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At least 1,009 records · Page 56Linked to original sources
PubMed2005

Progress testing: evaluation of four years of application in the school of medicine, University of São Paulo.

BACKGROUND: Progress testing is a longitudinal tool for evaluating knowledge gains during the medical school years. OBJECTIVES: (1) To implement progress testing as a form of routine evaluation; (2) to verify whether cognitive gain is a continuous variable or not; and (3) to evaluate whether there is loss of knowledge relating to basic sciences in the final years of medical school. METHODS: A progress test was applied twice a year to all students from 2001 to 2004. The mean percentage score was calculated for each school year, employing ANOVA with post hoc Bonferroni test evaluation for each test. RESULTS: Progress testing was implemented as a routine procedure over these 4 years. The results suggest a cognitive gain from first to sixth year in all eight tests, as a continuum (P for trend < .0001). Gain was found to be continuous for basic sciences (taught during the first 2 years), clinical sciences (P < .0001), and clerkship rotation (P < .0001). There was no difference between the performance of men and women. CONCLUSION: Progress testing was implemented as a routine, applied twice a year. Data suggest that cognitive gain during medical training appears to be a continuum, even for basic science issues.

Analysis of Variance↗
PubMed1996

An international comparison of knowledge levels of medical students: the Maastricht Progress Test.

The increasing international mobility of medical students has inspired the search for an international assessment format. As one step along this line, kinetics of knowledge acquisition and final cognitive levels of students were compared among one Dutch, one German and four Italian medical faculties. For this comparison, the Maastricht Progress Test (MPT) was used. For four out of the six participating faculties, it was possible to compare the level of knowledge of sixth-year students. These data showed no significant differences on the test as a whole. On the other hand, as judged from cross-sectional data on students from all study years, the kinetics of knowledge acquisition showed different trends. In one school applying problem-based learning, acquisition of knowledge by students occurred almost linearly. In another school, over the first 2 years, acquisition of knowledge occurred only in the basic sciences but not in clinical or public health/behavioural sciences. In two other schools over that same period, students seemed to gain no knowledge at all. In some faculties, a marked boost in knowledge was noted with third- or fourth-year students. These findings may be explained by peculiarities of the respective curricula, selection of students during their studies, and national or local assessment procedures. It is preliminarily concluded that the different educational approaches and assessment systems in medical education in Europe seem to have only limited influence on the final level of knowledge of the graduates. On the other hand, these differences may influence the kinetics of knowledge acquisition, especially in distinct domains like basic or clinical sciences. Therefore, the MPT may not be suitabe to solve the problem of assessment of individual international exchange students, but it may be helpful in identifying corresponding cognitive levels on, for example, basic sciences for students in different curricula.

Clinical Competence↗
PubMedDate not supplied

Inter-rater reliability of the diagnosis of vascular cognitive impairment at a memory clinic.

Consensus criteria for the diagnosis of vascular dementia (VaD) are gradually being replaced with data-based criteria. We report the inter-rater reliability of a new set of empirically-derived criteria for vascular cognitive impairment (VCI). Stratified sampling, with optimal allocation, was employed to randomly select 36 patients from the Queen Elizabeth II Health Science Centre's Memory Disability Clinic. Chart reviews were conducted independently by 4 physicians. Each physician classified the patients as having either: no cognitive impairment, VCI or Alzheimer's disease (AD). VCI was further classified both clinically (VCI without dementia, VaD or AD with a vascular component) and radiographically (infarcts, white matter changes, single strategic stroke). The intraclass correlation coefficient (ICC) for the diagnosis by physicians of VCI or otherwise was based on a repeated-measures analysis of variance with raters as the independent variable. A significant coefficient of reliability (average ICC = 0.88, 95% CI = 0.80-0.93) was obtained (H(o): rho </= 0.80, p = 0.03). Where differences in diagnosis occurred, the discrepancies most commonly resulted within the subtypes of VCI (9 cases) or between the diagnoses of AD and VCI (9 cases). Instances of diagnostic incongruity were typically due to the disagreement of a single rater (10 cases). This study demonstrates a high degree of reliability of criteria for VCI by physicians in a memory clinic, and can also be understood as an aspect of construct validation of those criteria. In the absence of a readily available biological marker for VCI, clinical criteria are necessary and can be reliably employed.

Activities of Daily Living↗
PubMed2003

A neurodevelopmental model for anorexia nervosa.

This paper integrates genetic and biological data on aetiological risk for anorexia nervosa (AN) with cognitive and psychosocial explanatory models. We have reviewed clinical and basic science data from each of these domains and then used a developmental perspective to formulate a multifactorial threshold model. By positioning interpersonal stress as a central component of this model, psychological, social and biological conceptualisations of AN can be used to generate a data driven, neurodevelopmental hypothesis for the aetiology of this complex disorder.

Adaptation, Psychological↗
PubMed1993

Use of analogy in learning scientific concepts.

Four experiments compared learning of scientific concepts as expressed in either traditional literal form or through an analogy. Comprehension of basic-level details and inferential implications was measured through multiple-choice testing. In Experiment 1, literal or analogical renditions were presented in textual form only. In Experiment 2, text was accompanied by a dynamic video. In Experiment 3, the video and text literal rendition was compared with a text-only analogical rendition. In Experiment 4, subjects read only about a familiar domain. Subjects consistently answered basic-level questions most accurately when concepts were expressed literally, but answered inferential questions most accurately when concepts were expressed analogically. Analysis of individual differences (Experiment 2) indicated that this interaction strongly characterized the conceptual learning of science novices. The results are discussed within the framework of schema induction.

Adult↗
PubMed1989

Evidence for subgroups of adextrals based on speech lateralization and cognitive patterns.

Some non-right-handers may prefer the left hand by virtue of well-organized or high levels of spatial ability, vested primarily in the right hemisphere, rather than as a result of anomalous speech representation. This study tested the hypothesis that adextral (left-handed or ambidextrous) individuals with high spatial ability might have cerebral speech lateralization patterns similar to dextrals. Paper-and-pencil tests of various cognitive abilities, a verbal dichotic listening task, and a handedness inventory were administered to two groups (science or non-science students) of adextral and dextral subjects. The science group had predictably higher spatial ability than the non-science group. Adextral science students were as lateralized on dichotic listening, and had equal spatial ability, compared to dextral science students. Adextral non-science males were less lateralized and had (unexpectedly) poorer spatial ability than dextral non-science males. Thus in adextrals, variations in ability patterns may be related to variations in speech lateralization.

Attention↗
PubMed2000

Representation, space and Hollywood Squares: looking at things that aren't there anymore.

It has been argued that the human cognitive system is capable of using spatial indexes or oculomotor coordinates to relieve working memory load (Ballard, D. H., Hayhoe, M. M., Pook, P. K., & Rao, R. P. N. (1997). Behavioral and Brain Sciences, 20(4), 723), track multiple moving items through occlusion (Scholl, D. J., & Pylyshyn, Z. W. (1999). Cognitive Psychology, 38, 259) or link incompatible cognitive and sensorimotor codes (Bridgeman, B., & Huemer, V. (1998). Consciousness and Cognition, 7, 454). Here we examine the use of such spatial information in memory for semantic information. Previous research has often focused on the role of task demands and the level of automaticity in the encoding of spatial location in memory tasks. We present five experiments where location is irrelevant to the task, and participants' encoding of spatial information is measured implicitly by their looking behavior during recall. In a paradigm developed from Spivey and Geng (Spivey, M. J., & Geng, J. (2000). submitted for publication), participants were presented with pieces of auditory, semantic information as part of an event occurring in one of four regions of a computer screen. In front of a blank grid, they were asked a question relating to one of those facts. Under certain conditions it was found that during the question period participants made significantly more saccades to the empty region of space where the semantic information had been previously presented. Our findings are discussed in relation to previous research on memory and spatial location, the dorsal and ventral streams of the visual system, and the notion of a cognitive-perceptual system using spatial indexes to exploit the stability of the external world.

Adult↗
PubMed1981

Why medicine cannot be a science.

My thesis is that, although medicine is scientific, it is not and can not become a science. After rejecting as flawed an argument attempting to show that medicine is already is science. I argue that a comparison of such basic, defining features as internal aims, criteria of success, and principles regulating the enterprises demonstrate that medicine and science are inherently different. I then argue that while it may be possible to reduce the cognitive content of medicine to biology, medicine itself cannot be reduced, for as an enterprise it possesses features that make it an inappropriate subject of reduction. I conclude by indicating four results that emerge from recognizing that medicine and science are basically distinct.

Medicine↗
PubMed2002

Emotional behaviour as the result of stochastic interactions. A process crucial for cognition.

This paper is aimed at exhibiting two striking features of the usual approach of emotional expression in science and philosophy, suggesting a different perspective. One is the generally shared belief that emotions are a state of utter disarray, which hampers objective knowledge; the other is the search for causal explanation, along a wide range of categorized approaches (psychology, neurosciences, developmental biology) each proposing its own theoretical framework. In both cases the result is to play down emotional expression. Alternatively, we propose to view emotions as something crucial in the choice of our conceptual tools, ideas and involvements, in the genesis of which various explanations interact in a complex stochastic way. Rather than being a harmful disruption of the mind calling for identification of a definite causality, emotional behaviour appears as a necessary process in cognition, which is irreducible to a unique origin.

Journal Article↗
PubMed2005

Predicting drug efficacy for cognitive deficits in schizophrenia.

The purpose of this article is to discuss the prediction of cognitive enhancement in schizophrenia from preclinical data. Despite increasing focus on the significance of cognitive impairment in schizophrenia, the progress of novel treatments has been slow. Hyman and Fenton's identification of a "translational gap" between preclinical and clinical science underscores the need to revise preclinical, clinical, and regulatory practice. A review of the clinical literature identifies evidence for some cognitive benefits with current antipsychotics. The magnitude of these effects may, in some cases, be too small to be functionally relevant, and many studies are methodologically flawed, but the data might nevertheless allow translational links to be identified between clinical and preclinical studies. The literature is reviewed to determine if the cognitive signal reported in clinical studies is detectable in preclinical studies. The effects of antipsychotics on prepulse-inhibition deficits in animals is robust and demonstrates a reversal of drug-induced and developmentally induced deficits, although predictive links to the clinic are not well established. The preclinical literature on antipsychotic effects on attention, learning and memory, and recognition and executive function shows, with rare exceptions, impaired learning or task performance, rather than improvement. In general, therefore, preclinical studies have not detected the small pro-cognitive signal evident in the clinical literature. A number of factors may account for this. Effective closure of the translation gap for cognitive deficits in schizophrenia will require the design of a coherent preclinical strategy, and some of the potential elements of such a strategy are outlined and discussed.

Animals↗
PubMed1988

Theory-based ability measurement: the learning abilities measurement program.

This paper briefly describes the U.S. Air Force Learning Abilities Measurement Program (LAMP), which is devoted to the development of a science-based system of ability measurement. A short history is given of ability testing and research in the military services, along with a statement of the value of ability testing for making personnel selection and classification decisions. Although few advances in ability measurement have been made in the last two decades, the present availability of micro-computers and recent progress in our understanding of human cognition create possibilities for a major breakthrough in the state-of-the-art. Examples are provided of recent LAMP studies on processing speed and processing capacity which hold promise for forecasting individual differences in learning efficiency, performance capabilities, and susceptibility to information overload. Also discussed is a program which encourages university scientists working toward the same goals to make use of U.S. Air Force subjects and testing facilities.

Aptitude Tests↗
PubMed2004

Interpreting course evaluation results: insights from thinkaloud interviews with medical students.

PURPOSE: To determine whether some of the fundamental assumptions that frequently underlie interpretation of course evaluation results are justified by investigating what medical students are thinking as they complete a typical basic science course evaluation. METHODS: A total of 24 students participated in thinkaloud cognitive interviews, voicing their thoughts while completing a typical evaluation instrument that included items on overall course design, educational materials and methods, and faculty teaching. Students' responses were organised to consider how they interpreted questions, formed judgements and selected response options. Major themes relevant to the meaningful interpretation of course evaluation data were identified. RESULTS: Medical students understood educational terms such as 'independent learning' in different ways from both one another and common usage. When formulating responses, students' judgements were sometimes based on unique or unexpected criteria, and they described editing their judgements by considering factors such as effort or caring on the part of teaching faculty. Students tended to avoid using the lower end of the rating scale, used the highest rating option selectively, but chose the second highest category indiscriminately. CONCLUSIONS: These results call into question fundamental assumptions that frequently underlie interpretation of course evaluation results, such as whether students understand the intended meanings of terms used in items; whether faculty members who receive the same rating are perceived similarly; whether ratings actually reflect teaching effectiveness, and whether 'positive' ratings reflect positive opinions. This study also demonstrates how thinkaloud interviews can be used in validity studies, providing information to supplement statistical and psychometric analyses.

Adult↗
PubMed2026

Effectiveness of psychosocial and lifestyle interventions in promoting behaviour change and improving cognitive outcomes in older people with memory concerns: A systematic review.

BACKGROUND: Older adults with mild cognitive impairment or subjective cognitive decline have a greater dementia risk, particularly those from minority ethnic and socioeconomically disadvantaged backgrounds. Psychosocial and lifestyle interventions targeting modifiable risk factors offer hope for reducing risk, yet behavioural mechanisms remain unclear. This systematic review examines these mechanisms and associated outcomes. METHOD: We searched PubMed, Embase (Ovid), PsycINFO (Ovid), Web of Science, and Scopus for randomised control trials testing interventions that aimed to improve lifestyle and cognition in older adults with memory concerns. We explored behavioural mechanisms using the COM-B model and synthesised intervention effectiveness, overall and within underserved groups. We prioritised lower risk of bias studies. RESULTS: 26 studies described 23 randomised controlled trials (14 multidomain, 9 single domain interventions). Certainty of evidence that behaviour change was associated with cognition was low. Moderate-certainty evidence indicated that interventions providing a socially supportive environment and combining nutritional education and counselling for 6&#x202f;+&#x202f;months improved diet. Physical activity improved primarily in interventions incorporating education, structured training, and enablement strategies (e.g., tailored programmes, providing tools). Interventions simultaneously targeting capability, opportunity and motivation showed greater overall effectiveness. Few studies recorded ethnicity (13%) or sociodemographic status (9%), and none explored their impact. CONCLUSIONS: Non-pharmacological interventions can help this population improve their lifestyles if they feel capable, equipped and motivated, highlighting the value of careful design and implementation. There is scarce evidence on how these interventions work for underserved populations. Future research should explore this to inform tailored interventions and develop equitable dementia prevention strategies.

Humans↗
PubMed2005

Cognitive performance and communications in a network-centric battle laboratory.

Many of the technological advances in the information sciences that make the network-centric battlefield possible will also foster methodologies that enable the study of the warfighter in this environment. Specifically, the tactical events and computer networks in a battle laboratory can be designed with capabilities to facilitate capture and analysis of embedded operational performance metrics. This paper refers to the Air Maneuver Battle Laboratory environment, its command and control components, its synthetic battle environment, and its basic communications structure as an example. This paper also introduces two papers. In the first paper, O'Donnell, Moise, and Schmidt describe their generalized methodology to evaluate personnel during performance of operational tasks. They discuss a cognitive taxonomy, test generator, and synthetic cognitive and motor tests with applicability to military or civilian tasks. Personnel are evaluated with these synthetic tests for those very cognitive skills and capabilities most required to successfully perform the actual operational task of interest. Perhaps the illustrative and innovative measurement methodologies described will encourage others to consider how new approaches can be used to leverage the study of cognitive performance of the future warfighter in a network-centric environment. The second paper by Whitmore discusses how communications and embedded operational performance metrics may be acquired in teams. Whitmore highlights some critical aspects leading to the successful measurement of team performance in realistic console operations; discusses the idea of process and outcome measures; presents two types of team data collection systems; and provides an example of team performance assessment.

Cognition↗
PubMed1996

Intuition and expertise: comments on the Benner debate.

The rift between "science' and "phenomenology' in current nursing theory is explored through an examination of two recent evaluations of the work of Patricia Benner, who has proposed a model of skill acquisition, latterly within a Heideggerian framework. English offers a critique of Benner's ideas from the perspective of cognitive psychology; while Darbyshire defends them against what he describes as a "positivist' attack. No attempt is made, in this paper, to evaluate Benner's work directly, but Darbyshire's response to the "critique' is analysed; and it is noted that, in making his defence, he invokes a network of concepts which he ascribes to a "traditional notion of objective science', and accuses English of subscribing to it. It is suggested that this "Cartesian' worldview is an outmoded myth, superseded by the philosophy of science during the last 30 years, and based on the rhetoric rather than the reality of scientific practice. Nursing is not, therefore, obliged to choose between "positivism' and a philosophy whose chief virtue is that it represents a "challenge' to positivism. It could instead build a scientific basis for research and theory by drawing, not on mid-century thinking, but on a more contemporary understanding of the nature of science.

Clinical Competence↗
PubMed2003

Fulminating adult-onset subacute sclerosing panencephalitis in a 49-year-old man.

CONTEXT: Subacute sclerosing panencephalitis (SSPE) is a rare, slow viral infection caused by a defective measles virus. It is characterized by progressive mental deterioration associated with motor impairment and prominent myoclonus. In about 10% of all cases, the disease can progress rapidly and lead to death within a few months. The oldest previously reported fulminating case was in a 25-year-old man. OBJECTIVE: To emphasize the relationship between retinal involvement and acute SSPE by reporting the case of a 49-year-old man with clinical, laboratory, and pathological evidence of acute SSPE. SETTING: Hôpital de l'Enfant-Jésus, Quebec, Quebec. REPORT OF A CASE: This man was referred to the Department of Neurological Sciences on March 21, 2001, because of recent behavioral changes and progressive cognitive impairment over the past few months. Medical history was unremarkable except for an episode of measles in his childhood. Neurological examination showed bilateral myoclonic jerks. Ophthalmic examination revealed bilateral macular swelling and papilledema. Electroencephalography showed periodic sharp and slow-wave discharges. Magnetic resonance imaging showed bilateral diffuse T2-signal hyperintensities in both periventricular and subcortical white matter. Cerebrospinal fluid antimeasles antibody titers were highly positive. An Omaya reservoir was inserted and therapy using a combination of high-dose intrathecal interferon alfa and oral isoprinosine were administered for 6 weeks. Despite transient subjective improvement in the patient's condition, it continued to deteriorate, he became bedridden, and he died on June 26, 2001. CONCLUSION: To our knowledge, this patient is the oldest case of SSPE reported in the literature. This patient and other patients with acute SSPE associated with bilateral macular swelling described in the literature raised the possibility of measles virus-acquired virulent neurotropism in the retina before invading the central nervous system.

Age of Onset↗