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PubMed2003

HIV/AIDS in the visual arts: applying discipline-based art education (DBAE) to medical humanities.

CONTEXT AND RATIONALE: Health professions educators have been systematically attempting to insert the humanities into health professions curricula for over 4 decades, with various degrees of success. Among the several medical humanities, the visual arts seem particularly adequate for the teaching/learning of crucial aspects of medicine. Educational efforts in the arts require, however, a sound pedagogical philosophy of art education. Health professions educators need therefore to be aware of educational frameworks in the arts. Discipline-based art education (DBAE) is a recognised contemporary educational framework for the teaching/learning of the arts, which may be adapted to medical humanities. OBJECTIVE: It is the ultimate objective of this essay to share the experience of applying this educational framework to a course in a medical curriculum. METHODS: The author describes a course on the representations of HIV/AIDS in the visual arts, with explicit reference to its objectives, content, instructional features and student assessment in the light of DBAE, whose principles and characteristics are described in detail. RESULTS AND CONCLUSION: Discipline-based art education may be applied to medical humanities courses in a medical curriculum. This essay throws light on how this structure may be particularly useful for designing other pedagogically sound art courses in health professions curricula.

Attitude to Health↗
PubMed1982

Selective networks capable of representative transformations, limited generalizations, and associative memory.

Two parallel sets of selective networks composed of intercommunicating neuron-like elements have been connected to produce a new kind of automaton capable of limited recognition of two-dimensional patterns. Salient features of this automaton are (i) preestablished unchanging connectivity, (ii) preassigned connection strengths that are selectively altered according to experience, (iii) local feature detection in one network with simultaneous global feature correlation in the other, and (iv) reentrant interactions between the two networks to generate a new function, associative memory. No forced learning, explicit semantic rules, or a priori instructions are used.

Computers↗
PubMed1995

Follow-up of vacuum and nonvacuum constriction devices as treatments for erectile dysfunction.

Of 20 men evaluated for erectile dysfunction (ED) for whom vacuum erection devices or constriction bands were recommended, only four experienced improvement of their erectile function by using the specific suggested method. Although use of a simple constriction band mechanism (e.g., a rubber band wound tightly around the penis) for men with brief erectile capacity has been described as a viable treatment, only one of five men who tried using it achieved any success. Three of six men who used a vacuum erection device were helped by it, particularly the men who suffered from only partial ED. Most patients did not follow through with the recommended treatment and stopped sexual activity, or belatedly returned for intracavernosal injections. The interviews revealed the pervasive influence of shame and demoralization regarding erectile problems, the importance of evaluation and treatment follow-up, and the necessity for careful, explicit, extensive, and concrete explanations and instructions regarding treatment options.

Adult↗
PubMed2001

Specifying executive representations and processes in number generation tasks.

The Interacting Cognitive Subsystems framework, ICS (Barnard, 1985) proposes that central executive phenomena can be accounted for by two autonomous subsystems, which process different forms of meaning: propositional and schematic (implicational) meanings. The apparent supervisory role of the executive arises from limitations on the exchange of information between these and other cognitive subsystems. This general proposal is elaborated in four experiments in which a total of 1,293 participants are asked to spontaneously generate a large verbal number to varying task constraints, with the intention of specifying the representations of number and task that underlie responses. Responses change systematically according to participants' use of explicit propositional information provided by the instructions, and inferred implicational information about what the experimenter is requesting. There was a high error rate (between 6% and 24%), participants producing responses that did not fall within the large range indicated by the instructions. The studies support the distinction between propositional and implicational processing in executive function, and provide a framework for understanding normal executive representations and processes.

Cognition↗
PubMed2000

Picture superiority in conceptual memory: dissociative effects of encoding and retrieval tasks.

We examined the role of encoding processes for picture superiority in explicit and conceptual-implicit memory. The nature of encoding instruction (naming or semantic categorization) yielded dissociative effects on picture and word memory on one explicit test, category-cued recall, and two conceptual-implicit tests, category-cued generation and category-cued verification. Category-cued recall was greater for pictures than for words following naming, but it did not differ for pictures and words following semantic categorization. Category-cued generation priming was greater for pictures than for words following naming, but it was greater for words than for pictures following semantic categorization. In contrast, category-cued verification priming did not differ for pictures and words following either naming or semantic categorization. Thus, picture superiority can be eliminated or reversed depending on the type of conceptual encoding task and conceptual-retrieval test.

Association Learning↗
PubMed2006

Instructional model to teach clinically relevant medicinal chemistry.

The relevance of medicinal chemistry to pharmacy practice has been questioned by many pharmacy educators as more emphasis has been placed on linking clinical knowledge and practice to pharmacy student educational outcomes. Faculty teaching in medicinal chemistry and other biomedical and pharmaceutical science courses have embraced this challenge. Various teaching methods and approaches within medicinal chemistry that emphasize application of this knowledge have been sought to improve the usefulness of this scientific discipline to the future careers of students. The newly revised ACPE guidelines and standards have reemphasized the role of the sciences in the curriculum. With this mandate, it is essential that all science faculty members adjust the way they teach to meet the new desired outcomes for pharmacy graduates. This manuscript describes an instructional model for teaching medicinal chemistry explicitly designed to meet these outcomes. A process of collaboration between experienced pharmacy faculty scholars was used to derive this approach. Pedagogy for cognitive and affective learning was incorporated. A case study using a representative drug class is presented to illustrate this model.

Chemistry, Pharmaceutical↗
PubMed1989

Improving compliance in Xhosa psychiatric patients.

Compliance with psychotropic medication is particularly poor in Xhosa psychiatric patients. A study demonstrated that explicit and repeated verbal and written instructions did not increase compliance with oral medication, but that a single home visit, limited to giving instructions about medication, almost doubled the compliance rate (to 65%). Similar increases also occurred in relation to intramuscular medication and clinic attendance. The most common reason for noncompliance was found to be resistance to, or plain ignoring of, what was actually known (64%). Several possible reasons for this are proposed, the most significant being the patients' cultural and social attitudes and belief system. Recommendations for increasing compliance are given.

Black or African American↗
PubMed1987

The effect of familiality on clinical presentation and survival in mammary carcinoma.

In a series of 467 patients treated for mammary carcinoma 96 (20%) had a family history for this tumour. Sixty-eight (71%) had at least one first degree, 28 (29%) a second or third degree family member. Only the mean age of the second degree relative group differed significantly from that of the non-familial group. The size of the primary tumour at first presentation did not differ significantly in the familial and non-familial group, as the estimated survival. So patients with a family history for mammary carcinoma did not present themselves in an earlier stage of disease. Because of the higher risk of developing this type of tumour in female relatives we have to instruct this potential patient group more explicitly.

Adult↗
PubMed1999

Teaching professionalism in undergraduate medical education.

CONTEXT: There is a growing consensus among medical educators that to promote the professional development of medical students, schools of medicine should provide explicit learning experiences in professionalism. OBJECTIVE: To determine whether and how schools of medicine were teaching professionalism in the 1998-1999 academic year. DESIGN, SETTING, AND PARTICIPANTS: A 2-stage survey was sent to 125 US medical schools in the fall of 1998. A total of 116 (92.3%) responded to the first stage of the survey. The second survey led to a qualitative analysis of curriculum materials submitted by 41 schools. MAIN OUTCOME MEASURES: Presence or absence of learning experiences (didactic or experiential) in undergraduate medical curriculum explicitly intended to promote professionalism in medical students, with curriculum evaluation based on 4 attributes commonly recognized as essential to professionalism: subordination of one's self-interests, adherence to high ethical and moral standards, response to societal needs, and demonstration of evincible core humanistic values. RESULTS: Of the 116 responding medical schools, 104 (89.7%) reported that they offer some formal instruction related to professionalism. Fewer schools have explicit methods for assessing professional behaviors (n = 64 [55.2%]) or conduct targeted faculty development programs (n = 39 [33.6%]). Schools use diverse strategies to promote professionalism, ranging from an isolated white-coat ceremony or other orientation experience (n = 71 [78.9%]) to an integrated sequence of courses over multiple years of the curriculum (n = 25 [27.8%]). Of the 41 schools that provided curriculum materials, 27 (65.9%) addressed subordinating self-interests; 31 (75.6%), adhering to high ethical and moral standards; 17 (41.5%), responding to societal needs; and 22 (53.7%), evincing core humanistic values. CONCLUSIONS: Our results suggest that the teaching of professionalism in undergraduate medical education varies widely. Although most medical schools in the United States now address this important topic in some manner, the strategies used to teach professionalism may not always be adequate.

Clinical Competence↗
PubMed1993

Differential effects of lorazepam and oxazepam on priming.

The effects of lorazepam (2 mg), oxazepam (30 mg) and placebo on performance in implicit and explicit memory tasks were compared in a double-blind, independent group study with 36 healthy volunteers. Both benzodiazepines (BZs) impaired performance on the explicit task (free recall). However, only lorazepam impaired performance of the implicit task (word-stem completion). A similar pattern of drug effects was observed on a secondary task which used different instructions at stimulus presentation. BZ effects on the explicit task were more associated with levels of sedation (indexed by finger tapping speed) than their effects on the implicit task. It is concluded that both BZs impair episodic memory but only lorazepam impairs priming.

Adolescent↗
PubMed1992

Volleyball and other analogies: a response to Englert.

Englert and her colleagues have contributed much to our knowledge about effective writing instruction. They have demonstrated that interventions that make explicit the writing process and text structures are successful with students with learning disabilities as well as those without. Englert attributes this success to the holistic, social, and interactive nature of the instruction. However, one must keep in mind that CSIW was a package approach that included other validated instructional components. CSIW teachers presented conceptual models, used examples and nonexamples to illustrate text structure concepts, modeled thinking overtly while demonstrating the process, provided guided practice by prompting the process through dialogue and think-sheets, faded prompts as students took over more of the responsibility for the process, and taught for generalization by addressing more than one text structure and promoting student talk about the process. As Englert reported, most teachers seldom do these things, even when they claim to teach the writing process. Englert allows for the possibility that all students with learning disabilities may not be ready for cognitive strategy instruction as it is described in her article, and professionals must acknowledge that different techniques may be more effective for students of different ages and abilities. Swanson (1990) emphasized that there must be a match between strategy and learner characteristics and that strategies must be considered in relation to a student's knowledge and capacity. Strategic teaching requires that the teacher have a repertoire of approaches along a continuum that encompasses coaching students to use their own mental resources at one end and basic skill instruction at the other.(ABSTRACT TRUNCATED AT 250 WORDS)

Achievement↗
PubMed1990

Organizing principles for single joint movements. III. Speed-insensitive strategy as a default.

1. Human subjects made discrete elbow flexions in a horizontal plane over different distances, from a stationary initial position to a visually defined stationary target 9 degrees wide. We measured joint angle, acceleration, and electromyograms (EMGs) from two agonist and two antagonist muscles. 2. Subjects made movements over four different distances following one of four different instructions. The first instructed the subject simply to choose a comfortable speed. The other three explicitly emphasized either speed, accuracy, or maintenance of the "same" speed over different distances. These instructions produced a wide range of movement velocities. 3. The initial rises of the acceleration (and therefore of the inertial torque), as well as the initial slope of the agonist EMG, were all invariant over changes in the target distance for any single instruction but were all sensitive to the given instruction. 4. Our results demonstrate that the speed-insensitive strategy is a standard or default pattern for performing movements that may be carried out for different instructions over a wide range of speeds. A uniform intensity of excitation pulse is not a byproduct of moving at maximal speed. Submaximal intensities are associated with submaximal speeds and are a selected feature of the pattern of movement control.

Acceleration↗
PubMed1995

Disciplining young children: the role of verbal instructions and reasoning.

Pediatricians are often asked to advise parents who are having difficulty managing the oppositional behaviors of their toddlers and preschool-age children. A large number of articles provide advice to pediatricians and parents on effective disciplinary strategies. However, despite the fact that verbal explanations, reasoning, and instructions are commonly used by parents, few articles directly address the use of these strategies to affect children's behavior. In this paper, we review studies that explicitly investigate the ability of adults' verbal explanations or instructions to alter the behavior of young children. These studies suggest that under most circumstances, verbal explanations and instructions are not effective in changing young children's problem behaviors. We then discuss how theories in developmental and behavioral psychology help explain the limitations of using verbal reasoning and instructions to change young children's problem behaviors. Finally, we provide some recommendations for parents on the use of verbal explanations and instructions in disciplining young children.

Adult↗
PubMed2001

Encoding tasks and the processing of perceptual information in young and older adults.

This study examined the degree to which different tasks promote the encoding of the characteristics of a talker's voice in young and older adults, and whether these characteristics encoded in long-term memory facilitate spoken word identification under difficult listening conditions. During the encoding phase, participants were given extensive exposure to the voices of two talkers and performed tasks that focused their attention on either voice characteristics (explicitly or incidentally) or linguistic information. Subsequently, participants identified novel words masked by noise, half of which were spoken by one of the familiar talkers and half by an unfamiliar talker. Young adults identified with greater accuracy words spoken in a familiar voice, whereas older adults benefited from voice familiarity only under instructions that promoted attention to voice characteristics either explicitly or incidentally. Age-related declines in sensory uptake (hearing loss) accounted for most of these task-dependent voice effects.

Adolescent↗
PubMed2001

Learning a coordination skill: interactive effects of instruction and feedback.

Information prior to and during the acquisition of a continuous bimanual task was manipulated. Participants practiced a difficult coordination pattern, which produced circular shapes on the computer, when they moved their arms correctly. Four groups were examined, which differed in the type and amount of information provided. Either limb or circle feedback was provided in the presence or absence of instructions detailing how to move the limbs. Circle feedback facilitated learning relative to the limb feedback in which the explicit displacements of the limbs was displayed. Under circle feedback conditions, instructions hindered acquisition. Little instructional effects were observed under limb feedback conditions, despite the prediction that instructions would benefit learning when the feedback was more compatible. Findings are discussed in relation to the complexity of the feedback and processing demands.

Adult↗
PubMed2005

Task-set inertia and memory-consolidation bottleneck in dual tasks.

Three dual-task experiments examined the influence of processing a briefly presented visual object for deferred verbal report on performance in an unrelated auditory-manual reaction time (RT) task. RT was increased at short stimulus-onset asynchronies (SOAs) relative to long SOAs, showing that memory consolidation processes can produce a functional processing bottleneck in dual-task performance. In addition, the experiments manipulated the spatial compatibility of the orientation of the visual object and the side of the speeded manual response. This cross-task compatibility produced relative RT benefits only when the instruction for the visual task emphasized overlap at the level of response codes across the task sets (Experiment 1). However, once the effective task set was in place, it continued to produce cross-task compatibility effects even in single-task situations ("ignore" trials in Experiment 2) and when instructions for the visual task did not explicitly require spatial coding of object orientation (Experiment 3). Taken together, the data suggest a considerable degree of task-set inertia in dual-task performance, which is also reinforced by finding costs of switching task sequences (e.g., AC --> BC vs. BC --> BC) in Experiment 3.

Attention↗
PubMed1987

Accidental firearm fatalities during hunting.

Swedish legislation concerning firearms is highly restrictive. It is illegal to possess weapons (except airguns) without a license. From 1970 through 1982, there were 79 accidental firearm fatalities in Sweden. This number, corresponding to 0.074/100,000/year, is very low in comparison with similar statistics worldwide. Of these fatalities, 47 were associated with hunting and were studied carefully. Despite an increase in both the popularity of hunting and in licensing of weapons, on change in the number of accidents per year could be confirmed. Twenty-nine accidents occurred during small game hunting, of which 24 involved shotguns, and 18 occurred during moose hunting. The mean age overall was 46 years. All victims and shooters were men. Most accidents occurred before noon and during the autumn. During moose hunting, the victim most commonly was either mistaken for game or was standing beyond game. During small game hunting, the most common reason for death was improper handling of the weapon. Firing of defective weapons caused at least 10 fatal accidents. Alcohol inebriation was uncommon. It is unlikely that more restrictive firearm legislation would further decrease the number of fatal accidents. Instead, we believe that accidental firearm fatalities during hunting can be prevented by safer and more careful handling of weapons, including unloading weapons before transporting them; by replacing older weapons with more modern and safer ones; and by not allowing children to handle weapons. No shots should be fired until it is clarified that the target really is a game animal, and when hunting with rifles, the fields of fire should be clarified beforehand. Shooters at stand must be instructed not to leave their stands until explicitly told to do so.

Accident Prevention↗
PubMed2005

Investigation of implicit memory during isoflurane anesthesia for elective surgery using the process dissociation procedure.

BACKGROUND: This prospective study evaluated memory function during general anesthesia for elective surgery and its relation to depth of hypnotic state. The authors also compared memory function in anesthetized and nonanesthetized subjects. METHODS: Words were played for 70 min via headphones to 48 patients (aged 18-70 yr) after induction of general anesthesia for elective surgery. Patients were unpremedicated, and the anesthetic regimen was free. The Bispectral Index (BIS) was recorded throughout the study. Within 36 h after the word presentation, memory was assessed using an auditory word stem completion test with inclusion and exclusion instructions. Memory performance and the contribution of explicit and implicit memory were calculated using the process dissociation procedure. The authors applied the same memory task to a control group of nonanesthetized subjects. RESULTS: Forty-seven patients received isoflurane, and one patient received propofol for anesthesia. The mean (+/- SD) BIS was 49 +/- 9. There was evidence of memory for words presented during light (BIS 61-80) and adequate anesthesia (BIS 41-60) but not during deep anesthesia (BIS 21-40). The process dissociation procedure showed a significant implicit memory contribution but not reliable explicit memory contribution (mean explicit memory scores 0.05 +/- 0.14, 0.04 +/- 0.09, and 0.05 +/- 0.14; mean automatic influence scores 0.14 +/- 0.12, 0.17 +/- 0.17, and 0.18 +/- 0.21 at BIS 21-40, 41-60, and 61-80, respectively). Compared with anesthetized patients, the memory performance of nonanesthetized subjects was better, with a higher contribution by explicit memory and a comparable contribution by implicit memory. CONCLUSION: During general anesthesia for elective surgery, implicit memory persists even in adequate hypnotic states, to a comparable degree as in nonanesthetized subjects.

Adolescent↗