PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “skill learning”

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 1,225 records · Page 68Linked to original sources
PubMed1984

Toileting skills in children with myelomeningocele: rates of learning.

Rates at which 173 children with myelomeningocele learned 20 different toileting skills were studied in an attempt to describe their acquisition of control over chronic urinary and stool incontinence. All had clinical or urodynamic evidence of neurogenic bowel and bladder dysfunction. Seventy-five other children were excluded because of intelligence quotients less than or equal to 70 points, uncontrolled hydrocephalus, spastic extremities, or other major disabilities. Inadequate follow-up or parent cooperation eliminated 27 other cases. Using a home inventory, parents recorded their child's accomplishments. An investigator contacted parents regularly to minimize inaccurate reporting and to screen data against preestablished criteria. The observation period lasted 2.5 years, but earlier achievements that met criteria were included in the cumulative data pool. Each child was categorized into one of four groups of motor paralysis (L2 and above, L3-4, L4-5, S1 and below), and calculations were made when 20%, 50%, and 80% of the children had attained each toileting skill. Intergroup and intragroup variances were often striking. Possible explanations for these variances include physical and psychosocial readiness as well as home and community support systems. For the child who meets the selection criteria, these specific learning rates can be used in evaluating treatment, describing current levels of bladder or bowel control, and setting realistic goals.

Adolescent↗
PubMed1994

Motor learning and occupational therapy: the organization of practice.

This article addresses implications for the practice of occupational therapy when that therapy is guided by theories of motor learning. In occupational therapy, clients must learn or relearn motor skills through the use of activities. The occupational therapist must present activities in a manner that elicits the retention and transfer of the desired skills for use in functional settings. Therefore, the therapist should strive for acquisition conditions that facilitate retention and transfer of the learned skills. The processes that underlie motor learning should guide therapy. Three major factors that affect motor learning are environmental conditions, cognitive processes, and movement organization. Examination of the clinical implications of these factors, however, results in contradictory predictions regarding optimal practice conditions for motor skills. This article explores the successful integration of these factors and its application in occupational therapy practice. It is suggested that increasing the difficulty of the learning context during practice is beneficial for retention.

Humans↗
PubMed2000

Dermatology practice management enhancement: implications for dermatology in the age of managed care.

Health care delivery in the United States has changed dramatically during the past 10 years. Dermatologists are faced with challenging changes in the way they learn new skills, practice, and provide dermatologic care. Dermatologists can survive and flourish in this environment if they learn proper management and enhancement skills. These skills include proper coding and documentation, regulatory compliance, and new levels of practice effectiveness and efficiency. Dermatologists can offer also the benefit of cosmetic procedures and ethical office-based dispensing to their patients. Greater future unification of this specialty will allow dermatology to flourish and show its need, efficiency, and cost-effectiveness.

Cosmetics↗
PubMed2002

The ambiguous and bewitching power of knowledge, skills and attitudes leads to confusing statements of learning objectives.

The words "knowledge", "skills" and "attitudes" are given different meanings by health personnel when discussing educational issues. Ambiguity is known as a handicap to efficient communication. In the design of a curriculum the quality of the definition of learning objectives plays a fundamental role. If learning objectives lack clarity, learners and teachers will face operational difficulties. As Robert Mager said, "If you are not certain of where you are going you may very well end up somewhere else and not even know it". Knowledge is not only memory of facts but what you do with it. The complexity of human behaviour should not be underestimated. This is why educational objectives need active non-ambiguous verbs in order to achieve better communication between teachers and learners and to assess that complexity. This is why I suggest using the expression intellectual skill (or competence) as meaning "a rational decision or act". Sensomotor skill (or competence) would replace "skills" as presently used and cover only "acts which require a neuromuscular coordination". Interpersonal communication skill (or competence) would replace "attitude(s)" and be limited to "verbal and non-verbal relation between persons". As the level of validity of assessment of learners' competencies is linked to the clarity of learning objectives, it is hoped that the above suggestions will raise the overall level of validity of the evaluation system. This is why it is important that everybody understands, in the same manner, the meaning of a learning objective. It will help learners to focus their learning efforts on the right target. It will help teachers to ensure the relevance to health needs of their teaching and the validity of assessment instruments. In both cases it will be beneficial to the health of the population.

Journal Article↗
PubMed1997

Segmentation, not rhyming, predicts early progress in learning to read.

We present a longitudinal study of children in the first two years of learning to read. A battery of tests of phonological skills administered when the children were prereaders identified two distinct and relatively independent factors, Rhyming (defined by measures of rhyme detection and rhyme production) and Segmentation (defined by measures of phoneme identification and phoneme deletion). Segmentation was strongly correlated with attainment in reading and spelling at the end of the first year at school, though Rhyming was not. In addition, letter name knowledge predicted both reading and spelling skill and showed an interactive effect with children's segmentation skills. By the end of the second year of school, however, rhyming had started to exert a predictive effect of spelling, but not on reading. The results are discussed in the context of current theories of the role of phonological skills in learning to read.

Achievement↗
PubMed1998

Segmentation, not rhyming, predicts early progress in learning to read.

We present a longitudinal study of children in the first 2 years of learning to read. A battery of tests of phonological skills administered when the children were prereaders identified two distinct and relatively independent factors, Rhyming (defined by measures of rhyme detection and rhyme production) and Segmentation (defined by measures of phoneme identification and phoneme deletion). Segmentation was strongly correlated with attainment in reading and spelling at the end of the first year at school, while Rhyming was not. In addition, letter name knowledge predicted both reading and spelling skill and showed an interactive effect with children's segmentation skills. By the end of the second year of school, however, rhyming had started to exert a predictive effect on spelling, but not on reading. The results are discussed in the context of current theories of the role of phonological skills in learning to read.

Achievement↗
PubMed1999

Towards (re)conciliation: (re)constructing relationships between indigenous health workers and nurses.

Currently in Australia, both Aboriginal and non-Aboriginal Australians are attempting to reconcile themselves with a history of colonization/invasion, which resulted in human rights violations against Australia's indigenous people. Australian nursing has to examine its past in relation to the treatment of Aboriginal Australians. Relationships between nurses and Aboriginal health workers are the most commonly occurring professional relationships between nurses and Aboriginal people and are of key importance to the successful delivery of health services to Aboriginal communities. This qualitative study, grounded in feminism, aimed to explore the professional relationships between Aboriginal health workers and nurses and to develop insights which could assist the Australian nursing profession through a process of reconciliation with Aboriginal Australians. Feminist analysis of narrative text revealed several key themes as being crucial to this process. These were: learning to know and understand; towards workplace equity; and skill sharing -- learning from each other. Implications for nursing, in its journey toward reconciliation with Aboriginal Australians, are drawn from this study.

Australia↗
PubMed2004

Retaining and transferring nursing knowledge through a hospital internship program.

In healthcare, organizations recognize that human capital is their most valuable asset. The importance of investing in knowledge workers is imperative given the current and future shortage of health professionals. Knowledge acquisition occurs through continuous learning and the transfer of information from those who are highly experienced to those who are less qualified. At St. Michael's Hospital, two innovative and unique programs were created for the transfer of knowledge. The first was a nurse fellowship program that enabled experienced nurses to spend two to three months learning new skills to advance clinical practice. The second was a nurse internship program in which new graduates spend three to four months in their area of hire to enhance clinical practice through skill development and prioritization of patient care needs. This paper describes both programs and presents an evaluation of the new-graduate internship program as an opportunity for professional development and career enhancement For nurse interns, the program promotes self-esteem and professional confidence, improves job satisfaction and rewards nurses for their contribution. For nurse preceptors, the program provides job enrichment, experience in teaching and recognition by the organization and peers that they are knowledge experts. In healthcare, organizations have come to acknowledge that their most valuable asset is human capital, in particular, knowledge workers (Horibe 1999). Knowledge workers contribute a composite of information, intellectual property and experience (Horibe 1999), acquired by study, investigation, observation or practice (Webster's Dictionary 1989). Investing in knowledge workers is investing in the future. In this regard, organizations have implemented recruitment and retention strategies to attract, retain and advance the highest calibre of health professional. Knowledge workers contribute to an organization through their ideas, analyses of complex situations and sound judgment in decision-making (Horibe 1999). They further develop these skills over the course of their career through continuous learning. This paper will focus on the importance of investing in nurses as knowledge workers. In particular, given the shortage of nurses and the reality that 25% of today's nurses can retire over the next 10 years (CNA 2001), it is imperative that knowledge transfer occur from highly experienced to less experienced nurses.

Attitude of Health Personnel↗
PubMed1984

The medical interview: a core curriculum for residencies in internal medicine.

A core curriculum for teaching medical interviewing is presented that enhances the internist's skills in a broad range of interactions with patients. Learning these skills is now left to chance and is often deficient. Four objectives are developed: patient-centered interviewing and treatment; an integrated (biopsychosocial) approach to clinical reasoning and patient care; personal development of humanistic values; and psychosocial and psychiatric medicine. Teaching options include real and simulated encounters with patients, observation with discussion, and use of groups. A general strategy for implementing the curriculum at the local level requires the intellectual and financial support of the dean and department chairman, and a multidisciplinary faculty committed to developing, implementing, and evaluating the curriculum. At many programs, faculty development will be necessary.

Curriculum↗
PubMed1989

Acquisition and generalization of social skills in elementary-aged children with learning disabilities.

The generalization of specific social skills to new environments/situations by elementary-aged students with learning disabilities was the primary focus of this study. During the spring semester of 1985, training in the learning disabilities resource room, including a discussion and verbal rehearsal of appropriate skill use and positive consequences of using the specific social skill appropriately, was initiated. Once the subject became proficient in the skill of interest, attempts to establish the skill outside the resource room were initiated (training sufficient exemplars). Reinforcement in the form of systematic attention was delivered in the new environments by teachers and parents. During the fall semester of 1985 each of the subjects was again observed with respect to the behaviors of interest. All subjects manifested generalization of the social skills to the new environments.

Behavior Therapy↗
PubMed2002

A communication assessment and skill-building exercise (CASE) for first-year residents.

OBJECTIVE: Good communication skills are essential for residents entering postgraduate education programs. However, these skills vary widely among medical school graduates. This pilot program was designed to create opportunities for (1) teaching essential interviewing and communication skills to trainees at the beginning of residency, (2) assessing resident skills and confidence with specific types of interview situations, (3) developing faculty teaching and assessment skills, (4) encouraging collegial interaction between faculty and new trainees, and (5) guiding residency curricular development. DESCRIPTION: During residency orientation, all first-year internal medicine residents (n = 26) at the University of Minnesota participated in the communication assessment and skill-building exercise (CASE). CASE consisted of four ten-minute stations in which residents demonstrated their communication skills in encounters with standardized patients (SPs) while faculty members observed for specific skills. Faculty and SPs were oriented to the educational purposes and goals of their stations, and received instructions on methods of providing feedback to residents. With each station, residents were provided one and a half minutes of direct feedback by the faculty observer and the SP. The residents were asked to deal with an angry family member, to counsel for smoking cessation, to set a patient-encounter agenda, and to deliver bad news. A resident's performance was analyzed for each station, and individual profiles were created. All residents and faculty completed evaluations of the exercise, assessing the benefits and areas for improvement. DISCUSSION: Evaluations and feedback from residents and faculty showed that most of our objectives were accomplished. Residents reported learning important skills, receiving valuable feedback, and increasing their confidence in dealing with certain types of stressful communication situations in residency. The activity was also perceived as an excellent way to meet and interact with faculty. Evaluators found the experience rewarding, an effective method for assessing and teaching clinical skills, a faculty development experience for themselves in learning about structured practical skills exercises, and a good way to meet new interns. The residency program director found individual resident performance profiles valuable for identifying learning issues and for guiding curricular development. Time constraints were the most frequently cited area for improvement. The exercise became feasible by collaborating with the medical school Office of Education-Educational Development and Research, whose mission is to collaborate with faculty across the continuum of medical education to improve the quality of instruction and evaluation. The residency program saved considerable time, effort, and expense by using portions of the medical school's existing student skills-assessment programs and by using chief residents and faculty as evaluators. We plan to use CASE next year with a wider variety of physician-patient scenarios for interns, and to expand the program to include beginning second- and third-year residents. Also, since this type of exercise creates powerful feedback and assessment opportunities for instructors and course directors, and because feedback was so favorable from evaluators, we will encourage participation in CASE as part of our faculty educational development program.

Clinical Competence↗
PubMed2003

A changing culture in interpersonal and communication skills.

In summary it is essential that we improve our interpersonal and communication skills. We can learn and be taught better skills. We will be evaluated on these skills in the future, and it is important for us to establish ourselves as good role models for the future surgeons who will be entering our profession. It is of benefit to our patients and will give them a better understanding of their disease and elevate their level of healthcare. It is also important to us to help reduce our stress and to eliminate burnout. We can improve our interpersonal and communication skills in many ways. First we must be aware that there is a problem and recognize this as a problem that can be solved and that we do need to improve our current skills. This can be done through multiple educational tools such as lectures, videos, and self-assessments. The responsibility for this culture change ranges from top to bottom, but really begins at the bottom. It is important for all of us especially individuals such as myself, who is not only a practicing surgeon but also a surgeon in a leadership position, a surgeon who teaches medical students and residents, and a chairman who develops the careers of young faculty members. It is important for organizations such as the Southeastern Surgical Congress to recognize this need of our members and to conduct seminars, luncheons, and courses in helping us acquire better skills and also giving us some assessment of the current status of our skills. The American College of Surgeons has already addressed this issue by forming the Task Force on Communication and Educational Skills. Various examining boards have already incorporated this into requirements and expectations of future physicians and surgeons. We must establish ourselves as good role models. Being a good role model cannot be overemphasized. We are very fortunate in being good role models in medical knowledge and mastering phenomenal technical feats; however, this is not enough. It is also important that we also improve our interpersonal and communication skills. We must establish goals and outcomes for ourselves and work on ways of assessing these to ensure that we are effective in improving our skills. We must incorporate interpersonal and communication skills into our training programs, postgraduate courses, and all aspects of lifelong continuing education. Addressing the improvement of our interpersonal and communication skills will have many beneficial effects including improved patient outcomes, a better healthcare status for our patients, and a high level of confidence that patients have in us as physicians and surgeons. We do at times have a less than ideal collegial relationship with other disciplines in medicine. This faulty relationship needs to be rectified. We need to restore and maintain a high collegial relationship with everyone in medicine not only other physicians, but also nurses, paramedical personnel, and others. These changes will require a great deal of effort and will take some considerable time. Initially laparoscopic cholecystectomy and laparoscopic skills were not adequately learned but with recognition of its importance, education, and time, we became master surgeons. We are very fortunate to have residents and practitioners with superb laparoscopic skills that they acquired during their training and in structured postgraduate courses. Likewise it is important to incorporate interpersonal and communication skills into our training programs and our continuing medical educational programs. Finally, this is not just a touchy-feely issue, but it is one of surgical professionalism. It is critical for us to address this as an important issue since it will enhance the good qualities that we already possess. Let's start today. I have enjoyed this year being your President, and wish to thank you for the opportunity of addressing you this morning.

Communication↗
PubMed2003

Rehab rounds: Involving families in rehabilitation through behavioral family management.

Introduction by the column editors: A wide variety of family psychoeducational approaches for persons with serious and persistent mental illness have been developed and used by mental health professionals since the introduction of such approaches in the 1960s (1). From 1970 to 1975, multifamily psychoeducation was implemented for large numbers of clients and relatives at the Oxnard Mental Health Center (2) and was followed by systematic studies of multifamily therapy at the Maudsley Hospital in London in 1976 (3) and Camarillo State Hospital in California in 1978 to 1980 (4). The type of intervention that arose from this work comprised a series of educational sessions followed by training in communication and problem-solving skills. Behavioral learning principles were used to promote acquisition of knowledge, coping skills, and problem solving for families. Other procedures and variants on this theme have proliferated throughout the United States and in many other countries (5). Most of these approaches have in common an adherence to practical goals that are individualized for each family and an educational rather than a "therapeutic" slant. In an attempt to overcome the obstacles to widespread clinical use of family interventions, a variety of dissemination strategies have been tried, including academic detailing, consensus building among all stakeholders (6), and the development of modules consisting of trainers' manuals, consumers' workbooks, slide shows, and video-assisted learning (7,8). This month's column describes one of the variants of family psychoeducation-behavioral family management-and its components, illuminated by case vignettes and results of efficacy studies.

Behavior Therapy↗
PubMed1982

EMG changes during acquisition of a motor skill.

Currently there are only a few studies which attempt to explain the neuromuscular changes which accompany skilled motor learning. Conflicting results have created the need for further research concerned with the electromyographical correlates of motor skill acquisition. A shuffleboard task was devised that isolated the triceps as the major agonist and the biceps as the major antagonist. Ten undergraduate males enrolled at Iowa State University participated in the study. Multivariate analysis and single degree of freedom components based on polynomial regression were used to test linear, quadratic and cubic trends for eight EMG characteristics plus movement time obtained from a systematic sampling of practice trials. Results indicated that trial period means for movement time, latency period and time to peak activity for the triceps exhibited significant linear trends (negative) during practice. No changes were seen in the integrated electromyograms for either the triceps or biceps. It was concluded that force parameters as measured by integrated EMG activity could be determined very early in the learning process and the distribution of these forces through various aspects of timing characterized learning.

Adolescent↗
PubMed1996

An active-learning approach to basic clinical skills.

Within the context of comprehensive changes in the preclinical curriculum at Northwestern University Medical School, the authors sought to create an active-learning approach to teaching the basic clinical skills of communication, physical examination, and diagnostic reasoning. This approach is built upon the premise that repetitive practice using a structured database, which is emphasized in traditional curricula, is necessary but not sufficient for students' early development as clinicians, as it marginalizes essential areas of discourse and restricts students' understanding of the scope of the medical encounter. Accordingly, this clinical skills curriculum incorporates small-group, patient-instructor, and peer-observation formats to encourage critical thinking and reflection. The clinical skills units have been among the most popular aspects of Northwestern's new curriculum. Preliminary data suggest that the overall attitudes, knowledge, and clinical proficiency of students completing this curriculum compare favorably with those of students who progressed through the preclinical curriculum before the active-learning approach was introduced.

Clinical Competence↗
PubMed1977

Motor proficiency of learning disabled and nondisabled students.

The motor proficiency of 55 learning disabled and 55 nondisabled students was compared on a comprehensive battery of motor-skills tests. Learning disabled students performed significantly lower than nondisabled students on measures of fine motor skills and on measures of gross motor skills. Their greatest deficiencies were on tasks requiring body equilibrium, controlled fine visual-motor movements, and bilateral coordination of movements involving different parts of the body. All of these areas include complex motor patterns that require the integration of visual and kinesthetic senses with motor responses. Implications of these findings for the development of motor training programs and for future research are discussed.

Adolescent↗