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Changing conceptions of practical skill and skill acquisition in nursing education.

The learning of practical skill in nursing is not a priority of nursing education today. This is a result of a narrow and mechanistic concept of practical skill and its acquisition in nursing education. This paper reviews these conceptions as they have been developed in major textbooks for nurse teachers and in research articles on skill teaching, learning and evaluation over the past 50 years. Nursing research must move out of the laboratory and into the clinical setting in order to incorporate the typical aspects of practical skill learning in nursing. Future challenges in this kind of research are discussed.

Clinical Competence↗

What colour are the alligators? A critical look at methods used to assess communication skills in adults with learning difficulties.

This paper describes the assessment of communication skills in 120 adults with severe to moderate learning difficulties. Each subject was assessed on the Communication Assessment Profile (CASP), a new communication assessment procedure for use with this client group. Qualitative and quantitative comparisons were made between three different methods of assessment used in CASP. These included observational assessment, elicited conversation and a structured language task. The relative usefulness of each method was evaluated, and the implications for communication assessment outlined.

Adolescent↗

Learning of a complex arithmetic skill in dementia: further evidence for a dissociation between compilation and production.

An amnesic Alzheimer's Disease patient was tested on his ability to learn an algorithm to square two-digit numbers. The results indicated a dissociation in the patient's ability to execute the individual steps of the algorithm and his ability to combine the steps of the algorithm, the former accounting for almost all of the improvement in response time. The results are discussed in conjunction with findings from Charness et al. (1988) and Milberg et al. (1988) and suggest that skill learning in Alzheimer's Disease may be compromised due to an inability to combine individual steps of a procedure.

Adult↗

Effectiveness of visual vs kinesthetic instruction for learning a gross motor skill.

The purpose of this study was to compare visual with kinesthetic instruction for learning a motor skill that is not visually monitorable. Previous studies comparing visual and kinesthetic information have all used arm tasks for which the nonvisual condition was artificial. 20 subjects were randomly assigned to either a kinesthetic or a visual instruction group. The task was to draw a horizontal line with the right foot while in a quadruped position. All subjects received visual knowledge of results. While performance improved over the course of the 10 instructional sessions and trials, no difference in performance was found between the two instructional groups. A follow-up study is required to determine whether this result was based on visual dominance. Understanding the effectiveness of the different modalities for teaching gross motor skills would be valuable to physical therapists, physical educators, and psychologists.

Adult↗

Teaching critical-thinking skills through group-based learning.

CONTEXT: Critical-thinking skills require the radiographer to analyze, evaluate and synthesize situations to determine a course of action most beneficial to the patient. OBJECTIVE: For radiography educators, it is important to understand how critical-thinking skills are acquired during the educational process for each student to reach his or her maximum potential. METHOD: Various teaching strategies such as problem-based learning are reviewed and discussed in this article. Although the teaching strategies discussed have been used in medical education for over 40 years, they are fairly new to radiography educational programs. CONCLUSION: Today's educators must prepare graduates who are proficient in a wide range of skills to work in a variety of clinical settings. This requires the integration of group-based learning into the radiography curriculum.

Clinical Competence↗

Social skills deficits as a primary learning disability.

Advances in the definition of social skills deficits in children and youth with learning disabilities are presented and critiqued. The proposed modified definition of learning disability by the Interagency Committee on Learning Disabilities, which includes social skills deficits as a specific learning disability, is presented and discussed. This definition is analyzed from primary, secondary, and social learning theory causative hypotheses. Development of an adequate assessment technology is viewed as critical to the identification and classification of social skills deficits in children and youth with learning disabilities.

Government Agencies↗

Mental flexibility and planning skills in children and adolescents with learning disabilities.

Mental flexibility (skill with shifting response set) and visual planning skills were examined with a group of 60 children and adolescents with learning disabilities. The sample consisted of 44 boys and 16 girls with an age range of 9 to 15. Scores from the Trail Making Test and the Wisconsin Card Sorting Test were cluster-analyzed and subgroups were formulated. The results of the cluster analysis indicated a two-group solution to be most appropriate. One subtype was clearly dysfunctional on the classifying variables, while the other subgroup approached average levels. The two subtypes were compared on measures of intellectual functions, academic skills, auditory memory, visual memory, visual-motor integration, motor speed, and tactile integration. Significance was found on several different tests. The results are discussed in terms of potential cortical dysfunction evidenced by the subgroups.

Adolescent↗

Effect of an audience on learning a novel motor skill.

The purpose of this study was to assess effects of an audience on learning a novel motor skill. Subjects (N=64) were randomly assigned to one of four experimental conditions and administered 15 30-sec. trials with 30 sec. intertrial periods on a pursuit rotor task on two different days. Comparison of Time-on Target performance between conditions indicated that the No Audience condition had significantly higher performance than the Audience condition in Session 1. Comparison of Absolute Retention and Final Retention scores among the four experimental conditions in Session 2 after 48 hr. yielded no significant differences attributable to the presence of an audience, thus supporting the hypothesis that an audience would have no effect on learning.

Adolescent↗

Nursing students learning to utilize nursing research in clinical practice.

The purpose of the study was to examine the significance of a learning assignment in relation to research skills and learning of nursing students in clinical practice. The learning assignment included an oral presentation of a nursing research article, which the students gave to their fellow students and ward nurses. The students also chaired the discussion after the presentation. The target group for the study was nursing students of a Finnish polytechnic who had been studying for 2-2 1/2 years and had accomplished a minimum of 120 ECTS credits of the total of 210 ECTS credits. When participating in the study, the students were completing a six-week clinical practice of optional studies. The data were collected with a questionnaire designed for the study. It consisted of six open-ended questions. Three of the questions were related to learning of research skills. Two questions were concerned with learning during the ongoing clinical practice. The final question inquired the students' views on the development of the learning assignment. The students received the questionnaire before the commencement of their clinical practice, and they returned it to the other researcher after their clinical practice. The questionnaire was given to 80 students, of which 50 returned it; the response rate was 63%. The data were analysed by content analysis question by question. According to the results, the learning assignment advanced the understanding of research concepts for the majority of the students. In particular, the students reported that the oral presentation clarified the research concepts, and the structure of a scientific article was also elucidated. The students stated that the assignment generated ideas concerning the development of nursing care. In relation to the ongoing clinical practice, the assignment advanced patient encounters and interaction, and bearing responsibility the most. Proposals for the further development of the learning assignment were expressed by more than half of the nursing students. Half of them suggested ensuring the interest in the topic from the ward.

Attitude of Health Personnel↗

Tissue plasminogen activator induction in Purkinje neurons after cerebellar motor learning.

The cerebellar cortex is implicated in the learning of complex motor skills. This learning may require synaptic remodeling of Purkinje cell inputs. An extracellular serine protease, tissue plasminogen activator (tPA), is involved in remodeling various nonneural tissues and is associated with developing and regenerating neurons. In situ hybridization showed that expression of tPA messenger RNA was increased in the Purkinje neurons of rats within an hour of their being trained for a complex motor task. Antibody to tPA also showed the induction of tPA protein associated with cerebellar Purkinje cells. Thus, the induction of tPA during motor learning may play a role in activity-dependent synaptic plasticity.

Animals↗

The clinical skills laboratory as a learning tool for medical students and health professionals.

Clinical skill laboratories CSL have become one of the essential facilities in an undergraduate medical curriculum. A wide range of training skills were recently introduced which includes clinical examination, diagnostic and therapeutic skills as well as communication skills. Although the educational value of the CSL is very well recognized, very little is written about it in the literature. The purpose of this paper is to provide an overview of the skills laboratory integrated in an undergraduate medical curriculum, highlight the nature of this trend, look at the advantages and disadvantages and suggest some guidelines for implementation.

Bahrain↗