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The authors describe a modular instruction method to teach nursing students important library skills and provide an example of the instructional module. A pilot study demonstrated the value of this approach in facilitating use of the library. Nurse educators can use this method to assist their students in accessing reference materials quickly and successfully.
Sixty-nine Latin American refugees with a mean age of 31 years participated in this study. The knowledge about dental health before and after reading a self-instructional manual in Spanish was tested by questionnaires. The test persons were also interviewed about their dietary habits. The results showed an improvement of 30% of right answers after reading the manual and that a frequent sugar consumption was common. This indicates that a self-instructional manual can be of value in oral health prevention in a similar group of non-resident immigrants.
A system of self-instruction in histology is described, using audio-tape and booklet instruction to supplement the microscopical examination of tissue sections. A pilot test demonstrated a slight superiority in retention of knowledge among students using this system, compared with those in the conventional class.
According to large-scale studies, oral contraceptive users become pregnant at rates that exceed ideal use failure rates. It is thought that a major cause is missed pills, but current research on consistent contraceptive pill taking is characterized by inadequate measures and a failure to investigate women's thinking about their own patterns of use. The purpose of this study was to gain some understanding about women's interpretations of consistency in their own pill taking through combining qualitative with quantitative data. The study was conducted in China, where contraception is free and widely available. Five urban and five rural oral contraceptive users were followed for up to three pill-taking cycles during 1996 for a total of 759 person-days. Consistency of pill taking was measured with electronic data obtained from a new blister package made by Anderson Clinical Technologies (Elmhurst, IL). Data from these devices were reviewed and interpreted by the study participants during in-depth private interviews. The users' reasons for missing pills included disruptions in their daily routines, their husband's absence, spotting, and trouble implementing the family planning program's instructions to take one pill per day for 22 days and start the next cycle on the fifth day of menses. One user gave these reasons for two cycles but denied missing numerous pills in her third cycle. Data from a series of four questionnaires showed that most demographic, psychosocial, and service system characteristics were not related to missed pills. However, results suggested that the daily routines of rural living may make consistent use more likely and that instructions for taking the pill may be associated with prolonged pill-free intervals and skipping pills during episodes of spotting. Three of the 10 women were at increased risk of pregnancy during the study period because of their pill-taking pattern. We concluded that the combination of qualitative with quantitative data enhances understanding of contraceptive use. Women themselves offer plausible reasons for their use behaviors. Listening to women could be useful in improving programs.
In a sample of 178 nurses who had been instructed in the performance of fingerstick monitoring of blood glucose (MBG), we investigated variables that may predict their proficiency at subsequent MBG performance. All nurses were given initial instruction in a classroom-type setting or via a self-instructional packet, and initial proficiency was documented by initial testing. All nurses were retested 1-8 mo later. To address whether actual frequency of performing MBG at work affected proficiency, the nurses were categorized based on the frequency of performing MBG groups: greater than 1 test/day (n = 53), greater than 1 test/wk (n = 51), greater than 1 test/mo (n = 52), and less than 1 test/mo (n = 22). No differences in test and retest scores were detected. To address whether the time interval from the original instruction and test to the retest affected proficiency, the nurses were divided into groups who had initial test less than 6 mo (n = 108) and greater than 6 mo (n = 70) before the retest. Mean change in test scores was less in the greater than 6-mo group than in the less than 6-mo group (P less than 0.01), and they had a lower retest fail rate (3 vs. 12%, P = 0.03). To explain this unexpected finding, test scores were analyzed by groups based on the type of original instruction. Nurses who attended class (n = 79) were compared with those who had self-instruction (n = 99). The classroom-trained group had less change in test-to-retest score (P = 0.0002) and a lower retest failure rate (3 vs. 12%, P less than 0.05).
Nurses prepared to work co-operatively with the world's peoples in achieving "Health for All" have a vital role in primary health care. At the University of Illinois, Nursing in Primary Health Care is offered through the Collaborative Baccalaureate Project, a basic instructional system which can be adapted to different educational settings. It is presented here as an example of an original approach for effective delivery of primary health care content.
Self-care education programs in operation in the United States during the mid-1980s are surveyed by mailed questionnaire to determine the nature and content of the curricula of these programs, their organizational sponsorship, the level and types of staff working in them, and their principal prevention emphases. Results indicate that over 75% of these programs offer instruction or sponsored activities intended to help individuals or their families to: (1) increase wellness or health status through lifestyle change; (2) reduce an established risk factor; and/or (3) prevent the onset of illness or injury. Fifty-five percent of the organizations offering these services classified themselves as health services delivery organizations. A surprising finding, given the American popular media treatment of self-care as a 'movement', is that relatively few laypersons function as instructors in these programs. The paper describes the way in which self-care has been absorbed into the mainstream of American health care, even though the concept of self-care has tended to drop from scholarly attention in the socio-medical sciences in the United States.
Four residents of a group home who had severe mental retardation were taught to use self-instruction in combination with multiple exemplars to solve task-related problems. The combined strategy was associated with generalization to untrained problems as well as response maintenance of the problem-solving strategy (i.e., responding to multiple exemplars and self-instructing). The use of the strategy was discussed in terms of instructional strategies for teaching self-instruction and areas for future research, including isolating the factors responsible for generalization and identifying the role of language in promoting generalized responding.
The purpose of this study was to generate information about possible relationships among preference for education structure (eg, high or low educational structure), self-directed learning, instructional methods (lecture or module), and achievement. The study was designed to use both the difference and correlation model to analyze these variables. The difference model is a 2 x 2 randomized block posttest-only design. Five research questions guided the study. It was found that (1) there was a statistically significant inverse linear relationship between preference for educational structure and self-directed learning (r = -.3081, P = .027); (2) there was no relationship between self-directed learning and achievement (P = .24); (3) neither of the instruments could successfully predict achievement (R2 = .12), but the direction of the prediction was other than expected; (4) students who preferred high structure had no statistically significant differences in achievement in either instructional method (t = -.53, P = .60), although the direction of the difference was of interest; and (5) students who preferred low structure had no statistically significant differences in achievement in either instructional method (t = 1.75, P = .099), although here too the direction of the difference was of interest. The unexpected outcomes in this study were opposite to what has been found in the literature and assumed for years.
Children of parents with intellectual disabilities (i.e., IQs less than 80, labeled as having mental retardation) are at risk for neglect due to inadequate parenting abilities. Previous studies have shown that these parents are responsive to parent-training packages consisting of instructions, pictorial cues, modeling, feedback, and reinforcement. This study evaluated the effectiveness of self-learning pictorial-parenting manuals in teaching basic child-care skills (diapering, treating diaper rash, bathing, safety) to parents with intellectual disabilities who are monitored by child protection agencies. The manuals alone increased child-care skills (to levels seen in parents without disabilities) in 9 out of the 10 mothers in the study and in 12 of 13 child-care skills. The remaining skill was acquired with the full training package. Follow-up indicated that the acquired skills were maintained for up to 3 years. Mean correct performance with the manual was positively correlated with the trainer's rating of the mother's reading level and acceptance of the manual when the mother was first given the manual. Consumer satisfaction ratings of the manuals were high. These results indicate that many parents with intellectual disabilities may improve their child-care skills without intensive training and that self-instruction may be an easily disseminable and cost-effective way of reducing the risk of child neglect due to parenting skill deficiencies.
The purpose of this research is to elaborate software about the physical examination of full-term newborns (TNB) for neonatal nursing teaching at undergraduate level. The software was developed according to the phases of planning, content development and evaluation. The construction of the modules was based on Gagné's modern learning theory and structured on the Keller Plan, in line with the systemic approach. The objectives were to elaborate and evaluate the contents of the self-instructional modules, to be used as a teaching strategy in the undergraduate course. After being structured, the material was reviewed and analyzed by 11 neonatal nursing experts, who rated the 42 exposed items as good or excellent.
The full participation of individuals with mental retardation in the community requires performance of newly acquired skills in novel circumstances and across the varying demands characteristic of life in the everyday world. For example, a person who has learned how to ride a bus may have to adapt to changes in scheduling, bus routes, or fares. Or an employee who has been taught by a coworker to make salads in a fast-food restaurant will need to continue to complete orders when the coworker no longer is present. Although skill generalization is an implicit educational goal, instructional strategies rarely are employed to influence the attainment of this goal (Haring & Laitinen, in press). Self-instruction is a strategy that has been effective in promoting the independent performance of people with mental retardation. Self-instruction provides individuals with the means for guiding their own behavior in novel situations not associated with training and after assistance has been withdrawn. For example, by using self-instruction, people with mental retardation have learned, among other skills, to sequence their tasks, increase their rate of production, and solve work-related problems. This chapter evaluated studies that investigated use of self-instruction among individuals with mental retardation in community settings. The focus of the review was on identification of factors relating to generalization across people, situations, tasks, and time. The combination of these factors suggests a model for promoting independent performance among individuals with mental retardation. This model combines self-instruction with teaching multiple exemplars and comprises the following six steps: (a) Select an array of examples (responses) an individual is likely to be required to perform in an environment (step 1); (b) classify responses into teaching sets based upon a functional analysis (step 2); (c) divide items of each set into responses that will serve as training examples and those that will serve as generalization probes (step 3); (d) teach trained examples using self-instruction (step 4); (e) evaluate effect of training on trained and untrained examples (i.e., generalization probes) as well as verbalized self-instructional statements (step 5); and (f) withdraw training based upon performance criteria while evaluating the effect of withdrawal (step 6). These steps represent the best practices for promoting independent performance of individuals with mental retardation in the community.
Successful patient information systems must have user-friendly services to transfer vast amounts of information. Whether it is preprinted discharge instructions for standard wound care, an algorithm-based triage discussion of one's chest pain, or simply a database to search out the current recommendations for flu shots or pediatric immunizations, the challenge for patient education in the communications revolution is high stakes indeed.
PURPOSE: The authors investigated the potential of subject instructions to alter the static accommodative stimulus-response function. They also investigated whether the reduced cue environment of the Badal optical system leads to accommodative responses different from those that occur for targets presented in real space. METHODS: Static accommodative responses with three focusing instructions were compared to baselines obtained with minimal instruction to stabilize gaze. Static accommodative responses were recorded for targets presented in real space and in a Badal optical system. RESULTS: Individuals differ widely in their responses to Instruction 1 (" ... make no special effort ... "), although some adopt a relatively fixed position of focus. Responses with Instruction 2 (" ... look at the words naturally ... ") and Instruction 3 (" ... carefully focus ... ") are not significantly different from each other, but differ slightly from the responses with the baseline instruction ("pick a word in the middle of the block of text and look at it"). In a sample including most subjects, mean responses for Badal and real space targets are identical. However, it appears that some subjects have difficulty accommodating for Badal targets. CONCLUSIONS: The authors recommend the use of Instructions 2 and 3 for investigation of the static accommodative response, with a number of provisos. Accommodative responses to Badal and real space targets are generally equivalent, but researchers should take care to identify those persons who have difficulties accommodating for Badal targets.
Prevention, through school-based education campaigns, has been suggested as a response to the AIDS crisis although the impact of such education is unproven. The seventh and tenth grade classes (n = 313) in one Rhode Island school district were surveyed regarding AIDS knowledge, attitudes, and coping skills before and after a two-session educational program. Following instruction, students reported more knowledge, greater tolerance of AIDS patients, and more hesitancy toward high-risk behaviors, but the changes were modest. Using residual change scores to control for baseline levels, two subgroups (seventh grade boys and tenth grade girls) changed the most in tolerance, and the correlations between variables were the strongest. In the general sample, change in knowledge was independent of change in tolerance, attitudes regarding high-risk behaviors, or coping strategies. These data lend support to the potential usefulness of school-based education programs, especially if behavior and coping skills are emphasized in the education. Evaluation of such programs should include assessment of change in subgroups to determine components of programs that can be tailored for more effective education.
Physical activity levels in young adults are low. Research supports the use of the Transtheoretical Model of behaviour change (TM) in designing physical activity interventions. This study used a pre-post randomized control design to investigate the effectiveness of a self-instructional intervention for helping sedentary young adults to initiate physical activity. Post-intervention, significantly more of the experimental group (80%), in comparison to the control group (68%), improved their exercise stage of change (SOC) from baseline (P < 0.05). Discriminant analyses revealed that discrimination between stage improvement/non-improvement was possible using the processes of change data. Stage improvers scored significantly higher on all of the behavioral and four out of five of the cognitive processes of change. For stage improvers, the processes of self-re-evaluation and self-liberation were most frequently used, whilst social liberation was used significantly more by the experimental than the control group. This inexpensive, self-instructional intervention, based on the TM and the 'active living message', is an effective method of assisting sedentary young adults to progress through the exercise SOC.
The effects of tape-recorded self-instruction cues on the mathematics performance of students with learning disabilities (LD) were investigated. Nine students were assigned to one of three conditions: an experimental condition, in which students attended two training sessions in self-instruction (SIT); an observer condition, wherein students observed SIT but did not participate; and a control condition, wherein students received neither training nor the opportunity to observe. Using a multiple probe design, data (problems attempted, problems completed correctly, and time for task performance) were collected across two baseline phases, two brief instructional periods, and two generalization phases. Without access to taped cues, experimental and observer students did not successfully utilize the SIT after the first self-instructional training. However, when experimental students were trained to use taped cues, they demonstrated the ability to accurately solve their problems. More important, they were able to successfully use SIT procedures when the taped cues were faded.
Two studies were conducted to investigate the effect of a task-specific self-instruction intervention to improve handwriting ability of children with poor handwriting quality in schools for regular education (Study 1) and children with poor handwriting quality in schools for special education (Study 2). Study 1 showed that children with poor handwriting quality who received handwriting intervention on an individual basis for three months improved on average more on quality of writing than control children without handwriting problems who did not receive intervention. In contrast, the control group improved more in speed of writing after the intervention period. At an individual level, three out of the seven children with poor handwriting quality before intervention were not classified as such anymore after the intervention period. Study 2 showed that after six months of intervention in a group setting children with poor handwriting quality improved their quality of writing more so than children with poor handwriting quality who had not received intervention. On speed of handwriting no significant group differences emerged. We conclude that the task-oriented self-instruction method applied in this study seems to improve especially the quality of handwriting, not speed, of children initially identified as having poor handwriting quality.