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PubMed2001

Determinants of cardiac function: simulation of a dynamic cardiac pump for physiology instruction.

A computer model is described that simulates the cardiac cycle of a mammalian heart. The model emphasizes the pressure-volume plot as a teaching tool to explain the behavior of the heart as a pump. It exhibits realistic responses to changes in preload, afterload, contractility, and heart rate while displaying time-dependent changes in pressure and volume in addition to the pressure versus volume plot. It differs from previous models by graphing these parameters on a beat-to-beat basis, allowing visualization of the dynamic adaptation of the pumping heart to various stimuli. A system diagram is also included to further promote student understanding of the physiology of cardiac function. The model is useful for teaching this topic to medical, graduate, or undergraduate students. It may also be used as a self-directed computer laboratory exercise.

Cardiovascular Physiological Phenomena↗
PubMed1984

Development of professional competence via self-instructional units.

In recent years, self-instructional teaching methods have come under criticism from educators, much of it warranted. But when self-instructional materials are written by experienced educators who teach the topic and are developed within a versatile process using a proven format, they are extremely valuable teaching aids. We discuss here the results of a grant project funded by W. K. Kellogg Foundation and describe the process used at Kettering Medical Center's School of Medical Technology to develop and produce over 100 self-instructional units. We also discuss potential uses of self-instructional units in professional continuing education programs and suggest ways self-instructional units might be used to promote interdisciplinary health care and expansion of professional knowledge banks. This project confirmed that professions can create their own educational materials through the independent efforts of their members.

Curriculum↗
PubMed1992

Facilitator not teacher: a role change for tutors in open learning nursing education.

Open learning is now an established, if rapidly changing, part of post-compulsory education and training in the United Kingdom. It has also developed in significant ways within nurse education. A key role in successful open learning is that of the tutor. Differences between the activities of teaching and facilitation are defined and ways of mapping the tutor's role within these are suggested. Differences in approach can be clustered around the topics of: the locus of control; learning methodology; the learning context and media; and the curriculum. These are discussed in turn to elicit what are the key issues for tutoring in relation to each one.

Curriculum↗
PubMed2003

The design of distance-learning programmes and the role of content experts in their production.

This paper describes an effective and efficient approach to the production of distance-learning materials in which content experts, editors and instructional designers collaborate. The approach is based on the development of a clearly defined agreed educational strategy and the use of a template for the programme. This allows the content experts to assemble the first draft of the programme in an appropriate format, with further revisions being carried out by the educationists in collaboration with the content editor. A task-based approach was adopted in the programme and a two-column layout incorporating nine different types of educational enhancements was used. Useful educational strategies which should be considered in the development of the template for a distance learning programme can be categorized into the following three areas: (1). interactivity enhancements including questions posed, think points for reflection, and case scenarios linking theory to practice; (2). enrichment enhancements including illustrations, readings and quotes from experts; (3). action/practice enhancements highlighting the application of portfolio building--provides useful advice on topics covered as they relate to the AFRC examination, and encourages trainees to apply their knowledge. The use made of the enhancements varies in the different modules. This project was challenging and ambitious but our objectives were met with all 39 authors satisfactorily producing the 42 SELECT Units.

Critical Care↗
PubMedDate not supplied

Effective development and utilization of self-learning modules.

This article provides guidelines to assist the nurse educator in designing self-learning modules for appropriate topics and learners, in creating the module, and in developing tools to evaluate the effectiveness of the module. By following the guidelines presented, the nurse educator can create cost-effective learning opportunities for professional nurses. Utilization of self-learning modules encourages nurses to be self-directed and allows the nurse educator to be the resource rather than the source of learning.

Cost-Benefit Analysis↗
PubMed1991

Distance learning in a local setting: a structured learning course for the introduction of general practice to undergraduate students.

This paper describes the development and evaluation of a structured introductory course in general practice. Following some of the principles developed in distance education, the Department provides everything the student needs for the formal learning requirement as well as detailed assistance in how best to tackle the selected topics. The course was reported to be demanding, relevant and enjoyable. The major areas requiring attention were in reducing the amount of reading required, more help in learning to work in small student-run groups and more one-to-one supervision of physical examination skills. With further refinement the course should be applicable to other medical schools in developed countries.

Curriculum↗
PubMed2001

Problem-based learning variant: transition phase for a large institution.

OBJECTIVE: To compare students' test scores and perceptions of problem-based learning (PBL) and lecture-based learning (LBL) by applying a PBL-variant. METHOD: For the transition from LBL to PBL, PBL was varied for one discipline only and for a large group of students. Two hundred forty nine second year medical students were taught a topic of Biochemistry by the LBL method and then 141 of these were taught another topic by the PBL-variant. At the conclusion of each topic an MCQ test was given. One week later a 9 item questionnaire was given to the 50 students now attending classes to assess their perceptions of the 2 teaching formats. The test scores of the two methods were compared. Students' ratings were differentiated by the Wilcoxon Signed-Rank test. RESULTS: There was no significant difference in the test scores by PBL or LBL, but PBL received significantly higher student ratings (p < 0.05) than LBL in self-study time, library time, number of books and computer consulted, enthusiasm for the topic, group discussion, depth of knowledge and interest taken in the teaching format. But there was no significant difference in students' ratings of the teacher's importance in either PBL or LBL. CONCLUSION: PBL variant and LBL produced similar MCQ test scores but the former is more conducive to enthusiastic self-study. Thus in the transition phase, PBL may be applied to one discipline and a large group of students without undermining its merits.

Biochemistry↗
PubMed1990

Reading illustrated science texts: a micro-computer based investigation of children's strategies.

Research has shown that the effect of illustrations on children's learning of science is related to ability. This study examines the hypothesis that children who show different levels of success in a learning task will employ different strategies in their picture-text processing. One hundred and eighty 14 year-old children were required to learn three illustrated science topics of different levels of difficulty which were presented to them on a BBC micro-computer. The computer was programmed to record the time spent on each sentence and each picture, as well as the point in the text at which the picture was accessed. Post hoc testing enabled the children to be divided into six groups according to their success rates on the learning tasks. Significantly longer times were spent looking at the pictures as the topics increased in difficulty; also the amount of time spent looking at pictures increased as the learning of the children decreased. For every second the least successful children spent accessing pictures, they spent about four seconds reading the text; for the most successful children this ratio was about one-to-six. The least successful children also accessed the pictures significantly more frequently than the most successful. The different strategies used by the children are discussed in terms of what is known about their differential learning gains from illustrated texts.

Adolescent↗
PubMed1984

Influence of programmed textbook review on American Board of Surgery In-service Examination scores.

Documentation of academic achievement throughout training is an essential component to residency accreditation. Resident performance evaluations by attending staff provide good assessments of affective behavior and technical skills, but evaluation of surgical knowledge is often subjective in nature. The American Board of Surgery In-Service Examination has become the standard by which academic performance is measured. Numerous types of educational programs are used to increase the knowledge base of residents. Sporadic reading of a standard surgical text is a common part of many residency programs. In 1981, the Michigan State University/Butterworth Hospital General Surgery Residency opted to drop the surgical text reading in favor of a review of specific topics attuned to resident needs. Results of the 1982 American Board of Surgery (ABS) examination identified a significant decrease in percentile scores and average resident performance. A program requiring a systematic review of a standard surgical text was then initiated. This review involved assigned reading and administration of weekly examinations covering each assignment. Following institution of this program, a dramatic improvement in the total average scores for the entire resident group was noted. Similar improvement was noted in individual group scores (PG I, II, III, IV, and V). Results of this study indicate that reading of a standard surgical text should be a required part of each residency program.

Achievement↗
PubMed2002

The Modular Resource Center: integrated units for the study of the anatomical sciences in a problem-based curriculum.

The Modular Resource Center (MRC) at the College of Veterinary Medicine at Cornell University was created in 1993 as a way to provide visual resources in support of a newly implemented problem-based curriculum in which the anatomical sciences are taught primarily in the first tutorial-based course, The Animal Body. Over two dozen modules have been created specifically in support of this course, whereas additional modules have been created in support of other basic science courses. The basic unit of organization of the MRC is a module presented in a carrel that provides students a way to study, either alone or in groups, a given topic. The topic is presented through a script and an integrated set of anatomical materials including plastinated dissected specimens, vascular casts, skeletal preparations, models, radiographs, histological slides, and photo- and electron micrographs. The key feature of this resource center is that it is not a museum; rather it is more analogous to an interactive library, that can be used for reference, study, and review, not only by veterinary students but also by faculty, interns, residents, and undergraduates. A unique aspect is that all materials have been made by veterinary students working with faculty during the summer. Although started as a resource in support of a tutorial-based curriculum, the MRC has evolved over a decade into an anatomy resource that would be highly valued in any curricular format.

Anatomy↗
PubMed2002

Real-time, evidence-based medicine instruction: a randomized controlled trial in a neonatal intensive care unit.

PURPOSE: The study assesses potential for improving residents' evidence-based medicine searching skills in MEDLINE through real-time librarian instruction. SUBJECTS: Ten residents on a rotation in a neonatal intensive care unit participated. METHODOLOGY: Residents were randomized into an instruction and a non-instruction group. Residents generated questions from rounds and searched MEDLINE for answers. Data were collected through observation, search strategy analysis, and surveys. Librarians observed searches and collected data on questions, searching skills, search problems, and the test group's instruction topics. Participants performed standardized searches before, after, and six-months after intervention and were scored using a search strategy analysis tool (1 representing highest score and 5 representing lowest score). Residents completed pre- and post-intervention surveys to measure opinions about MEDLINE and search satisfaction. RESULTS: Post-intervention, the test group formulated better questions, used limits more effectively, and reported greater confidence in using MEDLINE. The control group expressed less satisfaction with retrieval and demonstrated more errors when limiting. The test and control groups had the following average search scores respectively: 3.0 and 3.5 (pre-intervention), 3.3 and 3.4 (post-intervention), and 2.0 and 3.8 (six-month post-intervention). CONCLUSION: Data suggest that measurable learning outcomes were achieved. Residents receiving instruction improved and retained searching skills six-months after intervention.

Adult↗
PubMed2006

Estimating transfer of learning for self-instructional packages across dental schools.

The most common topic of research in dental education is assessing the effectiveness of self-instructional units in various formats compared to lectures covering the same material. Generally, these studies are of high methodological quality and reveal mixed results or results slightly favoring self-instruction. All such studies, save one, have been conducted in the context of various single schools, thus confounding the effects of self-instructional format with factors particular to schools and their students. A reanalysis, using Cronbach's generalizability analysis, was performed on a study in the literature that was conducted at six schools and measured student aptitude. The reanalysis found that the largest source of variance on immediate post-test quizzes for knowledge following a three-hour unit on disturbances in tooth development was the school at which the study was conducted (24 percent), followed by student aptitude measured by DAT score (20 percent). Difference in format among lecture, booklet, and audiotape presentations accounted for 5 percent of the variance. This reanalysis demonstrated that statistically significant results from rigorous experimental designs can overrepresent what is revealed by such research. The context-specificity of educational innovations may be underestimated because few studies are replicated across schools. Studies conducted as single schools, regardless of their methodological rigor, fail to address issues associated with potential transfer of findings to other schools.

Analysis of Variance↗
PubMed2004

Demonstration of the effectiveness and acceptability of self-study module use in residency education.

Educators face increasing challenges to promote lifelong learning skills, to include new content areas in an already full curriculum and to maximize limited resources for curriculum implementation. Self-study modules (hereafter modules) offer potential solutions. Three modules on preventive medicine topics were evaluated in Family Medicine residencies. A retrospective pre-/post-test of a resident's ability to meet the module's objectives was used for evaluation. Additionally, residents rated the appropriateness and acceptability of the modules, their preference for 13 methods of learning, and completed a multiple-choice knowledge test. This study demonstrates the effectiveness of modules at multiple levels of evaluation in accordance with a modified version of Kirkpatrick's hierarchy of levels of evaluation. Residents found the modules to be acceptable and useful. Significant gains were seen in residents' abilities to meet objectives. The multiple-choice knowledge test was used to demonstrate mastery of the module materials at an appropriate performance level for future practitioners. Module use was in the top five choices of preferred learning methods. No correlation was seen between residents' preference for learning using modules and educational outcomes. Modules are an effective and acceptable learning method for residents. Even those who prefer other learning methods show improved educational outcomes.

Humans↗
PubMed2001

Impact of problem-based learning on residents' self-directed learning.

OBJECTIVE: To examine the effect of a problem-based learning (PBL) curriculum on self-directed learning behaviors among a group of pediatric residents. METHODS: A controlled comparison study was conducted with 80 pediatric residents at a large urban academic medical center. Residents were observed over 3 distinct but consecutive periods. First, all residents participated in a 3-month-long daily lecture series (pre-exposure phase). Then, for another 3 months, 39 residents (PBL group) were exposed to twice-weekly PBL sessions while 41 residents continued with the daily lectures (lecture-based group) and served as controls. Problem-based learning was withdrawn after 3 months and all residents returned to the lecture series (follow-up phase). Residents' self-directed learning behaviors were assessed through self-administered questionnaires during the pre-exposure, exposure, and follow-up phases. RESULTS: There were no significant preexposure differences in self-directed learning behaviors between the groups. During the exposure phase, the PBL group had significantly higher self-directed learning: 5 or more hours of independent study (26% vs 7%) [corrected] (P=.001); 5 or more hours of medical discussions (28% vs 4%) (P=.008); 2 or more computer literature searches (51% vs 30%) (P=.005); and total hours of self-study per week (6 vs 4 hours) (P<.05). At the 3-month follow-up, the PBL group had returned to baseline levels of self-directed learning and there were no significant differences between the groups. CONCLUSION: Residents exposed to PBL engaged in significantly higher levels of self-directed learning than their counterparts.

Adult↗