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PubMed2005

Learning to use learning resources during medical school and residency.

OBJECTIVES: This study (1) examined the natural history of learning to use learning resources by medical students and residents and (2) considered whether that history is consistent with the ways in which physicians approach their learning tasks. METHODS: The authors conducted and analyzed thirty-two open-ended interviews of first-year and third-year medical students and first-year and senior residents in internal medicine, family medicine, or pediatrics. RESULTS AND DISCUSSION: Learning to use learning resources occurs at the same time as learning done to address instructional and clinical problems that physicians-in-training face, with all kinds of learning following well-documented stages. Skills for using resources are developed gradually and by overcoming barriers such as time constraints and existing habits. CONCLUSIONS: Implications of the natural history of learning to use learning resources can be employed by librarians and medical teachers to facilitate self-directed learning for physicians-in-training. Specific recommendations are provided.

Adult↗

PubMed2006

The simultaneous learning effect: why does simultaneous task learning improve retention?

Despite the prevalence of encoding variables that have been shown to influence the rate of learning, very few affect the rate of forgetting of verbal material. However, when a list of words is learned simultaneously with other lists, the rate of forgetting is markedly lower than that of single-task learning. Although the magnitude of this simultaneous learning effect is large compared with typical list learning effects, it has received little empirical attention. Experiments 1 and 2 tested the hypothesis that the simultaneous learning effect is the result of a differential contribution of short-term memory during encoding. The results showed that the advantage for simultaneous task learning was obtained even under conditions that minimized the potential effects of short-term memory. Experiment 3 revealed that the simultaneous learning effect was larger when the specific items learned simultaneously were the same on each learning trial than when they were different. This finding supported a cuing explanation of the effect: the items from the other lists act as retrieval cues during delayed recall.

Cues↗

PubMed2005

Early learning failure impairs adult learning in rats.

Early life experiences may affect adult learning ability. In two experiments we tested the effect of early learning failure on adult performance in Wistar rats. In the first experiment 17-day-old rats (PN17), but not 25-day-old rats (PN25), trained in a hidden platform water maze task showed deficits in tone-shock avoidance learning when they were 3-months-old. The second experiment, which included random-platform and non-platform control groups, confirmed the effect of early (PN18) spatial learning failure on adult avoidance learning. However, post-weaning training (PN25) without platform also tended to induce adult learning deficits as long as the adult task difficulty was increased. The older non-platform group did not differ from the impaired group which received early training in a fixed hidden platform task. The results are discussed in terms of the relevance of early learning outcome and developmental stage on adult general learning deficits which may be related to the learned helplessness phenomenon and developmental neural plasticity.

Age Factors↗

PubMed2026

Advancing nursing education through social and emotional learning: A systematic review guided by the Collaborative for Academic, Social, and Emotional Learning framework.

BACKGROUND: With Generation Z entering the nursing workforce in growing numbers, strengthening social and emotional learning is critical for academic success, professional adaptation, and safe practice. However, the existing evidence remains fragmented because of varied interventions and inconsistent approaches. OBJECTIVES: This systematic review examined (1) the social and emotional learning essential for nursing students and nurses within the Collaborative for Academic, Social, and Emotional Learning framework, (2) their impact on educational and clinical outcomes, and (3) implications for advancing nursing education and practice. METHODS: Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five international (PubMed, EMBASE, CINAHL, PsycINFO, Cochrane) and three Korean (RISS, KoreaMed, KMBASE) databases were searched up to June 2025. Eighteen studies involving 2,952 participants met the inclusion criteria, including quasi-experimental quantitative studies, descriptive quantitative studies, qualitative studies, and mixed-methods studies. The methodological quality of the included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS: Within the Collaborative for Academic, Social, and Emotional Learning framework, relationship skills and self-management were the most frequently studied competencies, emphasizing teamwork, communication, and stress regulation. Self-awareness and social awareness were underexplored, despite their importance in empathy, resilience, and reflective practice. Responsible decision-making was the least studied competency, despite its importance in ethical reasoning. Social and emotional learning was consistently associated with enhanced adaptation, communication, leadership, relationships, and clinical performance. Effective strategies included blended learning, simulation, reflective activities, and mentorship, which are aligned with Generation Z's learning preferences. CONCLUSION: Although social and emotional learning integration is associated with improvements in educational and clinical outcomes in nursing, current research has largely centered on relational and stress-related competencies while underrepresenting responsible decision-making. To cultivate reflective, empathetic, and ethically grounded nurses, curricula should integrate social and emotional learning through a balanced and structured approach. REGISTRATION: This study was registered on PROSPERO (ID: CRD420251005683).

Humans↗

PubMed1995

Effects of learning contexts on implicit and explicit learning.

Two parallel tasks involving rule learning were identified in Experiment 1A and were used to assess implicit and explicit learning. In both tasks, subjects had to input numbers in order to reach the target values of outputs. The relationship between inputs and outputs was either simple (in the simple task) or complex (in the complex task), and the way in which target values were presented could be in the form of either numbers (in the simple task) or lines (in the complex task). Experiment 1B examined the validity of the explicit measure in the complex task. Experiments 2-4 investigated the interaction between learning contexts and the simple/complex learning tasks. Verbalization and instructions to search for the rules facilitated the simple-task learning and hurt or have no effect on the complex-task learning. In the observational-learning condition, no learning occurred for the simple task, and the complex task learning was impaired. These results suggest that the complex task and simple task involve two distinct learning systems. Other implications are also discussed.

Adolescent↗

PubMed1992

Total amount learned versus learning rate of verbal and nonverbal information, in differentiating left-from right-brain injured patients.

Twenty Left-Brain Damaged (LBD), 20 Right-Brain Damaged (RBD), and 20 control subjects were compared on three different learning tasks: (a) verbal, the Paired Associate Learning subtest of the Wechsler Memory Scale; (b) figural, the Gollin Incomplete Figures task, which can be easily verbalized, and (c) spatial, the Stylus Maze. When learning ability was measured, by assessing the total amount learned (sum of items learned in all trials), the results showed that, on all three tasks, the control group's performance significantly surpassed that of the patient groups. The RBD group performed better than the LBD group on the verbal learning task, while LBD subjects performed better than their RBD counterparts on the spatial learning task. No significant difference between the two patient groups was detected on the figural task, suggesting that a task using visually and verbally codable stimuli is not useful in differentiating between LBD and RBD groups. When the learning rate was measured, similar results were obtained in the verbal and figural task. However, in the spatial task, the learning rates of the three groups did not significantly differ, probably because the specific task used required procedural learning, which is normally preserved in amnesics.

Journal Article↗

PubMed2004

Trends, current developments, and concepts in distance learning and E-learning.

A glance at the history of distance learning shows that there is a long tradition of using contemporary technical resources for learning and teaching purposes. For some, the holy grail of distance learning is the concept of the industrialization (mass production) of teaching and learning. Although reality has time and again caught up with technological promise, the scope for using new information and communication technologies in teaching has frequently been disregarded. In the future, learning will entail handling organized knowledge resources in demand-specific, organized communities formed for finding solutions to distinct problems and generating new knowledge about learning processes within the problem solving process. The development of the potential of "e-learning" (and actually, it bears contemplating whether this term puts too much emphasis on conventional learning organized in temporally-limited courses or similar, to the detriment of intelligent management of knowledge in its own working context) will depend upon the extent to which organizations succeed in promoting the development of a learning and working culture, for example, by incentive systems, team promotion, and free access to knowledge resources. The Masters degree in Organization Studies is presented against this background as an example of teaching using a combination of resources, leading to undreamed of learning success.

Computer-Assisted Instruction↗

PubMed2003

Discriminative taste aversion learning: a learning task for older chickens.

The study of learning and memory using the chicken model has relied on three learning paradigms, passive avoidance learning, imprinting and the pebble floor task. Passive avoidance learning and imprinting have been used predominantly in very young chickens and cannot be used to access learning and memory in older chickens. We have established a new behavioural learning paradigm, Discriminative Taste Aversion Learning (DTAL), that can be used with both young and older animals. The task requires chickens to discriminate between food crumbs dyed either red or yellow with one colour being associated with the aversive tasting substance, methylanthranilate. Learning can be tested at various times after the training session by presenting chickens with the coloured food crumbs without an aversive taste. Both chickens tested at 5 and 15 days post-hatch learned to avoid the aversive crumbs. Furthermore, the protein synthesis inhibitor anisomycin (30 mM; 10 microl per hemisphere) injected into the intermediate medial hyperstriatum ventrale 15 min pre-training or 45 min post-training blocked long-term memory for the DTAL task when tested 24 h later. Memory for the task was unaffected by anisomycin injection 120 min post-training or in control animals injected with saline at similar times. The timing of the cellular processes of protein synthesis needed for consolidation of the DTAL appears to be similar to those described for the other behavioural paradigms in young chickens.

Age Factors↗

PubMed1985

Storage-retrieval processes of normal and learning-disabled children: a stages-of-learning analysis of picture-word effects.

Previous research comparing acquisition performance of learning-disabled and normally achieving children has led to the suggestion that the locus of memory differences lies in either the storage or retrieval components of recall. In this paper we report a free-recall experiment in which a new stages-of-learning model was used to examine the effects of a picture-word manipulation on storage and retrieval differences between nondisabled and disabled grade 2 and 6 children. Although the results of this experiment were consistent with the idea that disabled students are poorer at memory tasks than nondisabled students, the stages-of-learning analysis provided information regarding the precise locus of the deficiencies. Specifically, although disabled and nondisabled children benefited from the presentation of information in pictorial format, normally achieving children were consistently better than their learning-disabled counterparts at storing and learning to retrieve both pictures and words. From a developmental standpoint, the most important finding was that while differences between learning-disabled and normally achieving students at storage remained age invariant, differences in learning to retrieve increased with age. As it turned out, however, differences between disabled and nondisabled children were absent when it came to retaining traces once they had been stored in memory and in retrieval performance between the time a trace was stored and retrieval learning was complete. These results are consistent with previous research in which it has been shown that the ability to learn how to reliably retrieve information that has been stored in memory develops more slowly for disabled than nondisabled children.

Age Factors↗

PubMed2006

Patients with Parkinson's disease learn to control complex systems-an indication for intact implicit cognitive skill learning.

Implicit memory and learning mechanisms are composed of multiple processes and systems. Previous studies demonstrated a basal ganglia involvement in purely cognitive tasks that form stimulus response habits by reinforcement learning such as implicit classification learning. We will test the basal ganglia influence on two cognitive implicit tasks previously described by Berry and Broadbent, the sugar production task and the personal interaction task. Furthermore, we will investigate the relationship between certain aspects of an executive dysfunction and implicit learning. To this end, we have tested 22 Parkinsonian patients and 22 age-matched controls on two implicit cognitive tasks, in which participants learned to control a complex system. They interacted with the system by choosing an input value and obtaining an output that was related in a complex manner to the input. The objective was to reach and maintain a specific target value across trials (dynamic system learning). The two tasks followed the same underlying complex rule but had different surface appearances. Subsequently, participants performed an executive test battery including the Stroop test, verbal fluency and the Wisconsin card sorting test (WCST). The results demonstrate intact implicit learning in patients, despite an executive dysfunction in the Parkinsonian group. They lead to the conclusion that the basal ganglia system affected in Parkinson's disease does not contribute to the implicit acquisition of a new cognitive skill. Furthermore, the Parkinsonian patients were able to reach a specific goal in an implicit learning context despite impaired goal directed behaviour in the WCST, a classic test of executive functions. These results demonstrate a functional independence of implicit cognitive skill learning and certain aspects of executive functions.

Aged↗

PubMed2003

Learning new words II: Phonotactic probability in verb learning.

Phonotactic probability, a measure of the likelihood of occurrence of a sound sequence, appears to facilitate noun learning (H. L. Storkel, 2001). Nouns and verbs, however, tend to differ in rate of acquisition, indicating that word-learning mechanisms may differ across grammatical class. The purpose of the current study was to examine the effect of phonotactic probability on verb learning. Thirty-four typically developing preschool children participated in a multitrial word-learning task involving nonwords varying in phonotactic probability paired with unfamiliar actions. Multiple measures of word learning were obtained at increasing numbers of exposures. Correct responses were analyzed to examine rate of word learning. Results paralleled those of the previous noun-learning study, with common sound sequences being learned more rapidly than rare sound sequences. The results are interpreted in relation to the effect of distributional regularities on acquisition and the reported discrepancy between noun and verb learning in English.

Analysis of Variance↗

PubMed2002

Translating learning principles into practice: a new strategy for learning clinical skills.

AIM: There are data to suggest that medical school may not adequately prepare doctors for practice and that there are deficiencies in undergraduate teaching of skills in history taking, physical examination, diagnosis and management (clinical skills). There is a need to re-evaluate methods by which we can teach clinical skills effectively. This aim of this review was to describe the literature concerning the important principles underpinning effective clinical learning. Subsequently a structured learning tool and teaching process was developed in order to support these principles. METHOD: The principles of effective clinical learning were derived after a search of the medical education and relevant behavioural science literature. Consequently, a structured learning tool and teaching process was developed in order to potentiate the translation of these principles into practice for medical school training in clinical skills. RESULTS: Ten principles were derived from the 68 articles referred to in this review. These were: making active decisions, an individual focus to learning, gaining experience, feedback to the learner, reciprocal learning, holistic care, relevant learning, feasibility, cost efficiency and mentoring. A process for history taking, physical examination and management plan was developed for medical students which incorporated these principles. CONCLUSION: Relevant literature can provide the foundations for teaching and learning methods in medical education. We plan to trial this method and evaluate the impact on student learning outcomes.

Clinical Competence↗

PubMed2006

Impact of self-assessment questions and learning styles in Web-based learning: a randomized, controlled, crossover trial.

PURPOSE: To determine the effect of self-assessment questions on learners' knowledge and format preference in a Web-based course, and investigate associations between learning styles and outcomes. METHOD: The authors conducted a randomized, controlled, crossover trial in the continuity clinics of the Mayo-Rochester internal medicine residency program during the 2003-04 academic year. Case-based self-assessment questions were added to Web-based modules covering topics in ambulatory internal medicine. Participants completed two modules with questions and two modules without questions, with sequence randomly assigned. Outcomes included knowledge assessed after each module, format preference, and learning style assessed using the Index of Learning Styles. RESULTS: A total of 121 of 146 residents (83%) consented. Residents had higher test scores when using the question format (mean +/- standard error, 78.9% +/- 1.0) than when using the standard format (76.2% +/- 1.0, p = .006). Residents preferring the question format scored higher (79.7% +/- 1.1) than those preferring standard (69.5% +/- 2.3, p < .001). Learning styles did not affect scores except that visual-verbal "intermediate" learners (80.6% +/- 1.4) and visual learners (77.5% +/- 1.3) did better than verbal learners (70.9% +/- 3.0, p = .003 and p = .033, respectively). Sixty-five of 78 residents (83.3%, 95% CI 73.2-90.8%) preferred the question format. Learning styles were not associated with preference (p > .384). Although the question format took longer than the standard format (60.4 +/- 3.6 versus 44.3 +/- 3.3 minutes, p < .001), 55 of 77 residents (71.4%, 60.0-81.2%) reported that it was more efficient. CONCLUSIONS: Instructional methods that actively engage learners improve learning outcomes. These findings hold implications for both Web-based learning and "traditional" educational activities. Future research, in both Web-based learning and other teaching modalities, should focus on further defining the effectiveness of selected instructional methods in specific learning contexts.

Cross-Over Studies↗

PubMed2007

Experience-based learning: a model linking the processes and outcomes of medical students' workplace learning.

OBJECTIVE: To develop a model linking the processes and outcomes of workplace learning. METHODS: We synthesised a model from grounded theory analysis of group discussions before and after experimental strengthening of medical students' workplace learning. The research was conducted within a problem-based clinical curriculum with little early workplace experience, involving 24 junior and 12 senior medical students. RESULTS: To reach their ultimate goal of helping patients, medical students must develop 2 qualities. One is practical competence; the other is a state of mind that includes confidence, motivation and a sense of professional identity. These 2 qualities reinforce one another. The core process of clinical workplace learning involves 'participation in practice', which evolves along a spectrum from passive observation to performance. Practitioners help students participate by being both supportive and challenging. The presentation of clear learning objectives and continuous periods of attachment that are as personal to the student(s) and practitioner(s) as possible promote workplace learning. CONCLUSIONS: The core condition for clinical workplace learning is 'supported participation', the various outcomes of which are mutually reinforcing and also reinforce students' ability to participate in further practice. This synthesis has 2 important implications for contemporary medical education: any reduction in medical students' participation in clinical practice that results from the patient safety agenda and expanded numbers of medical students is likely to have an adverse effect on learning, and the construct of 'self-directed learning', which our respondents too often found synonymous with 'lack of support', should be applied with very great caution to medical students' learning in clinical workplaces.

Attitude of Health Personnel↗

PubMed2003

How do learning issues relate with content in a problem-based learning pathophysiology course?

The relation between learning process and content coverage is becoming increasingly important for the understanding of the effects of problem-based learning (PBL) on students' learning. In our medical school, PBL is used as a major educational strategy in the discipline of pathophysiology. A computer program was developed allowing students to register learning issues identified as needed during tutorial sessions and learning issues stated as covered during the individual study periods. In our study, we compared "planned" (learning issues identified during PBL sessions) and "accomplished" learning issues (covered after the independent study periods) identified by pathophysiology students from three consecutive years. We found that the planned learning issues raised during tutorial sessions related to the issues effectively accomplished during the independent study and that their number grew stepwise from basic to preclinical to clinical sciences. Pathophysiology was, globally, the most mentioned discipline. Moreover, the most mentioned disciplines from the basic, preclinical, and clinical areas were physiology, histopathology, and internal medicine, respectively. The single-discipline approach did not limit the student's capacity to identify and cover learning issues beyond the objectives of pathophysiology.

Education, Medical↗

PubMed1995

Learning of sequential movements in the monkey: process of learning and retention of memory.

1. To characterize procedural learning and memory, we devised a behavioral paradigm that allows us to examine the process of learning of new procedures, repeatedly and without serious difficulties for primate subjects. We trained two monkeys to perform a sequential button press task. Upon pressing of a home key, 2 of 16 (4 x 4 matrix) light-emitting diode (LED) buttons (called "set") were illuminated simultaneously, and the monkey had to press them in a predetermined order that he had to find out by trial-and-error. A total of five sets (called "hyperset") was presented in a fixed order for completion of a trial; an error at any set aborted the trial. A given hyperset was repeated as a block of experiment until 20 successful trials were performed. Monkeys PI and BO experienced 313 and 92 hypersets, respectively. Most of these hypersets were experienced only once (1 block of experiment); the others (28 hypersets for monkey PI and 14 hypersets for monkey BO) were chosen for extensive practice. 2. The learning, indicated as the decrease in the number of trials to criterion and the decrease in the performance time, proceeded at three levels: 1) short-term and sequence-selective learning that occurred by repeating a particular hyperset during a block of experiment; our monkeys learned, to some degree, to perform a new hyperset within a short period (< 5 min); 2) long-term and sequence-selective learning that took place for each hyperset across days; by daily practice, they further improved their skills for performing the particular hyperset; and 3) long-term and sequence-unselective learning that was indicated by the improvement of performance for new hypersets; the monkeys were required to learn many hypersets, each just once (a block of trials), in which they performed gradually better with more experiences in the 2 x 5 task. 3. To examine whether the memory was retained for a long period, we had the monkey learn 12 hypersets sufficiently, then we stopped the training and retested them after 1 or 6 mo. After the 1-mo interruption the performance was significantly better than that for new hypersets. After the 6-mo interruption the performance was not different from new hypersets in terms of the number of trials but was significantly better than new hypersets in terms of the performance time. The results suggest that motor memory (measured by performance time) can be retained longer than procedural memory (measured by the number of trials).

Animals↗

PubMedDate not supplied

Using assistive technology adaptations to include students with learning disabilities in cooperative learning activities.

Cooperative learning (CL) is a common instructional arrangement that is used by classroom teachers to foster academic achievement and social acceptance of students with and without learning disabilities. Cooperative learning is appealing to classroom teachers because it can provide an opportunity for more instruction and feedback by peers than can be provided by teachers to individual students who require extra assistance. Recent studies suggest that students with LD may need adaptations during cooperative learning activities. The use of assistive technology adaptations may be necessary to help some students with LD compensate for their specific learning difficulties so that they can engage more readily in cooperative learning activities. A process for integrating technology adaptations into cooperative learning activities is discussed in terms of three components: selecting adaptations, monitoring the use of the adaptations during cooperative learning activities, and evaluating the adaptations' effectiveness. The article concludes with comments regarding barriers to and support systems for technology integration, technology and effective instructional practices, and the need to consider technology adaptations for students who have learning disabilities.

Cooperative Behavior↗

PubMed2000

Learning strategies, learning anxiety and knowledge acquisition.

In a study of adult technical trainees, it was found that four reported learning strategies were significantly associated with learning gain: Rehearsal, Interpersonal Help-seeking, Emotion Control and Motivation Control. However, all those associations were negative. A prior measure of learning anxiety (but not learning ability or learning motivation) was shown to account for that pattern, and several learning strategies and learning anxiety were found to interact in predicting knowledge change: associations between a strategy and learning were more positive for less anxious individuals. Research into learning strategies needs to examine additional variables (such as anxiety), and to look beyond the school and college settings typically investigated.

Adolescent↗