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Beams of X-rays and electrons used in external beam radiotherapy are characterized by differences in penetration, build-up, divergence, scatter etc. This short communication describes a very simple phosphor-loaded box that can be used to demonstrate directly to students the different properties of beams and the effect of field modifiers such as wedge filters, lead shields etc.
Geriatric educators are faced with several different challenges. The rapid growth of aged population in the Western world has led to a growing need for health and social services and thus, an increased need for trained professionals in this field. In addition, new learning theories and activating learning methods have achieved wide acceptance in academic medicine. How has geriatric education applied these new learning methods? In this article we review the current status of academic geriatric education in Western countries in these respects. We especially review the literature of how geriatric training has been experimenting with the new learning methods.
The Medical College of Wisconsin (MCW) and the Wisconsin Geriatric Education Center (WGEC) are committed to developing educational materials for primary care physicians in training. In response to the opportunity created by the Accreditation Council for Graduate Medical Education (ACGME) competency mandate, an MCW-led interdisciplinary working group has developed competency-linked video-based assessment tools for use in primary care residency training programs. Modeled after the Objective Structured Clinical Examinations (OSCE), used as part of the medical licensing examination process, we created geriatric-focused Objective Structured Video Examinations (OSVEs) as a strategy to infuse geriatrics into residency training. Each OSVE tool contains a 1-3 minute video trigger that is associated with a series of multiple choice and/or constructed response questions (e.g., fill in the blank). These questions assess residents' understanding of video-demonstrated ACGME competencies including professionalism, systems-based practice, communication, and practice-based learning. An instructor's guide and scoring key are provided for each tool. Response to the OSVEs has been overwhelmingly enthusiastic including greater than 90% commitment by statewide faculty to use the tools in residency training.
In gerontology and geriatrics, learning often requires both the acquisition of new facts and a change in attitude towards elderly persons. Games, in addition to stimulating a desire to learn, are powerful instruments to change attitudes. This paper introduces games currently being used by the Gateway Geriatric Education Center to teach gerontological and geriatric principles to healthcare providers. It summarizes assessments that have been used to measure the effectiveness of those games to promote learning. Arguments are made that more rigorous methodologies of evaluation for games should be adopted in order to demonstrate the effects of that learning on improved patient outcomes.
With continued adoption of course management systems, librarians are assuming new roles and challenges with regard to providing information resources and library services in a digital environment. For approximately five years, the Indiana University School of Medicine has employed Angel as its online teaching environment, and the Ruth Lilly Medical Library has been actively involved in the adoption of Angel. As the implementation phase was completed, a post-implementation evaluation was due. The authors conducted an evaluation of the Angel system to evaluate utilization level, content types, and library resources/services integration. This article provides the findings of the post-implementation Angel Courses Evaluation.
BACKGROUND: On the basis of a multimodal model of working memory, cognitive load theory predicts that a multimedia-based instructional format leads to a better acquisition of complex subject matter than a purely visual instructional format. AIMS: This study investigated the extent to which age and instructional format had an impact on training efficiency among both young and old adults. It was hypothesised that studying worked examples that are presented as a narrated animation (multimedia condition) is a more efficient means of complex skill training than studying visually presented worked examples (unimodal condition) and solving conventional problems. Furthermore, it was hypothesised that multimedia-based worked examples are especially helpful for elderly learners, who have to deal with a general decline of working-memory resources, because they address both mode-specific working-memory stores. SAMPLE: The sample consisted of 60 young (mean age = 15.98 years) and 60 old adults (mean age = 64.48 years). METHODS: Participants of both age groups were trained in either a conventional, a unimodal, or a multimedia condition. Subsequently, they had to solve a series of test problems. Dependent variables were perceived cognitive load during the training, performance on the test, and efficiency in terms of the ratio between these two variables. RESULTS: Results showed that for both age groups multimedia-based worked examples were more efficient than the other training formats in that less cognitive load led to at least an equal performance level. CONCLUSION: Although no difference in the beneficial effect of multimedia learning was found between the age groups, multimedia-based instructions seem promising for the elderly.
BACKGROUND: Recent research on the influence of presentation format on the effectiveness of multimedia instructions has yielded some interesting results. According to cognitive load theory (Sweller, Van Merriënboer, & Paas, 1998) and Mayer's theory of multimedia learning (Mayer, 2001), replacing visual text with spoken text (the modality effect) and adding visual cues relating elements of a picture to the text (the cueing effect) both increase the effectiveness of multimedia instructions in terms of better learning results or less mental effort spent. AIMS: The aim of this study was to test the generalisability of the modality and cueing effect in a classroom setting. SAMPLE: The participants were 111 second-year students from the Department of Education at the University of Gent in Belgium (age between 19 and 25 years). METHOD: The participants studied a web-based multimedia lesson on instructional design for about one hour. Afterwards they completed a retention and a transfer test. During both the instruction and the tests, self-report measures of mental effort were administered. RESULTS: Adding visual cues to the pictures resulted in higher retention scores, while replacing visual text with spoken text resulted in lower retention and transfer scores. CONCLUSIONS: Only a weak cueing effect and even a reverse modality effect have been found, indicating that both effects do not easily generalise to non-laboratory settings. A possible explanation for the reversed modality effect is that the multimedia instructions in this study were learner-paced, as opposed to the system-paced instructions used in earlier research.
The WORLD WIDE WEB has changed the way people interact. It has also become an important equalizer of information access for many social sectors. However, for many people, including some sign language users, Web accessing can be difficult. For some, it not only presents another barrier to overcome but has left them without cultural equality. The present article describes a system that allows sign language-only Web pages to be created and linked through a video-based technique called sign-linking. In two studies, 14 Deaf participants examined two iterations of signlinked Web pages to gauge the usability and learnability of a signing Web page interface. The first study indicated that signing Web pages were usable by sign language users but that some interface features required improvement. The second study showed increased usability for those features; users consequently couldnavigate sign language information with ease and pleasure.
The attitudes of teachers and parents of deaf children in India toward career choices for deaf and hearing people were investigated with respondents rating the suitability of eight professions for an imagined group of equally qualified deaf and hearing advisees. The attitudes of parents and teachers in India were found to be similar to those reported in previous studies conducted in the United States, Italy, England, and South Africa and showed that the hearing status of the imagined advisees selectively influenced the respondents' ratings of their suitability for those professions. These results suggested that differences in the availability of educational or technological support for deaf people do not necessarily lead to differences in attitudes regarding career choices for deaf people.
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It is frequently assumed that presenting the same material in written and spoken form benefits learning and understanding. The present work provides a theoretical justification based on cognitive load theory, and empirical evidence based on controlled experiments, that this assumption can be incorrect. From a theoretical perspective, it is suggested that if learners are required to coordinate and simultaneously process redundant material such as written and spoken text, an excessive working memory load is generated. Three experiments involving a group of 25 technical apprentices compared the effects of simultaneously presenting the same written and auditory textual information as opposed to either temporally separating the two modes or eliminating one of the modes. The first two experiments demonstrated that nonconcurrent presentation of auditory and visual explanations of a diagram proved superior, in terms of ratings of mental load and test scores, to a concurrent presentation of the same explanations when instruction time was constrained. The 3rd experiment demonstrated that a concurrent presentation of identical auditory and visual technical text (without the presence of diagrams) was significantly less efficient in comparison with an auditory-only text. Actual or potential applications of this research include the design and evaluation of multimedia instructional systems and audiovisual displays.
This review provides a discussion of the 14 videotape reviews that have appeared in the International Journal of Group Psychotherapy from 1996 through 2000. This retrospective analysis describes the recommendations made by the review authors concerning ways in which future video products may be enhanced to improve their instructional value. These recommendations include topics that might be given greater emphasis in future efforts as well as elements within the format of such tapes that aid learning and discussion.
Study of a ethnographic approach, type case study. Describing a person's bearer of chronic renal inadequacy accompaniment, with adhesion deficit to the treatment. The theoretical presupposition had the model SUNRISE proposed by Leininger. It's presented the Mr. Light and the involved sceneries. Described. Influences economical, social, cultural, technological and educational in the process of taking care. After the identification of the systems of health, were decided the actions of taking care through the maintenance, accommodation and restoration. The study possibilited effective interventions for the behaviors of non adherence. The referencial in continuous and lingering processes of care, favoured by the proximity between nurse and attended person.
OBJECTIVE: The purpose of this article is to identify literature-based content for the design of educational programs on depression for practicing primary care physicians. METHODS: A MEDLINE search was conducted of English-language medical literature published from 1982 through July 1997 for studies describing primary care physicians' knowledge, skills, practice patterns, and perceived barriers related to care of depressed patients. Studies focusing exclusively on residency training and those describing physician practices outside North America were excluded. Of 377 articles identified, forty met inclusion and exclusion criteria. RESULTS: Recommendations for educational content were identified from the literature review. For recognition, educators should prioritize communication skills and strategies for the use of depression questionnaires. For diagnosis, practice interpreting symptoms in the medically ill, strategies for efficient diagnosis, and systematic approaches to assessing suicide risk should be emphasized. For treatment, greater attention to the therapeutic alliance, staged therapy, and strategies for improving medication adherence are indicated. CONCLUSIONS: There is a moderately well developed literature describing self-perceived and observed gaps in the current care for depression in primary care. Addressing the entire list of needs would take more time than practicing physicians are likely to have. An important challenge for educators is to design flexible programs based on individualized needs assessment or, when not possible, to prioritize the most generalizable needs.
OBJECTIVE: Screening and brief intervention for substance abuse is effective yet underutilized by primary care physicians. This article reports on Project SAEFP (Substance Abuse Education for Family Physicians), which aimed to enhance the clinical and teaching skills and activities of U.S. family practice residency faculty. METHOD: Ten five-day workshops were designed and administered for 165 participants. Evaluation data included measures of participant satisfaction and pre-workshop and twelve-month post-workshop measures of the frequency of teaching, consulting, and clinical activities, and the attainment of self-identified teaching goals. RESULTS: The participants were very satisfied with the workshops. They improved significantly in the key outcome measures. CONCLUSIONS: Several workshops may have contributed to the apparent success of Project SAEFP. Attributes of the workshops which might have facilitated their success were their duration, funding, frequency of offering, collegial learning environment, opportunities for active learning, emotionally moving exposure to recovering individuals, focus on how to modify curriculum at participant residency programs, availability of family physician role models as faculty, and readily usable instructional materials. Planners of interventions for physician educators might profit from similar attention to these attributes.
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