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PubMed2026

Distal versus proximal radial access for diagnostic cerebral angiography: comparative outcomes and learning curve analysis.

BACKGROUND AND PURPOSE: Distal transradial access (dTRA) is an alternative to proximal transradial access (pTRA) for neuroangiography, but comparative real-world data and evidence on its early learning curve remain limited. We compared procedural performance and access-site complications between dTRA and pTRA and evaluated the early learning curve of dTRA. METHODS: We retrospectively analyzed 470 diagnostic cerebral angiography procedures, representing 421 unique patients, performed via radial access at a single center between January 2025 and February 2026, including 237 dTRA and 233 pTRA procedures. Baseline characteristics, including age, sex, body mass index (BMI) category, aortic arch type, and antiplatelet/anticoagulant use, procedural performance, and clinically assessed access-site events were compared between groups. Radial artery occlusion (RAO) was assessed by postoperative bedside pulse examination and confirmed with Doppler ultrasound when clinical findings were uncertain. Multivariable logistic regression was used to evaluate predictors of RAO, persistent bleeding or repeated compression, hand edema, and a composite access-site event endpoint. Because repeated procedures occurred in a subset of patients and event counts were limited, first-procedure sensitivity analysis and analyses of infrequent outcomes were interpreted cautiously. The dTRA learning process was assessed in the first 100 dTRA cases performed by a single operator using multivariable regression, cumulative sum (CUSUM) analysis, segmented trend analysis, and phase-based comparisons. RESULTS: Baseline characteristics were comparable between groups, including age, male sex, BMI category, aortic arch type, and antiplatelet/anticoagulant use. Compared with pTRA, dTRA was associated with more puncture attempts (3.0 [2.0-4.0] vs 2.0 [1.0-3.0], P&#xa0;<&#xa0;0.001), longer puncture time (2.0 [1.0-5.0] vs 2.0 [1.0-3.0] min, P&#xa0;=&#xa0;0.003), lower first-pass success (19.4% vs 35.2%, P&#xa0;<&#xa0;0.001), and a higher crossover rate (11.4% vs 6.0%, P&#xa0;=&#xa0;0.037). However, dTRA was associated with a lower clinically assessed RAO rate (2.5% vs 7.7%, P&#xa0;=&#xa0;0.011). On multivariable analysis, pTRA was independently associated with higher odds of RAO (OR 3.27, 95% CI 1.26-8.49, P&#xa0;=&#xa0;0.015) and the composite access-site event endpoint (OR 3.12, 95% CI 1.55-6.28, P&#xa0;=&#xa0;0.001). Similar findings were observed in a sensitivity analysis restricted to the first procedure per patient. In the first 100 dTRA cases, cumulative dTRA experience was independently associated with shorter total procedure time (beta&#xa0;=&#xa0;-0.074&#xa0;min/case, P&#xa0;=&#xa0;0.009), while CUSUM and moving-average analyses suggested that the major learning effect occurred within approximately the first 10-15 cases. CONCLUSIONS: In this retrospective single-operator cohort, dTRA was associated with lower clinically assessed RAO than pTRA despite greater access difficulty. The early learning effect was mainly reflected in shorter total procedure time. These findings support the feasibility of dTRA but should be interpreted cautiously given the study's observational design and limited anatomical data.

Humans↗
PubMedDate not supplied

Distance education outcomes in clinical laboratory science.

OBJECTIVE: To compare 2 types of delivery methods for clinical laboratory science students-the technology-driven method at distance sites versus the on-site method on campus-in terms of learning outcomes. DESIGN: The independent variable in this quasi-experimental study was the delivery method consisting of interactive videoteleconferencing and on-site classroom methods. The dependent variables were learning outcomes that were determined by 2 methods: the average score on 8 posttests scheduled at periodic intervals and a national certification examination score. SETTING: Clinical laboratory science (CLS) education program at the University of Nebraska Medical Center in Omaha and at 6 clinical sites in other cities across Nebraska. PARTICIPANTS: 40 senior CLS students enrolled in a baccalaureate degree program. Control group participants were assigned to 2 clinical sites in the Omaha area, and the experimental group were assigned to 6 distant clinical sites. MAIN OUTCOME MEASURES: Data analysis consisted of descriptive statistics, 2-way analysis of variance (ANOVA), 2-way analysis of covariance (ANCOVA), repeated measures analysis of variance, and Hotellings T2. RESULTS: Results showed no significant difference between the students' examination scores based on delivery method (p > 0.05), except in the chemistry topic area. There was no significant difference in the pattern of the examination scores over the semester of learners who were instructed by interactive videoteleconferencing methods and learners who were instructed by on-site classroom methods. CONCLUSION: Results of the study generally support the use of interactive videoteleconferencing as an effective, alternative delivery method for CLS students who cannot attend class on campus. Analysis by topic areas suggests that additional studies are needed to validate the variance found in the chemistry subject area.

Adult↗
PubMed1993

The epidemiology of disasters and adverse reproductive outcomes: lessons learned.

A disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally. Little is known about the adverse effects of natural disasters on reproductive outcomes. Important lessons can be derived from several disasters caused by human factors, such as the Minamata Bay disaster. Adverse reproductive outcomes include infertility, early pregnancy loss, stillbirths, congenital malformations, and serious developmental disabilities such as cerebral palsy and mental retardation. Recent disasters like the Chernobyl and Bhopal explosions have provided important lessons on the need for accurate and sound information about the risk of prenatal exposures for adverse reproductive outcomes. To study questions of adverse reproductive outcomes and disasters requires a well-planned approach. It should include early development of surveillance for adverse reproductive outcomes, analytic studies on the risk of disasters from direct and indirect effects, sensitive methods to measure early pregnancy loss, and long-term follow-up programs to assess outcomes such as developmental disabilities.

Animals↗
PubMed2005

The learning environment for junior doctor training--what hinders, what helps.

As part of a larger study on learning outcomes for the first year of postgraduate medical training (already reported), semi-structured interviews with middle grade trainees were used to explore their perceptions of trainee development during this first training year. Data generated focused not only on learning outcomes, but also on important process issues. Dissatisfaction was expressed with formal and informal teaching and learning opportunities. Factors that enhance the learning environment were identified. These included being supported, a feeling of being a valued member of the team, being stretched but not over stretched, having a broad range of experiences, knowing the system, having a clear remit and being well organized. Factors inhibiting the learning environment included fractured working patterns, insufficient time with patients and seniors, as well as the converse of many of the enhancing factors. The process issues gathered in this paper will be of interest to those involved in the delivery of training for junior doctors.

Attitude of Health Personnel↗
PubMed2001

An evaluation of a standards based portfolio.

In undergraduate and postgraduate nursing studies, the essay type assignment is commonly used to assess student learning. The literature suggests that of the alternatives for the assessment of learning, the use of portfolios may be an effective tool. A portfolio is generally conceptualized as a collection of the students best work or a collection of work that evidences incremental development. For a particular unit of learning, 'Nursing Business', second year undergraduate students in the Bachelor of Nursing programme were required to complete a portfolio. The assessment directed the students to meet specific criteria which in turn reflected the learning outcomes. Therefore the portfolio in this study is more appropriately described as a standards based portfolio (SBP). A SBP is a series of student work that seeks to address pre-determined learning outcomes. This study is an evaluation of student perceptions of a SPB and of interest to the study was the relationship between theory and practice, the availability of resources to complete the assignment and the contribution the portfolio made to the process of learning.

Attitude↗
PubMed2001

An evaluation of a standards based portfolio.

In undergraduate and postgraduate nursing studies, the essay type assignment is commonly used to assess student learning. The literature suggests that of the alternatives for the assessment of learning, the use of portfolios may be an effective tool. A portfolio is generally conceptualized as a collection of the students best work or a collection of work that evidences incremental development. For a particular unit of learning, 'Nursing Business', second year undergraduate students in the Bachelor of Nursing programme were required to complete a portfolio. The assessment directed the students to meet specific criteria which in turn reflected the learning outcomes. Therefore the portfolio in this study is more appropriately described as a standards based portfolio (SBP). A SBP is a series of student work that seeks to address pre-determined learning outcomes. This study is an evaluation of student perceptions of a SPB and of interest to the study was the relationship between theory and practice, the availability of resources to complete the assignment and the contribution the portfolio made to the process of learning.

Attitude↗
PubMed1999

Preparing adult branch students for their management role as staff nurses: an action research project.

AIM: This action research project aimed to investigate students', newly qualified staff nurses' and ward managers' views about the management skills and knowledge required by staff nurses, and how best students could be prepared for their management role. BACKGROUND: The importance of the staff nurse's management role is increasingly being recognized but the literature highlights the difficulties in preparing students for management, and personal experience confirmed this. METHODS: Focus group interviews were held with senior students and newly qualified staff nurses. A questionnaire was then developed which was completed by 23 ward managers. FINDINGS: A good insight into the management skills and knowledge expected of newly qualified staff nurses, and useful ideas about preparation for the role emerged. An extra 2 weeks in practice, supernumerary and with specific management learning outcomes, was implemented and evaluated well. CONCLUSIONS: Preparation of students for their management role as staff nurses benefits from being closely linked to practical experience, with clear learning outcomes and supportive clinical staff. Using an action research approach to investigate the problem and develop a strategy was found to be an appropriate methodology.

Adult↗
PubMed2006

Copying actions and copying outcomes: social learning through the second year.

The present work documents how the logic of a model's demonstration and the communicative cues that the model provides interact with age to influence how children engage in social learning. Children at ages 12, 18, and 24 months (n=204) watched a model open a series of boxes. Twelve-month-old subjects only copied the specific actions of the model when they were given a logical reason to do so--otherwise, they focused on reproducing the outcome of the demonstrated actions. Eighteen-month-old subjects focused on copying the outcome when the model was aloof. When the model acted socially, the subjects were as likely to focus on copying actions as outcomes, irrespective of the apparent logic of the model's behavior. Finally, 24-month-old subjects predominantly focused on copying the model's specific actions. However, they were less likely to produce the modeled outcome when the model acted non-socially.

Female↗
PubMed2003

Poultry production: a model for developing interactive Internet-based distance education.

Over the last several decades, many poultry science programs have merged with other departments, but the poultry industry has undergone tremendous expansion worldwide, leading to a growing instructional void with regard to poultry production information. The objective of this project was to address the demand for information by developing two Web-based poultry production courses that cover management of broilers, turkeys, breeders, and layers. The Internet was chosen as the platform because it is asynchronous and may be accessed from any connected site around the world. To be effective, web-based courseware must be theoretically grounded and interactive, but university-level web-based distance education courses often fail to meet these standards. During courseware development, the impact of instructional techniques and technologies on interactivity and learning outcomes was explored. A content expert, an instructional designer, and a graphic artist carefully reviewed a variety of instructional techniques to increase interactivity. Concept mapping was chosen because it has been shown to be a superior learning tool for enhancing the exchange of ideas and knowledge between instructors, students, and content. A unique instructional interface was established that includes threaded e-mail discussion, thought questions, animation, hypertext, rollover interactions, video clips, and concept mapping exercises. Results indicate that the integration of concept mapping into web-based learning environments successfully increased interactivity and learning outcomes.

Animal Husbandry↗
PubMed2000

Cortical ensemble activity increasingly predicts behaviour outcomes during learning of a motor task.

When an animal learns to make movements in response to different stimuli, changes in activity in the motor cortex seem to accompany and underlie this learning. The precise nature of modifications in cortical motor areas during the initial stages of motor learning, however, is largely unknown. Here we address this issue by chronically recording from neuronal ensembles located in the rat motor cortex, throughout the period required for rats to learn a reaction-time task. Motor learning was demonstrated by a decrease in the variance of the rats' reaction times and an increase in the time the animals were able to wait for a trigger stimulus. These behavioural changes were correlated with a significant increase in our ability to predict the correct or incorrect outcome of single trials based on three measures of neuronal ensemble activity: average firing rate, temporal patterns of firing, and correlated firing. This increase in prediction indicates that an association between sensory cues and movement emerged in the motor cortex as the task was learned. Such modifications in cortical ensemble activity may be critical for the initial learning of motor tasks.

Analysis of Variance↗
PubMed2001

The multiple sclerosis nurse as patient educator.

Patient education is an important part of neuroscience nursing. New treatments, such as beta interferon self-injections, have challenged nurses. The purpose of this study was to analyze the patient education given by 35 Finnish nurses who work with patients who have multiple sclerosis. The content and didactic solutions of patient education, evaluation of patients' learning skills, and learning outcomes were analyzed. Also, successful and unsuccessful patient education experiences are described. The results showed that patient teaching is based on individual and unstructured approaches. The role of the patient is important, and there is need for more systematic evaluation of learning outcomes. Results from teaching of beta interferon self-injections are similar. In general, more systematic research in this area is required.

Adult↗
PubMed2005

Computer-mediated instructional video: a randomised controlled trial comparing a sequential and a segmented instructional video in surgical hand wash.

BACKGROUND: Video-based instructions for clinical procedures have been used frequently during the preceding decades. AIM: To investigate in a randomised controlled trial the learning effectiveness of fragmented videos vs. the complete sequential video and to analyse the attitudes of the user towards video as a learning aid. MATERIALS AND METHODS: An instructional video on surgical hand wash was produced. The video was available in two different forms in two separate web pages: one as a sequential video and one fragmented into eight short clips. Twenty-eight dental students in the second semester were randomised into an experimental (n = 15) and a control group (n = 13). The experimental group used the fragmented form of the video and the control group watched the complete one. The use of the videos was logged and the students were video taped whilst undertaking a test hand wash. The videos were analysed systematically and blindly by two independent clinicians. The students also performed a written test concerning learning outcome from the videos as well as they answered an attitude questionnaire. RESULTS: The students in the experimental group watched the video significantly longer than the control group. There were no significant differences between the groups with regard to the ratings and scores when performing the hand wash. The experimental group had significantly better results in the written test compared with those of the control group. There was no significant difference between the groups with regard to attitudes towards the use of video for learning, as measured by the Visual Analogue Scales. Most students in both groups expressed satisfaction with the use of video for learning. CONCLUSION: The students demonstrated positive attitudes and acceptable learning outcome from viewing CAL videos as a part of their pre-clinical training. Videos that are part of computer-based learning settings would ideally be presented to the students both as a segmented and as a whole video to give the students the option to choose the form of video which suits the individual student's learning style.

Attitude of Health Personnel↗
PubMed2004

Education in pharmacoeconomics: an international multidisciplinary view.

There is a global need for more training in pharmacoeconomics. Pharmacoeconomics is a relatively new discipline that draws from other more established disciplines; hence, multidisciplinary collaboration is recommended. Descriptions of opportunities for pharmacoeconomics education can be found in the literature and on websites, but research on the trends in pharmacoeconomics education is largely limited to training in US pharmacy schools. Although basic pharmacoeconomics concepts and methods can be standardised for different countries and cultures, specific applications and examples will differ by region. There are also different levels of educational need (awareness, application, conceptualisation) and different methods of receiving pharmacoeconomics education (short courses, internships, fellowships, graduate degrees). In order to assess educational goals, some educational programmes have moved toward the concept of developing and measuring 'learning outcomes', defined as the knowledge, skills and attitudes needed to fulfil the societal roles expected of the learner. This method can improve the standardisation of the educational process; however, there is still much work to be done in order to achieve real consensus on 'learning outcomes' in pharmacoeconomics.

Clinical Competence↗
PubMed2000

The maintenance of cooperative and helping behaviours in cooperative groups.

BACKGROUND: This study was a full-year investigation of whether children, who had previously been trained to cooperate and help each other, were able to use these behaviours in reconstituted groups without additional training one year later. AIMS: (i) To examine whether children who have previously been trained to cooperate demonstrate more cooperative and helping behaviours in their groups than children who had no been trained and (ii) to determine the effect of prior training on children's learning. SAMPLE: The study involved 144 Grade 2 children (mean age = 94.5 months; third year of schooling), from nine schools in a similar socio-demographic area of Brisbane, Australia. Sixty-four children, who had been trained in cooperative group behaviours in the previous year, were assigned to the Trained groups and 80 children, who had not received any training, were assigned to the Untrained groups. METHOD: The children worked in four-person, mixed-ability (high-, medium-, and low-ability), gender-balanced groups (2 males, 2 females) for one six-week social studies unit of work each term for three school terms. Videotaping occurred in the 5-6 week of each work unit. Videotapes were coded for behaviour and verbal interactions. Learning outcomes data were also collected. RESULTS: The children in the trained groups exhibited more cooperative behaviour and they provided more explanations, both in response to explicit and implicit requests for help across the three periods of time. The children in the trained groups used higher level cognitive strategies such as providing specific concrete facts and reasons in their interactions and they also obtained higher scores on the learning outcomes questionnaire than their untrained peers. CONCLUSION: Young children who have been trained to cooperate and help each other are able to demonstrate these behaviours in reconstituted groups without additional training a year later.

Child↗
PubMed2005

Perceptions of dissection by students in one medical school: beyond learning about anatomy. A qualitative study.

INTRODUCTION: The practice of dissection, as part of undergraduate medical education, has recently resurfaced in the public eye. This paper focuses on a number of important learning outcomes that were reported by Year 1-5 medical students in a British medical school, during the dissection sessions in the first 2 years of their training, as part of a wider qualitative research project into undergraduate medical education. METHODS: A group of 29 students was selected by quota sampling, using the whole student population of the medical school as the sampling frame. Qualitative data were collected by 1 : 1 interviews with students and from formal non-participatory observations of dissection sessions. RESULTS: Apart from learning to cope with the overt 'emotional confrontation' with the cadavers which assists anatomical learning, 7 additional covert learning outcomes were identified by the students: teamwork, respect for the body, familiarisation of the body, application of practical skills, integration of theory and practice, preparation for clinical work, and appreciation of the status of dissection within the history of medicine. DISCUSSION: A number of medical schools have either removed the practical, hands-on aspect of dissection in the medical undergraduate curriculum or are seriously considering such a measure, on financial and/or human resource grounds. This study highlights the fact that dissection can impart anatomical knowledge as well as offer other relevant, positive learning opportunities to enhance the skills and attitudes of future doctors.

Adult↗
PubMed2005

Enhancing teamwork among allied health students: evaluation of an interprofessional workshop.

This report outlines the teamwork learning outcomes of an interprofessional workshop conducted with a cohort of 81 graduate-entry students of occupational therapy, physiotherapy, speech pathology, and audiology. This four-hour workshop was based around a case scenario of a child with developmental coordination disorder. This report describes and evaluates the development of knowledge and skills of teamwork that were facilitated through this workshop. Students completed questionnaires before and after the workshop about their knowledge of teamwork, requisites for working together, the utility of the workshop, and learning outcomes. The evaluation indicated that the workshop was successful from the students' perspectives in confirming the importance of teamwork and the processes of communication and collaborative goal setting. Students refined their own professional roles and developed an appreciation of the contribution of other professions and parents. This recognition of the comparative value of different professional contributions in providing holistic patient care is one of the starting points for education about interprofessional teamwork.

Allied Health Personnel↗