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At least 1,063 records · Page 59Linked to original sources
PubMed1999

Structured teaching methods enhance skill acquisition but not problem-solving abilities: an evaluation of the 'silent run through'.

OBJECTIVES: We aimed to evaluate whether a structured teaching technique (the silent run through) was of benefit in the learning of a skill sequence, and whether it would affect students' ability to improve their problem-solving skills or ability to make judgements. DESIGN: Students from one hospital were taught two different complex skills using a highly structured teaching method involving the breakdown of complex tasks into smaller components and the utilization of an internal, silent 'commentary'. Their subsequent ability to reproduce these skills was compared with a second group of students taught at another hospital. All students were assessed during a common end of attachment Objective Structured Clinical Examination on the two skills, by raters blind to the teaching techniques the students had received. SETTING: School of Medicine, University of Leeds, UK. SUBJECTS: Medical students. RESULTS: Students who received the structured teaching were significantly better at reproducing a complex, sequential clinical skill (examination of a squint). There was no demonstrable improvement in problem-solving skills as assessed on an X-ray interpretation station. Students expressed high levels of satisfaction with learning skills in such a structured way and reported increased confidence in their examination skills. CONCLUSIONS: This study provides some evidence to support the hypothesis that different teaching techniques may be more effective for improving different elements of skills learning. In particular, a highly structured technique involving breaking complex tasks down into smaller components and utilizing an internal 'commentary' may be an effective way of teaching the sequential motor components of complex clinical skills.

Clinical Competence↗
PubMed2006

The impact of preclinical preceptorships on learning the fundamentals of clinical medicine and physical diagnosis skills.

PURPOSE: To learn whether preclinical primary care preceptorships resulted in demonstrable clinical performance benefits to medical students. METHOD: This was a retrospective cohort study of 267 medical students who elected and 310 students who did not elect to take a four-week primary care preceptorship following the first year of training at the University of Texas Medical School at Houston in 2001-2003. Outcome variables were the students' performances on a written examination testing their integration of basic science and fundamentals of clinical medicine and performances on a comprehensive objective structured clinical examination (OSCE). After adjusting for factors that might have explained differences in the students' performances, logistic regression models were used to assess the association of the outcome variables with participation in a preceptorship. RESULTS: Students who participated in any one of the preceptorships performed better on the OSCE and on the fundamentals of clinical medicine examination than students who did not participate (p < .01). Students who participated in the family medicine or pediatric preceptorship scored higher on an OSCE (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.01-2.78 and OR, 2.26; 95% CI, 1.18-4.36, respectively) than those students who did not participate in a preceptorship. Students who participated in the internal medicine preceptorship scored higher on the fundamentals of clinical medicine examination (OR, 3.18; 95% CI, 1.92-5.23). CONCLUSIONS: Preliminary evidence indicates that a short preclinical primary care preceptorship can help medical students to consolidate and integrate the fundamental cognitive and clinical skills they will apply during the clinical years of medical training.

Adult↗
PubMed1993

Intelligence and motor skill acquisition by discrimination learning.

This experiment investigated the relation between intelligence and acquisition of motor skill using predictions from Zeaman and House's 1963 attention theory. 20 undergraduate students and 20 subjects of low IQ (WAIS-R Full Scale IQ range 50 to 73, M = 60) made linear positioning movements of long and short amplitude to the left and right of a central starting position. Four conditions (right-long, right-short, left-long, left-short) were created by specifying the corresponding target area on the positioning apparatus. One or both of the paired cues were varied, i.e., left, right, long, or short, while the dimensions of direction and amplitude remained unchanged across conditions. A shift from one condition to the next followed a criterion response of four consecutive movements to the target area. Results supported the hypothesis that subjects of low IQ would require more trials to criterion than subjects of normal IQ across all conditions of direction and extent. There was qualified support for the hypothesised interaction between intelligence and cue shifts. The practical implications and theoretical significance of these findings are discussed.

Adolescent↗
PubMed1998

Auscultation of the heart: a trial of classroom teaching versus computer-based independent learning.

Declining skills in auscultation of the heart prompted an evaluation of teaching methods for medical students. A comparison of classroom teaching and computer-aided independent learning of auscultation was carried out with two groups of approximately 20 second-year medical students. Both groups used approximately 20 recorded normal and abnormal heart sounds and murmurs, chosen to illustrate learning issues. For the classroom group a cardiologist presented each case through multiple stethophones and led the discussion. The individual study group used a new CD-ROM collection of cases and recordings in quiz format, with a hypertext link to a comprehensive text on auscultation and additional recordings. Students were tested with 16 multiple choice and 5 open questions on eight selected recordings, and evaluated the teaching by questionnaire. The classroom-taught students scored higher on open questions than the CD-ROM-taught group, but in general performance by both groups was satisfactory and equivalent. Students of both groups repeatedly had difficulty classifying regurgitant and ejection murmurs and identifying characteristics of the second heart sound. Both CD-ROM and classroom teaching methods were highly rated by students but most students preferred a combination.

CD-ROM↗
PubMed1988

The neural basis for learning of simple motor skills.

The vestibulo-ocular reflex (VOR) is a simple movement that has been used to investigate the neural basis for motor learning in monkeys. The function of the VOR is to stabilize retinal images by generating smooth eye movements that are equal and opposite to each head movement. Learning occurs whenever image motion occurs persistently during head turns; as a result image stability is gradually restored. A hypothesis is proposed in which the output from the cerebellar cortex of the flocculus guides learning; the locus of learning is in the brain stem, in VOR pathways that are under inhibitory control from the flocculus. Other, parallel VOR pathways do not receive inputs from the flocculus and are not subject to learning. Similarities among the VOR and other motor systems suggest some organizing principles that may apply in many forms of motor learning.

Action Potentials↗
PubMed2002

Use of the Cochrane electronic library in complementary and alternative medicine courses in medical schools: is the giant lost in cyberspace?

Courses in complementary and alternative medicine (CAM) are increasing in medical schools in the United States and, currently, approximately two thirds of U.S. medical schools offer at least one such course. As these courses grow in popularity, however, concerns are also growing that these courses lack an evidence-based perspective. We propose that one interesting and easy way to bring an evidence-based perspective to the CAM classroom is to utilize the Cochrane Electronic Library (CLIB), which is available in many medical libraries, as a teaching tool. The CLIB currently houses more than 80 CAM-related, full-text systematic reviews and approximately 5000 CAM-related clinical trials, making it a valued resource for people who seek CAM evidence. Moreover, the CLIB commitment to publishing reviews regardless of the results make it a resource where one can find reviews concluding there is strong evidence of benefit or no evidence of benefit. In addition to the access to CAM evidence which the CLIB provides, students can learn basic critical appraisal skills by learning the rationale behind Cochrane systematic reviews. A survey of CAM course directors, however, shows that almost one half of these directors have never used the CLIB. For those who have never used the CLIB, this editorial explains the four main databases within the CLIB and presents ideas for using them in CAM school courses.

Complementary Therapies↗
PubMed2001

Implicit learning of a perceptual-motor skill after stroke.

BACKGROUND AND PURPOSE: A motor skill can be learned implicitly, without awareness of what is being learned. The purpose of this study was to examine the ability of adults who had unilateral stroke to learn implicitly a perceptual-motor task. SUBJECTS: Subjects were 47 people who were poststroke and 36 control subjects. METHODS: Participants performed sequences of hand movements in response to target lights in 2 conditions: a patterned sequence and a random sequence. Participants were not given explicit knowledge of the presence of the 2 conditions. Those who had stroke performed with the upper-extremity ipsilateral to the lesion. RESULTS: Subjects who had stroke performed more slowly than control subjects. For both groups, times decreased with practice of the patterned sequence, increased with introduction of the random sequence, and decreased again with reintroduction of the patterned sequence. Group differences persisted in a retention test given the next day of the patterned sequence, and both groups showed decreased times over the course of the retention test. DISCUSSION AND CONCLUSION: People with stroke are able to learn a perceptual-motor task even without explicit instructions regarding the patterned sequence embedded in the task.

Analysis of Variance↗
PubMedDate not supplied

A summer program for underachieving adolescents.

This paper discusses a Summer Adolescent Program organized for mentally and physically handicapped teenagers with potential for a moderate level ofindependence, but lacking in self-help, socialization, and mobility skills, and prevocational readiness. The purpose of the seven-week program is to provide a practical, activity-oriented setting where teens can capitalize on existing skills, and learn and practice new skills. Program content includes assembly project, personal care and cooking units, recreation, interaction groups, and parent participation. Evaluations are based on objectives formulated for each adolescent at the beginning of the program and on staff ratings of contacts with each youngster.

Activities of Daily Living↗
PubMedDate not supplied

Mentoring for publication: faculty and student perspectives.

Mentoring can be used to teach the writing process and to encourage undergraduate minority nursing students to produce manuscripts for publication. Through a one-to-one mentoring relationship with a nursing faculty member, a student is made aware of the links between writing as a critical skill for learning and acquiring the skills for professional nursing. The mentoring relationship supports the student from developing an idea for publication to actively participating in preparing a manuscript.

Education, Nursing, Baccalaureate↗
PubMedDate not supplied

Fostering critical thinking skills in students with learning disabilities: an instructional program.

An instructional unit was developed to enhance the critical thinking skills of middle school and high school students with learning disabilities by teaching them the principles of scientific reasoning. Student-teacher dialogues were used to engage the students in an active process of critical inquiry. Students analyzed everyday information presented in brief magazine articles and advertisements by applying the principles of the scientific method. The students made statistically significant improvements in their ability to (a) identify the principal claim made in an article or advertisement, (b) graph the relevant data, and (c) evaluate the claims made in the article and explain their support or rejection of the claims based on data. After the instructional unit, the overall performance of the special education students exceeded that of a control group composed of regular education students who had not received instruction in critical thinking.

Adolescent↗
PubMed1989

The effects of daily homework assignments on the acquisition of basic skills by students with learning disabilities.

Examined in this two-study investigation was the effectiveness of supplemental homework assignments on the acquisition of basic skills by students with diagnosed learning disabilities (LD). In Experiment 1, an adapted alternating treatments design was used to investigate the efficacy of unstructured homework assignments with 6 elementary school-aged students having basic math problems. Although the impact of the homework assignments differed across students, three factors maximized the effectiveness of the homework assignments: rate of homework completion, percentage correct on the homework assignments, and the rate of acquisition of the content being presented. Experiment 2, designed to formally test the effectiveness of homework assignments structured specifically to address these identified factors, confirmed that homework can be employed to increase the effectiveness of direct instruction sequences with students diagnosed as LD.

Child↗
PubMedDate not supplied

Treatment of anomia using errorless versus errorful learning: are frontal executive skills and feedback important?

BACKGROUND: Studies from the amnesia literature suggest that errorless learning can produce superior results to errorful learning. However, it was found in a previous investigation by the present authors that errorless and errorful therapy produced equivalent results for patients with aphasic word-finding difficulties. A study in the academic literature of phoneme discrimination learning found that errorful learning produced equivalent results to errorless learning when feedback was given. In the authors' previous study, feedback was available to the participants in the errorful therapy. It is possible, therefore, that this feedback may have improved the results from errorless learning -- thereby reducing an underlying difference between the two techniques. Generally, feedback is thought to aid learning, however, there is little information in the speech therapy literature about this factor. AIMS: The present investigation was conducted as a follow-up to authors' original study to compare errorless and errorful therapy for the amelioration of aphasic word-finding difficulties. The second aim was to replicate key findings from the original study: namely, that recognition memory, executive/problem-solving skills and monitoring ability predict immediate and long-term naming improvements but not the participants' remaining language ability. METHODS & PROCEDURES: Seven of the original 11 participants took part in a multiple baseline, crossover, case series design. OUTCOMES & RESULTS: The previous results were replicated: errorless and errorful therapy produced equivalent results immediately post-therapy and at follow-up. There was no effect of omitting feedback - the participants learnt equally well without therapist's feedback about whether or not their response was correct. In addition, executive/problem-solving skills and monitoring ability again predicted immediate naming improvements not language ability. CONCLUSIONS: The findings support the view that cognitive abilities and in particular executive function are important contributors to rehabilitation.

Adult↗
PubMed2006

Neural averaging in motor learning.

The capacity for skill development over multiple training episodes is fundamental to human motor function. We have studied the process by which skills evolve with training by progressively modifying a series of motor learning tasks that subjects performed over a 1-mo period. In a series of empirical and modeling studies, we show that performance undergoes repeated modification with new learning. Each in a series of prior training episodes contributes such that present performance reflects a weighted average of previous learning. Moreover, we have observed that the relative weighting of skills learned wholly in the past changes with time. This suggests that the neural substrate of skill undergoes modification after consolidation.

Arm↗
PubMed1989

How do old dogs learn new tricks: teaching a technological skill to brain injured people.

Little is known about the way people learn technological skills. This investigation was carried out to see how 100 brain injured, 50 controls and two amnesic patients performed on a task requiring them to learn a six-step programme for an electronic memory aid. Performance was correlated with other measures of memory to determine whether the technological skill was similar to a procedural learning task, a spatial memory task, a visual task, a verbal task or an amalgam of these. All controls but only 59 percent of the patients learned the task within three trials. The two amnesic patients also failed to learn the new skill. There was a high correlation between overall performance on a standardized test of everyday memory (the Rivermead Behavioural Memory Test) but little evidence that the technological skill was similar to a procedural learning task; nor was it specifically related to visual, verbal or spatial memory. It is concluded that a combination of skills is required to learn the technological task. Implications for the concept of procedural learning are discussed.

Adolescent↗
PubMed2006

Implicit learning of a motor skill after mild and moderate stroke.

OBJECTIVE: To determine if adults in the subacute phase post moderate or mild stroke could learn a motor task under implicit practice conditions. DESIGN: Non-randomized, between-group design. SETTING: Subjects' homes. SUBJECTS: Sample of convenience of 15 adults with moderate stroke, 22 adults with mild stroke, and 32 age-matched controls. Stroke severity was determined using the Orpington Prognostic Scale. INTERVENTION: Practice of movements to target switches in two conditions, a repeated series and a random series. Practice was organized into a single session of six blocks of 80 trials such that blocks 1 and 2 were the random series, blocks 3 and 4 the repeated series, block 5 the random series, and block 6 the repeated series. Explicit knowledge of the two conditions was not provided. MAIN MEASURES: The mean response time and the coefficient of variation were calculated for each block for each group. RESULTS: Regardless of group, participants had a slower response time when practice was unexpectedly switched from the repeated to random condition. The response time and coefficient of variation for those with moderate stroke were persistently greater than those with mild stroke and controls, who were not different from each other. CONCLUSIONS: Implicit motor learning is preserved in adults with moderate stroke and may be a viable strategy for teaching motor skills in rehabilitation. The clinician should be aware that subjects with moderate stroke, even when performing with the less affected upper extremity, have significantly slower and more variable movements than those with mild stroke and controls.

Aged↗
PubMed2002

Evaluation of a faculty development program in managing care.

PURPOSE: To evaluate a faculty development program that teaches quality improvement and cost-effectiveness. METHOD: From October 2000 to February 2001, a two-part faculty development program was offered to 39 physicians from 19 U.S. medical schools supported by grants from the Partnerships for Quality Education (PQE) and Undergraduate Medical Education in the 21st Century (UME-21). Special features of the program included partnerships between academic and community physicians from each school, development of an educational innovation of interest to the participants, concurrent development of teaching skills and new medical knowledge, learning leadership skills (e.g., how to train colleagues to teach), and practice periods. The program focused on quality improvement and cost-effectiveness, but included other "managing care" topics. Prior to and after the course, participants assessed their knowledge of and competence to teach these topics, as well as other managing care topics. They also assessed their competence as medical educators and leaders. After the course, they indicated their progress in implementing their proposed educational innovations. RESULTS: Thirty-two of the 39 physicians completed evaluations both before and after the program. Self-assessed knowledge and competence to teach quality improvement and cost-effectiveness were significantly higher at the end of the course, as were all self-assessed teaching and leadership skills. The largest change scores occurred in assessments of competency to teach the new topics and to teach in new ways. Participants who implemented their innovations rated their competencies to teach quality improvement and cost-effectiveness higher than did non-implementers. CONCLUSION: Opportunities for faculty to learn how to teach a topic of stated importance to them, to practice what they have learned, and to work collaboratively with partners improved teaching skills.

Academic Medical Centers↗