no consensus on the ideal content. In this paper, we provide evaluation and content validity data on a 2-week intensive clinical transition course for beginning third-year medical students. METHODS: A multidisciplinary team designed, implemented, and evaluated a 2-week transition course. Students indicated through surveys how prepared they felt for 18 clinical skills. We analyzed pre- and post-survey data using a Wilcoxen rank sum test and compared current to prior students using a chi-square analysis. RESULTS: Students felt more prepared for 16 of 18 skills after the transitional course and for 14 of 18 skills compared to historical controls. CONCLUSIONS: A transitional course based on common skills is relevant to students' clerkship experiences and can increase students' self-reported preparedness for the clinical years of medical school.
Clinical Clerkship↗
Acquisition of intellectual and perceptual-motor skills.
Recent evidence indicates that intellectual and perceptual-motor skills are acquired in fundamentally similar ways. Transfer specificity, generativity, and the use of abstract rules and reflexlike productions are similar in the two skill domains; brain sites subserving thought processes and perceptual-motor processes are not as distinct as once thought; explicit and implicit knowledge characterize both kinds of skill; learning rates, training effects, and learning stages are remarkably similar for the two skill classes; and imagery, long thought to play a distinctive role in high-level thought, also plays a role in perceptual-motor learning and control. The conclusion that intellectual skills and perceptual-motor skills are psychologically more alike than different accords with the view that all knowledge is performatory.
Cognition↗
A model of psychological dependence in adolescent substance abusers.
Adolescent substance abuse appears to have its foundations in a distortion of perceived events at an age prior to involvement with substances. Substances are used as a compromise in an attempt to establish a lifestyle which has meaning to the individual. Because the individual's involvement with a substance has taken place during the crucial developmental phase of adolescence, and because the use of drugs alters one's perception of one's social, emotional and cognitive state, any experience during this time must, by necessity, be distorted. At the same time, other experiences, necessary for natural development into adulthood, are forsaken . Thus, certain learned skills are replaced by those learned whilst under the influence of substances or as a reaction to the substance abusing lifestyle. The latter two often being inappropriate in drug-free situations. As the abuse of substances severely hampers the individual's natural development, a model of Developmental Habilitation is the essence of change.
Adolescent↗
Modeling referential actions in 6- to 18-month-old infants: a precursor to symbolic understanding.
Social precursors to symbolic understanding of pictures were examined with 100 infants ages 6, 9, 12, 15, and 18 months. Adults demonstrated 1 of 2 stances toward pictures and objects (contemplative or manipulative), and then gave items to infants for exploration. For pictures, older infants (12, 15, and 18 months) emulated the adult's actions following both types of demonstration trials. For objects, infants did not emulate actions following either stance at any age. The findings suggest that infants enlist their imitative learning skills in the context of learning the conventions of action on pictorial symbols. The data are interpreted as pointing to the importance of social learning in developing an understanding of the referential function of pictorial symbols.
Cognition↗
Three-term contingency patterns in mother-child verbal interactions during first-language acquisition.
Selections from a large longitudinal data set of verbal interactions between a mother and her child are presented. Two sets of three-term contingency sequences that seemed to reflect maternal rewards and corrections were noted. Both the antecedents as well as the immediate consequences of maternal interventions are presented to explore training and learning processes. The observed frequencies of three-step sequences are compared to those expected based upon Markov-chain logic to substantiate the patterning of the interactions. Behavioral conceptualizations of the learning process are supported by these analyses, although their sufficiency is questioned. It is suggested that maternal rewards and corrections should be integrated with perceptual, cognitive, and social learning conceptualizations in a skill-learning approach to explain the complexity of language transmission and acquisition processes.
Journal Article↗
Multi-professional staff development programme for PAMs.
A unique, accredited, multi-professional education programme for junior staff in professions allied to medicine (PAMs) developed by Durham and Teesside Education and Training Consortium in collaboration with local trusts and social services is described. Designed to ensure competence to practice in line with clinical governance, it aims to strengthen multi-professional working practice through a greater understanding of roles and of the way the national health service (NHS) works. It enables staff to analyse their own learning needs and to employ self-directed learning skills for life-long learning. Using problem-based learning, it uses real clinical cases as triggers to promote critical evaluation and reasoning and the development of multi-professional care pathways.
Allied Health Personnel↗
Concept mapping--a strategy for assessment.
Rapidly expanding knowledge has led to changing approaches to teaching, learning and assessing. The emphasis is on student-centred approaches that encourage lifelong learning skills. One such approach to learning is concept mapping. The case study in this article discusses the use of mapping as a successful strategy for assessment.
Concept Formation↗
Cancer education for the generalist physician.
BACKGROUND AND OBJECTIVES: The care of cancer patients has become increasingly complex and multidisciplinary while more responsibility for cancer care has been shifted to primary care physicians. We developed a medical student educational program to teachfuture primary care physicians about care of cancer patients. METHODS: The Multidisciplinary Oncology Clerkship was designed for fourth-year medical students planning to enter primary care residencies. The clerkship hasfive major components: ambulatory patient care, multidisciplinary conferences, skill stations, problem-based learning in small groups, and supervised objective structured clinical examinations. Learning during the clerkship was evaluated with knowledge tests before, immediately after, and 6 months after the clerkship. RESULTS: Twenty-four students participated in the first year of the clerkship. Program evaluation revealed that the students' scores on the knowledge test rose 40% between the pre-clerkship and post-clerkship tests. Retesting at 6 months demonstrated knowledge retention of 90%. CONCLUSIONS: Multidisciplinary cancer education, using the combination of problem-based learning, skill stations, clinical exposure, and standardized patients, increases the cancer-care knowledge of medical students dedicated to a career in primary care.
Clinical Clerkship↗