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PubMed1992

What do medical students seek to learn from general practice? A study of personal learning objectives.

With the aim of stimulating learning which is more self directed, fourth year medical students in Liverpool are encouraged to set personal learning objectives for the general practice attachment. On average, a student defines seven objectives for the three week attachment. A classification of objectives derived from the 1989 cohort of students is presented and the objectives could be seen as focusing on the practice population and its health problems, the role of the general practitioner, the work of general practice, the management of general practice, general practice as a career, and general learning. The validity and reliability of the classification are considered. Along with the advantages of this approach in motivating students to learn, the findings are considered in relation to impending changes in undergraduate medical education and the future role of general practice teaching by departments and by practice based colleagues.

Curriculum↗
PubMed1990

[Change in cardiovascular activation in learning and performance situations in children with learning disorders].

A method is demonstrated for observing and statistically testing changes in cardiovascular activity in single cases between two types of situations, in this case a playing situation and a learning situation. Using this method it could be shown an abasement of cardiovascular activity during a learning situation together with their mother or father--compared to a playing situation--for 20 hyperactive children with learning problems of an average age of 9.7 years. Together with this abasement in cardiovascular activity there was observed a deterioration in the parent-child-relation. In the singles cases however it could be observed an abasement or an increase in cardiovascular activity. When the--often punishing--parent was replaced by a person who built up a positive relation to the child, there could be observed either an increase or an abasement or no change in cardiovascular activity, the effect being replaiable. The results point up to a critical examination of actual therapeutic concepts for children with learning problems.

Achievement↗
PubMedDate not supplied

Neurochemical specificity of learning: dopamine and motor learning.

In previous reports of studies of patients with alcoholic Korsakoff's psychosis, data were presented showing significant correlations between neuropsychometric measures of amnesia and the CSF levels of the major brain metabolite of norepinephrine (NE), which was consistently reduced among a large group of experimental subjects. Dopamine (DA) metabolite concentrations in the CSF of this same patient population were also significantly lowered but to a lesser degree and less consistently than the NE metabolite. CSF levels of the DA metabolite did not correlate with any measures of amnesia but did significantly correlate with performance on the Digit-Symbol Substitution Test (DSST) of the Wechsler Adult Intelligence Scale (WAIS), which involves psychomotor skill learning. DSST performance did not correlate with CSF levels of the NE metabolite. These findings led to the hypothesis that the acquisition of motor learning skills is related to brain DA activity. In this study, we tested the hypothesis by correlating the ability of a group of Korsakoff patients to learn two different motor tasks (rotary pursuit and mirror tracing) with the concentrations of CSF metabolites of NE, DA, and serotonin. For both tasks, improvement in performance over three daily testing sessions significantly correlated only with the DA metabolite levels. The data are consistent with the hypothesis of a specific role for DA in motor learning.

Alcohol Amnestic Disorder↗
PubMedDate not supplied

[Educational concepts, attitude to learning ability and learning concept in elderly adults--results of an empirical comparison of the aged].

This article analyzes the attitude of old people to education and learning in old age. The different factors influencing attitude systems are investigated. Moreover, this study investigates the types of association elderly people make with the terms "education" and "learning". The analysis revealed that old people regard learning as an important component of life. "Learning" not only comprises acquisition of knowledge, but is also seen as an increase in the ability to judge and criticize.

Aged↗
PubMed1993

[Impairment of learning and memory and the accessory symptom in aged rats as senile dementia model (2)--Learning and memory].

We attempted to investigate the ability of learning and memory of aged rats. Swimming speed of aged rats in Morris's water maze was slower compared with that of young rats. Therefore, we used goal distance to indicate ability of learning and memory. In training session, distance for both groups decreased with training, but in aged rats it was significantly longer than that in young rats. In retention test 24 d after the training, distance in aged rats was longer than that in young rats, although there was no difference in distance for both groups between acquisition and retention tests. The distance in the working memory tended to increase with aging. There was no difference in time spent within platform phase in probe trial, in percent movement of first trial in habituation test, and in step-through latency in passive avoidance, between young and aged rats. Drinking latency for aged rats in water finding task was significantly longer compared with that in young rats. These findings suggest that learning and memory were impaired by aging in spatial and latent learning tasks. Aged rats could acquire and maintain memory of simple tasks, but in spatial tasks they tended to show decreased ability of retention and working memory.

Aging↗
PubMed1996

[Problem-based learning in a social medicine course--a concept for improving learning achievement and practice relevance].

In many medical curricula around the world, problem-based learning (PBL), i.e. inductive, usually interdisciplinary learning based on real or constructed cases, has been shown to improve the acquisition of knowledge. Additionally, it is valued positively by students. On the other hand, lecturing is usually valued negatively. Teaching of epidemiology and social medicine is further handicapped by the fact that students consider it irrelevant. In 1994/95, one of 18 social medicine courses for fifth year medical students at Hannover Medical School was problem-based. The following "cases" were used: 1. rheumatic patient with various social medical problems (losing sick pay, receiving status as handicapped person, early retirement etc.), 2. cluster of patients with leukaemia in the surroundings of a nuclear power plant and 3. recent newspaper articles on the effects of the 1993 Health Care Reform Law (dentists refusing to treat patients because of a fixed budget, introduction of prepayment methods in hospital etc.). Evaluation by the students at the end of the course revealed that PBL is well accepted in social medicine. Students rated learning success, relevance of the subject compared to other disciplines and the ability to transfer the acquired knowledge into medical practice well above the traditional courses. Besides lectures, practical courses and seminars, PBL should therefore be used as a standard method of learning in undergraduate medical education.

Attitude of Health Personnel↗
PubMed1983

Luck and learning: feedback contingencies and initial success in verbal discrimination learning.

Ninety undergraduate volunteers learned a 12-pair, low frequency, verbal discrimination list. The independent variables were feedback (positive only, negative only, or both) and initial success (17%, 50%, or 83% correct on trial one). With the total errors on nine trials as the dependent variable, the main effect of feedback was found to be not significant. The main effect of initial success was significant. Subjects who started at 50% correct had the most difficulty learning the list and subjects in the 83% correct condition learned quickest. The predicted interaction between feedback and initial success was not significant, even though the means for the three types of feedback at the 17% correct starting level reflect the expected differences. The results are interpreted as supporting the rule-use component of frequency theory. The relationship between initial success and subsequent performance appears to be curvilinear, rather than linear, as many theorists have assumed.

Discrimination Learning↗
PubMed2002

Learning to vary and varying to learn.

We compared two sources of behavior variability: decreased levels of reinforcement and reinforcement contingent on variability itself. In Experiment 1, four groups of rats were reinforced for different levels of response-sequence variability: one group was reinforced for low variability, two groups were reinforced for intermediate levels, and one group was reinforced for very high variability. All of the groups experienced three different reinforcement frequencies for meeting their respective variability contingencies. Results showed that reinforcement contingencies controlled response variability more than did reinforcement frequencies. Experiment 2 showed that only those animals concurrently reinforced for high variability acquired a difficult-to-learn sequence; animals reinforced for low variability learned little or not at all. Variability was therefore controlled mainly by reinforcement contingencies, and learning increased as a function of levels of baseline variability. Knowledge of these relationships may be helpful to those who attempt to condition operant responses.

Animals↗
PubMed2001

Learning to network and networking to learn: facilitating the process of adaptive management in a local response to the UK's National Air Quality Strategy.

The adaptive management leitmotiv of "learning to manage and managing to learn" sets out an attractive agenda for dealing with the overwhelming complexity of environmental phenomena that humans have problematized. To ensure that this rallying cry translates into effective action, it is important to give consideration to structures and procedures for facilitating the efforts of those willing or able to respond to the adaptive management call. To date, calls to establish the right organization to coordinate multiagency responses have tended to emphasize the noun, or bounded-entity, sense of the word organization. We believe that this is at the expense of its other, verb or process, connotation. In this paper, rather than searching for the perfect organization structure that mandates mutual trust and collective action shaped by all relevant parties' perspectives and possible contributions, we direct attention towards the process of nurturing integrated adaptive responses among individuals who have diverse organizational allegiances. By shifting the balance towards the process connotation of the right organization, we hope that a new mindscape can be discerned for those interested in putting adaptive management principles into practice. We seek to conjure up an image of this mindscape through the phrase "learning to network and networking to learn," and set out to strengthen this by demonstrating how adaptive response networks can arise from the mutually defining relationship between stakeholders and issues. This is demonstrated through a local response to the United Kingdom's National Air Quality Strategy.

Air Pollution↗
PubMed2006

Situated cognition and cognitive apprenticeship: a model for teaching and learning clinical skills in a technologically rich and authentic learning environment.

The acquisition of a range of diverse clinical skills is a central feature of the pre-registration nursing curriculum. Prior to exposure to clinical practice, it is essential that learners have the opportunity to practise and develop such skills in a safe and controlled environment under the direction and supervision of clinical experts. However, the competing demands of the HE nursing curriculum coupled with an increased number of learners have resulted in a reduced emphasis on traditional apprenticeship learning. This paper presents an alternative model for clinical skills teaching that draws upon the principles of cognitive apprenticeship [Collins, A., Brown, J.S., Newman, S., 1989. Cognitive Apprenticeship: teaching the crafts of reading, writing and mathematics. In: Resnick, L.B. (Ed.) Knowing. Learning and Instruction: Essays in Honor of Robert Glaser. Lawrence Erlbaum Associates, New Jersey, pp. 453-494] and situated cognition within a technologically rich and authentic learning environment. It will show how high quality DVD materials illustrating clinical skills performed by expert practitioners have been produced and used in conjunction with CCTV and digital recording technologies to support learning within a pedagogic framework appropriate to skills acquisition. It is argued that this model not only better prepares the student for the time they will spend in the practice setting, but also lays the foundation for the development of a clinically competent practitioner with the requisite physical and cognitive skills who is fit for purpose [UKCC, 1999. Fitness for Practice: The UKCC Commission for Nursing and Midwifery Education. United Kingdom Central Council for Nursing Midwifery and Health Visiting, London].

Attitude of Health Personnel↗
PubMed2001

Learning to have less pain - is it possible? A one-year follow-up study of the effects of a personal construct group learning programme on patients with chronic musculoskeletal pain.

A randomised controlled study with the objective to explore the effects of a group learning programme based on a phenomenological epistemology and personal construct theory. Main outcome measures were: experienced pain, pain coping strategies, absenteeism, disability pension and health care consumption. One hundred and twenty-one patients with chronic musculoskeletal pain and high absenteeism were included in this study. The intervention group (n=77) consisted of nine smaller groups with 6-10 persons in each and were counselled by health personnel with special training. The control group consisted of 44 persons. The learning programme emphasised awareness, possible relations between bodily symptoms, emotions, mind and life situation, and change of focus from pain and disability to resources and potentials. One year after the end of the learning programme (T3), patients in the intervention group reported significant pain reduction, increased pain-coping abilities and a higher reduction of health care consumption than the control group (P<0.05). Absenteeism was not significantly reduced compared to the control group, but there were fewer persons receiving disability pension in the intervention group at T3 (38 versus 59%) (P<0.05). This group-learning programme should be considered an important adjunct to the therapy of patients with chronic muscular pain.

Absenteeism↗
PubMed2003

Meta-learning in reinforcement learning.

Meta-parameters in reinforcement learning should be tuned to the environmental dynamics and the animal performance. Here, we propose a biologically plausible meta-reinforcement learning algorithm for tuning these meta-parameters in a dynamic, adaptive manner. We tested our algorithm in both a simulation of a Markov decision task and in a non-linear control task. Our results show that the algorithm robustly finds appropriate meta-parameter values, and controls the meta-parameter time course, in both static and dynamic environments. We suggest that the phasic and tonic components of dopamine neuron firing can encode the signal required for meta-learning of reinforcement learning.

Algorithms↗
PubMed1998

Encoded pattern classification using constructive learning algorithms based on learning vector quantization.

A novel encoding technique is proposed for the recognition of patterns using four different techniques for training artificial neural networks (ANNs) of the Kohonen type. Each template or model pattern is overlaid on a radial grid of appropriate size, and converted to a two-dimensional feature array which then acts as the training input to the ANN. The first technique employs Kohonen's self-organizing network, each neuron of which is assigned, after training, the label of the model pattern. It is found that a graphical plot of the labels of the neurons exhibits clusters (which means in effect that the feature array pertaining to distorted versions of the same pattern belongs to a specific cluster), thereby justifying the coding strategy used in this paper. When the new, unknown pattern is input to the network, it is classified to have the same label of the neuron whose corresponding model pattern is closest to the given pattern. In an attempt to reduce the computational time and the size of the network, and simultaneously improve accuracy in recognition, Kohonen's learning vector quantization (LVQ) algorithm is used to train the ANN. To further improve the network's performance and to realize a network of minimum size, two constructive learning algorithms, both based on LVQ, are proposed: (1) multi-step learning vector quantization (MLVQ), and (2) thermal multi-step learning vector quantization (TLVQ). When the proposed algorithms are applied to the classification of noiseless and noisy (and distorted) patterns, the results demonstrate that the pattern encoding strategy and the suggested training techniques for ANNs are efficient and robust. For lack of space, only the most essential results are presented here. For details, see Ganesh Murthy and Venkatesh (1996b).

Journal Article↗
PubMed1999

Learning to perceive the world as articulated: an approach for hierarchical learning in sensory-motor systems.

This paper describes how agents can learn an internal model of the world structurally by focusing on the problem of behavior-based articulation. We develop an on-line learning scheme-the so-called mixture of recurrent neural net (RNN) experts-in which a set of RNN modules become self-organized as experts on multiple levels, in order to account for the different categories of sensory-motor flow which the robot experiences. Autonomous switching of activated modules in the lower level actually represents the articulation of the sensory-motor flow. In the meantime, a set of RNNs in the higher level competes to learn the sequences of module switching in the lower level, by which articulation at a further, more abstract level can be achieved. The proposed scheme was examined through simulation experiments involving the navigation learning problem. Our dynamical system analysis clarified the mechanism of the articulation. The possible correspondence between the articulation mechanism and the attention switching mechanism in thalamo-cortical loops is also discussed.

Journal Article↗
PubMed1993

Reduced feedback frequency enhances generalized motor program learning but not parameterization learning.

The purpose of the study was to examine the effects of a reduced feedback frequency on the learning of generalized motor programs and movement parameterization. Subjects practiced three movement patterns with the same relative timing and the same relative amplitude, but with varied movement time (Experiment 1) or varied movement amplitude (Experiment 2). KR was given either on 100% or 63% of the trials, with learning being assessed by retention and transfer tests. In both experiments, reduced KR frequency enhanced GMP learning but generally degraded parameter learning. These data provide converging evidence for the dissociation of the program and parameterization processes postulated in GMP theory.

Adult↗
PubMed2001

The concentration of isoflurane required to suppress learning depends on the type of learning.

BACKGROUND: Recent reports suggest that one type of learning, fear conditioning to context, requires more neural processing than a related type, fear conditioning to tone. To determine whether these types of learning were differentially affected by anesthesia, the authors applied isoflurane during the training phases of fear conditioning paradigms for freezing to context and freezing to tone. METHODS: The authors trained seven groups of eight rats to fear tone by administering a tone (conditioned stimulus) while breathing various concentrations of isoflurane from 0.00 to 0.75 minimum alveolar concentration (MAC; one concentration per group) separated by 0.12-MAC steps. On the succeeding day, and in the absence of isoflurane, the authors presented the tone (without shock) in a different context (different cage shape and odor) and measured the time each rat froze (became immobile). Six other groups of eight rats were trained to fear context by applying the shock in the absence of a tone but in the presence of environmental cues such as cage shape, texture, and odor. Fear to context was determined the succeeding day by returning the rat to the training cage (without shock) and measuring duration of freezing. Control groups (16 per group) received 0.75 MAC isoflurane but no foot shocks. Group scores were compared using analysis of variance, and the ED50 values for quantal responses of individual rats were calculated using logistic regression. RESULTS: Conditioning to context occurred at 0.00 and 0.13 MAC (P < 0.05 compared with unshocked control) but not 0.25 MAC; the ED50 was 0.25 +/- 0.03 MAC (mean +/- SEM). In contrast, conditioning to tone occurred at 0.48 MAC (P < 0.05) but not 0.62 MAC; the ED50 was 0.47 +/- 0.02 MAC (P < 0.01 for the difference between ED50 values). CONCLUSIONS: Suppression of fear conditioning to tone required approximately twice the isoflurane concentration that suppressed fear conditioning to context. Thus, the concentration of anesthetic required to suppress learning may depend on the neural substrates of learning. Our results suggest that isoflurane concentrations greater than 0.5 MAC may be needed to suppress both forms of fear conditioning.

Acoustic Stimulation↗
PubMedDate not supplied

Development of theory-based, online health learning modules for older adults: Lessons learned.

Recently, the number of older adult online users has increased rapidly. In 2004, 22% of Americans aged 65 years or older (about 8 million) used the Internet, and 66% of them performed online searches for health information. The Web, therefore, can serve as a useful medium to educate older adults on selected health topics. In this study, the researchers developed four Web-based learning modules related to hip fracture prevention and tested the usability of these modules employing eight older adult online users. The findings from the usability tests demonstrated that the online learning modules were usable to the older adult participants. Additionally, these individuals could acquire health knowledge using these online modules. The important lessons learned through the research process will assist the researchers in conducting further studies in using health Web learning modules for older adults. A further study will be conducted to test the effects of these modules on preventing hip fractures.

Aged↗
PubMed1994

Neural basis for motor learning in the vestibuloocular reflex of primates. III. Computational and behavioral analysis of the sites of learning.

1. We have used a combination of eye movement recordings and computer modeling to study long-term adaptive modification (motor learning) in the vestibuloocular reflex (VOR). The eye movement recordings place constraints on possible sites for motor learning. The computer model abides by these constraints, as well as constraints provided by data in previous papers, to formalize a new hypothesis about the sites of motor learning. The model was designed to reproduce as much of the existing neural and behavioral data as possible. 2. Motor learning was induced in monkeys by fitting them with spectacles that caused the gain of the VOR (eye speed divided by head speed) to increase to values > 1.6 or to decrease to values < 0.4. We elicited pursuit by providing ramp motion of a small target at 30 degrees/s along the horizontal axis. Changes in the gain of the VOR caused only small and inconsistent changes in the eye acceleration in the first 100 ms after the onset of pursuit and had no effect on the eye velocity during tracking of steady target motion. Electrical stimulation in the flocculus and ventral paraflocculus with single pulses or trains of pulses caused smooth eye movement toward the side of stimulation after latencies of 9-11 ms. Neither the latency, the peak eye velocity, nor the initial eye acceleration varied as a consistent function of the gain of the VOR. 3. The computer model contained nodes that represented position-vestibular-pause cells (PVP-cells) and flocculus target neurons (FTNs) in the vestibular nucleus, and horizontal gaze-velocity Purkinje cells (HGVP-cells) in the cerebellar flocculus and ventral paraflocculus. Node FTN represented only the "E-c FTNs," which show increased firing for eye motion away from the side of recording. The transfer functions in the model included dynamic elements (filters) as well as static elements (summing junctions, gain elements, and time delays). Except for the transfer functions that converted visual motion inputs into commands for smooth eye movement, the model was linear. 4. The performance of the model was determined both by computer simulation and, for the VOR in the dark, by analytic solution of linear equations. For simulation, we adjusted the parameters by hand to match the output of the model to the eye velocity of monkeys and to match the activity of the relevant nodes in the model to the firing of HGVP-cells, FTNs, and PVP-cells when the gain of the VOR was 0.4, 1.0, and 1.6.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗