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PubMedDate not supplied

Redesigning courses for the World Wide Web.

The use of computer-based instructional technologies has become almost ubiquitous in education, including health professions education. In addition, clinical practice requires the use of digital information, networking, and continued learning. Faculty, students, and clinicians must be prepared to use computer-based technologies and telecommunications. Many faculty members in the health professions need assistance with the transfer of traditional (campus-based) courses or course material to the World Wide Web. This article presents the instructional design and pedagogical aspects of redesigning a traditional campus-based course for the World Wide Web. Specific steps and a template are identified. The development of a virtual community of learners is also discussed as a critical element of on-line teaching and learning.

Computer-Assisted Instruction↗

PubMedDate not supplied

An introduction to the Mumford-Shah segmentation model.

Some papers of this special issue concern recent results on mathematical models of segmentation. As they are rather technical we propose here a pedagogical introduction for the non-mathematical reader. We briefly present the variational model of image segmentation proposed by David Mumford and we summarize some fundamental results of De Giorgi's school.

Animals↗

PubMed2005

A tension between genuine care and other duties: Swedish nursing students' views of their future work.

There is a current need for nurses to take on new roles due to changing health care policies, economic cut-backs and shortage of staff. It is therefore important to study nursing students' view of their future profession. The theoretical framework was contemporary theories of competence development, which has shown that people's understanding of their work is expressed in their actions. The aim of this study was to describe nursing students' understanding of their future professional role in health care. A purposeful sample of 12 nursing students wrote narratives. The texts were condensed in five steps using the Empirical Phenomenological Psychological Method. The essence of the students' view of their future work was A tension between genuine nursing care and other duties. Four themes constituted this essence: professional status, working conditions and stress, evidence-based nursing contra holistic care, teamwork, co-operation and disrespect, and intensive care instead of geriatrics. This study highlights pedagogic and practical problems that need to be constructively addressed. The nursing students' eagerness to care in a holistic way needs to be acknowledged and used in a fruitful way. This core function of nursing needs to be integrated with up-to-date nursing research.

Aged↗

PubMed2005

Nursing students' and tutors' perceptions of learning and teaching in a clinical skills centre.

BACKGROUND: Clinical Skills Centres (CSCs) can ease pressure on clinical skills development and assessment in clinical areas; and provide added value through experiential learning and self-directed learning. Published accounts of innovation in CSCs tell part of this story but little is known about perceptions of students and tutors engaged in day-to-day learning and teaching in CSCs. METHODS: This paper reports one strand of a mixed methods study in a busy multidisciplinary CSC: a questionnaire survey of nursing students' and tutors' perceptions of learning and teaching. Questionnaires focused on items representing commonly espoused views regarding the use and usefulness of CSCs. RESULTS: Students and tutors enjoyed learning and teaching within the CSC, although senior students were slightly muted in their views. All groups valued the supported practice of clinical and communication skills. The CSC was seen as a learning environment that supports the linking of theory and practice. There was some ambivalence, particularly among tutors, about the relationship between performance in the CSC and in clinical areas. DISCUSSION: The favoured pedagogic approach of expert demonstration by tutors followed by supported practice necessitates attention to tutors' training. The muted responses of senior students may signal a need to review the CSC learning experiences offered to them.

Attitude of Health Personnel↗

PubMed2005

Towards effective group-work in nurse education.

This focus of this paper is on meaningful learning within the context of small group-work in nurse education; a pedagogical approach that is increasingly being used throughout higher education. The paper explores the question: when working with others what conditions and types of interaction are necessary to promote higher learning? Some suggestions are drawn from the literature and a position is articulated. Some implications of this position for curriculum leadership in planning an effective learning environment within higher education are discussed.

Clinical Competence↗

PubMed2006

A comparison of on-campus first year undergraduate nursing students' experiences with face-to-face and on-line discussions.

Only limited pedagogical use has been made of information and communications technology (ICT) in nursing education in Norway. In this study the use of ICT was linked to assignments in the first year undergraduate nursing program and included four on-line discussions. There is evidence to suggest that on-line discussions can enhance the learning environment. The students' experiences of the on-line discussions are compared to those of the students participating in traditional group discussions. The results show little difference between the two groups' opinions of the discussions' fruitfulness and the ease in which they expressed their feelings, thoughts and ideas. However, there is a marked difference between the two groups regarding their experience of how the discussions affected the amount of contact between group members outside the discussions. Possible reasons for these findings are discussed.

Adult↗

PubMed2006

Nurse teachers' knowledge in curriculum planning and implementation.

BACKGROUND: Nurses are required to base care on research evidence but research findings on nursing practice often suggest that the linkage is poor and ritualistic routines often prevail. AIMS: The study explored the origin and nature of knowledge utilised by nurse teachers when developing and implementing a curriculum. METHODS: In a single, ethnographic case study data were collected from two curriculum development and two curriculum implementation groups, using interviews, participant observation and documents. The study drew directly on Bernstein's theory of the pedagogic device and cultural reproduction. RESULTS: Findings suggested that even though nurse education appears to be dominated by policies and guidelines produced by state agencies, it was teachers operating at institutional and classroom levels who determined what was delivered to student nurses as they relied upon their experience of teaching and clinical practice to plan and implement curriculum. Notwithstanding both national and local aspirations to the contrary, teaching and assessment practices were mostly teacher- rather than student-centred, with heavy reliance on propositional knowledge. CONCLUSION: The practices identified within this study may induce approaches to learning that may be antithetical to delivering research based care within a prevailing climate that advocates evidence-based practice, clinical effectiveness and governance.

Anthropology, Cultural↗

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↗

PubMed2004

Counseling children and parents about epilepsy.

In spite of remarkable progress in drug therapy, childhood and adolescent epilepsy is often a distressing condition lasting several years before possible recovery. Adaptation problems to the disease, and also to health recovery, are likely to occur. Stigma and discrimination may persist also after recovery. Learning problems involve a high number of patients. Neuropsychological problems related to localization of the epileptic focus may be present; intellectual deterioration in more severe cases and in some specific syndromes may occur. These problems are not unknown, but therapeutic effort is often directed only towards seizure control. The importance of counseling children and parents is stressed by the authors, and practical advice is given on planning doctor-patient dialogues, in order to prevent non-justified restrictions in day life, fears and negative reactions, and to ameliorate intrafamilial relation, integration in the school milieu and compliance towards drug intake. The role of neuropsychological evaluation and pedagogic advice is also emphasized. Children and adolescents with epilepsy and their families need more than medical therapeutic support to get an acceptable quality of life.

Adaptation, Psychological↗

PubMedDate not supplied

The RN-BSN distance education experience: from educational limbo to more than an elusive degree.

This study describes a qualitative study designed to gain an understanding of professional growth as experienced by RN-BSN students taking their program by distance delivery. A convenience sample of senior students enrolled in an RN-BSN program, taking their classes either by live televised broadcast or by online instruction, volunteered to participate in the study. Data were collected through the use of online student discussions that took place over a 2-week period. The discussion was guided by the use of a semistructured interview schedule and facilitated by one member of the research team. Interview questions were posted every 2 to 3 days; additional questions were posted as threads as discussion board comments warranted. RN-BSN students described their pursuit of a BSN as a journey of being and becoming a professional. Although students already felt "professional," the impetus for the journey could be traced to the overriding theme of "falling short as a professional." RN-BSN students described their beginning journey toward the baccalaureate degree as an "educational limbo," out of which they moved with discovery of the RN-BSN distance program. What began as pursuit of an elusive degree that was expected to produce minimal change became more as RN-BSN students evolved as professionals along many dimensions. The implications of these findings for the development and design of curricular and pedagogical approaches to better serve the needs of this unique group of learners will be addressed.

Adaptation, Psychological↗

PubMedDate not supplied

Improving perceptions of patient care--a nursing education and nursing practice initiative.

In January 2005, the University of Texas Medical Branch (UTMB) School of Nursing and the UTMB Hospitals and Clinics launched the first phase of a project to improve perceptions of patient care on the part of nursing faculty and nursing clinicians. A finding on the UTMB annual employee satisfaction survey that nursing faculty and clinicians tended to rate quality of UTMB patient care lower than other UTMB employees provided the impetus for the initiative. When UTMB colleagues noticed the findings, various entities including human resources and the Faculty Senate called for explanations from the dean of the School of Nursing, the chief nursing officer, and the CEO for the hospitals and clinics. In the process of attempting to give reasons for the findings, each of us determined we would take definitive action to address the situation. This article describes our accomplishments for Phase 1 of the initiative. Beginning with a vision for a productive professional community characterized by a pedagogical partnership between nursing education and practice, we share the processes we followed to (1) achieve mutual understanding among task force members, (2) obtain input on perceptions from nursing colleagues, (3) identify the clinical and nursing education aspects of the perceptions, (4) reach consensus on target perceptions for Phase 2 of the project, and (5) outline the next steps for the project.

Academic Medical Centers↗

PubMed2006

Accounting for EBM: notions of evidence in medicine.

This paper takes as a focus of anthropological enquiry the set of techniques and practices for the appraisal and clinical application of research evidence that has become known as evidence-based medicine (EBM) (or, more recently, evidence-based health care). It first delineates and classifies the criticisms of EBM emerging from within the health professions. It then charts the evolution of EBM in responding to these criticisms and uncovers its character as a pedagogical innovation aimed at transforming clinical practice. It identifies EBM as an indeterminate and malleable range of techniques and practices characterised not by particular kinds of methodological rigour, but by the pursuit of a new approach to medical knowledge and authority. It situates this characterisation within a contemporaneous political and economic climate of declining trust and growing accountability. This analysis provides a basis from which to consider the notions of evidence implicit in EBM itself and also in the qualitative social sciences, including anthropology, which not only critique but also contribute to these notions themselves. Finally, the paper considers possible future trajectories for EBM with regard to the incorporation of cultural and structural dimensions of health and the inclusion of qualitative material in the evidence base.

Anthropology↗

PubMed2006

The sexuality and social performance of androgen-deprived (castrated) men throughout history: implications for modern day cancer patients.

Androgen-deprivation therapy (ADT) via either surgical or chemical castration is the standard treatment for advanced prostate cancer (PCa). In North America, it is estimated that more than 40,000 men start ADT each year. The side effects of this treatment are extensive and include gynecomastia, erectile dysfunction, and reduced libido. These changes strongly challenge patients' self-identity and sexuality. The historical term for a man who has been castrated is 'eunuch', now a pejorative term implying overall social and sexual impotence. In this paper, we review key historical features of eunuch social performance and sexuality from a variety of cultures in order to assess the validity of contemporary stereotypes of the androgen-deprived male. Data were taken from secondary sources on the history of Byzantium, Roman Antiquity, Early Islamic societies, the Ottoman Empire, Chinese Dynasties, and the Italian Castrati period. This cross-cultural survey shows that castrated men consistently held powerful social positions that yielded great political influence. Many eunuchs were recognized for their loyalty, managerial style, wisdom, and pedagogical skills. Furthermore, rather than being consistently asexual and celibate, they were often sexually active. In certain cultures, they were objects of sexual desire for males, or females, or both. Collectively, the historical accounts suggest that, given the right cultural setting and individual motivation, androgen deprivation may actually enhance rather than hinder both social and sexual performance. We conclude that eunuch history contradicts the presumption that androgen deprivation necessarily leads to social and sexual impotence. The capabilities and accomplishments of eunuchs in the past gives patients on ADT grounds for viewing themselves in a positive light, where they are neither socially impotent nor sexually chaste.

Androgen Antagonists↗

PubMed2005

Estimation of ultrasound attenuation and dispersion using short time Fourier transform.

Determination of the acoustic attenuation and dispersion has important applications in ultrasound tissue characterization and non-destructive material testing. Current signal processing methods Fourier transform of ultrasound signals to get the spectra of amplitude and phase to estimate respectively the attenuation and dispersion of a given medium. These methods are frequency domain method and obsessed with ambiguity issue in the phase unwrapping calculation. Conventional ultrasound velocity measuring method detects the time of arrival of a pulse (or echo) signal, which is a time domain method to compute group velocity (not phase velocity). This paper presents a novel approach based on the short time Fourier transform (STFT)--a time-frequency analysis, to estimate the ultrasonic dispersion and attenuation. Only the amplitude information of the pulse-signal spectra is used. Based on the time-frequency presentation, the attenuation coefficient of the signal is obtained by computing the amplitude decay of pulse spectrum in time domain, while phase velocities are obtained based on the "time-of-flight" (TOF) of the mono frequency component of the pulse signals. As a result, we eliminate the ambiguity issue in phase angle calculation. Furthermore, the proposed method makes the phase velocity pedagogically intuitive for novice users. The paper presents experiments to evaluate demonstrate the performance of the proposed method.

Algorithms↗

PubMed1986

Theoretical study of a model for the ATP cap at the end of an actin filament.

The model used successfully by Pantaloni et al. to fit experimental data on steady-state actin polymerization is investigated theoretically. Many properties are deduced, as functions of the free subunit concentration. The model is simple enough so that one can examine analytically the question of whether actin shows the same dramatic phase changes associated with the GTP cap in microtubules. The answer is negative, judging from this model. However, it is possible to obtain such phase changes using the same model but with quite different, hypothetical choices of parameters. Thus, aside from its application to actin, this model is useful pedagogically to illustrate the nature of phase changes that may occur at the end of a steady-state polymer.

Actins↗

PubMed1996

Teaching light scattering spectroscopy: the dimension and shape of tobacco mosaic virus.

The tobacco mosaic virus is used as a model molecular assembly to illustrate the basic potentialities of light scattering techniques (both static and dynamic) to undergraduates. The work has two objectives: a pedagogic one (introducing light scattering to undergraduate students) and a scientific one (stabilization of the virus molecular assembly structure by the nucleic acid). Students are first challenged to confirm the stabilization of the cylindrical shape of the virus by the nucleic acid, at pH and ionic strength conditions where the coat proteins alone do not self-assemble. The experimental intramolecular scattering factor is compared with the theoretical ones for several model geometries. The data clearly suggest that the geometry is, in fact, a rod. Comparing the experimental values of gyration radius and hydrodynamic radius with the theoretical expectations further confirms this conclusion. Moreover, the rod structure is maintained over a wider range of pH and ionic strength than that valid for the coat proteins alone. The experimental values of the diffusion coefficient and radius of gyration are compared with the theoretical expectations assuming the dimensions detected by electron microscopy techniques. In fact, both values are in agreement (length approximately 300 nm, radius approximately 20 nm).

Biophysics↗

PubMed1997

Statistical mechanics of simple models of protein folding and design.

It is now believed that the primary equilibrium aspects of simple models of protein folding are understood theoretically. However, current theories often resort to rather heavy mathematics to overcome some technical difficulties inherent in the problem or start from a phenomenological model. To this end, we take a new approach in this pedagogical review of the statistical mechanics of protein folding. The benefit of our approach is a drastic mathematical simplification of the theory, without resort to any new approximations or phenomenological prescriptions. Indeed, the results we obtain agree precisely with previous calculations. Because of this simplification, we are able to present here a thorough and self contained treatment of the problem. Topics discussed include the statistical mechanics of the random energy model (REM), tests of the validity of REM as a model for heteropolymer freezing, freezing transition of random sequences, phase diagram of designed ("minimally frustrated") sequences, and the degree to which errors in the interactions employed in simulations of either folding and design can still lead to correct folding behavior.

Biophysical Phenomena↗

PubMed2002

Grappling with the evaluation of clinical competencies: a view from the Residency Review Committee for Urology.

We sought to highlight the perspective of the Residency Review Committee for Urology regarding the current changes in residency program accreditation. Although the pedagogic underpinnings of the shift of the American Committee for Graduate Medical Education to outcomes-based accreditation appear solid, several concerns were raised by the Residency Review Committee for Urology: the paucity of effective evaluation tools, the likely increased expense of these measures, and the lack of evidence that these changes will ultimately improve the training of residents. As a result, the Committee plans to continue cautiously (but optimistically) in the process of incorporating the teaching and evaluation of the clinical competencies in the program requirements.

Accreditation↗