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PubMed1994

Writing disturbances: an indicator for postoperative delirium.

OBJECTIVE: To study the writing ability pre- and postoperatively in patients undergoing major surgery. METHOD: In an open study twenty-four consecutive patients undergoing thoracotomy for pulmonary malignancy were monitored for postoperative delirium throughout their stay in the hospital. The writing ability was tested on a preoperative day and on the third day after the operation. Main outcome measures were delirium according to the DSM-III-R criteria and writing ability assessed on items such as reluctance to write and motor-, spatial-, syntactical- and spelling disorders. RESULTS: Five patients (21%) developed delirium according to the DSM-III-R criteria. The writing of all patients with delirium was severely impaired with features like reluctance to write, motor disability and spatial disturbances. No patient without delirium developed these disturbances. CONCLUSIONS: These results suggest that testing of writing ability may be useful in the diagnosis of delirium. The Delirium Writing Test is proposed as a diagnostic tool.

Adult↗

PubMed1984

Use of three writing tasks at an adolescent treatment center.

Adolescent residents placed in a state youth facility for crimes, misdemeanors, and anti-social behavior were presented with three writing modes during their language arts instruction. The modes required that they write a composition based on viewing a slide arrangement (Visual Composition), on imagery generated while the teacher provided sensual impressions (Imagery Composition), and on embellishing and rearranging a list of sentence fragments (Report Writing). The mean of a composition holistically scored prior to the writing treatment was significantly lower than the means of Report, Imagery, and Visual Composition writing for 14 subjects present for all writing tasks. While no significant differences emerged among the writing modes the percent gain over baseline was highest for Visual Composition (50%), a technique in which no printed language cues were available to the writer. Perhaps for problem adolescents with low literacy skills, direct emphasis on traditional and non-traditional, nonverbal approaches to composition may increase writing proficiency.

Adolescent↗

PubMed1991

Mentoring students in writing: "gourmet express" versus "fast food service".

Is writing a process or a product? To be an effective and an efficient mentor in the writing process, the answer must be "Both!" The final written manuscript is important, but the process by which the student learns to produce that manuscript is equally important. A graduate student recently remarked to one of the authors: "How did you learn to write? I don't remember anyone ever talking to me before about how to write. Professors seem to feel I should already know how." When writing is thought of as a cognitive process, rather than a static product, the benefits to be gained from coaching this process become evident. Many students are hungry for information about becoming better writers. Too often we offer them the "fast food service" approach, concentrating on the appearance of the final product, rather than the potential benefits to be gained in the preparation of the product. It is by mentoring students in both the process and product aspects of writing that nurse educators can realize the satisfaction of moving away from "fast food service" and investing their energies in the "gourmet express" approach, where the emphasis is not only on helping students learn to write, but also helping them use writing to learn.

Humans↗

PubMed1999

A curriculum self-study of writing assignments and reflective practice in nursing education.

Reflective practice is an ongoing process of purposeful thinking about one's clinical practice to develop understanding, insight, and clinical judgment. It can be enhanced through careful use of writing assignments that require reflection, evaluation, and thoughtful analysis. The uses of writing assignments in the undergraduate nursing programs at a midwestern college of nursing were studied over a 2-year period, using survey methodology. A purposive sample of all faculty who taught in baccalaureate or associate of science (ASN) programs (n=21) completed a questionnaire and were interviewed about the number and purpose of writing assignments in courses they taught. Quantification of the results in tabular form allowed the faculty to look at all writing assignments required of students across both programs with regard to the number, length, and nature of those assignments. Results were then recategorized by type of assignments, changes needed, and faculty assessment of the usefulness of these writing assignments. The summary of written assignments was then cross-referenced according to program, semester, and program level. This produced a working document that illustrated the quantity and type of writing assignments that each student, in each program, at a given level and semester must complete. Information was used by faculty teaching across courses to make changes that more effectively linked course writing assignments by association, themes, concepts, or areas of study. This process enables faculty to collaboratively develop writing assignments that facilitate the adult student's linking and associating concepts across courses, as a true exercise in critical thinking.

Adult↗

PubMedDate not supplied

The magic of writing.

The work of our daily lives leaves little time for the "accomplishment and recreation" of writing. Yet, writing accomplishes a vital service by connecting people with the world around them. It is possible to experience the joy of writing by developing some mastery of it. All writing begins with an idea; always consider that the problems you tackle today may be worth writing about tomorrow. You must collect research if you are to flesh out your ideas and get them onto paper. You will also need writing implements, a tape recorder and language references. When building an article, it helps to have an outline. You need to block off time devoted only to writing and set a deadline. A first draft is for getting ideas down on paper, and revisions are done to refine the presentation. Work on properly organizing and editing your material. Good word and sentence rhythm, carefully drawn word pictures, the use of pronouns to develop reader identification and buy-in and compelling leads and conclusions are some ways to make your writing more interesting.

Creativity↗

PubMed2002

[Writing Kanji without semantics in a case with probable Alzheimer's disease].

We examined a patient (NM) with probable Alzheimer's disease who showed phonologically plausible errors in kanji (logogram) writing. In semantic tasks, she showed no deficits in pointing or naming but had difficulty in more complex tasks such as proverb comprehension. In reading aloud of kanji words, she could read most kanji words correctly and showed little phonologically plausible reading errors. She performed poorly in lexical decision and on-reading of one-letter kanji (Sino-Japanese pronunciation derived from the Chinese language at the time of borrowing). Writing to dictation demonstrated no mistakes in kana letters and words, but many errors in kanji, which were phonologically equivalent but semantically inappropriate. To explore the relationship between the writing errors in kanji words and comprehension of the word meanings, we selected 33 words that she made phonologically plausible writing errors. We gave her the following five tasks using these words; 1) to ask meanings of the words, 2) to dictate the words, 3) to dictate sentences including these words, 4) to discriminate appropriate target words from distracters including her own erroneous responses, and 5) to write these words again. She showed no consistent errors in these tasks. In some occasions, she could write correct kanji words without understanding word meanings. She also showed phonologically plausible writing errors in spite of describing correct word meanings. In Japanese, word meaning deficits like Gogi aphasia were thought to cause phonologically plausible writing errors. As the impairments of word meanings in NM are comparatively mild, the underpinning of her kanji agraphias might be different from that of phonologically plausible errors in Gogi aphasia. It would be suggested that she frequently wrote phonologically equivalent errors because of her lexical deficits in spite that her phonological processing was preserved. Furthermore, she would not necessarily use the semantics (word meanings) of kanji words during dictation.

Aged↗

PubMed1990

Editor as educator: structuring services to develop faculty writing skills.

Academic health scientists rely heavily on writing to advance their understanding of research results and to disseminate those results to peers. Faculty's need to write well led our Department of Educational Resources to move its editorial support from its Printing Services division in 1987. At that time Instructional Development created a writing development service, distinct from copyediting, to assist faculty in learning to assess and improve their own writing. Beginning with one-to-one consultation, the developmental service has broadened to include workshops on writing for publication and interdisciplinary writing feedback groups. Under this developmental approach to editing, faculty have achieved publication success and shown positive attitudes toward writing, revising, and receiving feedback on their writing from peers. The approach holds promise both for health science faculty and for their students.

Education, Medical, Continuing↗

PubMed1994

Long-term experience with a program to improve prescription-writing skills.

BACKGROUND: Prescription-writing skills are often overlooked in resident education. The present study evaluates a method of improving prescription-writing skills over a 2-year period. METHODS: This was a prospective, nonblinded, nonrandomized trial of an educational method to improve prescription-writing abilities of a class of 12 family practice residents. The intervention included evaluation and feedback of prescription writing by a clinical pharmacist using copies of prescriptions written over a 2-year period and applying previously defined criteria for determining prescription-writing errors. RESULTS: The baseline prescription-writing error rate was 14.4%. Over the 2-year intervention, prescription-writing errors by all residents decreased to 6.0% (P = .0002). Error rates decreased 58% from the baseline during the last 6 months of the intervention (P = .001). CONCLUSIONS: Continuous evaluation and feedback improved prescription-writing skills and improved communication with pharmacists and patients.

Drug Prescriptions↗

PubMed1997

[Jargon agraphia in a case with Broca aphasia: dissociation between language and writing dominancy].

A 69-year-old left-handed man developed Broca aphasia and jargon agraphia following a right cerebral infarction. He learned to write with his right hand. There is no family history of left-handedness. Neurological examination revealed hemiparesis, sensory impairment, and hyperreflexia with pathological reflexes on the left side. An MRI demonstrated lesions in the area including the pre- and post-central gyri, the posterior part of the middle and inferior frontal gyri, and inferior parietal lobule on the right side. Neuropsychologically he was alert and cooperative. He demonstrated severe Broca aphasia and his verbal output was limited to a few residual words. On the other hand, he could communicate through writing Kanji words. Writing words was relatively preserved with Kanji but not with Kana characters. Asked to write a Japanese folk tale, he showed jargon agraphia mixed with some correct Kanji words. His comprehension of spoken and written sentences was well preserved. He showed mild ideomotor and buccofacial apraxia, left unilateral spatial neglect, and constructional impairment. Dissociation between spoken and written language is a prominent feature of this patient's language output. In this patient, right hemisphere seems to be dominant for language and praxis, and left hemisphere for motor engram of writing. Learning to write with the right hand may have enhanced the establishment and maintenance of motor engram for writing in the left hemisphere. The intact motor engram of characters in the left hemisphere could be retrieved by the right hand without control from the language area in the diseased right hemisphere, resulting in jargon agraphia especially with Kana characters. In left handed people, the hand with which they learn to write may effect interhemisphere lateralization of language functions.

Aged↗

PubMed2001

A functional MRI study on the neural substrates for writing.

Functional neuroanatomy of writing is relatively unknown compared to that of other linguistic processes. This study aimed at identifying brain regions crucial to the process of writing. Using functional magnetic resonance imaging (fMRI), brain hemodynamic activity was examined during three conditions that differentially engaged visual, linguistic, and/or motor functions: (1) writing names of pictures with the right index finger, (2) naming pictures silently, and (3) visually cued finger tapping. A writing minus naming comparison and a writing minus tapping comparison were performed, and brain regions commonly activated in these two contrasts were detected. Our main finding was that such common activation was observed in the anterior part of the left superior parietal lobule, the posterior part of the middle and superior frontal gyri, and the right cerebellum. The parietal and frontal regions were considered to subserve the process of writing as separated from that of naming and finger movements, which is consistent with the classical notion mainly proposed by studies of selective writing deficits called pure agraphia. The right cerebellar activation, on the other hand, was interpreted as the reflection of the execution of complex finger movements required for writing.

Adult↗

PubMed2005

Psychometric characteristics of a write-up assessment form in a medicine core clerkship.

BACKGROUND: Case write ups are ubiquitous in medicine clerkships, yet few studies have examined how they are assessed. PURPOSE: To examine the feasibility, reliability, and validity of scores on a new write-up assessment form. METHODS: In 2002, medicine core clerkship students (n = 165) submitted 3 patient write ups (n = 493). Each was graded using a 14-item form and given a Global Write-Up Assessment. Final Global Write-Up grades were correlated to National Board of Medical Examiners medicine subject exam scores and multiple clerkship ratings. RESULTS: For most items on the form, the full 4-point rating range was used. The reproducibility coefficient was .67 (SE = .12). Final Global Write-Up grades were correlated with exam scores (r = .35, p < .05) and inpatient (r = .28, p < .05) and outpatient (r = .16, p < .05) course grades. CONCLUSIONS: The write-up assessment form, as used in a design with multiple write ups and raters, provides relatively precise estimates of performance and can be used to assess written documentation skills.

Clinical Clerkship↗

PubMed1998

Mirror writing in the elderly.

OBJECTIVE: To determine if examination of mirror writing in the elderly could be used to assess the degradation of the brain function. METHODS: The occurrence of mirror writing in 146 subjects was examined. Among them, 104 were males and 42 females. All subjects were university graduates. Age ranged from 40 to 85 years with an average of 62.7 +/- 13.4. These subjects were divided into two groups, a non-elderly group consisting of 60 subjects (41.1%) and an elderly group 86 subjects (58.9%). All 146 subjects were examined with 10 items for determination of handedness, mini-mental state examination and the written language of Chinese Aphasia Examination Scale (Draft) including spontaneous writing, writing from dictation and copying. The above mentioned performances of written language were done by left and right hand. RESULTS: The results of examination revealed that in 146 subjects there were 7 subjects with mirror writing, which occurred only in the elderly group, accounting for 8.1%. In the elderly group, mirror writing was found in one subject of 70-79 years group and 6 subjects of age over 80 years. Mirror writing appeared in the elderly was of mild degree with an average percentage of 1.9 +/- 0.4. CONCLUSION: It is suggested that examination of mirror writing in the elderly may be used to assess the degradation of the brain function in senile subjects.

Adult↗

PubMed2004

[Writing and drawing impairment in patients with brain damage of various etiologies].

The evolutional relationship between writing and drawing functions, and partial overlapping their brain centers stimulated to investigate of writing and drawing errors of brain damaged patients. THE PURPOSE: of the work was elaboration of estimation criteria of writing and drawing errors of the patients, and indication of important likeness and differences between them. THE MATERIAL AND METHODS: 40 patients with brain damage of various etiology was examined by means of the writing/drawing scale consisted of 14 tasks. The quantitative and qualitative errors investigation was performed. RESULTS: The significant writing errors committed 17 persons, drawing errors--25 persons. 14 errors types were referred to writing, 15 to drawing, and 6 to writing and drawing together. The correlation between quantitative estimations of errors was moderate, and between qualitative estimations of errors was high. CONCLUSIONS: The significant writing errors committed 42.5% patients, drawing errors--62.5% patients. The differences between writing and drawing manifested by dissimilarities of majority of errors, the likeness--by 6 types common errors, and high correlation of results.

Adult↗

PubMedDate not supplied

Journal writing as a teaching technique to promote reflection.

OBJECTIVE: To introduce the process of journal writing to promote reflection and discuss the techniques and strategies to implement journal writing in an athletic training education curriculum. BACKGROUND: Journal writing can facilitate reflection and allow students to express feelings regarding their educational experiences. The format of this writing can vary depending on the students' needs and the instructor's goals. DESCRIPTION: Aspects of journal writing assignments are discussed, including different points to take into account before assigning the journals. Lastly, various factors to contemplate are presented when providing feedback to the students regarding their written entries. CLINICAL ADVANTAGES: Journal writing assignments can benefit students by enhancing reflection, facilitating critical thought, expressing feelings, and writing focused arguments. Journal writing can be adapted into a student's clinical course to assist with bridging the gap between classroom and clinical knowledge. In addition, journals can assist athletic training students with exploring different options for handling daily experiences.

Journal Article↗

PubMed1975

[Micromotor recording of writing pressure during intracerevral stimulation at stereotactic operations (author's transl)].

Eight cases of spastic torticollis were examined during the course of stereotactic operations with the writing pressure apparatus of Steinwachs while the ventrolateral thalamus was stimulated. When 50 stimuli per sec are given, the significant changes of motor function in writing are the following: slowing of writing speed, an increase in writing pressure, greater changes of pressure amplitude with tendences to parallel course. With 25 stimuli per sec, simular results may appear, but smaller amplitude changes and lowering of writing pressure may also occur. When 8 stimuli per sec are given, no changes of pressure patterns in writing were found. Three typical cases are described. It is concluded that the recording of fine pressure changes in writing may indicate alterations of cerebral motor regulations although specific changes for certain thalamic stimulus locations were lacking.

Adult↗

PubMed2006

The effects of expressive writing on adjustment to HIV.

Previous research suggests that writing about stressful experiences results in better health and psychological well-being. In the present study, a multi-ethnic sample of 79 HIV-positive women and men participated in a structured interview, and wrote about either their deepest thoughts and feelings about living with HIV (expressive writing) or their activities in the last 24 hr (control). Sixty-two participants returned for the 2-month follow-up and 50 returned for the 6-month follow-up interview. Oral fluid samples of beta2-microglobulin were taken at the baseline and follow-up assessments to examine the immunological effects of writing. No effects of writing condition were found, but expressive writing participants who included increasing insight/causation and social words in their writing had better immune function and reported more positive changes at follow-up. Results suggest that cognitive processing and changes in social interactions may be critical to the benefits of writing.

Adult↗

PubMed2006

Words and wards: a model of reflective writing and its uses in medical education.

Personal, creative writing as a process for reflection on patient care and socialization into medicine ("reflective writing") has important potential uses in educating medical students and residents. Based on the authors' experiences with a range of writing activities in academic medical settings, this article sets forth a conceptual model for considering the processes and effects of such writing. The first phase (writing) is individual and solitary, consisting of personal reflection and creation. Here, introspection and imagination guide learners from loss of certainty to reclaiming a personal voice; identifying the patient's voice; acknowledging simultaneously valid yet often conflicting perspectives; and recognizing and responding to the range of emotions triggered in patient care. The next phase (small-group reading and discussion) is public and communal, where sharing one's writing results in acknowledging vulnerability, risk-taking, and self-disclosure. Listening to others' writing becomes an exercise in mindfulness and presence, including witnessing suffering and confusion experienced by others. Specific pedagogical goals in three arenas-professional development, patient care and practitioner well-being - are linked to the writing/reading/listening process. The intent of presenting this model is to help frame future intellectual inquiry and investigation into this innovative pedagogical modality.

Affect↗

PubMed2004

Reading and writing skills in young adults with spina bifida and hydrocephalus.

Reading and writing were studied in 31 young adults with spina bifida and hydrocephalus (SBH). Like children with this condition, young adults with SBH had better word decoding than reading comprehension, and, compared to population means, had lower scores on a test of writing fluency. Reading comprehension was predicted by word decoding and listening comprehension. Writing was predicted by fine motor finger function, verbal intelligence, and short-term and working memory. These findings are consistent with cognitive models of reading and writing. Writing, but not reading, was related to highest level of education achieved and writing fluency predicted several aspects of functional independence. Reading comprehension and writing remain deficient in adults with SBH and have consequences for educational attainments and functional independence.

Adolescent↗