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PubMed1998

Qualitative evaluation of courses intended for patients suffering from chronic diseases. New observation method for the continuous training of the healthcare team.

Experience has shown that when teaching patients, healthcare providers concentrate more on information concerning the illness rather than on the handling of treatment. Therapeutic education of patients imposes a precise structure on the pedagogic method and teaching aids. It is essential that, during their clinical practice, care-providers develop teaching methods which encourage a maximum of interaction to help patients learn to manage their own treatment. In this perspective, the authors propose 'analytical observation' as a method of training evaluation for healthcare providers. Three observation charts, as well as an analytical method for evaluation, have been devised. They have been tried and validated during a study whose principal objective was to measure quantitatively the impact of supervision of care-providers in the domain of therapeutic education of patients. The authors conclude that this method has a definite impact on the pedagogic progress of the care-providers. It makes it possible to record and to give a structure to the pedagogic follow-up (inspection, examination, testing) of care-providers. Since patient education plays a key role in therapeutic success, this type of methodology for training and evaluation conforms to the rigorousness essential to any therapeutic undertaking.

Chronic Disease↗
PubMed2001

Modeling emotion and behavior in animated personas to facilitate human behavior change: the case of the HEART-SENSE game.

The goal of this research is to determine whether a computer based training game (HEART-SENSE) can improve recognition of heart attack symptoms and shift behavioral issues so as to reduce pre-hospitalization delay in seeking treatment. Since treatment delay correlates with adverse outcomes, this research could reduce myocardial infarction mortality and morbidity. In Phase I we created and evaluated a prototype virtual village in which users encounter and help convince synthetic personas to deal appropriately with a variety of heart attack scenarios and delay issues. Innovations made here are: (1) a design for a generic simulator package for promoting health behavior shifts, and (2) algorithms for animated pedagogical agents to reason about how their emotional state ties to patient condition and user progress. Initial results show that users of the game exhibit a significant shift in intention to call 9-1-1 and avoid delay, that multi-media versions of the game foster vividness and memory retention as well as a better understanding of both symptoms and of the need to manage time during a heart attack event. Also, results provide insight into areas where emotive pedagogical agents help and hinder user performance. Finally, we conclude with next steps that will help improve the game and the field of pedagogical agents and tools for simulated worlds for healthcare education and promotion.

Algorithms↗
PubMed2005

[Quality in nursing care--action research in "Hamburger Behindertenhilfe"/Hamburg to disabled care].

A two year action research program with the title "Quality in Nursing Care" was carried out by a large institute for disabled care in Hamburg. Presently, the importance of quality in nursing as a profession is seen to be secondary to that of pedagogy in the area of disabled care. A major explanation for this could be the fact that 150 years ago the treatment and care of disabled people lay predominately in the field of theology and only later in that of medicine. In the second half of the 20th century, in the 60ies and 70ies to be precise, starting with an investigative commission "Psychiatryenquete "pedagogical science began to focus on the education of disabled people and their integration within society. At this point in time, seen from the pedagogical point of view, the care of disabled people in theory and practice freed itself from being a medicine concentrated profession and from the dominance of nursing care. However in today's society due to the increasing number of disabled people requiring expert nursing care there is a necessity to examine care related needs of assistance. With the research project "Quality in Nursing Care" an institute for disabled care has looked at different nursing care interventions and methods that our society may require for the changing situation we are presently being confronted with. An analysis of the requirements, the content and evaluation of the three chosen project related interventions, (the individual consulting of inhabitants with regard to the broadening of the competence skills, the development of expert nursing competence through further and continuous education of multipliers, and the development of codes and guidelines for activities) will be introduced. Beginning with the basic and primary principle of the action research, the researchers have developed, with the participating members of the institutions, the specific aims of the work undertaken and the interventions studied and executed. The most important discovery made during the project work undertaken is that the assessment of the extensively nursing linked problems experienced by the inhabitants in disabled care at this point in time is either simply not receiving enough attention or not being taken sufficiently into consideration by the predominately pedagogically trained staff. Taking this into account it is quite clear that professional nursing support in the long term has an important role to play in a successful disabled people orientated care concept.

Attitude to Health↗
PubMed1994

The implementation of problem-based learning: changing pedagogy in nurse education.

Problem-based learning (PBL) employs approaches to teaching and learning in nurse education that develop meaningful links between theory and practice. The adoption of such approaches, however, may require changes in pedagogical beliefs and practices which reflect a student-centred approach to teaching and learning. This paper focuses on a group of volunteer nurse educators (n = 14) who attended a 7-month professional development programme centred on introducing pedagogical changes when adopting PBL. From this group, three nurse educators participated in an in-depth study which aimed to examine the processes of conceptual change associated with adopting PBL as part of alternative teaching strategies. These three participants held common concerns about the changes required to their current teaching practices when moving to a new pedagogical approach. On completion of the programme, varying degrees of change in existing instructional practices were evident. This change was found to result from engaging educators in reflection about practice, providing opportunities to implement the new approaches on a trial basis, and providing feedback and support throughout the change process.

Education, Nursing↗
PubMed2006

How women with breast cancer learn using interactive cancer communication systems.

To provide insights about how women with breast cancer learn from interactive cancer communication systems (ICCSs), this study examined how use of different types of services that employ conceptually distinct pedagogical methods relates to learning outcomes. The study sample included 231 recently diagnosed, lower income breast cancer patients. Participants were provided a free computer, Internet access and training in how to use an ICCS called the Comprehensive Health Enhancement Support System 'Living with Breast Cancer' program. Data comprised survey information collected at pre-test and 4 months after using the system and computer records of how women used the system (use data). The findings suggest that use of the information and interactive services independently contributed to perceived information competence, though the communication services, including both discussion group and ask an expert, did not. Consistent with expectations, use of discussion group and interactive services amplified the learning effects of using the information services. However, use of the ask an expert service did not amplify the learning effects of using the information services as predicted. Some constructivist pedagogical methods-specifically online support groups and intelligently designed, computer-driven interactive services-may supplement and extend the learning potential of information services delivered via a transmission-oriented pedagogical approach.

Breast Neoplasms↗
PubMed2004

A survey of medical ethics education at U.S. and Canadian medical schools.

PURPOSE: To assess the format, content, method, and placement of medical ethics education in medical schools; the faculty and curricular resources and institutional structure and support of medical ethics; and the perceptions of ethics education among deans of medical education and medical ethics course directors at U.S. and Canadian medical schools. METHOD: Two questionnaires were mailed to 125 U.S. medical schools and 16 Canadian schools: one to be completed by the deans of medical education and one to be completed by the medical ethics course director. Descriptive statistics were used to compare responses. RESULTS: In all, 123 (87%) deans and 91 (64%) course directors responded, providing information about 91 schools (six Canadian). All responding institutions offered some formal instruction in medical ethics, and among these, 71 (78%) incorporated ethics into required preclinical courses. The primary pedagogic course structure was small-group discussion and the primary pedagogic method was case discussions. One-fifth of schools provided no funding for ethics teaching, and 47 (52%) did not fund curricular development in ethics. Institutions with a dedicated ethics faculty member were twice as likely to have a mandatory introductory ethics course (64% versus 32%, p <.05). The primary obstacles to ethics education were thought to be a lack of time in the curriculum, a lack of qualified teachers, and a lack of time in faculty schedules. CONCLUSIONS: Within a few decades the number of U.S. and Canadian medical schools requiring medical ethics has increased. Nevertheless, significant variation in the content, method, and timing of ethics education suggests consensus about curricular content and pedagogic methods remains lacking. Further progress in ethics education may depend on institutions' willingness to devote more curricular time and funding to medical ethics.

Canada↗
PubMed2005

Dementia: involving patients in storytelling--a caring intervention. A pilot study.

AIMS AND OBJECTIVES: The aim of this study was to explore the potential therapeutic role of storytelling in patients with dementia and, if so, to formulate pedagogic implications for the field of nursing with the focus on dementia care. BACKGROUND: The present study is part of a larger project, Drama-Ger (Lepp et al. 2003: Journal of Clinical Nursing 12, 873-881), consisting of a cultural drama programme designed for patients with dementia and their caregivers. The programme consisted of two groups (A and B). Group A focused on dance, rhythm and songs, group B focused on storytelling and conversations. The present pilot study deals with group B. DESIGN: The study was an intervention study. METHODS: Six strategically selected patients, five women and one man, with intermediate and severe dementia, and their three female paid caregivers participated in the programme. They met on six occasions for 1.5 hours once a week for two months. The leader of the group, a Registered Nurse, who was also trained as a symbol pedagogue/teacher, told stories that were related to Erikson's development theory. She continuously kept a reflective diary which was qualitatively analysed. RESULTS: This pilot study clearly indicates that storytelling invited the patients to take part in associative conversations. The storytelling appeared to help them to remember and make associations with situations they had previously experienced in their lives. Erikson's stages of development could be traced in the conversations. The patients interacted with each other, their caregivers and the leader. CONCLUSIONS: A drama programme using storytelling appears to stimulate patients with dementia to communicate and interact with other people. Ten implications four statements about storytelling as a pedagogic tool and six statements to facilitate a pedagogic approach have been drawn from this study. RELEVANCE TO CLINICAL PRACTICE: The implications can be used as a guide when using storytelling for caring intervention with the focus on dementia care.

Aged↗
PubMed2007

On pedagogy.

Humans are adapted to spontaneously transfer relevant cultural knowledge to conspecifics and to fast-learn the contents of such teaching through a human-specific social learning system called 'pedagogy' (Csibra & Gergely, 2006). Pedagogical knowledge transfer is triggered by specific communicative cues (such as eye-contact, contingent reactivity, the prosodic pattern of 'motherese', and being addressed by one's own name). Infants show special sensitivity to such 'ostensive' cues that signal the teacher's communicative intention to manifest new and relevant knowledge about a referent object. Pedagogy offers a novel functional perspective to interpret a variety of early emerging triadic communicative interactions between adults and infants about novel objects they are jointly attending to. The currently dominant interpretation of such triadic communications (mindreading) holds that infants interpret others' object-directed manifestations in terms of subjective mental states (such as emotions, dispositions, or intentions) that they attribute to the other person's mind. We contrast the pedagogical versus the mindreading account in a new study testing 14-month-olds' interpretation of others' object-directed emotion expressions observed in a communicative cueing context. We end by discussing the far-reaching implications of the pedagogical perspective for a wide range of early social-cognitive competences, and for providing new directions for future research on child development.

Analysis of Variance↗
PubMed1992

Social and academic treatments in mixed-ethnic classes and change in student self-concept.

The efficacy of three pedagogical strategies for the enhancement of student academic and social self-concept in mixed-ethnic classes was examined among 594 Israeli children of varying status levels in their first year of junior high school. One treatment approach involved cooperative learning in small groups; a second approach employed a specially designed social relations programme; and the third approach presented the social relations programme and cooperative learning. A comparison group using traditional pedagogical approaches was also investigated. Status level was defined according to student sociometric standing and academic standing. Results indicated that low-achieving students of Middle Eastern background only in the comparison group sustained a significant negative change in their social and academic self-concepts. All three treatment strategies succeeded in curbing this decline. Findings were in the same direction when status was defined by sociometric standing. These results suggest that under proper pedagogical conditions minority children in mixed-ethnic classes need not suffer any decline in their self-concept.

Child↗
PubMed2005

Pimping: perspectives of 4th year medical students.

BACKGROUND: A well-known phenomenon among U.S. medical students known as pimping, or the pedagogical device of questioning students in the clinical setting, receives virtually no attention in medical literature. PURPOSE: Identifying 4th-year medical students' relevant knowledge and attitudes about pimping may help educators understand the range of beliefs about pimping and the role it plays in the socialization process into the medical community. METHODS: Over a 2-month period, 11 fourth-year medical students at a Midwest medical school were asked 6 open-ended questions focusing on pimping as understood and experienced in the clinical setting. Investigators individually analyzed the interview data using qualitative methods to characterize students' experiences and recurring ideas and concepts. RESULTS: All students noted the hierarchical nature of pimping, viewing it as a tool for attendings or residents to assess students' levels of knowledge. Although some students experienced malignant pimping, humiliated by incessant questioning or questions inappropriate to their level of training, all the students in the sample were positive about pimping and its effectiveness as a pedagogical tool. Investigators found that location within the clinical setting determines how students define and understand the motives for pimping. CONCLUSIONS: Understanding how students define and experience the pimping phenomenon prepares medical educators to scrutinize pimping as a pedagogical tool and to provide the most effective and encouraging environment for students.

Clinical Clerkship↗
PubMed2006

Developmental dynamics between mathematical performance, task motivation, and teachers' goals during the transition to primary school.

BACKGROUND: It has been suggested that children's learning motivation and interest in a particular subject play an important role in their school performance, particularly in mathematics. However, few cross-lagged longitudinal studies have been carried out to investigate the prospective relationships between academic achievement and task motivation. Moreover, the role that the classroom context plays in this development is largely unknown. AIMS: The aim of the study was to investigate the developmental dynamics of maths-related motivation and mathematical performance during children's transition to primary school. The role of teachers' pedagogical goals and classroom characteristics on this development was also investigated. SAMPLE: A total of 196 Finnish children were examined four times: (0) in October during their preschool year; (1) in October and (2) April during their first grade of primary school; and (3) in October during their second grade. METHOD: Children's mathematical performance was tested at each measurement point. Task motivation was examined at measurement points 2, 3, and 4 using the Task-value scale for children. First-grade teachers were interviewed in November about their pedagogical goals and classroom characteristics. RESULTS AND CONCLUSIONS: The results showed that children's mathematical performance and related task motivation formed a cumulative developmental cycle: a high level of maths performance at the beginning of the first grade increased subsequent task motivation towards mathematics, which further predicted a high level of maths performance at the beginning of the second grade. The level of maths-related task motivation increased in those classrooms where the teachers emphasized motivation or self-concept development as their most important pedagogical goal.

Child↗
PubMedDate not supplied

[The teaching of management in Brazil: the process of construction of managerial competences].

The study had as objectives: the identification of the conceptual, methodological and pedagogical bases adopted in the teaching of Management in Nursing Schools in Brazil; the identification and characterization of managerial competences which have been developed in educational practices. The approach adopted was a quantitative-qualitative one, carried out in two moments: the first had as a scenario eight schools; the second had five, representing the five geo-political regions. Data was collected from the teaching guidelines, into consideration: objectives, hour load, duration, the moment of insertion, program content, pedagogical strategies and the form of evaluation. Results showed that, although there has been advancement in the conceptual bases, development of managerial competences is not made explicit in the teaching guidelines; moreover, the pedagogical proposals are traditional.

Brazil↗
PubMed2001

[Teaching training: an important skill for undergraduate students].

This work describes the structure of the course "Pedagogical Training" introduced in the new Nursing Curriculum of Minas Gerais Federal University College of Nursing. We believe that attending this pedagogical course provides students with the opportunity to be the active subjects and architects of their own knowledge, which will make it possible for them to deliberately develop their roles as educators and perform in a critical manner in view of the reality of those involved. It can be said that pedagogical training constitutes one of the possibilities to think about, reflect on and construct the teaching-learning process during both the moments experienced in class and those in the fields of clinical practice.

Curriculum↗
PubMed2000

A community rheumatology practice offers an educational experience comparable to that of a university tertiary care center.

OBJECTIVE: To compare the teaching value of rheumatology patients seen in either a community rheumatology practice or in a tertiary care university center. METHODS: Consecutive patients seen at the 2 sites over a one month period were assessed for rheumatology diagnosis, complexity of rheumatologic disease, and treatments received, including number of interventions performed. The overall pedagogic value of the encounter was rated by the rheumatologist for both medical students and postgraduate trainees. RESULTS: Rheumatology patients were comparable at the 2 sites for overall pedagogic value, rheumatology diagnostic category, and complexity of disease. At the community site, however, there were more patients evaluated, more procedures performed, and more new treatments introduced. CONCLUSION: Contrary to current perceptions, comparable pedagogic value of rheumatology patients was observed outside a tertiary care setting. In the changing climate of education, and considering resource limitations that influence current rheumatology practice, community based rheumatology has the potential to offer a valuable educational experience.

Community Health Services↗
PubMed2002

[The main trends in a complex program of rehabilitation of children with oncological diseases].

The present-day therapeutical programmes allow physicians to cure as many as 70% of children with malignant neoplasms, in some tumor forms, the proportion of recovered children is much higher, which shows it urgent to elaborate comprehensive rehabilitation programmes required for the effective integration of prior patients of children's cancer clinics into a group. The paper presents a complex rehabilitation programme worked out at the Research Institute of Pediatric Oncology and Hematology, Russian Cancer Research Center, Russian Academy of Medical Sciences. The basic directions of the programme are medical, psychological, pedagogical, and social rehabilitation. For medical rehabilitation, phytotherapy, medical laser, climate therapy, and therapeutical exercises are widely used. Of particular value are physical and recreational activities, which include the use of therapeutical exercises, active recreational activities, participation in sporting events, and conditioning swimming. Psychological and pedagogical rehabilitation is aimed at solving personality and familial problems, at developing intellectual abilities, and at eliminating steady-state bad habits and behavioral deviations. A psychological and pedagogical programme is based on the work of art-therapeutical shops where a child realizes his/her strivings, which promotes the recovery of his/her mental and social status. The work of psychologists and psychotherapeutists with children's parents occupies a highly important place since correction of child-parent relations serves as a necessary basis for mental recovery in a child. The most important factor of social rehabilitation is an educational programme aimed at acquiring knowledge and at stimulating cognitive activities. To implement the comprehensive programme increases life quality in children who have sustained cancer diseases, improves their social adaptation and thus facilitates integration of these children in society.

Child↗
PubMed2002

[Role of patient associations in the development of therapeutic education in France].

The aim of this survey conducted among patient associations is to define the role and the position that they have with regard to the development of therapeutic education in France. 124 associations were solicited (out of over 500 existing), and 68 replied. 17 indicated that the survey was not relevant for them. 51 answered the 43 questions related to the conception and implementation of educational programmes, their goals and objectives, the choice and selection of educational activities, the target audiences and pedagogical principles of reference. The results obtained demonstrate the predominance of informational activities and psychological support. The responding associations declared that sometimes they conduct educational activities which rather resemble informational activities. Only three associations declared having Implemented and managed formalised educational programmes based on pedagogical methods. The aims and objectives most frequently targeted were focused on increasing the patients' knowledge on their disease and its treatment. These educational programmes are usually delivered by members of the association's office staff. However, overall most of the responding associations indicated that it is relatively difficult to provide precise data on the pedagogical methods of the activities undertaken. In light of the results, it is therefore necessary to consider the totality of the activities conducted by the associations as a mechanism for building educational resources in which the place of formalised educational programmes remains marginal, even quasi-absent, for the moment. Associations believe that patient education is an important issue for their development. It is highly likely that the emergence of such programmes will only be possible if the associations show some degree of autonomy in relation to the health care sector and assert a point of view specific to patients, above and beyond that of health care users.

France↗
PubMedDate not supplied

[Is it possible to improve the teaching methods of physicians who instruct patients? Comparative analysis of the same courses given before and after teacher's training].

The goal of the present study is to compare the pedagogic involvement of two groups of doctors, both of which were in charge of teaching the same courses to diabetic patients. Important structural differences were-shown exit between the two series of courses. The first group of ten doctors (who not undergone any pedagogic training) applied either ex-catedra teaching methods or proceeded by systematically asking questions to the patients. These scholastic methods led to passive attitudes in their patients in listening and replies to a large number of questions. In the second group of ten doctors (who had undergone pedagogic training) learning practices and a stimulating didactic material were used which resulted in more diversified and more attractive responses in the participation of the patients. Providing improved didactic means on the behalf of the doctors is aimed at obtaining better knowledge from patients who have themselves to assume the self-management of their treatment.

Diabetes Mellitus↗
PubMed2003

Physical therapy students' self-reports of development of clinical reasoning: a preliminary study.

Reports of student perceptions about the efficacy of educational tools used by academic and clinical instructors to facilitate clinical reasoning are limited. Physical therapist students' (PTSs') perceptions of tools for developing clinical reasoning and problem-solving skills were surveyed to determine the effectiveness of various teaching methods and to identify factors associated with clinical reasoning development. The purposes of this descriptive investigation were to determine (1) if factors, such as learning mode, life experience, and curriculum, influence PTS' perception of their clinical reasoning mastery; (2) the relative roles of academic and clinical instructors and the value of their pedagogic tools in assisting PTS with clinical reasoning development; and (3) how PTS rate their degree of mastery of clinical reasoning as they progress through training. A survey was mailed to 17 physical therapy schools in New York and 2 in New Jersey; 156 PTS near graduation responded, yielding a 22% response rate. The survey instrument had 6 open-ended and 19 multiple-choice questions. Frequency analysis showed (1) PTS' opinion about how they would teach clinical reasoning varied with their preferred learning mode, (2) prior life experiences were associated with clinical reasoning for some individuals, (3) academic and clinical instructors contribute to development of clinical reasoning, (4) the best pedagogic tools involved case study presentations/ assignments using actual patients or videotapes, and (5) PTS gained confidence in their clinical reasoning ability while progressing through clinical education experiences. Results support inclusion of diverse pedagogic tools, such as case studies, and emphasizing a variety of learning modes to facilitate PTS' development of clinical reasoning.

Allied Health Personnel↗