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PubMed2005

Adding problem-based learning tutorials to a traditional lecture-based curriculum: a pilot study in a dental school.

This article reports on the implementation of a problem-based learning (PBL) tutorial in our advanced program for second year students within an existing curriculum. The program was opened on the last 5 days of the summer vacation and students could volunteer to be part of the group. Students separated themselves into small groups by random sampling. The PBL tutorials were done during the first 3 days for medical problems according to our original scenarios (based on medical cases), and during the last 2 days, students made presentations of their learning outcomes, using information technology (IT) by themselves. Throughout this program, students were expected to engage in self-learning, except for a 1(1/2)-h group session with a tutor. Assessment was done by attendance at a group session and by portfolio analysis. Following the portfolio analysis, students identified the number of learning issues (group A, 26 +/- 7 issues; group B, 20 +/- 3 issues; group C, 21 +/- 7 issues). Research, by questionnaire, revealed that 84% of the students were strongly interested in each scenario and 95% of the students felt familiar with each scenario. The levels of satisfaction with the tutor were different in the three groups. All of the students were comfortable in the discussion room and IT center. These results suggested that PBL tutorials are supported by the scenario, the tutor, and the location of the group session, as well as by self-learning. Moreover, one of the most important factors for a PBL tutorial that the student is ready for the free discussions and has enough time for individual self-learning.

Computer-Assisted Instruction↗

PubMedDate not supplied

A comparison of training strategies to enhance use of external aids by persons with dementia.

UNLABELLED: The purpose of this study was to compare the effectiveness of two training approaches, Spaced Retrieval (SR) and a modified Cueing Hierarchy (CH), for teaching persons with dementia a strategy goal involving an external memory aid. Twenty-five persons with dementia living in either community or nursing home settings received training on two individual-specific strategy goals, one with each training approach. Results revealed that significantly more goals were attained using SR procedures than CH, but that a majority of participants learned to use external aids using both strategies. There were no significant differences in the number of sessions required to master goals in either condition; however, significantly more SR goals were maintained at both 1-week and 4-months post-training compared to CH goals. Mental status was not significantly correlated with goal mastery, suggesting the potential benefits of strategy training beyond the early stages of dementia. LEARNING OUTCOMES: As a result of this activity, the reader will be able to (1) identify ways to enable persons with dementia to make effective use of external memory aids; (2) describe a method, Spaced Retrieval, by which persons with dementia can learn and retain information; and (3) describe two approaches to working with persons with dementia to train a strategy learning goal.

Aged↗

PubMed1976

Piracetam-induced facilitation of interhemispheric transfer of visual information in rats.

The effect of Piracetam (UCB 6215, 2-pyrrolidoneacetamide) on learning mediated by transcommissural information flow was studied in hooded rats. Acquisition of monocular pattern discrimination was faster in drug-treated rats (100 mg/kg, 30 min before training) than in untreated controls. Subsequent relearning with one hemisphere functionally eliminated by cortical spreading depression showed that the strength of the primary engram formed under Piracetam in the hemisphere contralateral to the trained eye remained unaffected but that the secondary trace (in the ipsilateral hemisphere) was considerably improved and almost equalled the primary one (savings increased from 20-30% to 50-60%). Learning with uncrossed optic fibers was unaffected by the drug. Interhemispheric transfer of lateralized visual engrams acquired during functional hemidecortication was facilitated by Piracetam administration preceding the five transfer trials performed with the untrained eye open (imperative transfer). Piracetam was ineffective when the trained eye was open during transfer trials (facultative transfer). After a visual engram had been lateralized by 5 days of monocular overtraining, Piracetam facilitated formation of the secondary engram induced by 3 interocular transfer trials. It is concluded that Piracetam enhances transcommissural encoding mechanisms activated in the initial stage of monocular learning and in some forms of interhemispheric transfer, but does not affect the transcommissural readout. This effect is interpreted as a special case of the Piracetam-induced facilitation of the phylogenetically old mechanisms of redundant information storage which improve liminal or subnormal learning.

Animals↗

PubMed2004

When less means more: deactivations during encoding that predict subsequent memory.

In event-related functional MRI (fMRI) studies, greater activity for items that are subsequently remembered (R-items) than for items that are subsequently forgotten (F-items), or Dm effect (Difference in memory), has been attributed to successful encoding operations. In contrast, regions showing a reverse DM effect (revDM = F-items > R-items) have been linked to detrimental processes leading to forgetting. Yet, revDMs may reflect not only activations for F-items (aFs) but also deactivations for R-items (dRs), and the latter alternative is more likely to reflect beneficial rather than detrimental encoding processes. To investigate this issue, we used a paradigm that included a fixation baseline and could distinguish between the two types of revDMs (aF vs. dR). Participants were scanned while encoding semantic associations between words or perceptual associations between words and fonts, and their memory was measured with associative recognition tests. For both semantic and perceptual encoding, dR effects were found in dorsolateral prefrontal, temporoparietal, and posterior midline regions. In contrast with a prior study that attributed revDMs in these regions to detrimental processes, the present results suggest that these effects reflect beneficial processes, that is, the efficient reallocation of neurocognitive resources. At the same time, aF effects were found in other regions, such as the insula, and these are more consistent with an interpretation in terms of detrimental processes. Whereas most fMRI studies of encoding have focused on activation increases, the present study indicates that activation decreases are also critical for successful learning of new information.

Adult↗

PubMed1992

Evolution of behavioral attractors with learning: nonequilibrium phase transitions.

Learning a bimanual coordination task (synchronization to a visually specified phasing relation) was studied as a dynamical process over 5 days of practicing a required phasing pattern. Systematic probes of the attractor layout of the 5 Ss' coordination dynamics (expressed through a collective variable, relative phase) were conducted before, during, and after practice. Depending on the relationship between the initial coordination dynamics (so-called intrinsic dynamics) and the pattern to be learned (termed behavioral information, which acts as an attractor of the coordination dynamics toward the required phasing), qualitative changes in the phase diagram occurred with learning, accompanied by quantitative evidence for loss of stability (phase transitions). Such effects persisted beyond 1 week. The nature of change due to learning (e.g., abrupt vs. gradual) is shown to arise from the cooperative or competitive interplay between behavioral information and the intrinsic dynamics.

Adult↗

PubMed1995

Assessment of the learner: physiological readiness.

Patients with end-stage renal disease (ESRD) who undergo dialytic therapy or who receive a kidney transplant are expected to learn a great deal of information about their disease and treatment. As this population encompasses a vast number of persons of varying age, education, and life skills, the ability to learn new information may be a challenge for both the patient and staff. The uremic state and its effect on cognitive function influences the patient's physiological readiness and ability to learn. Recent research, testing methods, and understanding of other effects of renal failure on cognitive function have provided more information about the patient's physiological readiness/ability to learn. Health care professionals can incorporate these new findings into their teaching programs and strategies to assure successful patient learning and outcomes.

Aptitude↗

PubMed2005

The new paradigm of continuing education in surgery.

Concerns regarding the shortcomings of traditional continuing medical education (CME) have led to widespread acceptance of the concept of continuous professional development (CPD). Continuous professional development focuses on the individual learning needs of physicians across the continuum of their professional careers and encompasses a broad range of educational activities. Continuous professional development activities of practicing surgeons should be integrated with the core competency of practice-based learning and improvement (PBLI), which involves a cycle of 4 steps-identifying areas for improvement, engaging in learning, applying new knowledge and skills to practice, and checking for improvement. The effectiveness of CPD and PBLI should be objectively evaluated by assessing their impact on surgeons' learning and performance and on patient care outcomes. A portfolio may be used to document CPD and PBLI activities and can serve as a valuable learning and assessment tool. It should contain information on the personal learning projects pursued by the surgeon. Continuous professional development of the entire surgical team and education of patients and their families need to be considered within the context of the surgeon's CPD efforts to positively affect patient care. Thus, a concept of global 360 degrees education should be embraced. Continuous professional development integrated with PBLI can help surgeons address their specific learning needs and play a pivotal role in surgeons' providing the best care to patients.

Education, Medical, Continuing↗

PubMed1995

The manipulation of vision during the powerlift squat: exploring the boundaries of the specificity of learning hypothesis.

The available information for controlling a multidegree-of-freedom sport action was manipulated in 2 experiments. In the first, 10 intermediate lifters were participants; for the second, 8 skilled and 8 less skilled lifters were observed. Three single repetitions of a powerlift squat were performed under 3 vision conditions (i.e., full, ambient, no vision). The less skilled and intermediate lifters' technical performance decreased significantly with the removal of visual information. There was no detrimental effect in the skilled group. Despite the differing information constraints, skilled lifters exhibited a high level of positioning accuracy and timing consistency across conditions. These data fail to support the theoretical predictions of the specificity of learning hypothesis. The differences between the task constraints in this study and those in manual aiming investigations may represent a boundary to the current propositions of the specificity of learning hypothesis.

Adult↗

PubMedDate not supplied

Understanding learning styles. Implications for staff development educators.

The authors present information for understanding diverse learning styles among RNs. Various learning-style assessment tools are presented. Emphasis is placed on the use of a learning-style instrument that addresses multiple learning-style constructs. Implications for staff development educators are discussed.

Education, Nursing, Continuing↗

PubMed2001

Re-evaluation of the spatial memory deficits induced by hippocampal short lasting inactivation reveals the need for cortical co-operation.

Evidence has accumulated that the rat hippocampus plays a central role in spatial memory. In complement to lesion studies, reversible lidocaïne-induced inactivations have been used to investigate the time-course of the memory processes mediated by the hippocampus. A number of studies suggest that, in some conditions, the hippocampus is not necessary for online acquisition of spatial information. To test this hypothesis, we examined the effects of bilateral lidocaïne-induced inactivations of the dorsal hippocampus in the acquisition of new spatial information. After initial learning of a place navigation task in the water maze, rats were tested for acquisition of a new platform location and received injections of lidocaïne in the hippocampus prior to each daily four-trial block. The training blocks were separated by a 24-h period allowing the hippocampus to recover from inactivation. The results show that lidocaïne-injected rats were able to learn the new platform location like controls. Inactivations, however, was found to induce a within-block learning impairment. This suggests that the hippocampus can perform off-line processing and that another structure is able to handle spatial information during hippocampal inactivations. Parietal-lesioned rats that received an injection of lidocaïne were still able to learn the new platform location suggesting that the parietal cortex does not sustain this role. Overall, our results suggest that the hippocampus is not necessary for all stages of memory formation and co-operates with other brain, possibly cortical, structures which remain to be determined.

Anesthetics, Local↗

PubMed1978

A detailed description of mothers' knowledge before genetic counseling for Down syndrome: Part I.

This study focuses on counselees' knowledge of the Down syndrome before receiving genetic counseling. Data were collected from 47 mothers of children with the Down syndrome using a structured interview of 13 open-ended questions. This instrument was found to be both internally reliable and consistent. Results of this study document the enormous variation of counselees' knowledge of the Down syndrome before genetic counseling and show that this is positively associated with their educational background. Counselees with more than a high school education knew about 60% of the genetic information pertaining to the diagnosis before genetic counseling, while those with less than a high school education knew only 23% of this information before counseling. These results indicate that the better educated counselees are less apt to need to learn basic genetic information and may seek out genetic counseling services for other reasons. Possible motives are seeking knowledge confirmation, emotional support, and personalization of the information.

Adolescent↗

PubMed2004

Empowerment and assessment: a dichotomy?

Institutions of higher education are sites where the rhetoric of learning increasingly collides with the diverse needs of both learners and educators. Demands on tertiary institutions from the workplace, students themselves and the increasing demand for skilled graduates in the face of diminishing resources strongly suggest that intelligent and creative approaches to learning play a pivotal role in the success of higher education. Throughout tertiary education the subject of assessment is central to the complex processes involved in student learning. Therefore, it is important that nursing academics and practitioners involved in assessing student learning develop insight and awareness of the theories and philosophies that underpin different assessment strategies. This will inform teaching and learning practice to the benefit of all stakeholders. This paper examines issues of assessment in higher education; it will locate and deconstruct some principles underpinning traditional and innovative methods associated with assessment and suggest that creative approaches that embrace adult learning principles will empower students and ultimately facilitate more effective learning.

Adult↗

PubMedDate not supplied

The reality of virtual learning for nurses in the largest integrated health care system in the nation.

The health care network and hospital system within the Department of Veterans Affairs (VA), the Veterans Health Administration (VHA), provides employment to more than 56,000 nursing personnel and serves as clinical education site to countless other nursing and health professional students. Nurse administrators and educators are posed with the challenge of providing an environment in which each nurse is able to gain needed knowledge, learn new skills, and share and communicate this knowledge with other colleagues. The education of nurses improves the health status of veterans while also realizing individual professional enhancement. Regional and cultural diversity of the system present challenges to education, in both delivery and content. VHA's learning organizations, the Employee Education System and the Office of Special Projects, have maximized new technologies and information systems to provide innovative, virtual education opportunities, capitalizing on the benefits of informal and formal learning, thus moving VHA to the forefront in knowledge sharing and dissemination. The Virtual Learning Center, VA Knowledge Network, Learning Catalog, and VA Learning Online provide VHA's nurses with interactive, desktop virtual learning opportunities.

Computer-Assisted Instruction↗

PubMed2003

[Development of a hospital information system simulator for education].

When teaching students the hospital information system, it is impossible to use an actual hospital information system because of security reasons. To overcome this problem, a simulator of the hospital information system for student education has been developed. The purpose of this system is to help students understanding a hospital information system from actual experience. The characteristics of this system are as follows: 1) Students can easily learn a hospital information system on the Web pages in the computer training room. 2) The present system is not as complete as a hospital information system, however, helpful explanations regarding the data processing have been inserted. 3) The fictional patient data have been prepared for the pages relating to the electronic medical chart. Consequently, students can understand what kind of data has been saved in this system. Through a questionnaire, students evaluated this system in terms of understandability. The result from four years between 1999 and 2002 showed that 70% of them evaluated it as good system. We therefore consider this system to be effective over a short period of time, and useful for medical education.

Computer Simulation↗

PubMed2005

Early intervention care programme for parents of neonates.

Parents with neonates in the neonatal intensive care unit (NICU) experience different needs at different stages of their neonates' stay in the NICU. The needs of parents with neonates in NICU's play an important role in aspects such as the ability to cope with changing parental roles and emotions, the relationship between parent and infant and the managing of the parents' own needs. The aim of this study was to develop an intervention care programme for parents with neonates in the NICU. This intervention care programme will empower parents to manage their own needs and the needs of their neonates while the neonate is admitted to the NICU and after discharge from the NICU / hospital. Literature is available on care programmes for neonates, but not on programmes for the parents of neonates in NICU. The study was a multi-phased study, using qualitative methodologies to determine the needs of South African parents with neonates in level III NICU's. In phase I, the needs of parents with neonates in NICU were elicited qualitatively. The needs were identified from the data and the results led to the implementation of phase II. In phase II the question was adjusted and new data was collected. Phase III was implemented to validate the data derived from phases I and II. The data was categorised in different need categories and these categories were used to plan an intervention care programme for parents with neonates in NICU's. The programme provides information to address needs as identified by parents in the research study and as derived from the literature. Need categories identified from the study and literature were as follows: information, communication, emotional, learning, discharge and individual needs. This programme is available in electronic format to enable parents to obtain information according to their changing needs and to provide unlimited access to updated information. The "Early intervention care programme for parents of neonates" will empower parents to manage their own needs and the needs of their neonates while the neonate is admitted to the NICU and after discharge from the NICU / hospital.

Adaptation, Psychological↗

PubMed2005

Early intervention care programme for parents of neonates.

Parents with neonates in the neonatal intensive care unit (NICU) experience different needs at different stages of their neonates' stay in the NICU. The needs of parents with neonates in NICU's play an important role in aspects such as the ability to cope with changing parental roles and emotions, the relationship between parent and infant and the managing of the parents' own needs. The aim of this study was to develop an intervention care programme for parents with neonates in the NICU. This intervention care programme will empower parents to manage their own needs and the needs of their neonates while the neonate is admitted to the NICU and after discharge from the NICU/hospital. Literature is available on care programmes for neonates, but not on programmes for the parents of neonates in NICU. The study was a multi-phased study, using qualitative methodologies to determine the needs of South African parents with neonates in level III NICU's. In phase I, the needs of parents with neonates in NICU were elicited qualitatively. The needs were identified from the data and the results led to the implementation of phase II. In phase II the question was adjusted and new data was collected. Phase III was implemented to validate the data derived from phases I and II. The data was categorised in different need categories and these categories were used to plan an intervention care programme for parents with neonates in NICU's. The programme provides information to address needs as identified by parents in the research study and as derived from the literature. Need categories identified from the study and literature were as follows: information, communication, emotional, learning, discharge and individual needs. This programme is available in electronic format to enable parents to obtain information according to their changing needs and to provide unlimited access to updated information. The "Early intervention care programme for parents of neonates" will empower parents to manage their own needs and the needs of their neonates while the neonate is admitted to the NICU and after discharge from the NICU/hospital.

Adaptation, Psychological↗

PubMed1996

Memory for Relevant and Irrelevant Information: Evidence for Deficient Inhibitory Processes in Language/ Learning Disabled Children

The present study examined whether language/learning disabled children have greater difficulty than nondisabled children suppressing information that becomes irrelevant during a sentence processing and memory task. During study trials, children were asked to predict and remember the terminal nouns for a series of sentences that highly constrained a terminal noun. For half of the study trials (fillers) the child's prediction was confirmed by presenting the child with the expected ending (e.g., "Butterflies fly by flapping their . . . wings."). For the remaining study trials (critical trials), however, the sentence ending expected by the child was disconfirmed with a low-probability ending (target noun). Thus, when presented with the sentence, "We made a sandwich with peanut butter and . . . ," the child's prediction ("jelly") was disconfirmed with a different ending ("bananas"). Memory for the disconfirmed and target nouns of critical study trials were subsequently tested implicitly with a new sentence-completion task. In this case, memory for disconfirmed and target nouns that had been associated with individual study sentences were measured in terms of priming effects. The analysis of priming effects indicated that language/learning disabled children experienced greater difficulty than nondisabled children inhibiting the activation of irrelevant information (disconfirmed nouns) and sustaining the activation of relevant information (target nouns) during a verbal memory task. These results were discussed in terms of their implications for some of the memory and language difficulties of language/learning disabled children.

Journal Article↗

PubMed2006

Facilitating interpersonal interaction and learning online: linking theory and practice.

INTRODUCTION: An earlier study of physicians' perceptions of interactive online learning showed that these were shaped both by program design and quality and the quality and quantity of interpersonal interaction. We explore instructor roles in enhancing online learning through interpersonal interaction and the learning theories that inform these. METHODS: This was a qualitative study using focus groups and interviews. Using purposive sampling, 50 physicians were recruited based on their experience with interactive online CME and face-to-face CME. Qualitative thematic and interpretive analysis was used. RESULTS: Two facilitation roles appeared key: creating a comfortable learning environment and enhancing the educational value of electronic discussions. Comfort developed gradually, and specific interventions like facilitating introductions and sharing experiences in a friendly, informative manner were helpful. As in facilitating effective small-group learning, instructors' thoughtful use of techniques that facilitated constructive interaction based on learner's needs and practice demands contributed to the educational value of interpersonal interactions. DISCUSSION: Facilitators require enhanced skills to engage learners in meaningful interaction and to overcome the transactional distance of online learning. The use of learning theories, including behavioral, cognitive, social, humanistic, and constructivist, can strengthen the educational design and facilitation of online programs. Preparation for online facilitation should include instruction in the roles and techniques required and the theories that inform them.

Attitude of Health Personnel↗