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PubMed2000

A flexible architecture for constructing and executing tutoring processes.

The tutoring process of conventional case-oriented medical training systems can be characterised as either guided or unguided. In contrast to that, the aim of the system "Docs'n Drugs" is to distinguish between different levels of guidance. The author can realise the tutoring case as a guided, a half guided or an unguided tutoring process. The system architecture distinguishes between an authoring system and a tutoring system. Fundaments of these are the tutoring process model and the case data model. This structure allows the reuse of elements of existing tutoring cases. The tutoring cases can be realised in different languages, e.g. German and English.

Computer-Assisted Instruction↗
PubMed2001

Improvements following short term home based physical therapy are maintained at one year in people with moderate to severe rheumatoid arthritis.

OBJECTIVE: We previously demonstrated the efficacy of a 6 week home based physical therapy (PT) intervention for people with moderate to severe rheumatoid arthritis (RA). This followup study determined if short term improvements were maintained to one year. METHODS: Participants in the short term study were randomly assigned to receive a PT intervention (education, exercise, and pain relief modalities) delivered by physiotherapists with advanced rheumatology training (Weeks 0 to 6) or to a wait list control group. The control group received the intervention between Weeks 6 to 12. Outcome measures included the Stanford Arthritis Self-Efficacy Scale (SES), the Arthritis Community Research and Evaluation Unit Rheumatoid Arthritis Knowledge Questionnaire (KQ), and a visual analog scale for pain. Disease activity measures (tender joints, grip strength, and morning stiffness) were also included. MANOVA was used to compare within-subject scores at baseline and at 12 and 52 weeks. Paired t tests were used to determine if 12 week changes were maintained at 52 weeks. RESULTS: Of the 127 protocol completers, 117 (92.1%) were available for the one year followup. For those measures that showed significant improvement in the randomized controlled trial (SES, KQ, morning stiffness), improvements at 12 weeks were maintained at 52 weeks (p > 0.010). CONCLUSION: Subjects who participated in a short term home based PT intervention delivered by specially trained therapists reported improved outcomes following treatment, and these improvements were maintained at one year followup. Future studies need to explore the relative contributions of education, exercise, home based care, therapist training, and reinforcement strategies in improving longterm outcomes in RA.

Arthritis, Rheumatoid↗
PubMed2000

[Self instruction, multiple choice questions. Daily management of diabetes in children and adolescents].

The practitioner has usually relatively little experience in the daily management of pediatric diabetes, a complex issue due to multiple factors and individual variability. Seventeen multiple choice questions are proposed, which have been created for an interactive teaching session (see next article). For each question, a single answer is considered to be the most or the only correct one. This answer is given after the questions together with a brief comment about some of the proposed answers. The objective for the reader is self-teaching. The questions are not intended for self-evaluation.

Adolescent↗
PubMed1975

Evaluation of a program of systematic instructional procedures for extremely poor retarded children.

A demonstration program was conducted in which 54 innercity children classified as educable mentally retarded were selected on the basis of age, IQ, family income, race, and achievement scores. They were then placed into self-contained classrooms with two classes being taught by precision-teaching procedures and two classes being taught by the methods particular to their teachers. Tesults showed that a high percentage (60 percent) of the children taught by precision-teaching procedured were capable of acquiring the basic skills necessary for regular-class placement.

Child↗
PubMed2001

Does computer-assisted instruction really help to improve the learning process?

OBJECTIVES: We have developed both a computer-assisted instruction (CAI) multimedia program and a textbook on arterial blood gas interpretation with the same content as formal didactic instruction. A prospective, randomized study was designed to compare the outcomes of self-learning using the software and using the textbook. METHODS: 80 third-year medical students were randomly allocated to two groups: the CAI (n=40) and text group (n=40). A 30-item, type-K examination was administered as the pre-test. After the pre-test, the volunteers in the CAI group studied the software program, whereas those in the text group spent their time reading the textbook covering the same material. The post-test was held immediately at the end of a full day of study, and 3 weeks later, the final test was performed without prior notice. A P value of <0.05 was considered to be a statistically significant difference. RESULTS: Students in the text group seemed to fulfil their assignments and improved their scores post-test better than those in the CAI group. After 3 weeks, the final test scores of both groups demonstrated a significant decrease, but showed an insignificant difference between the two groups. CONCLUSION: Text-based learning seems to be a convenient method of education where time is limited. However, with more time available, use of software may be as good as the conventional learning method and can be an alternative tool. The computer-assisted instruction program seems to enhance the learning process.

Computer-Assisted Instruction↗
PubMed2001

Comparison of two training strategies for essential newborn care in Brazil.

OBJECTIVE: To compare the effectiveness of two training strategies for improving essential newborn care in the state of Pernambuco, Brazil. METHODS: Eight hospitals were selected, divided into two groups of four, and paired by geographical, structural, and functional characteristics. Doctors and nurses working at hospitals in Group 1 were given a conventional 5-day training course. Those in Group 2 were given the same manual used by Group 1 but the training course was organized as self-directed learning, with the participants having 5 weeks to complete the course. Participants' knowledge was tested at baseline, immediately after the course, and 3-6 months later. Participants' practices were observed before training and 3-6 months after training during 20 births and by interviewing 20 mothers before discharge at each hospital. FINDINGS: Not all participants completed all of the tests. The scores on the tests of knowledge improved more among those in Group 2 than those in Group 1 when the answers were classified as right or wrong, but there was no difference between groups when a scoring method was used that classified answers as correct, partially correct, incorrect, or missing. Practices related to thermal control after birth improved among those in Group 2 after training but practices related to thermal control on the ward worsened. The promotion of breastfeeding improved in both groups. CONCLUSION: There was no difference between the two training strategies, although self-directed learning was cheaper than conventional training. Neither strategy brought about the expected improvements in the quality of care. Other interventions in addition to training may be needed to improve care.

Brazil↗
PubMedDate not supplied

Comparison of independent and traditional registered nurse learners in a physical assessment course.

The purpose of this study was to determine if there was a significant difference in the time used to complete a neurological assessment by students who studied physical assessment and practiced independently when compared to students who used the traditional lecture method of instruction and practiced with the instructor. The research methodology utilized a descriptive comparative design. The convenience sample consisted of 20 Registered Nurses (RNs) randomly selected from a class of 34 RN students in one section of an undergraduate Physical Assessment course. A watch was used to measure the time the student used to complete the neurological assessment. A one-tailed independent samples t-test was used to compare the difference in time used as indicated by the means of the two groups. The level of significance was 0.05. The result of the study is that there was no significant difference found between the two groups on the amount of time used to complete a neurological assessment p > .05, t = 1.151, p = .303. The conclusion of this study was that RN students are able to learn physical assessment independently and successfully complete a neurological assessment in a similar amount of time as RN students who use the traditional classroom method. Recommendations include replicating the study with a larger sample and with students in a Graduate Health Assessment course to determine if similar results will occur.

Education, Nursing↗