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PubMed1993

Mirror reading in Alzheimer's disease: normal skill learning and acquisition of item-specific information.

Alzheimer's disease (AD) is characterized by severe explicit memory deficits and sparing of procedural learning. Most studies of skill learning in AD have been restricted to motor skills. This experiment was aimed at extending these studies to the domain of perceptual-verbal skills. Thirteen AD patients and 9 normal elderly controls were administered several explicit memory tests and a mirror reading paradigm with both unique and repeated word triads. In this last task, AD patients showed normal learning for unique word triads, that is, normal acquisition of the skill. Moreover, they benefitted from repeated triads to the same extent as did normal controls, although they were impaired in discriminating these repeated words from distractors at later recognition. These data demonstrate that patients with AD: (a) are able to learn and retain a perceptual-verbal skill at a normal rate; (b) can learn item-specific information (repeated triads) at a normal rate, even though their explicit memory is severely impaired. It is hypothesized that learning of item-specific information relies on repetition priming effects rather than on explicit memory processes.

Affect↗

PubMed2005

It's the activity that counts: what clients value in psycho-educational groups.

BACKGROUND: This qualitative pilot research study provides client-centred outcomes by evaluating psycho-educational groups from the clients'perspective. PURPOSE: This study was designed to determine what clients value in three psycho-educational groups offered in an acute inpatient psychiatric setting. METHODS: Interviews lasting 30 to 60 minutes relating to the 8 participants group experiences were recorded and transcribed verbatim. A constant comparative approach was used to analyze data allowing for both expected and emergent themes to be integrated into later interviews. RESULTS: Identified themes were group structure, readiness to attend groups and process information, and group milieu. Participants valued voluntary attendance and supportive milieu of groups. Insertion of relevant activity into groups to promote interaction, learning and information retention was also valued. PRACTICE IMPLICATIONS: Occupational therapists offering mental health groups should consider a number of factors. These include the importance of transitioning clients from activity groups to psycho-educational groups, as well as the value clients place in determining their readiness to attend a group and having a supportive milieu with limits to emotional disclosure.

Canada↗

PubMed1996

Modeling Hermissenda: II. Effects of variations in type-B cell excitability, synaptic strength, and network architecture.

Because the Hermissenda eye is relatively simple and its cells well characterized, it provides an attractive preparation for detailed computational analysis. To examine the neural mechanisms of learning in this system, we developed multicompartmental models of the type-A and type-B photoreceptors, simulated the eye, and asked three questions: First, how do conductance changes affect cells in a network as compared with those in isolation; second, what are the relative contributions of increases in B-cell excitability and synaptic strength to network output; and third, how do these contributions vary as a function of network architecture? We found that reductions in the type-B cells of two K+ currents, IA and IC, differentially affected the type-B cells themselves, with IC reductions increasing firing rate (excitability) in response to light, and IA reductions increasing quantal output (synaptic strength) onto postsynaptic targets. Increases in either type-B cel excitability or synaptic strength, induced directly or indirectly, each suppressed A-cell photoresponses, and the combined effect of both changes occurring together was greater than either alone. To examine the effects of network architecture, we compared the full network with a simple feedforward B-A pair and intermediate configurations. Compared with a feedforward pair, the complete network exhibited greater A-cell sensitivity to B-cell changes. This was due to many factors, including an increased number of B-cells (which increased B-cell impact on A-cells), A-B feedback inhibition (which slowed both cell types and altered spike timing relationships), and B-B lateral inhibition (which reduced B-cell sensitivity to intrinsic biophysical modifications). These results suggest that an emergent property of the network is an increase both in the rate of information acquisition ("learning") and in the amount of information that can be stored ("memory").

Animals↗

PubMed2003

The relationship between changes in learning and memory after right unilateral electroconvulsive therapy.

OBJECTIVE: We investigated whether the ability to learn new information, as opposed to recall information, would change significantly in depressed individuals treated by low- or high-dose right unilateral electroconvulsive therapy and tested whether change in learning explained changes in recall. METHOD: Fifty-four depressed patients randomized to receive right unilateral electroconvulsive therapy (ECT) at approximately 2.25 times their seizure threshold (ST) or at doses greater than 2.25 times ST were evaluated for verbal and figural memory as well as verbal and figural learning both pre- and post-ECT. A subset of scores from the Rey Auditory Visual Learning Test and the Rey Figure Test were analyzed using analysis of variance and linear regression techniques. RESULTS: Scores reflecting verbal learning decreased by a mean of approximately 50% immediately after a completed course of ECT as compared with pre-ECT verbal learning scores. Stratification of effect by dose of electrical charge revealed trends that did not achieve statistical significance. Approximately 8% of the change in delayed verbal recall was predicted by changes in verbal learning. Figural learning was not significantly changed in the aggregate (pre-versus post-treatment) or when the effect was stratified by electrical charge. CONCLUSIONS: Verbal learning scores declined immediately after ECT, but the change in learning scores explained only a minor part of the observed changes in verbal recall. These findings support the notion that the deficits in delayed recall after ECT represent a relatively specific cognitive effect that is not completely explained by changes in other aspects of cognition such as learning.

Aged↗

PubMedDate not supplied

Differential mechanisms of impairment of remote memory in Alzheimer's and frontotemporal dementia.

This paper describes retrograde memory performances of 12 Alzheimer's disease (AD) patients and 12 frontotemporal dementia (FTD) patients. First of all, we observed that FTD and AD patients did not differ for language tests (verbal fluency tests and oral denomination 80), for semantic memory tests, for logical memory test and Benton visual memory test and differed for anterograde verbal memory and frontal tests. Concerning retrograde memory, there was no difference between AD and FTD patients in retrograde memory scores (autobiographical memory interview, Crovitz's task, French public events interview battery) and both FTD and AD patients exhibited a retrieval deficit in their remote memory. We observed that the mechanisms of remote memory deficit was different in FTD and in AD patients. We observed no classical paradigm of Ribot for FTD patient's remote informations, and they appeared to have lost of access to memories and executive difficulties. In AD, the results indicated these patients' ability to learn new information and to search semantic memory failed.

Aged↗

PubMed1986

Education and evaluation in emergency cardiac care programs (CPR and advanced cardiac life support): state of the art.

To increase the survival rate for out-of-hospital cardiac arrest, improvements in training must be made so that lay rescuers are motivated and have the ability to get involved. To overcome some of the fear and lack of involvement, better education strategies are needed. Adults learn didactic information through understanding and skills through repetition and reinforcement. Due to the fact that there is limited time that adults will commit to learning CPR, methods of simplification of the techniques need to be used so that there can be sufficient repetition and reinforcement. Teaching two-rescuer CPR to lay rescuers should not routinely be done. Most adults, particularly those around high-risk individuals, should learn one-rescuer CPR. Infant resuscitation should be taught predominantly to those around small children. Methods of reinforcement through the mass media should be attempted on a routine basis. Whenever possible the courses should be spread over a period of time to allow for repetition and reinforcement, thereby maximizing learning. Advanced cardiac life support (ACLS) should be widely taught to health professionals. ACLS instruction needs to be spread over time, whenever logistically possible, to enhance learning and retention. Good, validated examinations are needed and should be routinely rotated. Better methods of evaluation are needed to look at the benefit of these types of programs and to improve the cost-benefit ratio.

Educational Measurement↗

PubMed2005

Attentional modulation of learning-related repetition attenuation effects in human parahippocampal cortex.

Two of the most fundamental processes in biological vision are attention and learning. Attention actively selects and enhances visual information that is most relevant to behavior. Learning enables the visual system to benefit from perceptual experience. The amount of visual information to learn is infinite; however, top-down control mechanisms must somehow regulate learning to achieve an adaptive balance between plasticity and stability in neural circuitry. Functional magnetic resonance imaging (fMRI) can measure learning-related changes in neural activity to previously viewed perceptual stimuli. Described variably as the repetition suppression or adaptation effect, the attenuation in neural activity to repeated stimuli versus novel stimuli provides a marker for stimuli-specific perceptual processing and memory. One important issue concerns whether repetition attenuation is automatic or not, and recent work has begun to show that it is sensitive to task demands. Accordingly, the present study further examined how attention controls the attenuated response to repeated stimuli, specifically testing whether attention is important for initial encoding, for the expression of memory traces, or for both encoding and expression. To manipulate attention, we used overlapping scene and face images and asked subjects to attend to either category. fMRI revealed significant attenuation in the parahippocampal place area for only the repeated scenes that were attended both during the initial presentation and during repetition. Thus, attention actively governs when neuronal activity is attenuated to repeated perceptual input, and such attention is important during both initial encoding and subsequent expression of the learned information.

Adolescent↗

PubMed2006

Conditional associative learning of spatial and object information in children with attention deficit/hyperactivity disorder.

The present study assessed frontostriatal mediated memory functions in children with ADHD (N=12) and healthy control participants (N=12) using two tests of conditional associative learning (i.e., object and spatial) that shared similar stimulus-response association structures but that differed in terms of the demands placed upon strategic processes. Children with ADHD displayed normal performance on the object learning task but were impaired on the spatial learning task that placed greater demands on internally derived strategic processes. Secondary analyses further indicated that this strategic processing impairment cannot be attributed specifically to perseverative or working memory errors but rather appears to be related to a more general inability to maintain a high degree of consistency in responding across trials. Although the results of this study must be interpreted in light of the small sample sizes, they suggest that ADHD does not produce a basic deficit in acquiring stimulus-response associations previously shown to be associated with basal ganglia dysfunction. Rather, these findings suggest that the impaired conditional associative learning performance of children with ADHD is attributable to deficits in strategic processes previously been found to be dependent upon the integrity of the prefrontal cortex.

Association Learning↗

PubMed1997

The Stanford Health Information Network for Education: integrated information for decision making and learning.

Although multiple decision support systems have been built for physicians, efficient delivery of valid and complete medical knowledge remains an elusive goal. In this paper we describe a new project, the Stanford Health Information Network for Education (SHINE). SHINE unifies core medical resources in an intuitive interface to support clinical decision making. Included in the description is a novel paradigm for continuing medical education (CME).

California↗

PubMed1992

Developmental plasticity in neural circuits controlling birdsong: sexual differentiation and the neural basis of learning.

In many species of passerine songbirds, males learn their song during defined periods of life. Female song is often reduced or absent, as are the brain regions controlling song. Sexual differences in the brain arise because of the action of sex steroids, which trigger the formation of some neural pathways (especially the pathway from the higher vocal center to the robust nucleus) and prevent the atrophy of others in males. These neural changes occur during periods of developmental song learning and can recur during periods of learning in adult birds. The process of learning is correlated with major increases or decreases in the numbers of neurons in specific neuronal populations, suggesting that the formation or loss of specific neural pathways regulates the ability to learn. Species differences in sexual differentiation and learning allow informative cross-species comparisons of neural structure and behavior.

Animals↗

PubMed1998

Teaching problem-solving and clinical reasoning: 20 years experience with video-supported small-group learning.

In the context of a curriculum reform the Faculty of Medicine of the University of Leuven, Belgium, introduced a new teaching project: video-supported small-group learning on problem-solving and clinical reasoning. The aim of this study is to reflect 20 years experience. The video-supported sessions for sixth-year medical students during their practical year in peripheral hospitals were constructed in four stages. The first stage is the video presentation of a case with history-taking and physical examination. The student and three tutors of internal medicine make notes and can ask further questions and perform additional physical examination acts after the video presentation. The coordinator of the course, who knows the patient, then simulates the patient and the doctor to answer the questions. The second stage consists of making up individually a synoptic problem list, integrating history and physical examination; a differential diagnosis list with the most likely diagnosis fitting the problem list; and a list with investigations to be asked for confirming the diagnosis. The third stage consists of three small student groups discussing the three lists requested in stage 2. Each small group of students, passively assisted by a tutor, has to come to the consensus lists. The fourth stage is the confrontation of the consensus lists of the three groups with the aim of coming to an overall agreement. At this stage tutors are more actively involved in the discussion. Several learning processes are involved in this way of teaching. During the first stage the students learn the traditional teaching 'see one, do one and teach one', a demonstration of a full history and physical examination. By asking for additional information they learn by a critical attitude and by developing a strategy of fact-finding. During the second and third stages, by making their lists and during the consensus processes, they learn the significance of individual findings, problem-framing and the synthesis of history and physical examination data in medical concepts. The third and fourth parts of the sessions bring up the process of clinical reasoning, formulation of a working hypothesis, the discussion of the pathophysiology of findings, clustering of problems and epidemiological considerations as incidence and prevalence. Finally, the exercise to select diagnostic tests gives the students the possibility of appreciating the value of sensitivity/specificity and risks, benefits and costs of diagnostic procedures. These video-supported clinical problem-solving and reasoning sessions were positively appraised by students, teachers and medical faculty over the years. Over 20 years, more than 90 cases have been recorded on video, with a widespread variation in diagnoses and clinical presentations. Small-group teaching with the aid of a video case, as described in this paper, can promote enjoyable learning for students and teachers.

Clinical Competence↗

PubMed2004

Learning-induced improvement in encoding and decoding of specific movement directions by neurons in the primary motor cortex.

Many recent studies describe learning-related changes in sensory and motor areas, but few have directly probed for improvement in neuronal coding after learning. We used information theory to analyze single-cell activity from the primary motor cortex of monkeys, before and after learning a local rotational visuomotor task. We show that after learning, neurons in the primary motor cortex conveyed more information about the direction of movement and did so with relation to their directional sensitivity. Similar to recent findings in sensory systems, this specific improvement in encoding is correlated with an increase in the slope of the neurons' tuning curve. We further demonstrate that the improved information after learning enables a more accurate reconstruction of movement direction from neuronal populations. Our results suggest that similar mechanisms govern learning in sensory and motor areas and provide further evidence for a tight relationship between the locality of learning and the properties of neurons; namely, cells only show plasticity if their preferred direction is near the training one. The results also suggest that simple learning tasks can enhance the performance of brain-machine interfaces.

Animals↗

PubMed1987

A method of self-directed learning in continuing medical education with implications for recertification.

A method of self-directed learning for physicians that can be used to satisfy a portion of specialty board recertification requirements integrates contract learning (self-formulated learning plans), information brokering (linking physicians with consultants and community resources), and collegial networking (discussion groups). The method encourages physicians to focus on educational objectives, supplies learning resources, and promotes interactions with colleagues in study groups. Fifty-nine (53%) of the 102 learning goals update physicians' knowledge. Print sources and discussions with experts were the commonest resources used. Forty-five (49%) of 91 participants completed their learning plans. Forty-nine (74%) completed projects were judged successful in achieving their goals. Twenty-five (45%) of 56 physicians responding to a questionnaire stated that the method was superior to traditional continuing medical education. Fifty-two percent of the participants found the method as effective as traditional continuing medical education. Proof of accomplishment allows the method to be used as part of a specialty board recertification process.

Certification↗

PubMed2002

Presenting risks and benefits to patients.

OBJECTIVE: To investigate whether patients are influenced by the order in which they learn the risks and benefits of a treatment and whether this effect is attenuated by a treatment's associated risk and/or benefit. DESIGN: Subjects were randomized to review 1 of 6 medical treatment information brochures. SETTING: Waiting rooms of primary care physicians at an academic health center. PARTICIPANTS: Six hundred eighty-five subjects, ages 18 to 70 years. INTERVENTION: Subjects reviewed 1 of 3 treatments for symptomatic carotid artery disease. The first (aspirin) was low-risk/low-benefit, the second (carotid endarterectomy surgery) was high-risk/high-benefit, and the third (extracranial-to-intracranial bypass surgery) was high-risk but of unknown benefit. Patients were also randomized to receive information about risk either before or after benefit. Patients were asked to rate the favorability of the treatment on a scale of 0 to 100 and whether they would consent. Finally, subjects rated how their decisions were influenced by the risk and benefit information. MAIN RESULTS: Subjects evaluating aspirin therapy were influenced by the order of the risk/benefit information. Those learning about risks after benefits had a greater drop in their favorability ratings than subjects learning about risks before benefits (-10.9 vs -5.2 on a 100-point scale; P = .02) and were less likely to consent (odds ratio, 2.27; P = .04). In contrast, subjects evaluating carotid endarterectomy and extracranial-to-intracranial bypass were not influenced by information order. When subjects were influenced by the order of information, they also reported that the treatment's risk had less influence on their decision making (P < .01). CONCLUSIONS: When patients evaluate low-risk medical interventions, they may form less favorable impressions of the treatment and be less likely to consent to the treatment when they learn about the risks after the benefits. Order effects were not observed with high-risk treatments regardless of potential benefits.

Adolescent↗

PubMed1999

Memory deficits for implicit contextual information in amnesic subjects with hippocampal damage.

The role of the hippocampus and adjacent medial temporal lobe structures in memory systems has long been debated. Here we show in humans that these neural structures are important for encoding implicit contextual information from the environment. We used a contextual cuing task in which repeated visual context facilitates visual search for embedded target objects. An important feature of our task is that memory traces for contextual information were not accessible to conscious awareness, and hence could be classified as implicit. Amnesic patients with medial temporal system damage showed normal implicit perceptual/skill learning but were impaired on implicit contextual learning. Our results demonstrate that the human medial temporal memory system is important for learning contextual information, which requires the binding of multiple cues.

Adult↗

PubMedDate not supplied

Guidelines for developing interactive multimedia. Applications in nurse education.

In an environment of increasing economic constraint, it is necessary for nurse educators to design and implement cost-effective teaching and learning strategies. Computer-based interactive multimedia applications in education have been touted as a cost- and time-effective method of providing a dynamic, information rich, learning environment. Given the profusion of this type of media in the general marketplace, an increasing number of educators are now wishing to develop specific computerized multimedia applications for use in nurse education. Accounts of a number of such developments exist in the literature. However, there is a dearth of literature outlining the processes involved in interactive multimedia production. It would, therefore, appear timely to address issues related to multimedia development. Based on the author's experiences, this article will offer a number of practical suggestions for the development of interactive multimedia applications in nursing education.

Education, Nursing↗

PubMed1994

[Problem based learning: achievement of educational goals in the information and comprehension sub-categories of Bloom cognitive domain].

The aim this work was to assess and compare the achievements of medical students, subjected to problem based learning methodology. The information and comprehension categories of Bloom were tested in 17 medical students in four different occasions during the physiopathology course, using a multiple choice knowledge test. There was a significant improvement in the number of correct answers towards the end of the course. It is concluded that these medical students obtained adequate learning achievements in the information subcategory of Bloom using problem based learning methodology, during the physiopathology course.

Education, Medical, Undergraduate↗

PubMed1987

Interocular transfer of shape discrimination in the goldfish--a reassessment of the role of the posterior commissure.

Previous work has implicated the hypothalamic horizontal commissure in the interocular transfer of learned shape information in the goldfish. In the experiments reported here, goldfish were classically conditioned to show a differential cardiac response. Fish with transection of this commissure acquired and transferred a circle/square discrimination, whereas animals with transection of the mesencephalic posterior commissure showed acquisition but not transfer of the same task. Other fish were trained on an orientation discrimination. Although all fish acquired the task, those with transection of the horizontal commissure showed transfer failure, whereas those with transection of the posterior commissure demonstrated transfer. We therefore suggest that information relating to shape is transferred via the posterior commissure, but that information relating to rotation transfers through the horizontal commissure.

Animals↗