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PubMed1995

[Assessment of curriculum by medical students: comparison of participants and non-participants in voluntary anamnesis groups. An empirical study].

A representative sample of medical students (n = 121) was given a questionnaire to assess parts of their medical education (lectures, seminars, clerkships) and to design a subjectively ideal timetable, which was compared with the real faculty program. Overall traditional lectures received a low rating (n = 0.17) and individual studies with the textbooks a high rating (n = 0.53). The information given in programs in psychiatry and psychosomatics in significantly less motivating than information to be learned in other medical subjects. This is surprising because the ground work for training in the doctor-patient relationship should be in these fields. Students with former group experience (participation in peer groups on history taking (wish to have more practically oriented education compared with the students without group experience. It is not clear whether the important factor is participation in group experience before starting medical school. (64% of the participants had group experience in the first group as opposed to only 45% of the other group). This information should be taken into consideration when reforming medical school programs.

Adult↗

PubMed2001

Comparing syntactic complexity in medical and non-medical corpora.

With the growing use of Natural Language Processing (NLP) techniques as solutions in Medical Informatics, the need to quickly and efficiently create the knowledge structures used by these systems has grown concurrently. Automatic discovery of a lexicon for use by an NLP system through machine learning will require information about the syntax of medical language. Understanding the syntactic differences between medical and non-medical corpora may allow more efficient acquisition of a lexicon. Three experiments designed to quantify the syntactic differences in medical and non-medical corpora were conducted. The results show that the syntax of medical language shows less variation than non-medical language and is likely simpler. The differences were great enough to question the applicability of general language tools on medical language. These differences may reduce the difficulty of some free text machine learning problems by capitalizing on the simpler nature of narrative medical syntax.

Artificial Intelligence↗

PubMed2006

Design of integrated practice for learning professional competences.

To acquire professional competences that entail performance of complex skills, an authentic learning environment is required focused on the integration of all aspects of competences. However, most educational programmes offer separate building blocks, such as separate modules for knowledge and skills. Students accumulate what they have learned in these modules as they progress through the curriculum. In this paper the authors advocate the Four-Component Instructional Design model (4C/ID), which offers a whole-task approach to course design for programmes in which students learn complex skills. The four core components of this approach are: learning tasks, supportive information, just-in-time information and part-task practice. A concrete example from medical education will be presented to clarify both the general ideas behind this approach and the differences between the whole-task approach and conventional educational designs.

Education, Medical↗

PubMedDate not supplied

Patients' and their spouses' needs after total joint arthroplasty: a pilot study.

PURPOSE: To describe the experiences and needs of patients and their spouses during hospitalization and recovery from either total hip or total knee arthroplasty. DESIGN: Descriptive. SAMPLE: A purposive sample of 5 patients and their spouses in one health sciences center. METHODS: Qualitative study using a videotaped focus group interview. FINDINGS: Content analysis revealed two perspectives of one theme: patients and their spouses need "help making transitions." Situational and role transitions that were problematic for patients reflected distress over not being able to resume activities they enjoyed within an expected time frame. Incongruence between expectations and reality was the source of distress. As a consequence of role reversal, spouses experienced feelings of insecurity and being overwhelmed. Health and illness transitions that patients experienced were also related to incongruence between expectations of the recovery period and the reality that recovery is a slow process. Pain experienced during postdischarge recovery and rehabilitation, and problems encountered when applying information and skills learned in the hospital to the home setting were sources of concern. CONCLUSION: The needs and experiences of patients and spouses after total joint arthroplasty reflect transitional change--changes in roles, relationships, abilities, and behaviors. Health care professionals can facilitate transitions by providing education that reflects "best case-worst case scenarios" so that expectations of the recovery process are realistic. By being the link between hospital and home, health care professionals can lend support to patients as they continue the recovery process. As a program evaluation strategy, focus groups provide useful information to health care professionals who are interested in the needs and expectations of health care consumers. IMPLICATIONS FOR NURSING RESEARCH: Further exploration of the needs of patients and their spouses following joint replacement surgery is warranted. Use of focus group methodology might provide additional insight into the needs of this population and suggest ways in which health care professionals can modify existing programs to help these patients and their spouses make the transitions.

Adaptation, Psychological↗

PubMed1994

Rule extraction with fuzzy neural network.

This paper deals with the learning of understandable decision rules with connectionist systems. Our approach consists of extracting fuzzy control rules with a new fuzzy neural network. Whereas many other works on this area propose to use combinations of nonlinear neurons to approximate fuzzy operations, we use a fuzzy neuron that computes max-min operations. Thus, this neuron can be interpreted as a possibility estimator, just as sigma-pi neurons can support a probabilistic interpretation. Within this context, possibilistic inferences can be drawn through the multi-layered network, using a distributed representation of the information. A new learning procedure has been developed in order that each part of the network can be learnt sequentially, while other parts are frozen. Each step of the procedure is based on the same kind of learning scheme: the backpropagation of a well-chosen cost function with appropriate derivatives of max-min function. An appealing result of the learning phase is the ability of the network to automatically reduce the number of the condition-parts of the rules, if needed. The network has been successfully tested on the learning of a control rule base for an inverted pendulum.

Artificial Intelligence↗

PubMed2006

Learning by selection: visual search and object perception in young infants.

The authors examined how visual selection mechanisms may relate to developing cognitive functions in infancy. Twenty-two 3-month-old infants were tested in 2 tasks on the same day: perceptual completion and visual search. In the perceptual completion task, infants were habituated to a partly occluded moving rod and subsequently presented with unoccluded broken and complete rod test stimuli. In the visual search task, infants viewed displays in which single targets of varying levels of salience were cast among homogeneous static vertical distractors. Infants whose posthabituation preference indicated unity perception in the completion task provided evidence of a functional visual selective attention mechanism in the search task. The authors discuss the implications of the efficiency of attentional mechanisms for information processing and learning.

Analysis of Variance↗

PubMed2003

Photoresponse from the statocyst hair cell in Lymnaea stagnalis.

Sensory cells for associative learning of light and turbulence were studied in Lymnaea. Intracellular recordings with Lucifer Yellow filled electrodes were made from photoreceptors and statocyst hair cells. Photoreceptors had a long latency, graded depolarizing response to a flash of light; they extended their axon to the cerebral ganglion. The caudal hair cell, one of 12 cells in the statocyst, responded to brief light with a depolarization and superimposed impulse activity. It formed its terminal arborization close to the photoreceptor endings in the cerebral ganglion. Ca(2+)-free saline reversibly abolished the photoresponse in the hair cell, suggesting the information was conveyed via a chemical synapse. These findings demonstrated that sensory information for associative learning was convergent at the statocyst hair cell.

Animals↗

PubMed2006

AORN guidance statement: creating a patient safety culture.

AORN believes all health care organizations must strive to create a culture of safety. Such a culture will provide an atmosphere where all members of the perioperative team can openly discuss errors, process improvements, or system issues without fear of reprisal. A culture of safety places an emphasis on flexibility and learning as a means of improving safety and reducing errors. Characteristics of a culture of safety include the following: communication is open and honest; the emphasis is on the team rather than the individual; standards and practices are developed in a multidisciplinary framework; staff members are helpful and supportive of each other; staff members trust each other; surgical team members have a friendly, open relationship emphasizing credibility and attentiveness; the environment is resilient, encourages creativity, and is patient outcomes-driven; the focus is on work flow and process; and these attributes are supported by an informed culture that learns from incidents and near misses. A commitment to safety must be articulated at all levels of the organization. Safety must be valued as the top priority, even at the expense of efficiency. Health care organizations must allocate an appropriate amount of resources and provide the necessary incentives or rewards to promote a robust patient safety culture. AORN recognizes that most patient safety initiatives will fail in the absence of a viable safety culture.

Communication↗

PubMed2002

The effects of depression and anxiety on memory performance.

The effects of depression and anxiety, as assessed by MMPI D and Pt scales, on memory performance was examined in 3999 veterans who completed the California Verbal Learning Test (CVLT). Depressive symptoms (without anxiety) had an adverse effect on immediate recall of new information and the total amount (but not rate) of acquisition; however, retrieval and retention were unaffected. On the other hand, high levels of anxiety did not have significant detrimental effects on any aspect of memory functioning assessed including immediate recall, total amount acquired, retention, and retrieval of novel information. However, when depression was compounded by anxiety, there was not only an adverse effect on immediate recall and amount (but not rate) of acquisition, but also on the retrieval of newly learned information. We conclude that the presence of comorbid anxiety may, in part, account for the variability in previous research findings regarding the effects of depression on memory functioning.

Journal Article↗

PubMed2006

Knowledge translation versus knowledge integration: a "funder's" perspective.

Each year, billions of US tax dollars are spent on basic discovery, intervention development, and efficacy research, while hundreds of billions of US tax dollars are also spent on health service delivery programs. However, little is spent on or known about how best to ensure that the lessons learned from science inform and improve the quality of health services and the availability of evidence-based approaches. To close this discovery-delivery gap, researchers and their funding agencies not only must recognize the gap between basic discovery and intervention development, addressed in part through translational research investments, but they must also work together with practitioners and their funding agencies to recognize the growing gap between innovative interventions developed through research and what is actually delivered to reduce the burden of chronic disease within the United States. From a funding-agency perspective, the complexity of the challenges of translating lessons learned from science to public health, primary care, or disease specialty service settings requires a multifaceted partnership approach to accelerate the translation of research into practice. This essay reviews the background and challenges of closing the development-to-delivery gap and some exemplar strategies that have been used by funding agencies to address these challenges to date.

Education, Continuing↗

PubMed2000

Learning paradigms for image interpretation.

In this paper we discuss image understanding and object recognition as a class of processes which involve binding what is seen with what is known. It follows from this perspective that it is important to explicate how systems may learn about spatial information from images, how it is encoded, and, how, in turn, such knowledge is matched with new image data. As well as discussing very specific solutions to these problems, this paper questions the view that our scientific understanding of image understanding is sufficiently circumscribed by the study of how image features are extracted and matched, per se.

Computer Simulation↗

PubMed2006

Placebo-controlled study examining effects of selegiline in children with attention-deficit/hyperactivity disorder.

There is evidence suggesting a role for dopamine in attention-deficit/hyperactivity disorder (ADHD). Pharmacological treatments that act on the dopamine system have been successful in reducing ADHD symptoms. However, unlike traditional stimulants (i.e., methylphenidate), selegiline is a monoamine oxidase inhibitor (MAOI) that has been shown to reduce ADHD symptoms without producing undesirable side effects. In this study using a randomized, double- blind, placebo-controlled, crossover design, cognitive tasks and behavioral rating scales were administered to measure the effectiveness of selegiline in treating different symptoms of ADHD in 11 children aged 6-13. Results indicate that selegiline may target specific symptoms of ADHD including: sustained attention, the learning of novel information, hyperactivity, and peer interactions. Because the drug was not associated with negative side effects and did not specifically reduce symptoms of impulsivity, selegiline may be a preferred treatment for individuals who present with the primarily inattentive subtype of ADHD.

Adolescent↗

PubMed1990

Factors influencing patients' informational needs at time of hospital discharge.

The relationship between patients' perceived informational needs and selected sociodemographic and illness-related variables were examined in a sample of 301 adult medical and surgical patients preparing for discharge from an acute care setting. Marital status, living arrangements and chronicity of illness had no influence on the importance of informational needs as measured by the Patient Learning Need Scale (PLNS). More informational needs were identified by females than males, and those with malignant as opposed to benign disease. Length of time spent in the hospital, number of discharge medications, and patient perception of the influence of the illness on life were positively correlated with informational needs at the time of discharge.

Adolescent↗

PubMed2000

Vocal behaviour in cattle: the animal's commentary on its biological processes and welfare.

The vocalizations of cattle provide conspecifics with meaningful information about the caller. If we can learn how to interpret this information correctly, it could be used to improve management and welfare assessment. Vocalization may be viewed as a subjective commentary, by an individual, on its own internal state. The vocal behaviour of cattle is potentially a useful indicator of their physiological and psychological functioning.In the first part of this article we ask what information is exchanged using auditory cues. Vocalizations provide information on the age, sex, dominance status and reproductive status of the caller. Calves can recognize their mothers using vocal cues but it is not clear whether cows recognize their offspring in this way. Vocal behaviour may play a role in estrus advertisement and competitive display by bulls. Under experimental conditions involving pain or social isolation, vocal response is useful as an indicator of welfare, if properly used. Unlike commonly used physiological measures, it can be recorded non-invasively and varies on a number of quantitative and qualitative dimensions.In the second part we review methodological approaches to the study of vocal behaviour and their application in cattle welfare research. Methods may focus on the actions of the vocalizing animal and the conditions which elicit vocal behaviour, the response of an animal to hearing another's vocalizations, or interactions between sender and receiver.We argue that vocal behaviour in cattle may be valuable in welfare studies if the endogenous, exogenous and developmental factors influencing its expression can be more thoroughly investigated and understood.

Journal Article↗

PubMed2003

Implicit learning of visuospatial sequences in schizophrenia.

The authors examined whether patients with schizophrenia learned sequential patterns in a probabilistic serial response time task in which pattern trials alternated with random ones. Patients showed faster and more accurate responses to pattern trials than to random trials, but controls showed greater sensitivity to patterns. The highest level of regularity learned in both groups was information about runs of 3 events. Pattern learning occurred largely outside of awareness, as participants could not describe patterns. Controls with higher memory spans learned the sequential pattern better than those with lower memory spans, suggesting that working memory influences implicit pattern learning. Pathology in motor sequencing systems and poor working memory may lead to deficits in learning sequence structure in schizophrenia.

Adult↗

PubMed2000

Cross-disciplinary verification of theories: the case of the triarchic theory.

There are at least 4 good reasons to study the history of psychology. First, we can give credit to those who deserve it. Second, historical views can provide converging operations that help demonstrate the validity of our own views (or rather, operations that invalidate our views). Third, we learn that other natural and social sciences can inform our views. Fourth, we learn that philosophical and psychological analyses often converge. I show how historical views can inform current thinking about intelligence.

Greece↗

PubMed1995

Learning during anaesthesia: a review.

Can learning occur during general anaesthesia? This paper reviews the studies which have addressed this issue and finds some evidence of implicit memory for intra-operative events, even with clinically adequate anaesthesia. This has implications both for clinical practice and for psychological theories of learning and awareness. However, since many of the studies have been opportunistic, neither the anaesthetic techniques nor the paradigms used to assess memory have been standardized. Methodological improvements are discussed, in particular the need for a reliable means of monitoring awareness during anaesthesia. These improvements would enable researchers to determine the conditions under which learning occurs and would provide information about the role of consciousness in learning.

Anesthesia, General↗

PubMed2005

Sources of confidence judgments in implicit cognition.

Subjective reports of confidence are frequently used as a measure of awareness in a variety of fields, including artificial grammar learning. However, little is known about what information is used to make confidence judgments and whether there are any possible sources of information used to discriminate between items that are unrelated to confidence. The data reported here replicate an earlier experiment by Vokey and Brooks (1992) and show that grammaticality decisions are based on both the grammatical status of items and their similarity to study exemplars. The key finding is that confidence ratings made on a continuous scale (50%-100%) are closely related to grammaticality but are unrelated to all of the measures of similarity that were tested. By contrast, confidence ratings made on a binary scale (high vs. low) are related to both grammaticality and similarity. The data confirm an earlier finding (Tunney & Shanks, 2003) that binary confidence ratings are more sensitive to low levels of awareness than continuous ratings are and suggest that participants are conscious of all the information acquired in artificial grammar learning.

Adult↗