PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Learning outcomes”

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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed2006

The use of games to improve patient outcomes.

In gerontology and geriatrics, learning often requires both the acquisition of new facts and a change in attitude towards elderly persons. Games, in addition to stimulating a desire to learn, are powerful instruments to change attitudes. This paper introduces games currently being used by the Gateway Geriatric Education Center to teach gerontological and geriatric principles to healthcare providers. It summarizes assessments that have been used to measure the effectiveness of those games to promote learning. Arguments are made that more rigorous methodologies of evaluation for games should be adopted in order to demonstrate the effects of that learning on improved patient outcomes.

Aged↗
PubMed2005

Contiguity and the outcome density bias in action-outcome contingency judgements.

In cause-outcome contingency judgement tasks, judgements often reflect the actual contingency but are also influenced by the overall probability of the outcome, P(O). Action-outcome instrumental learning tasks can foster a pattern in which judgements of positive contingencies become less positive as P(O) increases. Variable contiguity between the action and the outcome may produce this bias. Experiment 1 recorded judgements of positive contingencies that were largely uninfluenced by P(O) using an immediate contiguity procedure. Experiment 2 directly compared variable versus constant contiguity. The predicted interaction between contiguity and P(O) was observed for positive contingencies. These results stress the sensitivity of the causal learning mechanism to temporal contiguity.

Association Learning↗
PubMed2005

Outcome studies in type 2 diabetes.

BACKGROUND: Outcome studies are used to measure clinically meaningful primary end points, such as mortality and cardiovascular morbidity. However, few outcome trials have been conducted exclusively in people with diabetes; the majority of conventional diabetes trials use surrogate end points that may or may not translate into clinical benefits. Our current knowledge of the effects of pharmacotherapies on cardiovascular risk in patients with diabetes has been gained from subgroups included in large-scale studies. Several trials with lipid-modifying, antiplatelet and/or antihypertensive therapy, for example the recent Collaborative AtoRvastatin Diabetes Study, have included sufficient numbers of patients with diabetes to indicate that effective management can reduce cardio vascular risk in this patient population. The United Kingdom Diabetes Study and the Diabetes Control and Complications Trial provide important, but inconclusive data on the impact of glucose-lowering therapy on the incidence of cardiovascular complications in diabetes. Thiazolidinediones have only become available during the past few years, thus their effects were not assessed in these landmark trials. Ongoing studies in diabetic populations at high risk for further macrovascular events, such as the PROspective pioglitAzone Clinical Trial In macroVascular Events, have been designed to assess the effect of thiazolidinediones on cardiovascular outcome in patients with diabetes and should help to reinforce the importance of broad-based treatment of the multiple metabolic risk factors for cardiovascular disease in people with diabetes. SCOPE: This paper (based upon MEDLINE and EMBASE literature searches in the year range 1990-2005) reviews what we have learned from outcome studies up to the end of 2004 and looks at what we hope to learn from ongoing studies.

Cardiovascular Agents↗
PubMed2004

Lifelong learning--the key to competence in the intensive care unit?

With continual advances in technology and changes in medical and nursing practice there is a need to continue professional development whilst working within the Intensive Care environment. This paper aims to consider why and how nurses working within the Intensive Care environment learn knowledge and skills. To explore nurses' experiences, a qualitative approach using a semi-structured questionnaire comprising open questions was used. The questionnaires were then analysed using line by line coding. The findings revealed that intensive care nurses learn knowledge and skills continually through a lifelong learning process in order to become a competent practitioner. Three themes were identified within this process: learning, opportunity, and outcome, all being affected by three factors: internal, external and patient-related. It is suggested that in order to organise and support effective learning, there needs to be an awareness of all of these factors and to be able to overcome the negative aspects to enhance the learning experience for all. The ultimate outcome of learning for the intensive care nurses was to practice competently in order to deliver high quality patient care.

Attitude of Health Personnel↗
PubMed2001

Role of survey research in assessing rehabilitation outcomes.

Survey research, although often misperceived as superficial and less scientific than other research methodologies, is nonetheless a valid and reliable technique that physiatrists and researchers use to study a range of important rehabilitation outcomes. Surveys are particularly valuable for describing characteristics in large groups--such as the nature and extent of disability within a population--or for learning about outcomes in a given sample. They are the preferred approach for tracking the perceptions of rehabilitation consumers and for obtaining the data that drive service provision, programmatic development, and policy change. On the national, state, and local levels, the authors describe examples of successful survey research efforts, illustrating the types of data obtained, and the usefulness of those data.

Disability Evaluation↗
PubMed2003

Positive margins after laparoscopic radical prostatectomy: a prospective study of 100 cases performed by 4 different surgeons.

OBJECTIVE: Laparoscopic radical prostatectomy (LRP) has been refined by experienced surgeons into a competitive treatment alternative for localized prostate cancer. Less is known, however, about the outcomes of "learning curve" cases from newly trained surgeons. We prospectively studied 100 cases of LRP performed by 2 senior and 2 junior surgeons and addressed the rates of positive margins-an important early endpoint of oncologic efficacy. METHODS: 100 consecutive cases of LRP were performed by two senior (n=62) and two junior surgeons (n=38) by a 5-port transperitoneal route. Whole-mount step-section prostate specimens were examined by Stanford protocol. RESULTS: Positive margins occured in 25% of cases: 18% for pT2a (2/11), 18% for pT2b (11/61), 45% for pT3a (10/22), and 50% for pT3b (2/4) (p=0.002 pT2 vs. pT3). By surgeon experience, the rates were 19% (12/62) for senior and 34% (13/38) for junior (p=0.04). However, in a multiple logistic regression analysis, only pathologic stage (p=0.083) and Gleason sum (p=0.0133) reached statistical significance, while surgeon experience did not (p=0.0992). CONCLUSION: Positive margin rates after laparoscopic radical prostatectomy are significantly influenced by pathologic stage and Gleason score, and are within the range reported from open series. The higher positive margin rate from junior surgeons, although not statistically significant, suggests the need for further study and continued mentoring during surgery and/or video review of cases to improve oncologic results.

General Surgery↗
PubMed2005

Recovery from blocking between outcomes.

Contemporary associative learning research largely focuses on cue competition phenomena that occur when 2 cues are paired with a common outcome. Little research has been conducted to investigate similar phenomena occurring when a single cue is trained with 2 outcomes. Three conditioned lick suppression experiments with rats assessed whether treatments known to alleviate blocking between cues would also attenuate blocking between outcomes. In Experiment 1, conditioned responding recovered from blocking between outcomes when a long retention interval was interposed between training and testing. Experiment 2 obtained recovery from blocking between outcomes when the blocking outcome was extinguished after the blocking treatment. In Experiment 3, a recovery from blocking between outcomes occurred when a reminder stimulus was presented in a novel context prior to testing. Collectively, these studies demonstrate that blocking of outcomes, like blocking of cues, appears to be caused by a deficit in the expression of an acquired association.

Analysis of Variance↗
PubMed2006

Prevalence of risk factors for adverse pregnancy outcomes during pregnancy and the preconception period--United States, 2002-2004.

OBJECTIVES: To assess the prevalence of risk factors for adverse pregnancy outcome during the preconception stage and during pregnancy, and to assess differences between women in preconception and pregnancy. METHODS: Data from the 2002 and 2004 Behavioral Risk Factor Surveillance System, United States, were used to estimate the prevalence of selected risk factors among women 18-44 in the preconception period (women who wanted a baby in the next 12 months, and were not using contraception, not sterile and not already pregnant) with women who reported that they were pregnant at the time of interview. RESULTS: Major health risks were reported by substantial proportions of women in the preconceptional period and were also reported by many pregnant women, although pregnant women tended to report lower levels of risk than preconception women. For example, 54.5% of preconception women reported one or more of 3 risk factors (frequent drinking, current smoking, and absence of an HIV test), compared with 32.0% of pregnant women (p < .05). The difference in the prevalence of these three risk factors between preconception and pregnancy was significant for women with health insurance (52.5% in preconception vs. 29.4% in pregnancy, p < .05), but not for women without insurance (63.4% vs. 52.7%, p > .05). CONCLUSIONS: Women appear to be responding to messages regarding behaviors that directly affect pregnancy such as smoking, alcohol consumption and taking folic acid, but many remain unaware of the benefits of available interventions to prevent HIV transmission and birth defects. Although it appears that some women reduce their risk for adverse pregnancy outcomes after learning of their pregnancy, the data suggest that a substantial proportion of women do not. Furthermore, if such change occurs it is often too late to affect outcomes, such as birth defects resulting from alcohol consumption during the periconception period. Preconception interventions are recommended to achieve a more significant reduction in risk and further improvement in perinatal outcomes.

Adolescent↗
PubMed1992

Outcome factors in patient education.

Patient education requires a thorough knowledge of the subject and accurate assessment of patient abilities, readiness, and motivation. The teaching process involves agreement between the PA and the patient on what is to be learned and a clear, hands-on presentation that uses visual and other aids as appropriate. Feedback is essential, both from the PA in the form of correction and rewards and from the patient to draw attention to areas that need further clarification. As it can be extremely difficult to persuade a patient to modify his/her lifestyle over the long term, repetition and a flexible approach are vital.

Educational Measurement↗
PubMed1993

Problem-based learning: a review of literature on its outcomes and implementation issues.

The effects of problem-based learning (PBL) were examined by conducting a meta-analysis-type review of the English-language international literature from 1972 to 1992. Compared with conventional instruction, PBL, as suggested by the findings, is more nurturing and enjoyable; PBL graduates perform as well, and sometimes better, on clinical examinations and faculty evaluations; and they are more likely to enter family medicine. Further, faculty tend to enjoy teaching using PBL. However, PBL students in a few instances scored lower on basic sciences examinations and viewed themselves as less well prepared in the basic sciences than were their conventionally trained counterparts. PBL graduates tended to engage in backward reasoning rather than the forward reasoning experts engage in, and there appeared to be gaps in their cognitive knowledge base that could affect practice outcomes. The costs of PBL may slow its implementation in schools with class sizes larger than 100. While weaknesses in the criteria used to assess the outcomes of PBL and general weaknesses in study design limit the confidence one can give conclusions drawn from the literature, the authors recommend that caution be exercised in making comprehensive, curriculum-wide conversions to PBL until more is learned about (1) the extent to which faculty should direct students throughout medical training, (2) PBL methods that are less costly, (3) cognitive-processing weaknesses shown by PBL students, and (4) the apparent high resource utilization by PBL graduates.

Canada↗
PubMed2003

Medical student perceptions of factors affecting productivity of problem-based learning tutorial groups: does culture influence the outcome?

BACKGROUND: The popularization of problem-based learning (PBL) has drawn attention to the motivational and cognitive skills necessary for medical students in group learning. This study identifies the effect of motivational and cognitive factors on group productivity of PBL tutorial groups. DESCRIPTION: A self-administered questionnaire was completed by 115 students at the end of PBL tutorials for 4 themes. The questionnaire explored student perceptions about effect of motivation, cohesion, sponging, withdrawal, interaction, and elaboration on group productivity. We further analyzed (a) differences in perceptions between male and female students, (b) effect of "problems," and (c) effect of student progress over time on group productivity. EVALUATION: There were linear relations between a tutorial group's success and the factors studied. Significant differences were noted between male and female student groups. CONCLUSIONS: Students and tutors need to recognize symptoms of ineffective PBL groups. Our study emphasizes the need to take into account cultural issues in setting ground rules for PBL tutorials.

Cognition↗
PubMed1999

Measuring outcomes in children's rehabilitation: a decision protocol.

OBJECTIVE: To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. DESIGN: A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. SETTING: A children's rehabilitation center in a city of 50,000. PARTICIPANTS: All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. INTERVENTION: Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. OUTCOME MEASURES: Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). RESULTS: Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change. CONCLUSIONS: The "All About Outcomes" software is clinically useful. Further research should evaluate whether using the software affects the use of outcome measures in clinical practice.

Child↗
PubMedDate not supplied

Improving central placement rates of peripherally inserted catheters.

Recent advances in catheter technology and in the knowledge base of professionals in the practice of intravenous therapy have had a significant impact on patient care and improved outcomes. As professionals learn new techniques and monitor outcomes, they appropriately begin to question some traditional beliefs. One of the items that we monitor in our continuous quality improvement program is the number of malpositioned peripherally inserted central catheters immediately after insertion. By reviewing the literature and discussing procedures with the hospital radiologist, a new method for advancing peripherally inserted central catheters for tip placement in the superior vena cava was evaluated, obtaining excellent results.

Catheterization, Central Venous↗
PubMed1997

Office procedures. Education, training, and proficiency of procedural skills.

Clinical competence exists when a practitioner has sufficient knowledge and skill such that a procedure can be performed to obtain intended outcomes without harm to the patient. Practitioners who want to be competent in performing clinical procedures should examine how the procedures are relevant to their practice, place the procedures in a familiar context, learn what outcomes are expected, and practice self-evaluation. Competence has several components, including knowledge, clinical decision making, judgment, technical skills, attitudes, professional habits, and interpersonal skills. Each of these must be mastered using a variety of sources of information and skill acquisition.

Clinical Competence↗
PubMed2001

Multiprofessional learning: the attitudes of medical, nursing and pharmacy students to shared learning.

OBJECTIVES: The belief that the effectiveness of patient care will improve through collaboration and teamwork within and between health care teams is providing a focus internationally for 'shared learning' in health professional education. While it may be hard to overcome structural and organizational obstacles to implementing interprofessional learning, negative student attitudes may be most difficult to change. This study has sought to quantify the attitudes of first-year medical, nursing and pharmacy students' towards interprofessional learning, at course commencement. DESIGN: The Readiness for Interprofessional Learning Scale (RIPLS) (University of Liverpool, Department of Health Care Education), was administered to first-year medical, nursing and pharmacy students at the University of Auckland. Differences between the three groups were analysed. SETTING: The Faculty of Medical and Health Sciences, University of Auckland. RESULTS: The majority of students reported positive attitudes towards shared learning. The benefits of shared learning, including the acquisition of teamworking skills, were seen to be beneficial to patient care and likely to enhance professional working relationships. However professional groups differed: nursing and pharmacy students indicated more strongly that an outcome of learning together would be more effective teamworking. Medical students were the least sure of their professional role, and considered that they required the acquisition of more knowledge and skills than nursing or pharmacy students. CONCLUSION: Developing effective teamworking skills is an appropriate focus for first-year health professional students. The timing of learning about the roles of different professionals is yet to be resolved.

Attitude of Health Personnel↗
PubMed2005

Intraoperative neurophysiologic monitoring: indications and techniques for common procedures in otolaryngology-head and neck surgery.

Intraoperative cranial nerve monitoring can be an effective adjunct in otolaryngology-head and neck surgery. Monitoring is not considered standard of care, despite indications of cost effectiveness and improved functional outcomes. Lessons learned performing facial nerve monitoring are applicable to upper and lower cranial motor nerves. Auditory nerve monitoring can be modified accord-ing to need for selected otologic and neurotologic surgery. Process standardization and effective communication can lead to improved patient outcomes.

Cost-Benefit Analysis↗
PubMed2001

Measuring effectiveness for best evidence medical education: a discussion.

This paper considers how educational interventions should be evaluated for their effectiveness. Five levels of effectiveness are clarified and illustrated: outcomes, behaviour, learning, reaction and participation. These levels are then discussed, within the context of research evidence for education within the medical profession. Methodological and practical research conclusions are then drawn. From an analysis of over 300 abstracts the evidence shows that only limited research on healthcare outcomes has been undertaken, and there is considerable ambiguity over what constitutes an effectiveness measure. The benefits of a consistent set of terms are then considered. Finally, five key messages are distilled from the discussion and summarized.

Journal Article↗