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PubMed1996

Issues in cognitive psychology: implications for professional education.

Education and cognitive psychology have tended to pursue parallel rather than overlapping paths. Yet there is, or should be, considerable common ground, since both have major interests in learning and memory. This paper presents a number of topics in cognitive psychology, summarizes the findings in the field, and explores the implications for teaching and learning. THE ORGANIZATION OF LONG-TERM MEMORY: The acquisition of expertise in an area can be characterized by the development of idiosyncratic memory structures called semantic networks, which are meaningful sets of connections among abstract concepts and/or specific experiences. Information (such as the assumptions and hypotheses that are necessary to diagnose and manage cases) is retrieved through the activation of these networks. Thus, when teaching, new information must be embedded meaningfully in relevant, previously existing knowledge to ensure that it will be retrievable when necessary. INFLUENCES ON STORAGE AND RETRIEVAL FROM MEMORY: A wide variety of variables affect the capacity to store and retrieve information from memory, including meaning, the context and manner in which information is learned, and relevant practice in retrieval. Educational strategies must, therefore, be directed at three goals--to enhance meaning, to reduce dependence on context, and to provide repeated relevant practice in retrieving information. PROBLEM SOLVING AND TRANSFER: Much of the development of expertise involves the transition from using general problem-solving routines to using specialized knowledge that reduces the need for classic "problem solving." Two manifestations of this specialized knowledge are the use of analogy and the specialization of general routines in specific domains. To develop these specialized forms of knowledge, the learner must have extensive practice in using relevant problem-solving routines and in identifying the situations in which a particular routine is likely to be useful. CONCEPT FORMATION: Experts possess both abstract proto-typical information about categories and an extensive set of separate, specific examples of categories, which have been obtained through individual experience. Both these sources of information are used in categorization and diagnostic classifications. Thus, it is important for educators to be aware that experience with sample cases is not just an opportunity to apply and practice the rules "at the end of the chapter." Instead, experience with cases provides an alternative method of reasoning that is independent of, but equally useful to, analytical rules. DECISION MAKING: Experts clearly do not use classic formal decision theory, but rather make use of heuristics, or shortcuts, when making decisions. Nonetheless, experts generally make appropriate decisions. This suggests that the shortcuts are useful more often than not. Rather than teaching learners to avoid heuristics, then, it might be more reasonable to help them recognize those relatively infrequent situations where their heuristics are likely to fail.

Cognition↗

PubMed2006

Newborn screening for cystic fibrosis: parents' preferences regarding counseling at the time of infants' sweat test.

Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents' preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents' preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents' distress while mismatched counseling tended to increase parents' worry about their infant.

Adaptation, Psychological↗

PubMed1994

Laminar selectivity of the cholinergic suppression of synaptic transmission in rat hippocampal region CA1: computational modeling and brain slice physiology.

ACh may set the dynamics of cortical function to those appropriate for learning new information. In models of the putative associative memory function of piriform cortex, selective suppression of intrinsic but not afferent fiber synaptic transmission by ACh prevents recall of previous input from interfering with the learning of new input (Hasselmo, 1993). Selective cholinergic suppression may play a similar role in the hippocampal formation, where Schaffer collateral synapses in stratum radiatum (s. rad) may store associations between activity in region CA3 and the entorhinal cortex input to region CA1 terminating in stratum lacunosum-moleculare (s. l-m). A computational model of region CA1 predicts that for effective associative memory function of the Schaffer collaterals, cholinergic suppression of synaptic transmission should be stronger in s. rad than in s. l-m. In the hippocampal slice preparation, we tested the effect of the cholinergic agonist carbachol (0.01-500 microM) on synaptic transmission in s. rad and s. l-m. Stimulating and recording electrodes were simultaneously placed in both layers, allowing analysis of the effect of carbachol on synaptic potentials in both layers during the same perfusion in each slice. Carbachol produced a significantly stronger suppression of stimulus-evoked EPSPs in s. rad than in s. l-m at all concentrations greater than 1 microM. At 100 microM, EPSP initial slopes were suppressed by 89.1 +/- 3.0% in s. rad, but only by 40.1 +/- 4.1% in s. l-m. The muscarinic antagonist atropine (1 microM) blocked cholinergic suppression in both layers. These data support the hypothesis that synaptic modification of the Schaffer collaterals may store associations between activity in region CA3 and the afferent input to region CA1 from the entorhinal cortex. In simulations, feedback regulation of cholinergic modulation based on activity in region CA1 sets the appropriate dynamics of learning for novel associations, and recall for familiar associations.

Animals↗

PubMed1995

Iowa's National Laboratory for the study of Rural Telemedicine: a description of a work in progress.

As the federal administration advances the idea of the "information superhighway," many disciplines are being challenged to find ways to use advanced telecommunications to improve access to information, enhance learning opportunities, and achieve higher levels of international competitiveness. Telemedicine, the use of communications technology in the practice of medicine, may change the way rural health care is provided by improving access to medical information, diagnostic tools, and consultations. The information and health care services required by health care professionals are rapidly changing, and dissemination of this information to isolated practitioners has proven to be difficult. By providing support electronically from a central site, the most current information is more readily available. Using test-bed hospitals in rural and urban settings, the National Library of Medicine-funded National Laboratory for the Study of Rural Telemedicine at the University of Iowa is currently developing the necessary infrastructure to support targeted projects studying how telemedicine applications can be made more effective and readily available.

Clinical Laboratory Information Systems↗

PubMed2001

Hallucinogens on the Internet: a vast new source of underground drug information.

OBJECTIVE: The illicit use of hallucinogens is reemerging in the United States, especially among well-educated adults and teenagers. These same groups are also frequent users of the Internet. The authors sought to characterize the extent of information about hallucinogens available to Internet users. METHOD: Using standard Internet search techniques, the authors located 81 hallucinogen-related sites and categorized the information provided. RESULTS: Internet sites offer thousands of pages of information-albeit of questionable accuracy-on how to obtain, synthesize, extract, identify, and ingest hallucinogens. Much of this information has yet to appear in textbooks. By contrast, the authors found few U.S. government agency sites offering cautionary material about hallucinogen use. CONCLUSIONS: Using the Internet, potential hallucinogen users can bypass traditional channels of medical information and learn in great detail how to obtain and use numerous drugs with unknown hazards.

Adolescent↗

PubMed1992

Maximize learning through wellness.

By achieving wellness to some degree in all five components of health, the self-concept of the health care employee can be raised. If the worker begins with physical health, this can in turn affect the emotional, mental, social, and spiritual health of the individual. All of these elements of well-being have been shown to have a profound effect on learning abilities and performance levels of the adult. Health care professionals are dealing with life or death decisions on a daily basis. Hopefully, everyone would agree that the health care team should be performing at its peak ability. To do this, each member of the health care team should strive for wellness. The health care facility should promote wellness for its employees first, so they in turn can deliver quality health care services. Keeping current with the constant changes in the health care industry and learning new information is a critical part of that delivery of quality care.

Education, Continuing↗

PubMed1993

Problem-based learning in American medical education: an overview.

The recent trend toward problem-based learning (PBL) in American medical education amounts to one of the most significant changes since the Flexner report motivated global university affiliation. In PBL, fundamental knowledge is mastered by the solving of problems, so basic information is learned in the same context in which it will be used. Also, the PBL curriculum employs student initiative as a driving force and supports a system of student-faculty interaction in which the student assumes primary responsibility for the process. The first PBL medical curriculum in North America was established at McMaster University in Toronto in 1969. The University of New Mexico was the first to adopt a medical PBL curriculum in the United States, and Mercer University School of Medicine in Georgia was the first U.S. medical school to employ PBL as its only curricular offering. Many interpretations of the basic PBL plan are in use in North American medical schools. Common features include small-group discussions of biomedical problems, a faculty role as facilitator, and the student's relative independence from scheduled lectures. The advantages of PBL are perceived as far outweighing its disadvantages, and the authors conclude that eventually it will see wider use at all levels of education.

Curriculum↗

PubMed2006

The effects of category overlap on information-integration and rule-based category learning.

In three experiments, we investigated whether the amount of category overlap constrains the decision strategies used in category learning, and whether such constraints depend on the type of category structures used. Experiments 1 and 2 used a category-learning task requiring perceptual integration of information from multiple dimensions (an information-integration task) and Experiment 3 used a task requiring the application of an explicit strategy (a rule-based task). In the information-integration task, participants used perceptual-integration strategies at moderate levels of category overlap, but explicit strategies at extreme levels of overlap--even when such strategies were suboptimal. In contrast, in the rule-based task, participants used explicit strategies, regardless of the level of category overlap. These data are consistent with a multiple systems view of category learning, and suggest that categorization strategy depends on the type of task that is used, and on the degree to which each stimulus is probabilistically associated with the contrasting categories.

Adolescent↗

PubMed2005

Selective cognitive impairments associated with NMDA receptor blockade in humans.

Hypofunction of the N-methyl-D-aspartate receptor (NMDAR) may be involved in the pathophysiology of schizophrenia. NMDAR antagonists like ketamine induce schizophrenia-like features in humans. In rodent studies, NMDAR antagonism impairs learning by disrupting long-term potentiation (LTP) in the hippocampus. This study investigated the effects of ketamine on spatial learning (acquisition) vs retrieval in a virtual Morris water task in humans. Verbal fluency, working memory, and learning and memory of verbal information were also assessed. Healthy human subjects participated in this double-blinded, placebo-controlled study. On two separate occasions, ketamine/placebo was administered and cognitive tasks were assessed in association with behavioral ratings. Ketamine impaired learning of spatial and verbal information but retrieval of information learned prior to drug administration was preserved. Schizophrenia-like symptoms were significantly related to spatial and verbal learning performance. Ketamine did not significantly impair attention, verbal fluency, or verbal working memory task performance. Spatial working memory was slightly impaired. In conclusion, these results provide evidence for ketamine's differential impairment of verbal and spatial learning vs retrieval. By using the Morris water task, which is hippocampal-dependent, this study helps bridge the gap between nonhuman animal and human NMDAR antagonism research. Impaired cognition is a core feature of schizophrenia. A better understanding of NMDA antagonism, its physiological and cognitive consequences, may provide improved models of psychosis and cognitive therapeutics.

Cognition Disorders↗

PubMed2006

Reducing hazard vulnerability: towards a common approach between disaster risk reduction and climate adaptation.

Over the past few decades, four distinct and largely independent research and policy communities--disaster risk reduction, climate change adaptation, environmental management and poverty reduction--have been actively engaged in reducing socio-economic vulnerability to natural hazards. However, despite the significant efforts of these communities, the vulnerability of many individuals and communities to natural hazards continues to increase considerably. In particular, it is hydro-meteorological hazards that affect an increasing number of people and cause increasingly large economic losses. Arising from the realisation that these four communities have been largely working in isolation and enjoyed only limited success in reducing vulnerability, there is an emerging perceived need to strengthen significantly collaboration and to facilitate learning and information exchange between them. This article examines key communalities and differences between the climate change adaptation and disaster risk reduction communities, and proposes three exercises that would help to structure a multi-community dialogue and learning process.

Community Networks↗

PubMed2003

Can the repetition effect maximize learning in multiple sclerosis?

OBJECTIVE: The 'repetition effect' stipulates that recall ability improves as the number of learning trials that a person receives increases. While the repetition effect has been supported through many empirical investigations in healthy individuals, it has not yet been applied to clinical populations. The present study tested the hypothesis that an increased number of learning trials improves recall ability in persons with a neurological disorder, namely multiple sclerosis (MS). DESIGN: Prospective between-group design with 30-minute, 90-minute and one-week assessments. SETTING: Private, nonprofit, research facility. SUBJECTS: Sixty-four MS subjects; 20 healthy control subjects (HC). INTERVENTIONS: Subjects were given a modified Selective Reminding Test (SRT), a list of 10 words to remember in a selective reminding format. To control for the amount of information initially learned, the learning trials were repeated until the subject recalled all 10 words on two consecutive trials. MAIN OUTCOME MEASURES: SRT word recall and recognition was tested 30 minutes, 90 minutes and one week subsequent to initial acquisition. RESULTS: Interestingly, the antithesis of our hypothesis was found. That is, persons with MS who required more learning trials to reach the perfect learning criterion performed significantly worse on the recall trials. However, this was not the case in a sample of healthy individuals undergoing the same protocol. CONCLUSIONS: These results indicate that individuals with MS may not benefit from repetition in isolation, but rather require the use of more intensive cognitive rehabilitation strategies (i.e., increased organization) to help improve their depth of encoding of new information.

Adult↗

PubMed2005

Finite state automata resulting from temporal information maximization and a temporal learning rule.

We extend Linkser's Infomax principle for feedforward neural networks to a measure for stochastic interdependence that captures spatial and temporal signal properties in recurrent systems. This measure, stochastic interaction, quantifies the Kullback-Leibler divergence of a Markov chain from a product of split chains for the single unit processes. For unconstrained Markov chains, the maximization of stochastic interaction, also called Temporal Infomax, has been previously shown to result in almost deterministic dynamics. This letter considers Temporal Infomax on constrained Markov chains, where some of the units are clamped to prescribed stochastic processes providing input to the system. Temporal Infomax in that case leads to finite state automata, either completely deterministic or weakly nondeterministic. Transitions between internal states of these systems are almost perfectly predictable given the complete current state and the input, but the activity of each single unit alone is virtually random. The results are demonstrated by means of computer simulations and confirmed analytically. It is furthermore shown numerically that Temporal Infomax leads to a high information flow from the input to internal units and that a simple temporal learning rule can approximately achieve the optimization of temporal interaction. We relate these results to experimental data concerning the correlation dynamics and functional connectivities observed in multiple electrode recordings.

Action Potentials↗

PubMedDate not supplied

"They're just going to get worse anyway": perspectives on rehabilitation for nursing home residents with dementia.

UNLABELLED: In recent years, researchers have provided data to show that individuals with Alzheimer's disease (AD) can learn new information and functional behaviors, despite significant declarative memory deficits. However, clinicians in long-term care frequently have difficulty justifying and providing needed services to persons with Alzheimer's disease in LTC settings. In this paper, implicit learning will be discussed as a theoretical rationale to support rehabilitation along with practical issues related to the provision of speech-language pathology services for residents with Alzheimer's disease in LTC settings. LEARNING OUTCOMES: After reading this article, learners will be able to: (1) Define implicit learning; (2) discuss evidence for implicit learning in Alzheimer's disease; (3) describe how to capitalize on implicit learning during rehabilitation for individuals with Alzheimer's disease; (4) explain how to justify and provide interventions for individuals with Alzheimer's disease in LTC settings.

Aged↗

PubMed1994

mRNA nuclear export.

The export of mRNA from the nucleus to the cytoplasm is an essential step in the expression of genetic information in eukaryotes. It is an energy-dependent process and involves transport across the nuclear pores. It requires both cis-acting ribonucleoprotein particle signals and specific trans-acting factors. Although much remains to be learned, recent information has begun to define this pathway at both the cellular and biochemical levels and indicates that it is used as a key regulatory step by several viruses.

Animals↗

PubMed2003

Learning support for the consultation: information support and decision support should be placed in an educational framework.

BACKGROUND: Advances in information technology mean that it is now possible to provide contextually relevant, evidence-based information during the course of the consultation. As a consequence, the practitioner has to consider the new information (from the computer) in the situation of the present consultation and in the light of his or her own experience. This task has to be carried out in a short time, in the presence of the patient. METHOD: Drawing on experience of the development of one decision support system, this paper places that task for the practitioner in an educational framework. We begin by reviewing theories of professional experience and knowledge and go on to look at schema theory and the role of cognitive dissonance and reflection in learning. CONCLUSION: This paper considers the provision of real time decision support in the light of learning and the experienced practitioner. We conclude that framing the implementation of decision support in this way provides useful insights. The key process is learning by the practitioner, in the course of the consultation. This process should be supported by decision support and information support software. There are implications here for the design of such software, and also for the way in which practitioners are trained to use it.

Cognitive Dissonance↗

PubMed2004

Entropy-based kernel mixture modeling for topographic map formation.

A new information-theoretic learning algorithm for kernel-based topographic map formation is introduced. In the one-dimensional case, the algorithm is aimed at uniformizing the cumulative distribution of the kernel mixture densities by maximizing its differential entropy. A nonparametric differential entropy estimator is used on which normalized gradient ascent is performed. Both differentiable and nondifferentiable kernels are in principle supported, such as Gaussian and rectangular (on/off) kernels. The relation is shown with joint entropy maximization of the kernel outputs. The learning algorithm's performance is assessed and compared with the theoretically optimal performance. A fixed-point rule is derived for the case of heterogeneous kernel mixtures. Finally, an extension of the algorithm to the multidimensional case is suggested.

Algorithms↗

PubMed1985

Informing patients about tardive dyskinesia.

The effects of a formal (written) approach v an informal (oral) approach to obtaining informed consent for neuroleptic treatment were compared in 25 schizophrenic outpatients with tardive dyskinesia. Both groups had significant increases in knowledge, but only the informal/oral presentation group retained significant new knowledge at two-month follow-up. Overall, patients did not learn the information deemed most relevant for rational decision making about neuroleptic treatment. Younger patients started out with more knowledge and retained significant new knowledge at follow-up. All study patients remained in treatment and all but one remained on neuroleptic regimens. There was no increase in relapse or treatment noncompliance in the study population compared with a comparison group. While information about tardive dyskinesia can be safely disclosed to schizophrenic outpatients, such disclosure is evidently most meaningful when repeated informally in the context of a therapeutic relationship.

Adult↗

PubMed2004

Are there gender-specific neural substrates of route learning from different perspectives?

Psychological studies have demonstrated sex differences in performance and tactics for route learning. Route information can be encoded in different ways, such as the survey perspective (as in maps) and the route perspective (as we experience the world). Here we show, using functional magnetic resonance imaging, that men and women use the same brain areas to learn routes from both perspectives, and that the observed sex differences in route learning are not due to differences in the parts of the brain being used. We also show that many of the same brain areas are used in route learning from both perspectives, such as the parahippocampus, precuneus, posterior cingulate gyrus and middle frontal gyrus. However, paired comparisons of route learning from both perspectives shows that the survey perspective activates the superior and middle temporal gyri and the angular gyrus, which are not activated in the route perspective.

Adult↗