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PubMed2000

Breaking the language barrier: an emergentist coalition model for the origins of word learning.

How do children learn their first words? The field of language development has been polarized by responses to this question. Explanations range from constraints/principles accounts that emphasize the importance of cognitive heuristics in language acquisition, to social-pragmatic accounts that highlight the role of parent-child interaction, to associationistic accounts that highlight the role of "dumb attentional mechanisms" in word learning. In this Monograph, an alternative to these accounts is presented: the emergentist coalition theory. A hybrid view of word learning, this theory characterizes lexical acquisition as the emergent product of multiple factors, including cognitive constraints, social-pragmatic factors, and global attentional mechanisms. The model makes three assumptions: (a) that children cull from multiple inputs available for word learning at any given time, (b) that these inputs are differentially weighted over development, and (c) that children develop emergent principles of word learning, which guide subsequent word acquisition. With few exceptions, competing accounts of the word learning process have examined children who are already veteran word learners. By focusing on the very beginnings of word learning at around 12 months of age, however, it is possible to see how social and cognitive factors are coordinated in the process of vocabulary development. After presenting a new method for investigating word learning, the development of reference is used as a test case of the theory. In 12 experiments, with children ranging in age from 12 to 25 months of age, data are described that support the emergentist coalition model. This fundamentally developmental theory posits that children construct principles of word learning. As children's word learning principles emerge and develop, the character of word learning changes over the course of the 2nd year of life.

Child, Preschool↗
PubMed2003

Learning input correlations through nonlinear temporally asymmetric Hebbian plasticity.

Triggered by recent experimental results, temporally asymmetric Hebbian (TAH) plasticity is considered as a candidate model for the biological implementation of competitive synaptic learning, a key concept for the experience-based development of cortical circuitry. However, because of the well known positive feedback instability of correlation-based plasticity, the stability of the resulting learning process has remained a central problem. Plagued by either a runaway of the synaptic efficacies or a greatly reduced sensitivity to input correlations, the learning performance of current models is limited. Here we introduce a novel generalized nonlinear TAH learning rule that allows a balance between stability and sensitivity of learning. Using this rule, we study the capacity of the system to learn patterns of correlations between afferent spike trains. Specifically, we address the question of under which conditions learning induces spontaneous symmetry breaking and leads to inhomogeneous synaptic distributions that capture the structure of the input correlations. To study the efficiency of learning temporal relationships between afferent spike trains through TAH plasticity, we introduce a novel sensitivity measure that quantifies the amount of information about the correlation structure in the input, a learning rule capable of storing in the synaptic weights. We demonstrate that by adjusting the weight dependence of the synaptic changes in TAH plasticity, it is possible to enhance the synaptic representation of temporal input correlations while maintaining the system in a stable learning regime. Indeed, for a given distribution of inputs, the learning efficiency can be optimized.

Action Potentials↗
PubMedDate not supplied

[Social learning in animals: comparative analysis of different forms and levels].

Social learning as one of the key concepts of cognitive ecology includes different forms of behavioural displays from relatively simple, such as "social release" and "stimulus enhancement" up to "teaching" and "cultural transmission" in animal communities. Rapid development of this fields resulted in some contradictions in methods and terminology. In this review different forms and levels of social learning are analyzed. Ecological aspects of social learning are connected with diet shaping, fear of predators and mate choice. The first aspect is the most studied but still discussible. Social learning being an intricate component of feeding behaviour matches with innate behaviour, imprinting as well as early associative learning. Investigation of cognitive aspects of social learning going back to Thorndike's crucial question "Do apes ape?" are now developing into series of questions including even: "Do ants ape?". Elaboration of universal methods of comparative studying of social learning such as "artificial fruit" and "two ways/one outcome" has essentially enlightened these questions and made comparative analysis possible. Large continuum of displays of cognitive skills in social learning has been revealed in non-primate species. One of the discussible issues in the role of social learning is distribution of innovations. Many authors have investigated this intriguing aspect of animal behaviour in different ways, such as long field observations as well as laboratory experiments based on "artificial innovators" that is specimens specially taught by experimentalists. Many impressive results were obtained; in particular it turned out in contradiction with some mathematical models that individuals in groups are rather different in their psychophysiological predisposition to innovative behaviour. Role of teaching in such different forms of behaviour as shaping of species-specific behavioural patterns and spread of innovations is considered. Although the majority of animals in wild populations are not good teachers and pupils, some cultural aspects of behaviour were recently revealed, mostly in primates. At the same time some classical results concerning cultural transmission of new patterns (for example, bottle-opening in tits) were experimentally revised. Many problems still remain unsolved, in particular, how spread of innovations may favour prosperity of populations; to what degree behavioural peculiarities of local groups may be determined by processes of social learning; which internal and external factors and under what circumstances invest into social learning in natural environment.

Animal Nutritional Physiological Phenomena↗
PubMed1996

Learning disabilities.

Approximately 5% of all public school students are identified as having a learning disability (LD). LD is not a single disorder, but includes disabilities in any of seven areas related to reading, language, and mathematics. These separate types of learning disabilities frequently co-occur with one another and with social skill deficits and emotional or behavioral disorders. Most of the available information concerning learning disabilities relates to reading disabilities, and the majority of children with learning disabilities have their primary deficits in basic reading skills. An important part of the definition of LD is its exclusions: learning disabilities cannot be attributed primarily to mental retardation, emotional disturbance, cultural difference, or disadvantage. Thus, the concept of LD focuses on the notion of a discrepancy between a child's academic achievement and his or her apparent capacity to learn. Recent research indicates, however, that disability in basic reading skills is primarily caused by deficits in phonological awareness, which is independent of any achievement-capacity discrepancy. Deficits in phonological awareness can be identified in late kindergarten and first grade using inexpensive, straightforward testing protocol. Interventions have varying effectiveness, depending largely on the severity of the individual child's disability. The prevalence of learning disability identification has increased dramatically in the past 20 years. The "real" prevalence of LD is subject to much dispute because of the lack of an agreed-upon definition of LD with objective identification criteria. Some researchers have argued that the currently recognized 5% prevalence rate is inflated; others argue that LD is still underidentified. In fact, it appears that there are both sound and unsound reasons for the increase in identification rates. Sound reasons for the increase include better research, a broader definition of disability in reading, focusing on phonological awareness, and greater identification of girls with learning disabilities. Unsound reasons for the increase include broad and vague definitions of learning disability, financial incentives to identify students for special education, and inadequate preparation of teachers by colleges of education, leading to overreferral of students with any type of special need. There is no clear demarcation between students with normal reading abilities and those with mild reading disability. The majority of children with reading disabilities have relatively mild reading disabilities, with a smaller number having extreme reading disabilities. The longer children with disability in basic reading skills, at any level of severity, go without identification and intervention, the more difficult the task of remediation and the lower the rate of success. Children with extreme deficits in basic reading skills are much more difficult to remediate than children with mild or moderate deficits. It is unclear whether children in the most severe range can achieve age- and grade-approximate reading skills, even with normal intelligence and with intense, informed intervention provided over a protracted period of time. Children with severe learning disabilities are likely to manifest an increased number of and increased severity of social and behavioral deficits. When children with disabilities in reading also manifest attention deficit disorder, their reading deficits are typically exacerbated, more severe, and more resistant to intervention. While severe reading disorders are clearly a major concern, even mild deficits in reading skills are likely to portend significant difficulties in academic learning. These deficits, too, are worthy of early identification and intervention. Even children with relatively subtle linguistic and reading deficits require the expertise of a teacher who is well trained and informed about the relationships between language development and reading development.

Adolescent↗
PubMed1996

The effects of prenatal cocaine exposure on subsequent learning in the rat.

This chapter has reviewed the animal studies related to prenatal cocaine administration and subsequent learning. A summary of these studies and their findings is given in table 1. It is important to note that there is a relative scarcity of reports in this area. Given the potential number of infants that might be exposed to cocaine prenatally, it is certain that more work needs to be done. Second, from this table and the preceding review, it is difficult to conclude that prenatal cocaine exposure has wide-ranging effects. There certainly appears to be ample evidence from Spear's lab that prenatal cocaine exposure disrupts early olfactory learning. These findings are in need of independent replication. In fact, the authors have partially replicated a deficit in an odor-aversion task following gestational cocaine administration. The evidence provided by Spear and colleagues (1989a, 1989b), however, indicates that this deficit is relatively transitory and is not found in animals after perhaps 15 days of Furthermore, it does not appear that these cocaine-exposed animals are incapable of learning. In the Goodwin and colleagues (1992) study, where animals were given either 2, 3, or 4 acquisition trials, animals exposed to cocaine prenatally and reared by surrogate untreated mothers did learn the association when given 4 trials. It must be stressed, however, that early deficits that diminish as the animals mature or deficits which can be overcome by repetition can still have long-lasting consequences. Requiring more experience with an association prior to learning that association or having a transitory learning deficit in no way diminishes its potential importance for the organism. On more common tasks of learning, such as passive and shuttle avoidance and maze learning, there is really very little evidence to support the notion that cocaine is acting as a behavioral teratogen. The available evidence would appear to indicate that significant, biologically meaningful deficits on these tasks are not found over a wide range of doses. There are a number of reasons for these failures to find effects. It may be that these tasks are too simple to detect underlying behavioral anomalies. Passive avoidance is a simple task that is easily learned by animals by the time of weaning. Active avoidance is much more difficult, but it too may not place enough challenges on the organism. The work by Heyser and colleagues (1992b) may signal that more complicated tasks, such as reversal of a conditional discrimination, might be necessary to show cocaine's behavioral teratogenic action. However, even in this case the effect was not very substantial, consisting of less than one extra incorrect response relative to controls prior to the first reward. More challenging situations such as successive discriminations (e.g., learning to learn) might lead to bigger differences in performance between cocaine-exposed animals and controls. These types of tasks need to be assessed. Similarly, perhaps cocaine-exposed animals need to be challenged physiologically, either by placing them in extremely stressful situations or assessing their response to other drugs that disrupt normal physiological functioning (see Spear, this volume). Another reason for a failure to find substantial effects on a wide range of behavioral assessments is that cocaine may act as a behavioral teratogen through a number of different mechanisms. It might be a direct toxin to certain developing neurotransmitter systems, it may function indirectly by inducing hypoxia, or both. If the mechanism of action varies in different animals and the effects are not large in any animal, then it would be extremely difficult to detect group differences using the sample sizes normally assessed in these studies. It may be that only a small subset of a group of animals is affected and that group variability must be assessed in addition to alterations in group means. Finally, it may be that cocaine is not a behavi

Animals↗
PubMed1997

The effect of incorporating women's health into a PBL curriculum on students' tendencies to identify learning issues in an ambulatory care setting.

PURPOSE: To investigate whether the incorporation of women's health into problem-based learning (PBL) cases affects students' tendency to identify learning issues related to women's health as they encounter patients in an ambulatory care setting. METHOD: Students in the PBL curriculum at the Allegheny University of the Health Sciences, MCP-Hahnemann School of Medicine, participate in a nine-week primary care practicum at the end of their first year, during which they spend three half-days per week in an ambulatory setting examining patients and completing patient logs that include any learning issues identified. Patient logs from 23 first-year PBL students who had not been exposed to a new women's health education program prior to their practicum in 1993 and from 22 first-year PBL students who had been exposed to the program prior to their practicum in 1994 were reviewed. For each women's health learning issue identified, the sex of the student and the sex, specialty, and practice setting of the student's preceptor were recorded. Data were analyzed with several statistical methods. RESULTS: There was no statistically significant difference in the numbers of men and women students or preceptors between the two years. In 1993 an average of 59% of the patients seen per student were women; in 1994 the average was 61%. The mean numbers of total learning issues identified (including women's health learning issues) were similar in the two years, but the mean percentage of clinical women's health learning issues identified increased significantly between 1993 and 1994, as did the mean percentage of community/preventive health women's health learning issues identified. There was a significant student-sex-by-preceptor-sex interaction for the total number of women's health learning issues identified (p = .024): for both years, the students paired with a preceptor of the same sex identified a higher number of women's health learning issues than did the students paired with a preceptor of the opposite sex. CONCLUSION: The results suggest that PBL is an effective way to increase students' awareness of women's health issues in a primary care clinical setting. More studies are needed to define the effect of PBL on the kind of reading and learning students will do when they get to the clinical setting.

Adult↗
PubMedDate not supplied

Prenatal phenytoin exposure and spatial navigation in offspring: effects on reference and working memory and on discrimination learning.

Previous research has shown that rats exposed to phenytoin (PHT) in utero demonstrate abnormal circling, decreased learning, hyperactivity, and delayed air righting reflex development. The effects of prenatal PHT on offspring learning have been found on multiple-T mazes (Biel and Cincinnati types) and on spatial navigation (Morris maze). However, the specificity of the latter effects is unknown. Herein, we tested the effects of prenatal PHT in a Morris maze using six different procedures: cued versus spatial reference memory-based learning, cued versus spatial working memory-based learning, and cued versus spatial discrimination learning. PHT-exposed offspring showed increased preweaning mortality, growth reduction, and abnormal circling as noted in previous studies. PHT offspring were separated into those exhibiting circling and those not. PHT noncircling offspring demonstrated impaired reference memory-based spatial learning (acquisition and reversal), but no other effects. By contrast, PHT circling offspring demonstrated not only impaired reference memory-based spatial learning, but also impaired cued platform learning, impaired spatial discrimination, and impaired working memory-based learning. These data confirm that prenatal PHT induces a specific reference memory-based spatial learning deficit even in asymptomatic (noncircling) offspring that is distinct from the impairment induced in littermates exhibiting the circling impairment.

Analysis of Variance↗
PubMed2006

Development pathways in learning to be a physiotherapist.

BACKGROUND AND PURPOSE: Few studies have examined the experiences of students' professional socialization in physiotherapy. This international longitudinal study aimed to study experiences of situated learning and change in a student cohort during a physiotherapy education programme. METHOD: A phenomenographic design with semi-structured interviews was carried out with a cohort of physiotherapy students from two sites, strategically selected for variation in gender, age, educational background, work experience and academic level. Interviews were carried out after each of the first five semesters in the programme by a team of researchers. Seventy-six interviews explored students' learning experiences. Analysis identified the variation in experiences seen as important to becoming a physiotherapist. RESULTS: Distinct perceptions of professional growth and progression are identified in four pathways of development: 'Reflecting on Practice'; 'Communicating with Others'; 'Performing Skills'; and 'Searching Evidence'. These pathways demonstrate qualitative differences in the focus of learning experiences and preferred learning context, and include learning in a context which supports reflection, learning as agreed by others in a context with patients and other professionals, learning physiotherapy skills in a practice context and learning formal knowledge in a context where theory can be linked with practice. CONCLUSIONS: In a cohort of students professional growth can be seen in a variety of development pathways. Each shows progress of professional growth in the 'what' as changes in experiences and the 'how' as ways of learning from them. In addition, the pattern of pathways in a cohort may change from one semester to another suggesting individuals may adopt different learning pathways throughout their education. Teaching staff are challenged to consider how they recognize a variation in development pathways in their student cohorts and how they purposefully ensure experiences to guide students through different learning pathways in socialization to become a physiotherapist.

Clinical Competence↗
PubMed1996

Learning style preferences of public health students.

OBJECTIVES: The learning style preferences of public health students are investigated. Learning styles, as defined by Kolb, refer to the four distinct manners of processing information. METHODS: Students' learning styles are analyzed for associations by gender, occupation, and public health program. The value of learning styles to predict students' preference for oral presentation versus written exams, performance on different types of exams, and course grade are studied. RESULTS: Learning styles of the students sampled were neither predominantly of one learning style nor evenly distributed. Learning style preferences did not vary significantly according to gender, occupation, or public health program. Learning styles also did not predict the students' choice of oral presentation or written exam. Assimilators, however, scored significantly higher than the other three learning styles on the theoretical exam and in their course grade. DISCUSSION: The authors suggest that public health instructors employ a variety of teaching methods and evaluative opportunities when class composition is initially assessed as having diverse learning styles. This "instructional pluralism' is necessary to facilitate learning, maximize participation, and permit multiple pathways for students to demonstrate educational performance.

Chi-Square Distribution↗
PubMed2002

Computer-based learning--an aid to successful teaching of pharmacology?

Various types of software have been developed for use in pharmacology courses. These include: simple drill (question and answer) software; electronic books; video material; tutorial type programs; simulations; and electronic learning environments for course organisation and delivery. These different types of software can be used in different ways to achieve very different learning objectives and gains in teaching efficiency. For example, software can be used: in tutorial and small group teaching; in lectures; to better prepare students for practical work; as a replacement for practicals; to provide options within a limited course structure; to supplement lectures and enable students to work at their own pace; to provide ongoing access to self-assessment throughout a course; to aid distance learning; as remedial teaching and to extend the student learning experience in areas which are too expensive or too time consuming or for which staff expertise does not exist. Evidence indicates that it is insufficient simply to make computer based learning material available to students. Like a laboratory class, it must be fully integrated into a module if real benefits are to be obtained. Students need to be taught how to learn from computer-based learning materials and how to integrate this learning tool in their learning strategy. Teachers need to be supported not only with information about the availability of software but, equally importantly, about how it can be integrated into modules. We are all delivering teaching and facilitating learning in a changing environment and subject to a variety of increasing pressures. It may well be that computer based learning materials may help to maintain a high quality of pharmacology teaching within this changing environment but we need more pedagogical research at the discipline level to establish how this can best be done.

Animals↗
PubMed2004

Guidance hypothesis with verbal feedback in learning a palpation skill.

OBJECTIVE: To investigate whether a force application of a novel motor skill was simple or complex and to determine the appropriate level of feedback during training. The objective was to determine the effects of various amounts of knowledge of results (KR) on learning a novel skill that is frequently taught in chiropractic for the assessment of vertebral motor unit dysfunction. METHODS: Thirty-five active subjects were taught the novel skill of spring testing to a particular force range through 9 or 10 teaching sessions over a 2-week period (a school holiday limited some to only 9 sessions). To determine the particular force range, an initial phase of the study involved a licensed and practicing clinician performing motion palpation spring testing of the thoracic spine of a prone subject. The data from a total of 47 pushes throughout the thoracic spine were recorded, and the mean force and standard deviation were calculated. The second phase of the study used the obtained mean and standard deviation for teaching the force of prone thoracic spine motion palpation to 35 active subjects by administering spring testing to 35 passive subjects. The active subjects were randomly divided into 4 groups, with each receiving a varying amount of verbal feedback to move toward the target force of their learned skill. Each passive subject was laid prone on an instrumented adjusting table. Group 1 received the least amount of feedback while learning the novel skill. Groups 2 and 3 received more frequent, intermittent feedback while learning the skill, and group 4 received constant, frequent feedback during each of the 10 teaching sessions. All subjects returned within 2 weeks for 2 retention trials to determine the efficacy of the learned skill. RESULTS: The mean force determined was 143 N with a standard deviation of 14 N. Each subject was taught spring testing within this target range. The 2 final retention trials showed group 3 to have demonstrated the most targeted retention of the learned motor skill. These subjects exhibited the closest force range to the target for the motor skill learned and fewer changes in standard deviation compared with their acquisition trials and thus the highest retention. Group 4, receiving 100% feedback, demonstrated the most accurate spring testing during the acquisition trials, but the subjects did not effectively demonstrate when compared on acquisition and retention trials. CONCLUSION: The results of this study show data to be consistent with the guidance hypothesis in learning a novel motor skill. The constant KR feedback is beneficial for learning when used to reduce error during practice but detrimental when relied upon for retention and learning. These data suggest the necessity of using motor skill development learning theory in the teaching of chiropractic.

Adult↗
PubMed2006

Nociceptive plasticity inhibits adaptive learning in the spinal cord.

Spinal plasticity is known to play a role in central neurogenic pain. Over the last 100 years researchers have found that the spinal cord is also capable of supporting other forms of plasticity including several forms of learning. To study instrumental (response-outcome) learning in the spinal cord, we use a preparation in which spinally transected rats are given shock to the hind leg when the leg is extended. The spinal cord rapidly learns to hold the leg in a flexed position when given this controllable shock. However, if shock is independent of leg position (uncontrollable shock), subjects fail to learn. Uncontrollable shock also impairs future learning. As little as 6 min of uncontrollable shock to either the leg or the tail generates a learning deficit that lasts up to 48 h. Recent data suggest links between the learning deficit and the sensitization of pain circuits associated with inflammation or injury (central sensitization). Here, we explored whether central sensitization and the spinal learning deficit share pharmacological and behavioral features. Central sensitization enhances reactivity to mechanical stimulation (allodynia) and depends on the N-methyl-d-aspartate receptor (NMDAR). The uncontrollable shock stimulus that generates a learning deficit produced a tactile allodynia (Exp. 1) and administration of the NMDAR antagonist MK-801 blocked induction of the learning deficit (Exp. 2). Finally, a treatment known to induce central sensitization, intradermal carrageenan, produced a spinal learning deficit (Exp. 3). The findings suggest that the induction of central sensitization inhibits selective response modifications.

Analysis of Variance↗
PubMed2004

[Typology of the French medical learned societies. Survey of 129 organizations].

INTRODUCTION: A study on the relationship between the ANDEM--Agence Nationale pour le Développement de l'Evaluation Médicale (French agency for the development of health technology assessment) and the learned societies showed that a definition of the role of these organisations and criteria to define learned societies were lacking. We conducted a survey among the learned societies in the field of medicine so as to elaborate a definition. METHODS: We used the files of the learned societies of the Anaes--Agence Nationale d'Accréditation et d'Evaluation en Santé (French Agency for accreditation and evaluation in health) in 1998, which included 225 organisations. We sent a letter together with a single-page questionnaire and copies of the 2 publications on the relationship between the ANDEM and the learned societies. To analyse the suggestions for a definition, having read the replies, a segmentation of the population, the means and modalities of action and the aims and fields of action were used. A proposal for a definition was discussed during 2002/2003 with the board of the Fédération des Spécialités Médicales (FSM) (Federation of medical specialties) regrouping 33 medical and 12 surgical societies. Three meetings between a representative of the Anaes and the board of the FSM resulted in the proposition of so-called "validation" criteria for learned societies. A search on the French Internet listing such societies was made using a research motor (March 20, 2004). RESULTS: Out of the 225 organisations contacted, 129 (57%) replied. Among the latter, 115 considered themselves as a learned society and 14 did not. Among the 115 organisations defining themselves as a learned society, 97 proposed a definition, 16 made use of the definitions proposed in the questionnaire and 81 proposed their own definition. The analysis identified 6 important elements (reporting, knowledge, education, research, diffusion, promotion). The data analysed permitted the elaboration of a definition based on the proposals of the learned societies: "An organised group, within the framework of a given discipline, the members' aim of which is to report on their work, to improve knowledge on their discipline, to ensure education and research, to diffuse information on their work and research and to support and promote their discipline". Thirty-two of the 45 societies of the FSM accepted the 11 validation criteria proposed, some of which were commented on. Only one society abstained and 12 did not reply. No French Internet web site listing the learned societies specified a definition of criteria for inclusion in the lists. DISCUSSION: A definition of the learned societies and validation criteria, obtained through the participation of the principle actors, could serve as a basis for the recognition and identification of such societies.

Data Collection↗
PubMed1990

Grouping students for instruction: effects of learning style on achievement and attitudes.

The present study examined the effects of matching and mismatching American middle-school students with a preference for learning alone or learning with peers with selected instructional treatments in order to determine the impact upon their attitudes and achievement in social studies. Analysis revealed that the learning-alone preference performed significantly better in the learning-alone condition and that the learning-with-peers preference performed significantly better in the learning-with-peers condition. However, no-preference students also performed significantly better in the learning-alone condition than with peers. In addition, data revealed that the learning-alone and the learning-with-peers students had significantly more positive attitudes when matched with their preferred learning style; the nopreference students had more positive attitudes in the learning-alone condition.

Achievement↗
PubMed2001

Quality of student-generated learning issues in a problem-based curriculum.

In a problem-based curriculum students generate learning issues that are the guidelines for their individual study. In an earlier study it was found that a useful learning issue contains a keyword that demarcates the content of a certain topic to be studied and is formulated concisely and unambiguously for all members of the tutorial group. This study investigates two questions. First, how many learning issues can be classified as being of good or bad quality as evaluated against three criteria? Second, what are examples of well and badly formulated learning issues? Learning issues were collected for two problems in the first year during two tutorial meetings of the Maastricht Medical School in the academic year 1998-99. In the next academic year, 12 first year-students were asked to judge the learning issues for each problem against three criteria. The results showed that 21% of the learning issues for one problem and 32% for the other problem were classified as scoring high on all three characteristics. A very small percentage of learning issues (5% and 2%) were classified as scoring low on all three characteristics. Most learning issues scored differently on each of the characteristics. Although most learning issues contain a keyword, many of them were formulated ambiguously and not concisely. It is concluded that first-year students are not yet able to formulate clear learning issues.

Journal Article↗
PubMed2005

Evaluating clinical simulations for learning procedural skills: a theory-based approach.

Simulation-based learning is becoming widely established within medical education. It offers obvious benefits to novices learning invasive procedural skills, especially in a climate of decreasing clinical exposure. However, simulations are often accepted uncritically, with undue emphasis being placed on technological sophistication at the expense of theory-based design. The author proposes four key areas that underpin simulation-based learning, and summarizes the theoretical grounding for each. These are (1) gaining technical proficiency (psychomotor skills and learning theory, the importance of repeated practice and regular reinforcement), (2) the place of expert assistance (a Vygotskian interpretation of tutor support, where assistance is tailored to each learner's needs), (3) learning within a professional context (situated learning and contemporary apprenticeship theory), and (4) the affective component of learning (the effect of emotion on learning). The author then offers four criteria for critically evaluating new or existing simulations, based on the theoretical framework outlined above. These are: (1) Simulations should allow for sustained, deliberate practice within a safe environment, ensuring that recently-acquired skills are consolidated within a defined curriculum which assures regular reinforcement; (2) simulations should provide access to expert tutors when appropriate, ensuring that such support fades when no longer needed; (3) simulations should map onto real-life clinical experience, ensuring that learning supports the experience gained within communities of actual practice; and (4) simulation-based learning environments should provide a supportive, motivational, and learner-centered milieu which is conducive to learning.

Computer Simulation↗
PubMed2004

Exploring the self-learning experiences of patients with depression participating in a multimedia education program.

The purpose of the present study was to explore the self-learning experiences of depression patients on interactive multimedia education program. Qualitative in-depth interviews were employed. Fourteen patients with a first episode of major depression were recruited from a psychiatric outpatient department. Explanations of the purposes of the exercise and on-the-spot teaching were provided by the researcher before the study began. A tape-recorded, semi-structured interview format was employed after two weeks. Data analysis was performed in the framework of line-by-line content, contextual and thematic analysis. Eight subjects successfully completed the entire learning activities. Content analysis revealed 4 main aspects of successful self-learning experiences: the triggering of learning motivation, the enjoyment of self-paced learning, support for the effects of learning materials, and the gaining of self- awareness and changes. The factors influencing learning performance were related to: environmental impact, the degree of familiarity with traditional learning, possession or non-possession of the necessary computer operation skills, and good computer support. However, the findings provide a preliminary understanding of the application of interactive multimedia education programs in terms of self-learning outcomes and recognizing key elements of learning impediments among the study sample. A larger sample size with different clinical contexts is recommended to determine the effect and generalizability for future research. Furthermore, the creation of a computerized learning environment with different educational styles is crucial to patients' success in obtaining depression-related information and understanding effective adaptive skills.

Adaptation, Psychological↗
PubMed2005

A strategic approach to developing e-learning capability for healthcare.

OBJECTIVES: This article examines a strategic approach to developing e-learning capability to enhance learning opportunities for the workforce of a healthcare organization. Emphasis is given to the procurement of a bespoke Managed Learning Environment (MLE). Strategic organizational issues impacting on future e-learning developments are considered. METHODS: The 2-year implementation plan was evaluated through a two phase external research project. The first phase focused on the effectiveness of a training programme designed to build capacity for e-learning within the Northern area and also included a virtual learning environment usability study which informed the MLE specification. The second phase evaluation is ongoing during 2005 and interim findings are presented. RESULTS: The MLE has been piloted and on-line learning packages have been acquired. There has been a phased take-up of e-learning opportunities and e-tutor training. Some virtual Communities of Practice have been established. Key organizational issues have been identified and ongoing findings are informing strategic planning. CONCLUSIONS: The healthcare MLE is offering enhanced learning opportunities and assisting area healthcare providers in training their dispersed workforces. Blended learning strategies are most successful. The need for protected time for e-learning is a key issue, financial savings are available. Progress has been slowed by identified organizational constraints-the MLE's benefits are widely recognized.

Community Networks↗