Portfolio outcome assessment: lessons learned.
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Attitude of Health Personnel↗
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Results for “Learning outcomes”
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Stakeholders' views on measuring outcomes for people with learning disabilities.
What works and how do we know? These are recurring questions for health and social care professionals, although mediated through differing philosophies and historical perspectives. The aims of the study reported here were to discover views of managers and commissioners of services for people with learning disabilities in Scotland regarding (a) current approaches to service evaluation (as an indication of what is to be measured) and (b) healthcare outcome measurement (as an indication of preferences regarding how this should be measured). A postal questionnaire was used to survey 94 stakeholders from the NHS, Local Authorities, and non-statutory organisations across Scotland. Respondents' views were sought on current approaches to service evaluation within learning disabilities; outcome measurement; appropriateness of specified methods of measuring health outcomes; desired future methods of outcome measurement within learning disabilities; and service user involvement in care. A 77% (73/94) response rate to the questionnaire was achieved. Different methods of service evaluation were used by different stakeholders. Staff appraisal was the most frequently identified method (used by 85% of respondents). Specific outcome measures were used by 32% of respondents although there were differences of opinion as to what constitutes specific outcome measures. Overall there was strong support for goal-setting and reviewing (83%) and individualised outcome measures (75%) as appropriate methods for use with people with learning disabilities. The hypothetical question asking what outcome measures should be introduced for this client group had by far the lowest response rate (51/73). The overwhelming majority of all respondents, 68 (92%), reported user involvement in their service. Staff ambivalence to outcome measurement was evident in the research and respondents highlighted the complexity and multidimensional nature of outcomes for this service user group. Managers recognised that outcome measurement was expected but were uncertain how to go about it.
Humans↗
Laparoscopic splenectomy: outcomes and lessons learned from over 200 cases.
BACKGROUND: In this study of laparoscopic splenectomy (LS), we evaluate prospectively gathered perioperative patient data and review lessons learned in the evolution of this procedure. METHODS: At 2 university medical centers between November 1993 and March 2000, there were 203 patients (122 female patients and 81 male patients) who underwent LS after preoperative evaluation. RESULTS: LS was successfully completed in 197 patients (97%). The mean operative time was 145.5 minutes and the length of stay averaged 2.7 days with 143 (70.4%) staying less than 48 hours. The most common indication was idiopathic thrombocytopenic purpura (ITP). Six patients required conversion to open splenectomy (OS), with only 2 conversions in the last 163 cases. No deaths were attributed to the procedure. Complications occurred in 19 patients (9.3%). Thirty accessory spleens were identified in 25 patients (12.3%). Seventeen patients (8.4%) underwent concomitant procedures, most commonly cholecystectomy. CONCLUSIONS: LS by the lateral approach is both safe and feasible in patients of all ages.
Adolescent↗
Outcomes and lessons learned from the John A. Hartford Foundation Building Academic Geriatric Nursing Capacity Initiative Centers of Geriatric Nursing Excellence.
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Aged↗
Learning from demonstrations: the role of visual search during observational learning from video and point-light models.
In this study, we examined the visual search strategies used during observation of video and point-light display models. We also assessed the relative effectiveness of video and point-light models in facilitating the learning of task outcomes and movement patterns. Twenty-one female novice soccer players were divided equally into video, point-light display and no-model (control) groups. Participants chipped a soccer ball onto a target area from which radial and variable error scores were taken. Kinematic data were also recorded using an opto-electrical system. Both a pre- and post-test were performed, interspersed with three periods of acquisition and observation of the model. A retention test was completed 2 days after the post-test. There was a significant main effect for test period for outcome accuracy and variability, but observation of a model did not facilitate outcome-based learning. Participants observing the models acquired a global movement pattern that was closer to that of the model than the controls, although they did not acquire the local relations in the movement pattern, evidenced by joint range of motion and angle-angle plots. There were no significant differences in learning between the point-light display and video groups. The point-light display model group used a more selective visual search pattern than the video model group, while both groups became more selective with successive trials and observation periods. The results are discussed in the context of Newell's hierarchy of coordination and control and Scully and Newell's visual perception perspective.
Adult↗
Discrimination between outcomes in instrumental learning: effects of preexposure to the reinforcers.
In two experiments rats received instrumental training with two response levers, one response being reinforced by sucrose solution and the other by sucrose pellets. Prior to a test session, on which both levers were made available in the absence of reinforcement, the rats were given free access to one of the reinforcers, a procedure known to reduce its value. It was found that the rats responded at a lower rate on the lever that had produced the now-devalued reinforcer, but that this effect was substantial only in rats that had received preexposure to the two reinforcers before instrumental training was begun (Experiment 1). Experiment 2 demonstrated that this effect was obtained only when presentations of the two reinforcers were presented according to an inter-mixed schedule during preexposure. It is suggested that this result constitutes an instance of the perceptual learning effect in which intermixed preexposure to similar events enhances their discriminability.
Animals↗
Learning from disappointing outcomes: an evaluation of prevocational interventions for methadone maintenance patients.
To increase rates of employment and improve overall rehabilitation in methadone maintenance treatment, three prevocational trainings, Vocational Problem Solving, Job Seekers Workshop, and the two combined, were evaluated as adjunctive services. Between March 1995 and April 1998, subjects in treatment were interviewed at baseline, randomly assigned to one of the trainings, and followed up at 6 and 12 months postbaseline. None of the three models produced significantly greater employment or better overall rehabilitation. Experience from the study suggests that closer integration of prevocational training with treatment, individualizing efforts to meet training needs, and providing support during job-finding and early job-holding might improve program effectiveness.
Adult↗
The role of perceptions and attributions for response-outcome noncontingency in learned helplessness: a commentary and discussion.
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Achievement↗
Strategies for active learning in online continuing education.
Online continuing education and staff development is on the rise as the benefits of access, convenience, and quality learning are continuing to take shape. Strategies to enhance learning call for learner participation that is self-directed and independent, thus changing the educator's role from expert to coach and facilitator. Good planning of active learning strategies promotes optimal learning whether the learning content is presented in a course or a just-in-time short module. Active learning strategies can be used to enhance online learning during all phases of the teaching-learning process and can accommodate a variety of learning styles. Feedback from peers, educators, and technology greatly influences learner satisfaction and must be harnessed to provide effective learning experiences. Outcomes of active learning can be assessed online and implemented conveniently and successfully from the initiation of the course or module planning to the end of the evaluation process. Online learning has become accessible and convenient and allows the educator to track learner participation. The future of online education will continue to grow, and using active learning strategies will ensure that quality learning will occur, appealing to a wide variety of learning needs.
Attitude of Health Personnel↗
Learning from poor outcomes in today's health care.
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Delivery of Health Care↗
The positive force of vocational education: transition outcomes for youth with learning disabilities.
Successful transitions to postsecondary settings are associated with such adult outcomes as continuing education, independent living, and employment. The purpose of this article is to present research that supports the use of vocational education programs to improve the adult outcomes of students with learning disabilities as they transition to employment. The literature review focuses on four major topics: (a) data from follow-up and follow-along studies illustrating the relationship between vocational-technical education and adult outcomes; (b) recent program trends in vocational education; (c) current practices in vocational education regarding placement and access, instructional and setting demands, and teacher attitudes and preparation; and (d) speculations about the effects of school reform and pending legislation.
Adolescent↗
Effect of learning curve on the outcome of external cephalic version.
AIM: The aim of this study was to find out the effect of learning curve on the outcome of external cephalic version (ECV) at term, using tocolytics. The effect of various factors affecting the outcome of ECV was also studied in relation to the learning curve. METHODS: This is a prospective longitudinal observational study of 80 consecutive cases of ECV. They were analysed in relation to outcome, parity, type of breech, placental site and birth weight. The cases were divided consecutively into 4 groups of 20 cases each, in order to analyse the effect of learning curve. RESULTS: The learning curve for ECV is very sharp. The success rate of external cephalic version plateau after the first 20 cases from 45% to about 60%. Only parity and type of breech have a significant effect on the outcome. The success rate is lower for primipara and non-flexed breech. This negative effect is strongest in the first 20 cases and again plateaus after the first 20 cases. The high success rate of multipara and primipara flexed breech is obtained even in the first 20 cases and does not improve with further experience. CONCLUSIONS: The learning curve for ECV is sharp and plateaus after the first 20 cases. Outcome of ECV for patients with favourable factors such as multiparity and flexed breech is not affected by learning curve.
Clinical Competence↗
Problem-based learning in online vs. face-to-face environments.
UNLABELLED: This study compared outcomes of problem-based learning between synchronous online groups and face-to-face tutorial groups. Specifically, the study compared learning outcomes, time-on-task and learning issue generation. METHODS AND PROCEDURES: A post-test only control group design was used to investigate the effects of learning conditions on learning outcomes and processes. The experimental learning condition was defined as computer-mediated problem-based learning (CMPBL) and the control condition was traditional problem based learning in face-to-face groups (TPBL). The learning process consisted of four elements: an initial tutorial, a period of self-directed learning, a second tutorial and a laboratory session. During the initial tutorial students generated learning issues that they submitted to the research assistant. In the self-directed learning phase, students researched their learning issues and returned for the second tutorial with their findings. Students in the CMPBL groups interacted with the resource person electronically via email, chat room or bulletin board. At the second tutorial, groups shared information related to their learning issues and completed their products for the problem. RESULTS: There was no difference in learning outcomes between groups. The CMPBL group spent significantly more time on learning than the TPBL group. There was no overall difference between groups on generation of learning issues; however, there was a significant relationship between number of learning issues generated and higher score on the examination regardless of tutorial medium.
Computer-Assisted Instruction↗
Likelihood judgment based on previously observed outcomes: the alternative-outcomes effect in a learning paradigm.
Previous research has demonstrated that intuitive perceptions of certainty regarding a focal outcome are sensitive to variations in how evidence supporting nonfocal alternatives is distributed, even when such variations have no bearing on objective probability. We investigated this alternative-outcomes effect in a learning paradigm in which participants made likelihood judgments on the basis of their memory for past observations of relevant outcomes. In Experiment 1, a manipulation of evidence (observed frequencies) across alternative outcomes influenced not only intuitive certainty estimates about a focal outcome but also numeric subjective probabilities. Experiment 2 ruled out the possibility that these effects were attributable to the influence of information loss on frequency estimations. The findings were consistent with the heuristic comparison account, which suggests that the judged likelihood of a focal outcome will be disproportionately influenced by the strength (frequency) of the strongest alternative outcome.
Humans↗
Evidence for an association between the discriminative stimulus and the response-outcome association in instrumental learning.
In 4 experiments, rats received 1 of several outcomes for engaging in various instrumental responses in the presence of discriminative stimuli. Discriminative stimuli shared some response-outcome relations but not others. When a response was subsequently extinguished in the presence of 1 discriminative stimulus, that produced relatively more decrement in responding in other stimuli that shared the same response-outcome relation. Other discriminative stimuli, in the presence of which that response had been reinforced by other outcomes and in which the original outcome had reinforced another response, were less affected. Moreover, postextinction devaluation of that outcome suggested that the particular response-outcome relation extinguished had undergone decrement. These results suggest that discriminative stimuli have relatively specific associations with the response-outcome relations that obtain in their presence.
Animals↗
Problem-based learning. Challenges, barriers and outcome issues.
Although many recent studies have discussed specific issues related to problem-based learning in medical education, a comprehensive review of the literature on the consequences of its use and the outcomes of curriculum based on problem-based learning have not been accurately looked at. Furthermore, there is no available review that critically evaluates challenges and barriers to the implementation of problem-based learning curriculum in medical schools. The purpose of this part is to highlight the major challenges and barriers reported during curriculum preparation and implementation and to critically evaluate the consequences of problem-based learning introduction and its educational outcomes.
Attitude of Health Personnel↗
Treatment outcomes for students with learning disabilities: how important are internal and external validity?
This study analyzed the magnitude of experimental intervention outcomes as a function of violations in internal and external validity for studies that included students with learning disabilities. The results indicated that treatment outcomes were significantly affected by the following violations: teacher effects, establishing criterion levels of instructional performance, reliance on experimental measures, using different measures between pretest and posttest, using a sample heterogenous in age, and using incorrect units of analysis. Furthermore, the underreporting of information related to ethnicity, locale of the study, psychometric data, and teacher applications positively inflated the magnitude of treatment outcomes. A weighted hierarchical regression analysis revealed that composite scores of the aforementioned high-risk variables accounted for 16% of the total variance in effect size. The implications for interpreting intervention research to practice are discussed.
Analysis of Variance↗
Creating an outcomes-based tool for learning barrier assessment in an outpatient education program.
The purpose of this project was to develop an outcomes-based measurement tool that could be used to screen patients for learning barriers. A comprehensive, objective tool to assess for patient learning barriers was developed and implemented in an outpatient, Stage II Cardiac Rehabilitation program. Definitions for seven barriers to learning, along with criteria to identify their presence, were compiled from the current literature and incorporated into the design of the outcomes-based tool. Utilization of the learning barrier tool may provide an objective, outcomes-based methodology for the identification of patient learning barriers, allowing educators to individualize patient education.
Ambulatory Care↗