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PubMed2005

Concept mapping: an introduction to structured conceptualization in health care.

Structured conceptualization is a specific form of concept mapping that is a mixed methods participatory approach that combines group processes (brainstorming, sorting, group interpretation) with a sequence of multivariate statistical analyses (multidimensional scaling, hierarchical cluster analysis). Concept mapping's relevance to health care quality and services is described. The basic steps and analysis sequence in the concept mapping method are outlined and a brief example of the results for a health planning project are presented. Several examples of the use of concept mapping in health are provided.

Cluster Analysis↗
PubMed2003

Who cares? The views of sexual offenders about the group treatment they receive.

This paper describes one of the first systematic focused attempts to elicit the views of sexual offenders about the treatment that they have received. The paucity of previous research in this area is suggested to be the result of negative societal attitudes towards sexual offenders, as exemplified by recent tabloid newspaper coverage of this population. It is suggested that these attitudes may have a negative impact upon the attitudes of clinicians and researchers, and thus upon the treatment offered to this client group. Therefore, it is argued that seeking the views of the clients is essential in order to ensure that treatment is relevant and reflexive, and promotes relapse prevention. A questionnaire was distributed to participants who had completed treatment groups run by the Psychology Service at a Regional Secure Unit and at a Probation Service Sexual Offender Unit. The questionnaire aimed to elicit their views of the group experience, including issues to do with programme structure and content, group process, and therapeutic style of group facilitators. The results (including a pilot study) indicated that, on the whole, participants' experiences of the group were positive, for example aspects of the group process, understanding and preventing reoffending. Some suggestions for the modification and development of future sexual offender treatment are outlined, based on the feedback from subjects, for example, consideration of alternative treatment modalities, enhancing the content of group sessions, improving the organization of groups and modifying the training of groups leaders.

Adult↗
PubMedDate not supplied

Numerical cognition: age-related differences in the speed of executing biologically primary and biologically secondary processes.

Groups of younger and older adults were administered numerical and arithmetical tasks that varied in the extent to which they assess evolved versus culturally specific forms of cognition, termed biologically primary and biologically secondary abilities, respectively. Componential analyses of solution times suggested that younger adults are faster than older adults in the execution of biologically primary processes. For biologically secondary competencies, a pattern of no age-related differences or an advantage for older adults in speed of processing was found. The results are consistent with the view that there has been a cross-generational decline in arithmetical competencies in the United States and are discussed in terms of models of age-related change in cognitive performance.

Adult↗
PubMed2005

Gene expression profiling of diaphragm muscle in alpha2-laminin (merosin)-deficient dy/dy dystrophic mice.

Deficiency of alpha2-laminin (merosin) underlies classical congenital muscular dystrophy in humans and dy/dy muscular dystrophy in mice and causes severe muscle dysfunction in both species. To gain greater insight into the biochemical and molecular events that link alpha2-laminin deficiency with muscle fiber necrosis, and the associated compensatory responses, gene expression profiles were characterized in diaphragm muscle from 8-wk-old dy/dy mice using oligonucleotide microarrays. Compared with age-matched normal muscle, dystrophic diaphragm was characterized by predominantly augmented gene expression, irrespective of the fold-change threshold. Among the 69 genes with at least plus or minus twofold significantly altered expression, 30 belonged to statistically overrepresented Gene Ontology (GO) biological process groups. These covered four specific themes: development including muscle development, cell motility with an emphasis on muscle contraction, defense/immune response, and cell adhesion. An additional 11 gene transcripts were assigned to more general overrepresented GO biological process groups (e.g., cellular process, organismal physiological process); the remaining 28 did not belong to any overrepresented groups. GO cellular constituent assignment resulted in the highest degree of overrepresentation in extracellular and muscle fiber locations, whereas GO molecular function assignment was most notable for various types of binding. RT-PCR was performed on 38 of 41 genes with at least plus or minus twofold significantly altered expression that were assigned to overrepresented GO biological process groups, with expression changes verified for 36 of 38 genes. These results indicate that several specific groups of genes have altered expression in response to genetic alpha2-laminin deficiency, with both similarities and differences compared with data reported for dystrophin-deficient muscular dystrophies.

Animals↗
PubMed2000

Rats alternate on a dry-land but not swimming-pool (Morris task) place task: implications for spatial processing.

Groups of rats were rewarded with food for traveling from a start point to 2 different locations while their alternations in choice between those locations on 2 daily trials were recorded. In one experimental condition, the rats swam and received food once they climbed upon a platform that was hidden just below the surface of the water at the food location. In the other condition, the rats walked to reach the food. It was found that the rats did not alternate their choices between target locations when swimming but that they did alternate target choices when walking. Even experience in alternating when walking did not produce reliable alternation when swimming. It is proposed that rats treat escape (swimming) and search (walking) tasks in different ways, and this difference is discussed with respect to the possibility that different central processes may be used in the task solutions.

Animals↗
PubMed2006

Analysis of verbal interactions in tutorial groups: a process study.

INTRODUCTION: Collaborative learning, including problem-based learning (PBL), is a powerful learning method. Group interaction plays a crucial role in stimulating student learning. However, few studies on learning processes in medical education have examined group interactions. Most studies on collaboration within PBL used self-reported data rather than observational data. We investigated the following types of interactions in PBL tutorial groups: learning-oriented interactions (exploratory questioning, cumulative reasoning and handling conflicts about knowledge); procedural interactions, and irrelevant/off-task interactions. AIM: The central question concerned how much time is spent on the different types of interaction during group sessions and how the types of interaction are distributed over the meeting. METHOD: Four tutorial group sessions in Year 2 of the PBL undergraduate curriculum of Maastricht Medical School were videotaped and analysed. The sessions concerned the reporting phase of the PBL process. We analysed the interactions using a coding scheme distinguishing several verbal interaction types, such as questions, arguments and evaluations. RESULTS: Learning-orientated interactions accounted for 80% of the interactions, with cumulative reasoning, exploratory questioning and handling conflicts about knowledge accounting for about 63%, 10% and 7% of the interactions, respectively. Exploratory questioning often preceded cumulative reasoning. Both types occurred throughout the meeting. Handling conflicts mainly occurred after the first 20 minutes. CONCLUSIONS: Task involvement in the tutorial groups was high. All types of learning-orientated interactions were observed. Relatively little time was spent on exploratory questions and handling conflicts about knowledge. Problem-based learning training should pay special attention to stimulating discussion about contradictory information.

Communication↗
PubMed1997

The process in psychological debriefings.

Critical Incident Stress Debriefings have become an intervention method used in various cultures, countries and groups following critical incidents. Although the structure of such meetings has been adequately described, utilization of the group processes involved has received less attention. A model, process debriefing (PD), based on experiences from Europe, is presented. Some differences between the current CISD process in the United States and the Europe based model are outlined. Various factors that impact the process of debriefings are discussed with a special emphasis on leadership, and implications of these group process variables for psychological debriefing are presented. It is emphasized that the continued exploration and discussion of process issues is critical to advance the understanding of the critical elements of debriefing.

Crisis Intervention↗
PubMed2000

A comparison of learning outcomes and attitudes in student- versus faculty-led problem-based learning: an experimental study.

OBJECTIVES: To compare learning outcomes and perceptions of facilitator behaviours and small-group process in problem-based learning (PBL) groups led by students and those led by faculty. DESIGN: A prospective, Latin-square cross-over design was employed. Second-year medical students participated in 11 PBL cases over the course of the academic year. For each case, half the student groups were led by faculty and the other half by a student group member selected randomly to serve in the facilitator role. Learning outcomes were assessed by performance on objective examinations covering factual materials pertinent to the case. Perceptions of facilitator behaviours and of group functioning were assessed with a questionnaire completed at the end of each individual case. Focus-group discussions were held to gain more in-depth information about student perceptions and experience. Student-led sessions were observed at random by the investigators. SETTING: A state-supported, US medical school with a hybrid lecture-based and problem-based curriculum. SUBJECTS: One hundred and twenty-seven second-year medical students and 30 basic science and clinical faculty. RESULTS: No differences were detected in student performance on the objective evaluation based on whether the facilitator was a faculty member or peer group member, nor were there any differences in the perceptions of group process. Students gave peer facilitators slightly higher ratings in the second semester of the experiment. In the focus-group discussions, students voiced a general preference for student-led groups because they felt they were more efficient. Observation and focus-group reports suggest that groups led by students sometimes took short cuts in the PBL process. CONCLUSION: In a hybrid lecture- and PBL-based curriculum, student performance on objective examinations covering PBL materials is unaffected by the status of the facilitator (student vs. faculty). However, in peer-facilitated groups, students sometimes took short cuts in the PBL process that may undermine some of the intended goals of PBL.

Attitude of Health Personnel↗
PubMedDate not supplied

Videotaped focus groups: transforming a therapeutic strategy into a research tool.

Focus groups have become a popular method of collecting data for research projects. The addition of using a videotaped approach has broad implications for researchers, as it allows constant replay of the session. Although on the surface this approach seems straightforward and easy to use, the authors caution that this is not an approach for the novice. Investigators planning to use a focus group method must be well versed in group process. There is an unpredictable nature to the focus group process, and researchers need to prepare for the inevitable mishaps that lead to lost opportunities for data collection.

Data Collection↗
PubMed2003

Patients' ranking of therapeutic factors in group analysis.

The aim of this research is to assess which therapeutic factors are of greatest importance to patients in group analytic psychotherapy, and whether the patients' characteristics and the phase of the group process influenced their evaluation of therapeutic factors. The Yalom's group therapeutic factors questionnaire was filled out by 66 patients, members of small groups conducted according to group analytic principles. The average scores for each therapeutic factor were subsequently ranked by importance to the patients and related to their age, sex, education, previous psychotherapeutic experience and phase of group process. Self-understanding was the highest-ranking therapeutic factor for the patients (average score 21.32 +/- 0.04 out of 25 maximum), whereas identification was the lowest ranking factor (15.88 +/- 0.06 in average). Group therapeutic factors were scored higher by women, patients up to 30 years of age, high-school graduates, and those with previous psychotherapeutic experience. Self-understanding seems to be the most important therapeutic factor in group analysis, emphasizing the importance of appropriate selection of patients for group analysis in order to utilize therapeutic factors the best.

Adult↗
PubMed1997

Outcomes and informatics.

OBJECTIVE: To provide an overview of the potential contribution that informatics can make for pathologists who become involved in outcomes assessment and management. DATA SOURCES: Contemporary scientific articles centered on pathologists and the assessment of outcomes, the definitions of outcomes assessment and management, and related methodologic issues, especially those pertaining to information technology and outcomes, and a summary of eight independent group process sessions involving volunteer pathologists and a group facilitator discussing issues related to informatics and outcomes as structured by a clinical scenario with focusing questions. STUDY SELECTION: Articles reviewed were drawn primarily from the literature published since 1985 and found through Medline key word searches of titles and abstracts; likely articles were then selected for subsequent detailed review on the basis of the abstract's contents. Group process data were drawn from summaries of each of the eight groups as prepared by the facilitator from notes taken during the session by a designated scribe. CONCLUSIONS: It is crucial for pathologists to participate in clinical outcomes studies. Informatics can serve as a tool kit for performing outcomes studies relevant to pathology (eg, collect data or analyze data), or it can be seen as a malleable component of health care processes that can be modified to achieve improved outcomes. Pathologists see many potential avenues for using informatics to leverage the impact that the pathologist and laboratory can have on clinical outcomes. Focusing on some specific informatics learning objectives can help the pathologist become a leader in outcomes studies.

Databases, Factual↗
PubMed1998

Problem based teaching and learning as a bridge from basic anatomy to clinical clerkships.

This article describes a Clinical Anatomy course designed to bridge basic anatomy with clinical clerkships. It is given in the second year, after the traditional dissecting anatomy course. Students revisit anatomy during small group discussions of clinical cases. An example of a case is described together with a summary of a typical group process stimulated by the case. The group process enables students to develop clinical thinking and problem solving skills fundamental to clinical practice. They learn to search for medical knowledge resources, and to work in teams. The tutor evaluates the students' progress based on their knowledge building, problem solving and development of their interpersonal skills. Problem based learning in this interdisciplinary anatomy course allows students and faculty both horizontal and vertical integration within the curriculum.

Anatomy↗
PubMed2003

Reproductive health indicators for China's rural areas.

We report community-based development of reproductive health indicators for China's rural areas. To generate these indicators, we sequenced two participatory techniques known as nominal group process and Delphi survey methodology. Nominal group process entailed grassroots reproductive health workers' generating indicators, followed by refinement and prioritization of these indicators through a consensus-building Delphi process among nationally and internationally known reproductive health experts. Major criteria for the indicators were practicality, feasibility, and measurability within China's rural areas. We explain the importance of establishing these indicators for application in rural China and other developing countries as a complement to the World Health Organization's reproductive health indicators for global monitoring; present the identified indicators; and describe lessons learned from field testing in low-, middle-, and high-income counties of China's countryside.

Adult↗