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PubMedDate not supplied

Training basic teaching skills to community and institutional support staff for people with severe disabilities: a one-day program.

Shortcomings in the technology for training support staff in methods of teaching people with severe disabilities recently have resulted in calls to improve the technology. We evaluated a program for training basic teaching skills within one day. The program entailed classroom-based verbal and video instruction, practice, and feedback followed by on-the-job feedback. In Study I, four undergraduate interns participated in the program, and all four met the mastery criterion for teaching skills. Three teacher aides participated in Study 2, with results indicating that when the staff applied their newly acquired teaching skills, students with profound disabilities made progress in skill acquisition. Clinical replications occurred in Study 3, involving 17 staff in school classrooms, group homes, and an institution. Results of Studies 2 and 3 also indicated staff were accepting of the program and improved their verbal skills. Results are discussed regarding advantages of training staff in one day. Future research suggestions are offered, focusing on identifying means of rapidly training other teaching skills in order to develop the most effective, acceptable, and efficient technology for staff training.

Adolescent↗

PubMed2002

Anticipation skill in a real-world task: measurement, training, and transfer in tennis.

Anticipation skill in tennis was examined using realistic film simulations, movement-based response measures, and a portable eye movement recording system. Skilled players were faster than their less skilled counterparts in anticipating the direction of opponents' tennis strokes, with this superior performance being based, at least in part, on more effective visual search behaviors. The processes mediating superior performance were then modeled in groups of recreational tennis players using video simulation, instruction, and feedback. Players who received perceptual training improved their performance on laboratory- and field-based tests of anticipation when compared with matched placebo and control groups that did not receive any instruction regarding expert performance strategies. The approach used may have practical utility in a variety of performance contexts.

Adult↗

PubMedDate not supplied

Multifocal projection: a multiprojector technique for increasing focal depth.

In this paper, we describe a novel multifocal projection concept that applies conventional video projectors and camera feedback. Multiple projectors with differently adjusted focal planes, but overlapping image areas are used. They can be either differently positioned in the environment or can be integrated into a single projection unit. The defocus created on an arbitrary surface is estimated automatically for each projector pixel. If this is known, a final image with minimal defocus can be composed in real-time from individual pixel contributions of all projectors. Our technique is independent of the surfaces' geometry, color and texture, the environment light, as well as of the projectors' position, orientation, luminance, and chrominance.

Algorithms↗

PubMed1978

A variable aperture fluoroscopic unit for reduced patient exposure.

A real time fluoroscopic imaging system which provides capability for reduced patient exposure by as much as a factor of five has been developed. Modifications to the system include the incorporation of a variable aperture iris between the image intensifier output phosphor and television camera and the use of the video signal as the feedback element in the fluoroscopic automatic exposure rate control system. Quantitative and qualitative performance of the system is described.

Fluoroscopy↗

PubMed2002

Review: complications of minimally invasive spinal surgery.

Complications of minimally invasive spinal surgery can be related to anesthesia, patient positioning, and surgical technique. The performance of successful minimally invasive spinal surgery is beset with several technical challenges, including the limited tactile feedback, two-dimensional video image quality of three-dimensional anatomy, and the manual dexterity needed to manipulate instruments through small working channels, which all account for a very steep learning curve. Knowledge of possible complications associated with particular minimally invasive spinal procedures can aid in their avoidance. This article reviews complications associated with minimally invasive spinal surgery in the cervical, thoracic, and lumbar spine by reviewing reported data of sufficient detail or with sufficient numbers of patients. In addition, possible complications associated with anesthesia use, patient positioning, and surgical techniques during thoracoscopic and laparoscopic spinal procedures are reviewed.

Endoscopes↗

PubMed2001

Augmented feedback reduces jump landing forces.

STUDY DESIGN: Randomized, experimental design using a 1-way ANCOVA to determine the influence of various forms of feedback on jump landing forces. OBJECTIVE: To investigate the effects of augmented feedback versus sensory feedback on the reduction of jump landing forces. BACKGROUND: Several investigators have reported an increased risk of lower extremity injury associated with landing from a jump. METHODS AND MEASURES: Nonimpaired college students (N=63) were randomly assigned to 1 of 4 feedback groups. Subjects were instructed to perform maximal vertical jumps onto a force plate for 3 testing sessions (baseline, 2-minute post-test, and 1-week post-test). Three feedback groups (augmented, sensory, and control I) were tested during all 3 testing sessions, while a fourth feedback group (control II) was evaluated at only 2 sessions (baseline and 1-week post-test). Subjects in the augmented feedback condition were provided information via video and verbal analysis of how to land softer. Subjects in the sensory feedback condition were asked to use the experience of their baseline jumps to document how they could land softer. Subjects in each of the control groups were not provided any extraneous feedback. Peak vertical ground reaction force data were collected for analysis. RESULTS: The subjects in the augmented feedback group significantly reduced their peak vertical ground reaction force in both post-test conditions (2-minute post-test reduction, 0.85+/-0.62; 1-week post-test reduction, 0.74+/-0.58) as compared to the sensory, control I, and control II feedback groups. CONCLUSIONS: High impact landing forces may be reduced by the implementation of augmented feedback information instructing individuals about how to land properly. The reduction of jump landing forces with the use of augmented feedback may prove beneficial in the creation of instructional landing programs.

Adaptation, Physiological↗

PubMed1988

Effect of stress on oesophageal motor function in normal subjects and in patients with the irritable bowel syndrome.

Stress can modulate the motor function of the stomach, small bowel, and colon in healthy subjects, and of the small bowel and colon in patients with the irritable bowel syndrome (IBS). The effect of stress on oesophageal motility in eight healthy subjects and in eight IBS patients was studied, using two pressure transducers positioned just above the lower oesophageal sphincter and 5 cm proximally. Stressors were: a video arcade game, delayed audio feedback, and hand immersion in cold water. Each stress period was followed by five swallows of water. Frequency and amplitude of oesophageal contractions and the number of simultaneous and multipeaked contractions were manually counted for each stress period and compared to the preceding rest period. Frequency of contractions (per minute) tended to decrease during stress periods, but achieved significance only with the video arcade game in the control group (2.0 (0.6) v 1.2 (0.4); p less than 0.01). No other trend was evident in either control or IBS patients. No abnormalities of oesophageal body function were recorded in IBS patients either in basal conditions, or under stress. Unlike the more complex motor programmes elsewhere in the gut, the preprogrammed nature of oesophageal peristalsis is not modulated by stress.

Adult↗

PubMed2000

Communication skills training for emergency department senior house officers--a qualitative study.

OBJECTIVE: To identify common weaknesses in senior house officer-patient consultation skills, and evaluate direct observation with feedback and negotiation of educational contracts, as a teaching tool in an emergency department setting. METHOD: Common weaknesses were identified through review of feedback charts by three trained observers. Alteration in clinical and learning behaviour, as well as senior house officer and observer perceptions of the teaching were evaluated qualitatively by a combination of semistructured interviews and focus groups. RESULTS: Several common weaknesses were identified, notably the use of closed questions, and poor negotiation and explanation of treatment plan and follow up. The senior house officers perceived improvement in their clinical practice, welcomed feedback, and subsequently set, though did not complete educational contracts. While comfortable with this style of teaching, the observers felt that it did not make efficient use of teaching time. CONCLUSIONS: This study identifies common weaknesses in the consultation skills of emergency department senior house officers and confirms the need for training in this area. Direct observation is effective in changing behaviour to this end, though self directed learning is not necessarily stimulated. Video recorded consultations with group feedback may be a more effective teaching tool.

Communication↗

PubMed2003

Intervention to reduce intentions to use tobacco among pediatric cancer survivors.

PURPOSE: In this randomized controlled trial, we sought to determine whether a risk counseling intervention would increase knowledge and perceived vulnerability to tobacco-related health risks and decrease future intentions to use tobacco among preadolescents and adolescents previously treated for cancer. PATIENT AND METHODS: Participants included 103 cancer survivors between the ages of 10 and 18 years who were randomly assigned to either a standard care control (SCC) group or a tobacco intervention (TI) group. Patients in the SCC group received standard advice about the risks of tobacco use. Patients in the TI group received more intensive late effects risk counseling in addition to an educational video, goal setting, written physician feedback, smoking literature, and follow-up telephone counseling. The effect of our intervention was assessed by self-reported knowledge, perceived vulnerability, and intentions at baseline, 6, and 12 months. RESULTS: Compared with the SCC group, patients who received our intervention had significantly higher knowledge scores, higher perceived vulnerability scores, and lower intention scores at 12 months. No significant differences between the SCC and TI groups at 6 months, across all measures, were found. CONCLUSION: Pediatric survivors' knowledge, perceived vulnerability to health risks, and intentions to use tobacco can be modified by a risk counseling intervention. The delayed effect of our intervention indicates that these changes may evolve over time. Implications for health care providers who engage in tobacco counseling with young cancer survivors are discussed. Additional longitudinal studies are needed to determine definitive long-term intervention effects on actual tobacco use in this high-risk population.

Adolescent↗

PubMed1996

The effects of breathing pattern training on ventilatory function in patients with COPD.

The purpose of this study was to assess the effects of a particular breathing pattern training (BPT) on forced expiratory volume during the first second (FEV1) and forced vital capacity (FVC) in patients with chronic obstructive pulmonary disease (COPD). The subjects adjusted each breath to a target breath displayed on a video screen, by using visual feedback. This target was chosen in an individual sample recorded at rest. We used a randomized, controlled group design. Twenty patients with stable COPD, FEV1 less than 1.5 liters, undergoing a traditional rehabilitation program were randomly assigned to the BPT group or to the control group. Each BPT subject underwent 30-35 training sessions spread out over four weeks, in addition to the traditional program. FEV1 and FVC were performed before and after this program. ANOVAs showed that FEV1 and FVC significantly improved in BPT subjects, with a mean percent increase of 22% and 19%, respectively. Corresponding changes in controls were not significant. This study showed short-term increases in FEV1 and FVC in COPD patients practicing BPT in addition to respiratory rehabilitation, in comparison with controls. Further studies should incorporate outcome data to clarify the mechanisms and the duration of this effect.

Aged↗

PubMed1998

Changes in motor cortical activity during visuomotor adaptation.

We examined neuronal activity in three motor cortical areas while a rhesus monkey adapted to novel visuomotor transforms. The monkey moved a joystick that controlled a cursor on a video screen. Each trial began with the joystick centered. Next, the cursor appeared in one of eight positions, arranged in a circle around a target stimulus at the center of the screen. To receive reinforcement, the monkey moved the joystick so that the cursor contacted the target continuously for Is. The video monitor provided continuous visual feedback of both cursor and target position. With those elements of the task constant, we modified the transform between joystick movement and that of the cursor at the beginning of a block of trials. Neuronal activity was studied as the monkey adapted to these novel joystick-cursor transforms. Some novel tasks included spatial transforms such as single-axis inversions, asymmetric double-axis inversions and angular deviations (also known as rotations). Other tasks involved changes in the spatiotemporal pattern and magnitude of joystick movement. As the monkey adapted to various visuomotor tasks, 209 task-related neurons (selected for stable background activity) showed significant changes in their task-related activity: 88 neurons in the primary motor cortex (M1), 32 in the supplementary motor cortex (M2), and 89 in the caudal part of the dorsal premotor cortex (PMdc). Slightly more than half of the sample in each area showed significant changes in the magnitude of activity modulation during adaptation, with the number of increases approximately equaling the number of decreases. These data support the prediction that changes in task-related neuronal activity can be observed in M1 during motor adaptation, but fail to support the hypothesis that M1 and PMdc differ in this regard. When viewed in population averages, motor cortex continued to change its activity for at least dozens of trials after performance reached a plateau. This slow, apparently continuing change in the pattern and magnitude of task-related activity may reflect the initial phases of consolidating the motor memory for preparing and executing visuomotor skills.

Adaptation, Physiological↗

PubMed1994

Performance and learning during voluntary control of breath patterns.

Fourteen subjects learned to adjust their breath pattern to two target breaths displayed on a video screen, by using visual feedback, during two sessions 24 h apart. These two targets were respectively the smallest and the largest breaths of a ten-breath sample previously recorded from each subject's resting spontaneous breathing. Performances were significantly better for the large than for the small target breath. This cannot be directly inferred from current knowledge related to the control of movement time and amplitude, but rather it may be inferred from the periodic character of breathing, to the higher mental load during the small breath task, or to the presumably different frequencies of target breaths in the whole span of spontaneous breathing. In the second session, performance on the two targets levelled out as a result of learning.

Adult↗

PubMed2002

Development and evaluation of a computer-assisted learning module on glomerulonephritis for medical students.

An interactive computer-assisted learning (CAL) module on glomerulonephritis, previously identified by fourth-year medical students as a difficult topic, was developed. The module comprised background material, case studies, graphics, animation, video and supporting quizzes with feedback. The impact of the module on student learning was evaluated by comparing the performance of two matched groups of students, only one of which accessed the CAL module, in an online assessment. The analysis examined the effect of having completed a clinical term in renal medicine. A significant improvement in the performance of those students who used the CAL module was demonstrated. Unexpectedly, completing a renal medicine term had no beneficial influence on students' performance. Students who used the CAL module perceived a significant decrease in the difficulty of the topic. It is concluded that the module is an effective learning tool, but important caveats are noted associated with using CAL modules in redesigned medical curricula.

Computer-Assisted Instruction↗

PubMed2005

Relative effectiveness of worker safety and health training methods.

OBJECTIVES: We sought to determine the relative effectiveness of different methods of worker safety and health training aimed at improving safety knowledge and performance and reducing negative outcomes (accidents, illnesses, and injuries). METHODS: Ninety-five quasi-experimental studies (n=20991) were included in the analysis. Three types of intervention methods were distinguished on the basis of learners' participation in the training process: least engaging (lecture, pamphlets, videos), moderately engaging (programmed instruction, feedback interventions), and most engaging (training in behavioral modeling, hands-on training). RESULTS: As training methods became more engaging (i.e., requiring trainees' active participation), workers demonstrated greater knowledge acquisition, and reductions were seen in accidents, illnesses, and injuries. All methods of training produced meaningful behavioral performance improvements. CONCLUSIONS: Training involving behavioral modeling, a substantial amount of practice, and dialogue is generally more effective than other methods of safety and health training. The present findings challenge the current emphasis on more passive computer-based and distance training methods within the public health workforce.

Humans↗

PubMed1996

Voluntary control of breathing pattern in asthmatic children.

15 asthmatic children and 15 healthy children were trained to adjust their breathing pattern to a target pattern displayed on a video screen by using visual feedback. The error scores in the two groups were not significantly different. These data did not support the hypothesis that voluntary control of respiratory muscles is impaired in asthmatics.

Asthma↗

PubMed1993

Using role-plays to teach palliative medicine.

Teaching of communication skills in Palliative Medicine can be achieved using a three hour exercise involving role-plays, a time of feedback and discussion, a teaching video and a reading list. Using this teaching method self-ratings of perceived skills recorded on a questionnaire before and four weeks after the exercises showed a significant increase in both undergraduates and postgraduates. The validity of these self-ratings as a tool to measure communication skills was assessed by correlating the self-ratings with the ratings given by the participant and the observers after the clinical scenarios from the questionnaire were simulated in role-plays.

Communication↗

PubMed2003

The Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study. Aims and results of quality control.

AIM: The results of the Asymptomatic Carotid Atherosclerosis Study (ACAS) study have provided the first scientific evidence that in patients with asymptomatic carotid stenosis greater than 60% carotid endarterectomy reduces the risk of stroke from 2% to 1% per year. The implications are that approximately 20 operations need to be performed in order to prevent 1 stroke in 5 years. The aims of the Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study are to identify a subgroup or subgroups at a risk for stroke higher than 4% and a group at a risk for stroke less than 1% per year using systemic and local risk factors (plaque characterization) in addition to the degree of stenosis. The aim of this paper is to present the protocol and the results of the quality control. METHODS: The ACSRS is a multicentre natural history study of patients with asymptomatic internal carotid diameter stenosis greater than 50% in relation to the bulb. The degree of stenosis is graded using multiple established ultrasonic duplex criteria. In addition, ultrasonic plaque characterization is performed and clinical risk factors and medications are recorded. Training is provided centrally. All carotid ultrasound examinations are recorded on video-tape which together with CT-brain scans and ECG are analysed at the coordinating centre with feedback information to partner centres. RESULTS: The video recordings and analysis of data centrally with feed back information have provided quality control with a significant improvement not only in the completion of data forms but also in the grading of internal carotid stenosis and plaque recordings using ultrasound. CONCLUSION: The high level of quality of data collected will add credibility to the results of the ACSRS study and may eventually promote the development of international standards of plaque imaging and characterization.

Carotid Artery, Internal↗

PubMed2003

Distorted retrospective eyewitness reports as functions of feedback and delay.

Participant-witnesses viewed a crime video and attempted to identify the culprit from a culprit-absent lineup. The 253 mistaken-identification eyewitnesses were randomly given confirming, disconfirming, or no feedback regarding their identifications. Feedback was immediate or delayed 48 hr, and measures were immediate or delayed 48 hr. Confirming, but not disconfirming, feedback led to distortions of eyewitnesses' recalled confidence, amount of attention paid during witnessing, goodness of view, ability to make out facial details, length of time to identification, and other measures related to the witnessing experience. Unexpectedly, neither delaying the measures nor delaying feedback for 48 hr moderated these effects. The results underscore the need for double-blind lineups and neutral assessments of eyewitnesses' certainty and other judgments prior to feedback.

Attention↗